The Congressional Budget Office (CBO) came out with its score of the amended American Health Care Act (AHCA), and the new bill is just as devastating as the original (you can read the report here, and our official statement here). CBO’s job is to estimate the effect bills will have on the federal budget. In its report, CBO estimates that the AHCA would cause 23 million people to lose health insurance, mainly through massive cuts to the Medicaid program.

CBO analyzed an older version of the bill in March. The House passed an amended version without waiting for an updated CBO report. Some of the legislators who voted for the bill may have believed that the amendments fixed some of the negative findings from the first analysis.  But yesterday’s report found very few differences. Governor Cuomo estimated that the original bill would cost 2.7 million New Yorkers their health insurance, and there is no reason to believe we are better off with this version.

For those who purchase their own insurance, the worst effects would be for low- and moderate-income people between 50 and 64. Their example is a 64-year-old who makes $26,500. The assistance provided by the ACA means that person is only expected to pay $1,700 for health insurance. The AHCA would mean that person pays $16,100, over half of their income. The bill would let states waive protections for people with pre-existing conditions, something New York’s leaders are unlikely to do. But CBO estimates that the older people who are most likely to have pre-existing conditions, like the person in their example, will be priced out of the market anyway. Removing those people from the market would lower premiums for everyone else – but only four percent, hardly worth the pain and suffering it will cause.

The bill would permanently change the Medicaid program by requiring states to stick to a per-person budget. Now, when people are eligible for the Medicaid program and need care, the state and federal governments split the costs of that care. Caps would quickly force states to make decisions based on a budget regardless of how much care people need. If people need more care than the federal government allows, the state has to pick up the tab, start dropping people from the program, or start denying people necessary care.

It seems incredible that New Yorkers have to keep fighting these policy changes when there is so much evidence that they are bad for our state. But we do. Here are some ideas for how:

• One of the best ways to fight this is open conversation about how you get health care and how a bill like this would affect you. We are gathering stories about both Medicaid and the ACA to share with policymakers – you can fill out our story forms here (for Medicaid) and here (for the ACA). You can also talk to people online – the goal is to remind everyone that 23 million is not just a number: 23 million individuals are going to find themselves in a terrible situation needlessly. Some of the hashtags people have used are #BecauseofMedicaid and #SaveOurCare.

• You can find out how your Representative voted here – let them know what you think of their vote and why.

• Look for like-minded people in your community and go to events. One place to check is Resistance Near Me. New Yorkers for Healthcare is another great site that lists health events only.