The Congressional Budget Office finally came out with its scoring of TrumpCare 2.O: The Wreckening, and determined that it will leave almost as many Americans without health insurance as the first version did (23 million by 2026 vs. 24 million under TrumpCare 1). And it gets worse: In states that opt out of requiring essential health benefits and protections for patients with preexisting conditions (in which Scott Walker, for one, has already expressed beady-eyed interest), premiums for many people would go up by tens of thousands of dollars a year, pricing many out of insurance altogether. It's a shit pizza of a healthcare bill, and millions of Americans won't even be able to afford a slice.

The only thing resembling good news about this mess is that there's not a chance in hell the House version of the bill would be passed by the Senate, so depending on what parts the Senate keeps, the actual horror that comes shambling out to conference committee will have a different shape -- if anything passes the Senate at all. Senate Majority Leader Mitch McConnell, while not commenting on the CBO score, said he was unsure Senate Republicans can agree enough to get the 50 votes (plus a tiebreaker by Mike Pence) they'd need to pass any healthcare bill this year. (He could just be blowing smoke to give Democrats a false sense of security, only to unveil something truly evil that'll get 50 R votes.)

Like the previous version of the "American Health Care Act," the re-fluffed bill would result in about 14 million people dropping their insurance in the next year due to the repeal of the individual mandate, plus another 9 million being forced off insurance by 2026 as Medicaid expansion is rolled back. A sixth of states are projected to drop both mandatory coverage of essential health benefits and protections for preexisting conditions, and in those states, younger, healthier policyholders would enjoy lower premiums overall, since insurers could charge older, sicker customers through the nose. The CBO also noted that in those states, people would also be able to purchase very inexpensive plans -- junk insurance -- that don't really cover much of anything; as before, such minimal plans were not counted as actual insurance in the CBO estimate.

The CBO report also predicts that about half of states would be likely to keep policy requirements as they are, with current protections (but less assistance for low-income folks in the individual marketplace, since Obamacare's premium subsidies would be replaced with less-generous tax credits), and that a third of states might opt to get waivers to modify essential health benefits and protections for preexisting conditions without eliminating them altogether; in those states, premiums would be reduced on average, but only because policies cover fewer services. Younger, healthier people would see most of the premium savings, while older policyholders would get bupkis or pay more, depending on what changes states chose.

Also, regardless of whether states took waivers or not, older policyholders would still face one of the AHCA's worst ideas, allowing insurers to charge them up to five times as much for coverage as young people. There truly is something for everyone to hate about this plan.

The real fun would come in the red states that opt out of essential health benefits mandates and protections for preexisting conditions. While the preexisting condition protections would remain in place for those with insurance already, anyone who goes two months without coverage would get slammed. With the elimination of mandatory benefits, coverage for non-mandated services would have to be purchased with a separate rider, and that would be especially expensive for people who want the option of using their uterus, which would no longer be covered because so many wingnuts bitched about men having to pay for mammograms and other ladystuff:

A thousand bucks a month for maternity benefits seems reasonable, right? All you have to do is keep paying an extra $12,000 a year until menopause, or when you decide to get your tubes tied (if you're a whore).

Also, in the sixth of the states projected to go with full waivers, the CBO predicts the "nongroup market would start to become unstable beginning in 2020," with exactly the sort of "death spiral" Republicans falsely claim Obamacare is in now (it is not). Sure, insurance policies for older people with preexisting conditions might still be available -- at an 800% increase in cost.

Not surprisingly, Republicans are very busy insisting the CBO report is either wrong, because the numbers are terrible for Republicans' reelection chances, or dismissing it altogether because the Senate will fix it. New York Rep. John Faso -- the guy who promised a tearful cancer survivor he'd never vote to strip away her coverage, then voted for this bill -- told the Washington Post he didn't believe the CBO's estimate that a sixth of states would take waivers, no, not at all:

“Frankly I doubt any state would try to take advantage of that provision,” he said. “I think that is completely out of the ballpark.”

Asked why the House included the provision if no state would seek such waivers, he replied, “I’m sure it will be stripped out in the Senate.”

Translation: I voted for this shitty bill because I promised I'd repeal Obamacare, but I really hope the Senate will fix what I voted for.

And then there's super-compassionate "Republican moderate" Lindsey Graham, who doesn't seem inclined to vote for the House plan, but ... well, we'll let him Tweet for himself:

Not that the ACA is actually collapsing; apparently Graham is happy to go along with Donald Trump's plan to stab it to death by not actually funding it. That'll teach Democrats to pass a law Republicans don't want to follow. Hooray for "moderation."

Here's the CBO score of Trumpcare 2.0 for you to gaze at in horror for yourselves:

eilsnell by browncm2 on Scribd

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[WaPo / WaPo / CBO Report on Scribd]

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