A Republican plan to repeal key provisions of the Affordable Care Act would leave 32 million people without health coverage and double the cost of insurance premiums over the next decade, according to an analysis by the nonpartisan Congressional Budget Office (CBO).

The budget office report, released on Tuesday, analyzed the likely impact of a Republican proposal approved by Congress in 2015 and vetoed by Barack Obama that would repeal major provisions of the healthcare law while leaving other parts in place. The estimate does not account for a replacement plan, which Republicans have vowed to propose soon.

The report follows a weekend of action by Democratic lawmakers and liberal groups to protest against the law’s repeal and adds to the pressure on Republicans in Congress to craft replacement legislation that would avoid losses in coverage for millions of Americans and disruptions to stability in the market.

Over the weekend, Donald Trump promised that a Republican plan would provide “insurance for everybody”. He has also demanded that his party immediately repeal the Affordable Care Act, known as Obamacare, and pass a healthcare law “simultaneously”.

The CBO report, which was requested by top Senate Democrats, estimated that 18 million people would lose their insurance and premiums would rise by 20% to 25% in the first year following the dismantling of the law. The number of uninsured could rise to 32 million by 2026, while causing premiums to double in that timeframe.

The report arrived at 32 million people by estimating that 23 million fewer people would have coverage through the individual insurance market and 19 million fewer people would have coverage under Medicaid. These changes would be partially offset by an estimated increase of 11 million people who are covered through insurance offered by their employer.

“This projection is meaningless, as it takes into account no measures to replace the law nor actions that the incoming administration will take to revitalize the individual market that has been decimated by Obamacare,” said AshLee Strong, a spokeswoman for the House speaker, Paul Ryan.

Democrats seized on the report, arguing that a repeal of the law would throw millions Americans off their insurance plans.



“Nonpartisan statistics don’t lie,” the Senate minority leader, Chuck Schumer, said in a statement. “It’s crystal clear that the Republican effort to repeal the Affordable Care Act will increase healthcare costs for millions of Americans and kick millions more off of their health insurance.”

Nonpartisan statistics don’t lie Chuck Schumer

Expressing a similar response, the House minority leader, Nancy Pelosi, called Republican efforts’ to repeal the law “nothing less than a nightmare for the American people”.

“While President-elect Trump promises ‘insurance for everybody’, Republicans are moving to destroy the health coverage of tens of millions of Americans and drive up costs for millions more,” Pelosi said in a statement. “The GOP plan isn’t repeal and delay, or repeal and replace – it’s cut and run.”

Republicans moved quickly with a plan to repeal the law in the first two weeks of Congress but have yet to provide details on which parts of the law they will dismantle – and what their plan is to replace it.



Over the next few weeks, four congressional committees will be working on a draft of the repeal legislation. Though Republicans have provided few details on this process, they are thought to be using as a framework the 2015 bill assessed in the CBO report.

The bill would eliminate the tax penalties against people who do not have insurance, the linchpin of the law that is known as the individual mandate. It would also eliminate a provision expanding Medicaid eligibility and subsidies available to lower-income people to buy insurance through the marketplaces. However, the bill does not remove the requirement for insurance companies to provide coverage regardless of pre-existing health conditions.

A spokesman for the Senate majority leader, Mitch McConnell, said that the report assumes a “situation that simply does not exist and that no one in Congress advocates”.

“After years of devastating news about the consequences of Obamacare, I can see why Democrats would want to change the subject. But Democrats face a choice now: do they agree with their leader and refuse to work together on any reforms at all?” said Don Stewart, the McConnell spokesman. “Or do they agree with us that doing nothing is not an option, and work with us on a series of step-by-step reforms to prevent the scenario envisioned by the CBO report.”

But as Republicans move to unwind the law, they may face a changing landscape. According to a new NBC News/Wall Street Journal poll, the law has “never been more popular”. The poll released on Tuesday found that 45% of respondents believe Obamacare is a “good idea” – the highest percentage since they began asking the question in April 2009.

Meanwhile, the poll found that half of Americans say they have “little to no confidence” that Republican proposals would improve the law.