It’s taken seven years, but Congressional Republicans and the Trump administration are finally having their “If you like your health-care plan you can keep it” moment.
Like President Barack Obama, who saw millions of Americans initially lose coverage under his signature plan, President Donald Trump, who vowed “insurance for everyone,” is finding some promises are nearly impossible to keep.
An eagerly awaited report by the independent Congressional Budget Office released Tuesday held plenty of bad news for the new president and his Republican allies on Capitol Hill.
It was also a reminder that, when it comes to health care, the White House and Congressional Republicans are singing from very different hymnals.
The biggest blow to the White House?
The CBO report makes clear that the House GOP plan doesn’t mean insurance for everyone. In fact, it means insurance for 14 million fewer people next year and then 24 million fewer by 2026.
As The New York Times and other outlets reported, average premiums would rise by 15 to 20 percent in 2018 and 2019 than they would be under the current law. But premiums would be 10 percent lower by 2026, the CBO analysis found.
The GOP bill would also trim Medicaid by $880 billion, dropping tens of millions of people from the rolls.
The cuts would particularly affect the poor and women. It would further lead to an increase in births by de-funding Planned Parenthood, cutting off access to contraception and family planning services for 2.5 million men and women nationwide.
Ironically, among those the hardest hit are voters who went the most enthusiastically for Trump in 2016.
And while the GOP bill reduces the deficit by $337 billion over 10 years, millions of older Americans will see the price of their coverage rise, according to the CBO analysis.
Right now, a single 21-year-old earning $26,500 a year, with a $5,100 policy, would receive a $3,400 tax credit, leaving him or her responsible for paying $1,700 of their premium. Under the GOP plan, that share would drop to $1,450, The New York Times reported.
A similarly situated 64-year-old, on the other hand, could see the price of a $15,300 premium rise to $19,500, because the bill currently allows insurance companies to charge older Americans up to three times more than their younger counterparts.
That 64-year-old would receive a $4,900 credit, leaving them on the hook to the tune of $14,600, according to the CBO analysis.
House Speaker Paul Ryan is trying to rally conservatives with the prospect of lower costs, increased access and a reduced deficit.
He made the rounds trying to put a happy face on the admittedly discouraging news in the report. Unlike Trump, Ryan has consistently soft-pedaled the notion that coverage would expand under the House GOP proposal.
Meanwhile, Trump administration officials are trying to undermine the CBO, arguing that its non-partisan analysis doesn’t take into account other market reforms that will be enacted as a part of the law.
Some conservative pundits, including Avik Roy, at The National Review, are also raising questions about the validity of the CBO’s analysis.
Still, surprising almost no one, both conservatives and liberal Democrats have both found something to hate in the new bill. Conservatives, such as U.S. Sen. Rand Paul, dislike the bill because they believe it doesn’t go far enough.
Liberal Democrats, such as Senate Minority Leader Chuck Schumer, hate the bill because it guts coverage and drives up costs for the most vulnerable populations.
Some of this policy nightmare could have conceivably been avoided had Republicans not made the mystifying decision to craft their bill behind closed doors.
That cut out the major stakeholders, such as hospitals, physicians’ groups and drug makers, who were given a seat at the table during the Obamacare debate.
Trump has reportedly put his vaunted deal-making skills to work and says there’s a “big, fat, beautiful negotiation” going on with the health-care bill.
What’s clear is that, right now, Trump and Republicans have a big, fat problem with their health-care bill. And whether further negotiations will in fact lead to an improvement over the existing law, as Trump promised, is an open question.
Better than halfway into his first 50 days, Trump is learning that campaigning is easy.
Governing, as he might say, is much more complicated than he thought.

An award-winning political journalist, Micek is the Opinion Editor and Political Columnist for PennLive/The Patriot-News in Harrisburg, Pa. Readers may follow him on Twitter @ByJohnLMicek and email him at jmicek@pennlive.com.