washington twenty-two million americans would lose insurance next decade u.s. senate republican healthcare bill nonpartisan congressional office say monday complicate path forward already-fraught legislation congressional budget office cbo score senator susan collins moderate republican say could support move forward bill write collins opposition highlight delicate balance senate majority leader mitch mcconnell must strike try deliver legislative win president donald trump reconcile republican party moderate conservative wing moderate senators concern millions people lose insurance key conservative senators say senate bill enough repeal obamacare cbo assessment additional 15 million people would uninsured 2018 bill prediction insurance premiums would skyrocket first two years prompt concern side mcconnell goal vote bill july recess start end week several republicans include collins say would approve procedural motion would clear way vote mcconnell afford lose two republican senators 52-seat majority 100-seat senate would allow passage bill vice president mike pence cast tie-breaking vote fence ... cbo score help think go hard get 50 easy republican senator lindsey graham say bill prospect cbo score also likely amplify criticism industry group american medical association say early monday senate bill violate doctor precept first harm cbo able assess impact legislation within 10-year window say insurance losses expect grow beyond 22 million due deep cut medicaid insurance program poor disable schedule go effect 2025. trump republicans congress make repeal replace obamacare former democratic president barack obama signature domestic legislation central campaign promise pressure deliver control white house house representatives senate republicans view obamacare costly government intrusion say individual insurance market collapse obamacare expand health coverage 20 million americans expand medicaid mandate individuals obtain health insurance cbo score release hours republicans revise bill add measure would penalize people let insurance coverage lapse extend period move follow criticism original bill would result sick expensive insurance pool least four conservative republicans senators ted cruz rand paul ron johnson mike lee express opposition senate legislation moderate republicans warn replace obamacare legislation similar version pass house say would cause many people especially low incomes lose health coverage cbo estimate house bill would cause 23 million people lose insurance trump call house bill mean ask senate republicans come generous legislation democrats uniformly oppose house senate versions bill cbo report today make clear bill every bite mean house bill senator chuck schumer democratic leader tell reporters white house statement monday criticize cbo issue flaw report say assessments trust blindly trump mcconnell work shore support president call key conservative senators weekend white house spokesman sean spic say cruz johnson say concern cbo estimate insurance premiums would initially rise much 30 percent first two years decline help people whose premiums skyrocket next year cruz tell reporters kind problem johnson say short-term premium increase johnson paul say oppose procedural motion would allow senate move forward vote cruz draft suggest fix paul remain oppose bill first moderate republican oppose bill senator dean heller already face political fallout america first policies political group run former trump campaign staffers say would air healthcare-related attack ads heller face competitive re-election race nevada next year senator rob portman ohio say whether support bill dress mcconnell monday leadership meet senior republican aide tell reuters ohio participate obamacare medicaid expansion republican governor john kasich criticize senate bill portman office respond request comment senator marco rubio florida say governor fellow republican rick scott would capitol hill week discuss bill impact state constituent industry group critical senate bill proposal reduce medicaid healthcare program poor point cbo analysis would disproportionately affect old adults senate rule bill must replicate save project house version pass last month clear critical hurdle cbo estimate would decrease budget deficit 321 billion 2017-2026. revision bill impose penalty prolong lapse insurance coverage address original bill provision drop obamacare penalty insurance experts warn cancel fine could lead sick insurance pool young healthy people would face consequences fail purchase insurance bill would impose six-month wait period anyone let health insurance lapse 63 days want re-enroll plan individual market 15 million people cbo estimate would uninsured 2018 largely due repeal penalty associate uninsured cbo evaluate revise version include new wait period insurer blue cross blue shield say encourage inclusion incentives continuous coverage molina healthcare say prefer obamacare mandate say senate bill even revise would simply delay care senate pass bill either approve house two chamber would reconcile differences conference committee house could pass new version bounce back senate republican healthcare bill imperil 22 million see lose insurance