The CBO report estimated that 3 million more Americans would lose their health insurance over the next ten years because of the changes in the revised versions that would allow for health insurance companies to charge higher premiums for people with so-called pre-existing conditions and to offer so-called insurance that doesn't cover major medical risks, which is not really health insurance. Further, the CBO estimated that there were 50 million Americans who lived in areas where the individual health insurance market might collapse because of these changes.

Hardest hit by insurance losses would be low-income adults. The CBO estimated that the percentage of adults in households making less than 200% of the official poverty line (or about $40,000 for a family of three) who would wind up without health insurance would double under Trumpcare, as compared to Obamacare. For older adults (50 to 64 years old) in low-income households the percentage would triple – from about 10% to almost 30% going without health care. And no wonder: according to the CBO report, the premiums paid by an individual who is 64 years old could jump from less than $150 a month under Obamacare to more than $1200 a month (or even more) under Trumpcare version 2.

The total number of people losing their health insurance in ten years was estimated by the CBO to be 23 million, down slightly from the first version where the CBO projected a 24 million loss. Some commentators have labeled Trumpcare version 2 as just as bad as the original. But the CBO estimate is based on the projection that businesses will cover 4 million more people than in the original bill. But given that Trumpcare would eliminate the employer mandate for large businesses to provide health insurance for their employees, and that businesses were steadily cutting workers from health insurance before Obamacare, it is quite likely that the revised version of the AHCA could leave even more Americans without health insurance.

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The Affordable Care Act or ACA, popularly known as Obamacare, mandates a number of benefits that health insurance has to cover. Under Trumpcare Version 2, states could opt out, allowing for-profit health insurance companies to offer insurance without emergency room or hospital coverage, maternity care, mental health and drug abuse, prescription drugs, and lab tests. This opens the door for millions of people to be underinsured – having health insurance but leaving gaps that can drive people into bankruptcy or not getting the health care that they need.

In particular, Trumpcare Version 2 allows states to let insurance companies charge higher prices for people with pre-existing conditions. Almost 60 million adults have pre-existing health conditions, and 2 million of them could lose their health insurance. This would be in addition to the 24 million who will lose coverage from Trumpcare mainly from cuts in Medicaid and loss of employer health benefits (under the ACA, larger companies are required to offer health insurance to their workers, this is not the case under Trumpcare).

While Trump and House Republicans bragged about the extra $8 billion dollars added to help pay for insurance for people with pre-existing conditions who would be put into ‘high-risk pools.’ This money, along with the $15 billion already in the bill, is only enough to cover a bit more than 100,000 people, a tiny fraction of the more than 2 million people who buy their own health insurance that have pre-existing conditions. If Texas or Florida, two states that have already opted out of the Medicaid expansion under the ACA, were to allow higher charges for preexisting conditions, the total money available nationwide would only cover half the people who need help in just one state.

Why are President Trump and the House Republicans so intent on taking health insurance from 26 million Americans? Many mainstream groups such as the AARP, the American Medical Association, and the American Hospital Association all opposed Trumpcare. But Trumpcare is being pushed by the president and House Republicans because it would end the taxes on high-income individuals that help to pay for Obamacare, saving the rich billions of dollars. In addition, the cut in health spending would pave the way for Trump and the House Republicans’ tax plan, which would cut taxes on the rich by billions more.

The bill now moves to the Senate where it is expected to encounter stiff resistance.

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