Eliza Collins

USA TODAY

WASHINGTON — The Republican bill to repeal and replace Obamacare passed by the House earlier this month would lead to 23 million fewer people having health insurance by 2026, according to an analysis from the Congressional Budget Office released late Wednesday afternoon.

That number is 1 million fewer than an analysis of a March draft version of the bill. The previous CBO analysis had predicted the draft bill would leave 24 million more people without health insurance than Obamacare would cover.

The legislation is also expected to increase insurance premiums by 20% in 2018 and 5% in 2019. But by 2020, premiums are expected to decrease. The expected decrease varies by state depending on how the states choose to implement the law.

The bill as approved will still decrease the deficit by $119 billion, about $32 billion less than the prior version of the bill.

The AHCA’s effect on individual insurance premiums would depend a lot on where you live, what you earn and how old you are. About a sixth of the population lives in areas where the individual insurance market will be increasingly unstable starting in 2020, CBO said.

Less healthy people in these areas will have extremely high premiums and might not be able to enroll in insurance at all. Those who are 64 and earn $26,500 – 175% of the federal poverty limit - will pay about $12,000 to $14,000 a year more a year in premiums under the AHCA than under current law. People in that income bracket who are 21 will pay less or about the same under the ACA as the AHCA.

Because insurers in some states would be allowed to reduce the number of “essential health benefits” they cover and sicker people will find it harder to buy insurance, CBO notes insurance would be cheaper on average for those who can get it. But “the variation around that average would be very large,” the report said.

Many House Republicans avoided specifics of the analysis and instead focused on the overall picture which was "that the American Health Care Act achieves our mission: lowering premiums and lowering the deficit," House Speaker Paul Ryan, R-Wis., said.

“We’re on a rescue mission, and today’s CBO report reinforces what we’ve said before — our American Health Care Act will lower premiums and reduce the deficit," said House Republican Conference Chair Cathy McMorris Rodgers, R-Wash. "The CBO report doesn’t tell the whole story when it comes to the benefits of this bill, but we’re one step closer to keeping our promise to repeal and replace Obamacare."

But some Republicans, including Health and Human Services Secretary Tom Price, questioned the accuracy of the CBO report. Republicans have been trashing CBO for months, saying they don’t know how to count this stuff.

“The CBO was wrong when they analyzed Obamacare’s effect on cost and coverage, and they are wrong again. In reality, Americans are paying more for fewer healthcare choices because of Obamacare," Price said.

“The Affordable Care Act is on the brink of collapse and no bureaucratic government report can change that," said Rep. Tom MacArthur, R-N.J. "While I certainly respect the work of the Congressional Budget Office and the staff there, it is important to remember how wildly inaccurate they have been on projections related to the Affordable Care Act."

The House narrowly passed the legislation May 4 after adding language negotiated between Rep. Mark Meadows, R-N.C., the chair of the hardline conservative Freedom Caucus and MacArthur who until this week chaired the more moderate Tuesday Group. The MacArthur Amendment gave states the ability to waive certain insurance mandates and allowed insurance companies to charge more for people with pre-existing conditions.

While that amendment brought dozens of House conservatives on board, it pushed away moderate members. MacArthur has since given up his Tuesday Group leadership post following fall-out from some members of the moderate group. The bill eventually garnered enough support — though barely — from Republicans after a last-minute addition of $8 billion to help patients with pre-existing health problems.

Democrats immediately pounced on the new CBO numbers, particularly who would be uninsured.

House Minority Leader Nancy Pelosi called the score “devastating” and said that “House Republicans have tattooed themselves with a Trumpcare bill that means higher costs, 23 million hard-working Americans losing coverage, shredding key protections, a crushing age tax and stealing from Medicare.”

“The CBO non-partisan, fact-based score shows what a horror show this Republican plan is for the people who need health care most," said Sen. Richard Blumenthal, D-Conn.

Planned Parenthood, which would lose its federal funding for non-abortion services under the bill, called the bill "the worst legislation for women’s health in a generation" and NARAL Pro-Choice America tweeted a picture of a dumpster fire with the sentence: "Our official statement on the #CBOScore for #AHCA."

Ryan has not yet sent the House bill to the Senate because he was waiting for the final score from the CBO to confirm that it would pass specific Senate rules that allow for the legislation to be passed with a simple majority rather than the usual 60 votes required for Senate legislation. No Democrats are expected to vote for a repeal bill.

Republicans in the Senate have been meeting frequently to compile legislation of their own. Texas conservative Sen. Ted Cruz has been a leader of an effort to bring lawmakers from various sections of the party together. So far, senators say they are in the very early stages, and that their version will be unique to the Senate.

"Our bill will be different than #AHCA but we will analyze the #CBOSCORE & ensure a smooth transition to better care," said Sen. James Lankford, R-Okla. in a tweet.

Sen. Dean Heller, R-Nev., who is considered one of the most vulnerable senators up for re-election in 2018 released a statement immediately following the score’s release saying he did not support the House bill.

"This bill does not do enough to address Nevada’s Medicaid population or protect Nevadans with pre-existing conditions," Heller said. "The AHCA is a first step, but not the solution; now the Senate is doing its own work to put forth its own ideas that could work for states like Nevada."

But Senate Democrats attempted to connect the House bill to what Senate Republicans were doing.

Sen. Chris Murphy, D-Conn., said he was convinced that the negotiations between Senate Republicans were using the House bill as a "framework" because they couldn't do a completely different bill than the House or else House conservatives would not approve the Senate version.

The Trump administration did some counterprogramming ahead of the CBO release Wednesday morning.

“New @HHSGov report shows premiums increased 105% under #ObamaCare. Not good! #RepealAndReplace this disaster,” President Trump tweeted with a link to a Health and Human Services report that showed premiums had increased under Obamacare.

But supporters of Obamacare say some of the issues with the law are caused by Republican policies. Backers say the Trump administration has weakened the ACA with a series of actions — including Trump's varying statements whether the federal government would continue to pay subsidies to insurers to cover low-income clients — that led to much higher premiums and insurers' withdrawals in several states. Critics say the law was doomed before Trump took office.

"Our republican colleagues are sabotaging people's health care to prove a political point," Schumer said Wednesday evening.

Contributing: Jayne O'Donnell