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Eighteen million people could lose their insurance within a year and individual insurance premiums would shoot upward if Congress repealed major provisions of the Affordable Care Act while leaving other parts in place, the nonpartisan Congressional Budget Office said on Tuesday. A report by the office sharply increases pressure on Republicans to come up with a comprehensive plan to replace the health care law. (Pear, 1/17)

In the first year, insurance premiums would jump by 20% to 25% for individual policies purchased directly or through the Obamacare marketplace, according to the report. The number of people who are uninsured would increase by 18 million. Those numbers would only increase in subsequent years. Premium prices would continue to climb by 50% the next year, with the uninsured swelling to 27 million, as full repeal took effect, the report said. (Mascaro, 1/17)

Spotlighting potential perils for Republicans, the report immediately became a flashing hazard light for this year's effort by Donald Trump and GOP lawmakers to annul Obama's law and — in a more complicated challenge — institute their own alternative. (Fram, 1/17)

Democrats seized on the report, issued Tuesday by the nonpartisan Congressional Budget Office, to discredit Republican efforts to repeal Obamacare and rally Americans who are insured under the program. The report underscored the political peril that Trump faces in trying to meet one of his top campaign promises — and also the discord among Republicans about how to do it. (Eilperin, Sullivan and Goldstein, 1/17)

Republicans are using their 2015 Obamacare repeal bill as a framework for their latest effort, although they have yet to release final details on how much of Obamacare they plan to repeal and what they intend to enact as a replacement. This report is based on the 2015 repeal legislation, and does not take into account any GOP plan that would replace Obamacare. (Haberkorn, 1/17)

Some of the CBO's previous reports on the ACA have been controversial for how far off they were in their projections of ACA enrollment. But it isn't because of any liberal bias. The office is now headed by Keith Hall, a conservative former economist in the George W. Bush administration who also worked at the free market Mercatus Center at George Mason University.Chris Jacobs, a former Republican congressional policy aide, said in a blog post Tuesday, that CBO's earlier miscalculations undercut its new message. (O'Donnell, 1/17)

“CBO and JCT estimate that about half of the nation’s population lives in areas that would have no insurer participating in the nongroup market in the first year after the repeal of the marketplace subsidies took effect,” said the report. And that would rise to “about three-quarters of the population by 2026.” (Rovner, 1/17)

“[It’s] crystal clear that the Republican effort to repeal the Affordable Care Act will increase health care costs for millions of Americans and kick millions more off of their health insurance. The numbers are even worse than experts could have imagined: tens of millions will lose their health insurance, and individuals will see their premiums double,” Senate Minority Leader Charles E. Schumer of New York, one of the lawmakers that requested the report, said in a statement about CBO’s findings. (Williams, 1/17)

House Minority Leader Nancy Pelosi said the CBO report describes a “nightmare” scenario under which “health care costs will explode, Americans in the individual market will see their premiums double by 2026, and the number of uninsured Americans will surge by 18 million in the first year alone and by 32 million by 2026.” The California Democrat added: “Republicans need to wake up to the brutal impact that repealing the ACA will have on the lives of their constituents.” Members of her team and other Democrats picked up on the theme as well. (McPherson, 1/17)

“This projection is meaningless,” said Ashlee Strong, a spokesperson for Speaker Paul Ryan, as she argued the CBO report “takes into account no measures to replace the law nor actions that the incoming administration will take to revitalize the individual market that has been decimated by Obamacare.” “CBO misses the point,” said House Majority Whip Steve Scalise (R-LA). “Obamacare will be replaced with lower costs and more choices.” (Dupree, 1/17)

Under Obamacare, the uninsured rate fell to 8.9 percent in the first half of 2016, down from 16 percent in 2010 after 20 million people gained coverage. With three days to go until President-elect Donald Trump’s inauguration, the report offers a look at a possible post-repeal landscape. Trump has expressed support for "essentially simultaneously" repealing and replacing Obamacare, and said his own plan is almost complete. But House Speaker Paul Ryan said Friday that passing a new law would be a "thoughtful, step-by-step process." (Greifeld, 1/17)

Trump and the Republicans have promised a plan that will not only cover as many Americans as the ACA, but will provide even better care at lower costs, while providing wider choice. However, all of the plans put forward so far have been outlines at best, in which hand-waving about the power of market forces does virtually all of the heavy economic lifting. (Garver, 1/17)