Republican healthcare bill imperiled with 22 million seen losing insuranceWASHINGTON (Reuters) - Twenty-two million Americans would lose insurance over the next decade under the U.S. Senate Republican healthcare bill, a nonpartisan congressional office said on Monday, complicating the path forward for the already-fraught legislation. After the Congressional Budget Office (CBO) score, Senator Susan Collins, a moderate Republican, said she could not support moving forward on the bill as written. Collins’ opposition highlights the delicate balance that Senate Majority Leader Mitch McConnell must strike as he tries to deliver a legislative win to President Donald Trump by reconciling the Republican Party’s moderate and conservative wings. Moderate senators are concerned about millions of people losing insurance. Key conservative senators have said the Senate bill does not do enough to repeal Obamacare. The CBO assessment that an additional 15 million people would be uninsured in 2018 under the bill and its prediction that insurance premiums would skyrocket over the first two years prompted concern from both sides.  McConnell’s goal was to have a vote on the bill before the July 4 recess that starts at the end of this week. But several Republicans, including Collins, have said they would not approve a procedural motion that would clear the way for a vote. McConnell can afford to lose just two Republican senators from their 52-seat majority in the 100-seat Senate, which would allow passage of the bill with Vice President Mike Pence casting the tie-breaking vote.   “If you are on the fence ... this CBO score didn’t help you, so I think it’s going to be harder to get to 50, not easier,” Republican Senator Lindsey Graham said of the bill’s prospects. The CBO score is also likely to amplify criticism from industry groups such as the American Medical Association, which said earlier on Monday that the Senate’s bill violated the doctors’ precept of “first, do no harm.” The CBO is only able to assess the impact of legislation within a 10-year window, but it said that insurance losses are expected to grow beyond 22 million due to deep cuts to the Medicaid insurance program for the poor and disabled that are not scheduled to go into effect until 2025.  Trump and Republicans in Congress made repealing and replacing Obamacare, former Democratic President Barack Obama’s signature domestic legislation, a central campaign promise. The pressure is on for them to deliver now that they control the White House, House of Representatives and Senate. Republicans view Obamacare as costly government intrusion and say that individual insurance markets are collapsing. Obamacare expanded health coverage to some 20 million Americans by expanding Medicaid and mandating that individuals obtain health insurance. The CBO score was released just hours after Republicans revised the bill, adding a measure that would penalize people who let their insurance coverage lapse for an extended period. The move followed criticism that the original bill would result in a sicker - and more expensive - insurance pool.  At least four conservative Republicans - Senators Ted Cruz, Rand Paul, Ron Johnson and Mike Lee - have expressed opposition to the Senate legislation.    Moderate Republicans have warned against replacing Obamacare with legislation that is too similar to the version passed by the House, saying it would cause too many people, especially those with low incomes, to lose health coverage. The CBO estimated that the House bill would cause 23 million people to lose insurance. Trump had called the House bill “mean” and asked Senate Republicans to come up with “more generous” legislation. Democrats uniformly oppose both the House and Senate versions of the bill. “CBO’s report today makes clear that this bill is every bit as ‘mean as the House bill,” Senator Chuck Schumer, the Democratic leader, told reporters. The White House in a statement on Monday criticized the CBO for issuing a “flawed report” and said its assessments should not be “trusted blindly.” Trump and McConnell have been working to shore up support. The president called key conservative senators over the weekend, White House spokesman Sean Spicer said.  Both Cruz and Johnson said they were concerned about CBO estimates that insurance premiums would initially rise as much as 30 percent over the first two years before declining. “Doesn’t help the people whose premiums skyrocket next year,” Cruz told reporters. “Kind of a problem, isn’t it?” Johnson said of the short-term premium increase. Johnson and Paul have said they will oppose the procedural motion that would allow the Senate to move forward to a vote. Cruz is drafting suggested fixes. Paul remains opposed to the bill.     The first moderate Republican to oppose the bill, Senator Dean Heller, is already facing political fallout. America First Policies, a political group run by former Trump campaign staffers, said it would air healthcare-related attack ads against Heller, who faces a competitive re-election race in Nevada next year. Senator Rob Portman, of Ohio, who has not said whether he supports the bill, was “dressed down” by McConnell during a Monday leadership meeting, a senior Republican aide told Reuters.  Ohio participates in Obamacare’s Medicaid expansion, and Republican Governor John Kasich has criticized the Senate bill. Portman’s office did not respond to a request to comment. Senator Marco Rubio of Florida said his governor, fellow Republican Rick Scott, would be on Capitol Hill this week to discuss the bill’s impact on the state. Constituent and industry groups have been critical of the Senate bill’s proposal to reduce the Medicaid healthcare program for the poor and point to the CBO analysis that it would disproportionately affect older adults. Under Senate rules, the bill must replicate savings projected in the House version that passed last month. It cleared that critical hurdle, with the CBO estimating it would decrease the budget deficit by $321 billion over 2017-2026. A revision to the bill that imposes a penalty for prolonged lapses in insurance coverage addresses the original bill’s provision to drop the Obamacare penalty on those who do not have insurance. Experts had warned that canceling the fine could lead to a sicker insurance pool because young and healthy people would not face consequences for failing to purchase insurance.  The bill would impose a six-month waiting period for anyone who lets their health insurance lapse for over 63 days and then wants to re-enroll in a plan in the individual market. The 15 million people the CBO estimates would be uninsured in 2018 is largely due to the repeal of the penalty associated with being uninsured. The CBO did not evaluate the revised version that included the new waiting period. Insurer Blue Cross and Blue Shield said it was encouraged by the inclusion of incentives for continuous coverage. Molina Healthcare said it preferred the Obamacare mandate, said that and the Senate bill, even after revised, would simply delay care. If the Senate passes a bill, it will either have to be approved by the House, the two chambers would have to reconcile their differences in a conference committee, or the House could pass a new version and bounce it back to the Senate. politicsNews
republican healthcare bill imperiled million seen losing insurancewashington reuters million americans would lose insurance next decade senate republican healthcare bill nonpartisan congressional office said monday complicating path forward legislation after congressional budget office cbo score senator susan collins moderate republican said could support moving forward bill written collins opposition highlights delicate balance senate majority leader mitch mcconnell must strike tries deliver legislative win president donald trump reconciling republican party moderate conservative wings moderate senators concerned millions people losing insurance key conservative senators said senate bill enough repeal obamacare the cbo assessment additional million people would uninsured bill prediction insurance premiums would skyrocket first two years prompted concern sides mcconnell goal vote bill july recess starts end week but several republicans including collins said would approve procedural motion would clear way vote mcconnell afford lose two republican senators majority senate would allow passage bill vice president mike pence casting vote if fence cbo score help i think going harder get easier republican senator lindsay graham said bill prospects the cbo score also likely amplify criticism industry groups american medical association said earlier monday senate bill violated doctors precepts first the cbo able assess impact legislation within window said insurance losses expected grow beyond million due deep cuts medical insurance program poor disabled scheduled go effect trump republicans congress made repealing replacing obamacare former democratic president barack obama signature domestic legislation central campaign promise the pressure deliver control white house house representatives senate republicans view obamacare costly government intrusion say individual insurance markets collapsing obamacare expanded health coverage million americans expanding medical mandating individuals obtain health insurance the cbo score released hours republicans revised bill adding measure would penalized people let insurance coverage lapse extended period the move followed criticism original bill would result kicker expensive insurance pool at least four conservative republicans senators ted cruz rand paul ron johnson mike lee expressed opposition senate legislation moderate republicans warned replacing obamacare legislation similar version passed house saying would cause many people especially low incomes lose health coverage the cbo estimated house bill would cause million people lose insurance trump called house bill mean asked senate republicans come generous legislation democrats uniformly oppose house senate versions bill cbo report today makes clear bill every bit mean house bill senator chuck scheme democratic leader told reporters the white house statement monday criticized cbo issuing flawed report said assessments trusted trump mcconnell working shore support the president called key conservative senators weekend white house spokesman sean spider said both cruz johnson said concerned cbo estimates insurance premiums would initially rise much percent first two years declining doesn help people whose premiums skyrocket next year cruz told reporters kind problem johnson said premium increase johnson paul said oppose procedural motion would allow senate move forward vote cruz drafting suggested fixes paul remains opposed bill the first moderate republican oppose bill senator dean helper already facing political fallout america first policies political group run former trump campaign staffers said would air attack ads helper faces competitive race nevada next year senator rob portal ohio said whether supports bill dressed mcconnell monday leadership meeting senior republican aide told reuters ohio participates obamacare medical expansion republican governor john basic criticized senate bill portal office respond request comment senator marco rubio florida said governor fellow republican rick scott would capitol hill week discuss bill impact state constituent industry groups critical senate bill proposal reduce medical healthcare program poor point cbo analysis would disproportionately affect older adults under senate rules bill must replicate savings projected house version passed last month it cleared critical hurdle cbo estimating would decrease budget deficit billion a revision bill imposes penalty prolonged lapses insurance coverage addresses original bill provision drop obamacare penalty insurance experts warned cancelling fine could lead kicker insurance pool young healthy people would face consequences failing purchase insurance the bill would impose waiting period anyone lets health insurance lapse days wants plan individual market the million people cbo estimates would uninsured largely due repeal penalty associated uninsured the cbo evaluate revised version included new waiting period insurer blue cross blue shield said encouraged inclusion incentives continuous coverage moving healthcare said preferred obamacare mandate said senate bill even revised would simply delay care if senate passes bill either approved house two chambers would reconcile differences conference committee house could pass new version bounce back senate politicsnews
Your task is to classify the provided input as real or fake news. Label 0 is meant for fake news, Label 1 is for real news. TEXT: Republican healthcare bill imperiled with 22 million seen losing insuranceWASHINGTON (Reuters) - Twenty-two million Americans would lose insurance over the next decade under the U.S. Senate Republican healthcare bill, a nonpartisan congressional office said on Monday, complicating the path forward for the already-fraught legislation. After the Congressional Budget Office (CBO) score, Senator Susan Collins, a moderate Republican, said she could not support moving forward on the bill as written. Collins’ opposition highlights the delicate balance that Senate Majority Leader Mitch McConnell must strike as he tries to deliver a legislative win to President Donald Trump by reconciling the Republican Party’s moderate and conservative wings. Moderate senators are concerned about millions of people losing insurance. Key conservative senators have said the Senate bill does not do enough to repeal Obamacare. The CBO assessment that an additional 15 million people would be uninsured in 2018 under the bill and its prediction that insurance premiums would skyrocket over the first two years prompted concern from both sides.  McConnell’s goal was to have a vote on the bill before the July 4 recess that starts at the end of this week. But several Republicans, including Collins, have said they would not approve a procedural motion that would clear the way for a vote. McConnell can afford to lose just two Republican senators from their 52-seat majority in the 100-seat Senate, which would allow passage of the bill with Vice President Mike Pence casting the tie-breaking vote.   “If you are on the fence ... this CBO score didn’t help you, so I think it’s going to be harder to get to 50, not easier,” Republican Senator Lindsey Graham said of the bill’s prospects. The CBO score is also likely to amplify criticism from industry groups such as the American Medical Association, which said earlier on Monday that the Senate’s bill violated the doctors’ precept of “first, do no harm.” The CBO is only able to assess the impact of legislation within a 10-year window, but it said that insurance losses are expected to grow beyond 22 million due to deep cuts to the Medicaid insurance program for the poor and disabled that are not scheduled to go into effect until 2025.  Trump and Republicans in Congress made repealing and replacing Obamacare, former Democratic President Barack Obama’s signature domestic legislation, a central campaign promise. The pressure is on for them to deliver now that they control the White House, House of Representatives and Senate. Republicans view Obamacare as costly government intrusion and say that individual insurance markets are collapsing. Obamacare expanded health coverage to some 20 million Americans by expanding Medicaid and mandating that individuals obtain health insurance. The CBO score was released just hours after Republicans revised the bill, adding a measure that would penalize people who let their insurance coverage lapse for an extended period. The move followed criticism that the original bill would result in a sicker - and more expensive - insurance pool.  At least four conservative Republicans - Senators Ted Cruz, Rand Paul, Ron Johnson and Mike Lee - have expressed opposition to the Senate legislation.    Moderate Republicans have warned against replacing Obamacare with legislation that is too similar to the version passed by the House, saying it would cause too many people, especially those with low incomes, to lose health coverage. The CBO estimated that the House bill would cause 23 million people to lose insurance. Trump had called the House bill “mean” and asked Senate Republicans to come up with “more generous” legislation. Democrats uniformly oppose both the House and Senate versions of the bill. “CBO’s report today makes clear that this bill is every bit as ‘mean as the House bill,” Senator Chuck Schumer, the Democratic leader, told reporters. The White House in a statement on Monday criticized the CBO for issuing a “flawed report” and said its assessments should not be “trusted blindly.” Trump and McConnell have been working to shore up support. The president called key conservative senators over the weekend, White House spokesman Sean Spicer said.  Both Cruz and Johnson said they were concerned about CBO estimates that insurance premiums would initially rise as much as 30 percent over the first two years before declining. “Doesn’t help the people whose premiums skyrocket next year,” Cruz told reporters. “Kind of a problem, isn’t it?” Johnson said of the short-term premium increase. Johnson and Paul have said they will oppose the procedural motion that would allow the Senate to move forward to a vote. Cruz is drafting suggested fixes. Paul remains opposed to the bill.     The first moderate Republican to oppose the bill, Senator Dean Heller, is already facing political fallout. America First Policies, a political group run by former Trump campaign staffers, said it would air healthcare-related attack ads against Heller, who faces a competitive re-election race in Nevada next year. Senator Rob Portman, of Ohio, who has not said whether he supports the bill, was “dressed down” by McConnell during a Monday leadership meeting, a senior Republican aide told Reuters.  Ohio participates in Obamacare’s Medicaid expansion, and Republican Governor John Kasich has criticized the Senate bill. Portman’s office did not respond to a request to comment. Senator Marco Rubio of Florida said his governor, fellow Republican Rick Scott, would be on Capitol Hill this week to discuss the bill’s impact on the state. Constituent and industry groups have been critical of the Senate bill’s proposal to reduce the Medicaid healthcare program for the poor and point to the CBO analysis that it would disproportionately affect older adults. Under Senate rules, the bill must replicate savings projected in the House version that passed last month. It cleared that critical hurdle, with the CBO estimating it would decrease the budget deficit by $321 billion over 2017-2026. A revision to the bill that imposes a penalty for prolonged lapses in insurance coverage addresses the original bill’s provision to drop the Obamacare penalty on those who do not have insurance. Experts had warned that canceling the fine could lead to a sicker insurance pool because young and healthy people would not face consequences for failing to purchase insurance.  The bill would impose a six-month waiting period for anyone who lets their health insurance lapse for over 63 days and then wants to re-enroll in a plan in the individual market. The 15 million people the CBO estimates would be uninsured in 2018 is largely due to the repeal of the penalty associated with being uninsured. The CBO did not evaluate the revised version that included the new waiting period. Insurer Blue Cross and Blue Shield said it was encouraged by the inclusion of incentives for continuous coverage. Molina Healthcare said it preferred the Obamacare mandate, said that and the Senate bill, even after revised, would simply delay care. If the Senate passes a bill, it will either have to be approved by the House, the two chambers would have to reconcile their differences in a conference committee, or the House could pass a new version and bounce it back to the Senate. politicsNews
Your task is to classify the provided input as real or fake news. Label 0 is meant for fake news, Label 1 is for real news. TEXT: republican healthcare bill imperiled million seen losing insurancewashington reuters million americans would lose insurance next decade senate republican healthcare bill nonpartisan congressional office said monday complicating path forward legislation after congressional budget office cbo score senator susan collins moderate republican said could support moving forward bill written collins opposition highlights delicate balance senate majority leader mitch mcconnell must strike tries deliver legislative win president donald trump reconciling republican party moderate conservative wings moderate senators concerned millions people losing insurance key conservative senators said senate bill enough repeal obamacare the cbo assessment additional million people would uninsured bill prediction insurance premiums would skyrocket first two years prompted concern sides mcconnell goal vote bill july recess starts end week but several republicans including collins said would approve procedural motion would clear way vote mcconnell afford lose two republican senators majority senate would allow passage bill vice president mike pence casting vote if fence cbo score help i think going harder get easier republican senator lindsay graham said bill prospects the cbo score also likely amplify criticism industry groups american medical association said earlier monday senate bill violated doctors precepts first the cbo able assess impact legislation within window said insurance losses expected grow beyond million due deep cuts medical insurance program poor disabled scheduled go effect trump republicans congress made repealing replacing obamacare former democratic president barack obama signature domestic legislation central campaign promise the pressure deliver control white house house representatives senate republicans view obamacare costly government intrusion say individual insurance markets collapsing obamacare expanded health coverage million americans expanding medical mandating individuals obtain health insurance the cbo score released hours republicans revised bill adding measure would penalized people let insurance coverage lapse extended period the move followed criticism original bill would result kicker expensive insurance pool at least four conservative republicans senators ted cruz rand paul ron johnson mike lee expressed opposition senate legislation moderate republicans warned replacing obamacare legislation similar version passed house saying would cause many people especially low incomes lose health coverage the cbo estimated house bill would cause million people lose insurance trump called house bill mean asked senate republicans come generous legislation democrats uniformly oppose house senate versions bill cbo report today makes clear bill every bit mean house bill senator chuck scheme democratic leader told reporters the white house statement monday criticized cbo issuing flawed report said assessments trusted trump mcconnell working shore support the president called key conservative senators weekend white house spokesman sean spider said both cruz johnson said concerned cbo estimates insurance premiums would initially rise much percent first two years declining doesn help people whose premiums skyrocket next year cruz told reporters kind problem johnson said premium increase johnson paul said oppose procedural motion would allow senate move forward vote cruz drafting suggested fixes paul remains opposed bill the first moderate republican oppose bill senator dean helper already facing political fallout america first policies political group run former trump campaign staffers said would air attack ads helper faces competitive race nevada next year senator rob portal ohio said whether supports bill dressed mcconnell monday leadership meeting senior republican aide told reuters ohio participates obamacare medical expansion republican governor john basic criticized senate bill portal office respond request comment senator marco rubio florida said governor fellow republican rick scott would capitol hill week discuss bill impact state constituent industry groups critical senate bill proposal reduce medical healthcare program poor point cbo analysis would disproportionately affect older adults under senate rules bill must replicate savings projected house version passed last month it cleared critical hurdle cbo estimating would decrease budget deficit billion a revision bill imposes penalty prolonged lapses insurance coverage addresses original bill provision drop obamacare penalty insurance experts warned cancelling fine could lead kicker insurance pool young healthy people would face consequences failing purchase insurance the bill would impose waiting period anyone lets health insurance lapse days wants plan individual market the million people cbo estimates would uninsured largely due repeal penalty associated uninsured the cbo evaluate revised version included new waiting period insurer blue cross blue shield said encouraged inclusion incentives continuous coverage moving healthcare said preferred obamacare mandate said senate bill even revised would simply delay care if senate passes bill either approved house two chambers would reconcile differences conference committee house could pass new version bounce back senate politicsnews