The new Republican health care bill approved by the House of Representatives will leave 23 million more Americans uninsured by 2026 than under current law, a congressional forecast announced Wednesday.
That figure is only slightly less than the 24 million people losing or dropping insurance under a previous version of the bill backed by President Donald Trump.
"The increase in the number of uninsured people relative to the number projected under current law would reach 19 million in 2020 and 23 million in 2026," the non-partisan Congressional Budget Office said in a highly-anticipated report.
The reforms would reduce the federal deficit by some $119 billion -- $32 billion less than the estimated net savings in the previous version of the bill, CBO reported.
That's because House leaders added funding to offset costs for consumers with expensive medical conditions.
When the original bill collapsed in March, Republican leadership agreed to tweak the legislation to win over several conservative lawmakers along with some moderates. It squeaked through the House on a 217-213 vote.
The Senate, which like the House is controlled by Republicans, intends to craft its own bill, which would then need to go back to the House. But the CBO report only highlighted the difficulties ahead in reaching Republican consensus on a path forward.
Despite the forecast of many uninsured, House Speaker Paul Ryan hailed the report as "another positive step toward keeping our promise to repeal and replace Obamacare."
Trump's team reacted by saying CBO has shown itself to be "totally incapable" of accurately predicting the effects of US health care law.
"We must repeal and replace the disastrous Obamacare law with the American Health Care Act -- the vehicle which will reform our broken healthcare system," a White House official said.
The CBO findings immediately led several Democrats to blast the Republican bill.
"The report makes clear that Trumpcare would be a cancer on the American health care system -- causing costs to skyrocket, making coverage unaffordable for those with preexisting conditions and many seniors, and kicking millions off of their health insurance," Senate Minority Leader Chuck Schumer said.
"Unless you're a healthy millionaire, Trumpcare is a nightmare."
Several Republicans have expressed concern about the House plan's rollback of Medicaid, and a provision that allows insurers to increase health premiums for people with pre-existing conditions -- a practice Obamacare prohibits.
Under the new plan, federal funding for health care programs for the poor and disabled would shrivel by $834 billion through a phase out of Medicaid's expansion.
Several states opted for such an expansion in recent years to families living slightly above the poverty line.
The subsidies that help low-income Americans purchase insurance premiums under Obamacare would be replaced by tax credits under the new measure, beginning in 2020. But they would be less generous than current subsidies, according to CBO.
It also warned of rising costs for patients should insurance companies be allowed to charge higher rates for those with more serious medical conditions.
And it said costs could rise in states that apply for waivers to modify or remove the "essential health benefits," such as maternity care, that are currently required in all insurance plans.
"People who are less healthy (including those with preexisting or newly acquired medical conditions) would ultimately be unable to purchase comprehensive non-group health insurance at premiums comparable to those under current law, if they could purchase it at all," CBO stated.
While Republicans repeatedly warn that Obamacare is collapsing, CBO said sufficient demand remains under current law for insurance marketplaces to stay "stable in most areas."