If anxious members were hoping the CBO score might temper Republican leadership's plans to push the bill forward, they'd be wrong. Leaders were quick to dismiss the aspects of the score they didn't like and tout what was favorable.
"They are the official score card, but they've been wrong before," Sen. John Cornyn, the Senate's No. 2 Republican said Monday. "So this is their initial pass on it, and surely gives us a target of what we need to work on, and we're going to keep working on it. When you don't punish people financially for their refusal to buy government-approved insurance, some people are going to make a decision not to buy it."
At the White House, officials continued to de-legitimize the report.
The CBO report is "just not believable," Health and Human Services secretary Tom Price told reporters at the White House adding that the plan failed to account for all of the steps he planned to take at HHS, which the White House believes could help cover more Americans than the CBO score is reflecting.
The score, which said 24 million fewer Americans would have health care coverage by 2026, was always expected to be a political doozy for Republicans, who have struggled to hold their members together in pushing to repeal and replace the Affordable Care Act. Now that the score is out, that isn't expected to get any easier. The political realities have been a significant reason why Republicans waited seven years to unveil their own serious legislation to replace the health care law.
House Speaker Paul Ryan highlighted the positive aspects of the bill, a sign leadership is still as committed as ever to moving it through Congress without substantial changes.
"This report confirms that the American Health Care Act will lower premiums and improve access to quality, affordable care. CBO also finds that this legislation will provide massive tax relief, dramatically reduce the deficit, and make the most fundamental entitlement reform in more than a generation," Ryan said in a statement. "These are things we are achieving in just the first of a three-pronged approach. It's important to note that this report does not take into consideration additional steps Congress and the Trump administration are taking that will further lower costs and increase choices."
Ryan also told Fox News after the CBO report's release that the report was encouraging.
"Actually, if you read the reports, I'm encouraged by it," the Wisconsin Republican said. "It exceeded my expectations."
Republicans had been bracing for this score for weeks, laying the groundwork to delegitimize the nonpartisan scoring agency during its mark-ups of the bill last week and arguing their projections have been off in the past.
"The Congressional Budget Office in their own projections said 21 million people would be covered under the Affordable Care Act by the year 2016," Rep. Michael Burgess of Texas said during the House Energy and Commerce Committee last week. "That number in fact was 10 million, so the Congressional Budget Office score while useful ... is hardly the final word on the issue."
Republicans are downplaying the projected drop in the number of insured, however, as little more than Americans having more choices.
"The one thing I'm certain will happen is CBO will say, 'Well, gosh, not as many people will get coverage,'" Ryan said on CBS's "Face the Nation" Sunday. "You know why? Because this isn't a government mandate.'"
Republicans are also arguing that the CBO is only scoring a portion of their overall plan. They've long explained they have a three-step process. The first is to pass their legislation to repeal and partially replace the Affordable Care Act, which is what the CBO has scored Monday, through a process known as budget reconciliation. Budget reconciliation requires only 51 votes in the Senate, but is narrow in terms of what lawmakers can get passed under the process.
Next, the GOP is expected to allow Price to use his jurisdiction at HHS to make regulatory reforms.
Finally, the GOP plans to bring individual bills to the floor that would make additional regulatory reforms. Those bills, which would do things such as allow insurers to sell insurance across state lines, would need some bipartisan support to reach the 60 votes to pass in the Senate. It's unclear if Republicans will ever be able to convince their Democratic colleagues to help them after using the highly partisan budget reconciliation process.
House Ways and Means Chairman Kevin Brady used the CBO score to argue that this report made it harder to liken the GOP plan to "Obamacare Lite" as some conservatives had done.
"It's not surprising that the CBO coverage estimates released today are different than Obamacare's coverage estimates. The American Health Care Act is a dramatic departure from Obamacare, which forced Americans to buy expensive, one-size-fits-all health insurance. Our legislation gives individuals and families the freedom to access health care options that are tailored to their needs — not Washington's," he said in a statement.
Democrats wasted little time Monday railing against the Republicans' bill, suggesting that it proved what Democrats has suspected all along.
Sen. Bernie Sanders told reporters "thousands of Americans will die if this legislation is passed."
"I think that throwing 24 million Americans off of health insurance, raising premiums for older low income Americans, while giving $285 billion in tax breaks to the top 2% is a disgusting and immoral proposal," the Vermont independent who ran in the Democratic presidential primary last year. "Thousands of Americans will die if this legislation is passed and we have to do everything that we can to see that is defeated. "
"Today's CBO report now confirms what we already knew: Despite promises that 'everyone would be covered' and 'no one would be worse off,' this Republican bill would rip away health insurance from 24 million Americans over the next decade and ask millions to pay more for less coverage," Energy and Commerce Committee ranking member Frank Pallone of New Jersey and Ways and Means Committee ranking member Richard Neal of Massachusetts said. "This report also reaffirms that the Republican plan does absolutely nothing to control costs or protect consumers. Instead, it guts Medicaid, raises costs on older Americans, and pulls billions of dollars from Medicare, all in order to pay for tax cuts for the rich."