A nonpartisan U.S. congressional report said Tuesday that 18 million Americans could lose their health care insurance in the first year if the Republican-controlled U.S. Congress repeals President Barack Obama's signature health care reforms without a replacement.
The Congressional Budget Office said that with the repeal of the Affordable Care Act, popularly known as Obamacare, the number of people without insurance would grow to 32 million within a decade and the cost of insurance premiums would jump sharply.
President-elect Donald Trump, who assumes power in Washington on Friday, says he wants "insurance for everybody" and that he is nearing completion of a plan to replace the nearly seven-year-old policies of Obama, the Democrat who has led the country for the last eight years.
Republican lawmakers have taken the first legislative steps in recent days to repeal the law — a goal ever since Democrats approved it without the support of a single Republican vote in 2010. But Republicans have yet to agree on a plan to replace it.
With Trump in the White House, the overhaul of the health care law is expected to be one of his and Republican lawmakers' key efforts in the first 100 days of his four-year term. Republicans have long objected to the law as an example of government overreach, especially the requirement that all Americans buy health insurance or pay a fine if they do not.
But minority Democratic lawmakers have vowed to block the effort to overturn the law, under which 20 million people now have health insurance coverage who previously did not.
The vast majority of American workers have health insurance coverage through their employers, but the health law has helped millions of others, some self-employed workers and others impoverished, get health insurance for the first time or after years without coverage. But premiums have risen sharply, leading to more calls to replace the law.
Trump and many Republicans, however, have vowed to keep two of the most popular Obamacare features: requiring insurers to cover patients' pre-existing health care medical needs and allowing young people to stay on their parents' health care insurance plan until they turn 26 years old.
The question for some Republicans, however, is how much of the law they can keep without the requirement that everyone pay for insurance, which could make new policy changes exorbitantly expensive for the government and health care consumers.