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(J. Scott Applewhite / AP)

Most Republicans have one goal in repealing and replacing the Affordable Care Act: bring down premiums. So how did they do? The CBO verdict on the American Health Care Act is mixed: average individual market premiums would go down, and young and healthy people would be better off, but sick people could end up paying drastically more than they do under the ACA. Some would be priced out of the market.

What Republicans are saying: They're happy with the overall premium reductions. "This CBO report again confirms that the American Health Care Act achieves our mission: lowering premiums and lowering the deficit," House Speaker Paul Ryan said in a statement.

What's changed since the last CBO report: The biggest thing is that the House added state waivers to the bill, which would allow states to opt out of the ACA's essential health benefits and the requirement that sick people be charged the same premiums as healthy people. Whether states take those waivers has a big impact on whose premiums increase or decrease, and by how much.

In the short term, before most of the House bill provisions take effect, CBO estimates premiums will rise by 20 percent in 2018, and by another 5 percent in 2019. But they'd decrease after that — with some really big exceptions.

How waivers impact premiums: CBO divided states into three different categories:

  • States that don't take waivers: This is about half the population, and CBO estimates premiums in the individual market would decrease by 4 percent for these people, on average. But since the House bill allows insurers to charge older people more than the ACA does, premiums would be substantially reduced for younger people and would rise for older people.
  • States that use the waivers to make modest changes to ACA regulations: These states, which contain about a third of the population, would see bigger premium reductions. CBO estimates that premiums would be 20 percent less in 2026 than under current law, "primarily because, on average, insurance policies would provide fewer benefits." Again, younger people would benefit more than older people.
  • States that use waivers to make substantial changes to ACA regulations: This group contains about one-sixth of the population. Premiums would be lower than under current law, but people with pre-existing conditions "would face extremely high premiums." Premium variation would be very large.
  • It's not just premiums: People who live in states that take waivers could also see substantial rises in their out-of-pocket costs, as less benefits may be covered.

CBO also predicted how premiums would vary with age and income compared to under the ACA:

  • Older, lower-income people would pay "much larger" premiums.
  • Younger, lower-income people would pay about the same or smaller premiums.
  • Higher-income people of most ages would pay lower premiums, on average.

Go deeper

3 hours ago - Politics & Policy

Trump to issue at least 100 pardons and commutations before leaving office

Photo: Mandel Ngan/AFP via Getty Images

President Trump plans to issue at least 100 pardons and commutations on his final full day in office Tuesday, sources familiar with the matter told Axios.

Why it matters: This is a continuation of the president's controversial December spree that saw full pardons granted to more than two dozen people — including former Trump campaign chair Paul Manafort, longtime associate Roger Stone and Charles Kushner, the father of Trump's senior adviser and son-in-law, Jared Kushner.

  • The pardons set to be issued before Trump exits the White House will be a mix of criminal justice ones and pardons for people connected to the president, the sources said.
  • CNN first reported this news.

Go deeper: Convicts turn to D.C. fixers for Trump pardons

Schumer's m(aj)ority checklist

Senate Minority Leader Chuck Schumer. Photo: Tasos Katopodis/Getty Images

Capitalizing on the Georgia runoffs, achieving a 50-50 Senate and launching an impeachment trial are weighty to-dos for getting Joe Biden's administration up and running on Day One.

What to watch: A blend of ceremonies, hearings and legal timelines will come into play on Tuesday and Wednesday so Chuck Schumer can actually claim the Senate majority and propel the new president's agenda.

The dark new reality in Congress

National Guard troops keep watch at security fencing. Photo: Kent Nishimura/Los Angeles Times via Getty Images

This is how bad things are for elected officials and others working in a post-insurrection Congress:

  • Rep. Norma Torres (D-Calif.) said she had a panic attack while grocery shopping back home.
  • Rep. Jim McGovern (D-Mass.) said police may also have to be at his constituent meetings.
  • Rep. Adam Kinzinger (R-Ill.) told a podcaster he brought a gun to his office on Capitol Hill on Jan. 6 because he anticipated trouble with the proceedings that day.