WASHINGTON — The House Republicans’ plan to replace the Affordable Care Act is messy and confusing. No one is sure exactly how Americans will be affected and how much more health insurance will cost them.

But there are two certainties. Their health care plan provides a tax cut for the wealthiest Americans. And it will make it easier for Republicans to pass more tax cuts this year. It could also be viewed by some people as a break from some of the populist campaign promises President Trump made to lift up the country’s “forgotten men and women.”

The Congressional Budget Office analysis of the Republican plan released this week revealed the full scope of the windfall that the legislation would bring. It offers billions of dollars’ worth of tax cuts to health insurers, pharmaceutical companies, investors and even tanning salon operators. The cuts amount to nearly $1 trillion over a decade. The beneficiaries would be the richest Americans who for years have complained that the Affordable Care Act unfairly burdened them with the responsibility of subsidizing insurance for the poor.

The repeal of the Affordable Care Act’s taxes is necessary for Republicans to move forward with an even more ambitious part of their agenda: tax reform. “Doing this first shrinks the amount of revenue they are going to have to raise to make their tax bill add up,” said Howard Gleckman, a fellow at the Tax Policy Center.