Republicans have pointed to these elements as their chief criticisms of the 2010 health care law.Maintaining the protections was a nod to the rule of the budget reconciliation process, which would allow Republicans to pass their bill with a simple majority.Republicans promised that their scheme would promote a “stable transition” to a new system a vow McConnell made again on Tuesday morning, while speaking on the Senate floor.But when the Congressional Budget Office examined the proposal, it concluded that the combination of keeping those protections in place and eliminating the mandate and then the subsidies for buying private insurance would wreak havoc with insurance markets.Carriers, rightly fearful that their risk pools would tilt toward sicker and sicker customers, would jack up premiums in response making coverage unaffordable for many. The problem would hit quickly, because the individual mandate penalty is a major incentive for healthy people to get coverage.In those states, anybody in a household with income below or just above the poverty line now qualifies for Medicaid, helping to bring the number of Americans without insurance to historic lows. Medicaid has become particularly vital for battling opioid addiction in states like Ohio and West Virginia whose GOP senators, not coincidentally, have been among the most anxious about proposed Medicaid cuts in repeal legislation.CBO predictions are subject to same considerable uncertainty as all predictions about health insurance markets.

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