House Republicans were so eager to pass a repeal of the Affordable Care Act – also known as Obamacare – that they rushed through the American Health Care Act on May 4 without subjecting it to the normal scrutiny of the Congressional Budget Office. That itself was laughable given how much Republicans had properly criticized congressional Democrats for rushing through their health care overhaul without having a full grasp on its effects.

Now the CBO report is out, and it makes more laughable the depiction of the American Health Care Act as something which would, as House Speaker Paul Ryan said, “give every American access to quality, affordable health care.” Instead, the CBO forecasts that if the bill is enacted, the number of Americans with insurance would decline by 23 million by 2026, while saving the federal government $119 billion over the same time span. This is a cold-hearted budget cut masquerading as health reform.

The good news is the Senate seems unlikely to follow the House’s lead. The bad news is Obamacare is in deep trouble in some states and a third of all counties – and that congressional Republicans and the president show no interest in trying to fix the program’s flaws, starting with the incentives it gives healthy people not to buy coverage. When it comes to health care in America, the prognosis is bleak.

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