The Congressional Budget Office has a new report on federal subsidies of health insurance under the Affordable Care Act, and it's not good news for people with Obamacare. Or tax payers. Or Republicans. The CBO plainly says that the Trump administration's sabotage efforts are causing premiums to rise and enrollments to go down.

The CBO projects that the average premium for a benchmark plan will be 15 percent higher in 2018 than 2017 "largely because of short-term market uncertainty—in particular, insurers’ uncertainty about whether federal funding for certain subsidies that are currently available will continue to be provided—and an increase in the percentage of the population living in areas with only one insurer in the marketplace." They're referencing the Cost Saving Reduction payments insurers get for helping subsidize the out-of-pocket costs for lower income enrollees—help that the insurance companies are required by the law to provide. Trump continues threatening to stop making those payments. That same uncertainty is going to drive more insurers away, the CBO says.

They foresee a small increase in enrollments in 2018, from 10 million to 11 million, but project that growth is going to be limited compared to what it would have been "by projected premium increases due to near-term market uncertainty and by announced reductions in federal advertising, outreach, the enrollment period, and other enrollment efforts, which push enrollment down." Over the next decade, that will mean an average of 7 million fewer people getting coverage than they estimated in March 2016, when the government was actually working to make the law succeed—and get people insured.

So Trump's sabotage won't necessarily kill the law, according to the CBO: it will just keep millions more people from getting coverage. Which potentially means that thousands, tens of thousands, or maybe hundreds of thousands of people could be struck by preventable diseases and death.