Changes proposed to attract additional Republican votes for theparty’s bill to repeal and replace Obamacare will narrow theamount of deficit reduction by more than half, according to thenonpartisan Congressional Budget Office, potentiallyfurther complicating conservative support for the legislation.

Changes proposed this week would increase federal spending toeventually raise the size of tax credits offered to older people tobuy health care. Those changes mean the bill would reduce thedeficit by $150 billion over a decade, down from a previousversion’s $337 billion, the CBO found.

The effect on insurance coverage and premiums is broadly thesame as the past version of the GOP bill, the CBO said. The CBOdetermined last week that 24 million more people would be uninsuredin 2026 under the Republican bill, compared to the Affordable CareAct. The changes to the bill included measures that could limitMedicaid enrollment, such as an option for states to institute awork requirement for able-bodied adults.

The Republican health bill is teetering on the edge of failure,after GOP leaders scratched a planned floor vote on the measureThursday amid wavering support from conservative members. A newvote hasn’t yet been set, and key provisions like scrapping somehealth benefit requirements, are still under negotiation.

Changes to bill

The alterations lower the amount that Americans can deduct fromtheir income taxes for the cost of medical expenses. This wouldcreate a $90 billion pot of money, according to the CBO, whichHouse leaders intend for the Senate to use to boost financialassistance for older working people.

Changes to the bill would also reduce the amount of savings fromMedicaid, the federal-stage program for the poor that was expandedunder Obamacare and Republicans are proposing to roll back. Changesto the bill would give more money to pay for older, blind anddisabled people, while other changes would spend less federaldollars on services in New York state.

As the legislation, called the American Health Care Act, wasoriginally introduced earlier this month, a 64-year-old earning$26,500 a year would pay $14,600 a year out of pocket for healthinsurance, compared to $1,700 under Obamacare, because thefinancial assistance under the Republican bill is much smaller forlow-income older people in particular.

House conservatives have balked at the tax credits in general,saying they have the potential to create a new entitlement. Yetmoderates, particularly in the Senate, have expressed concern overhow the elderly will afford coverage, making the upper chamber themore attractive place to attempt to increase assistance. Still,lowering the deficit had been an asset for conservative budgethawks, and the new, smaller number may make it harder for thosecurrently opposed to the bill to be convinced to flip.

House Speaker Paul Ryan and his GOP lieutenants can afford tolose no more than 21 votes in the chamber, presuming all Democratsvote against the bill.

Copyright 2018 Bloomberg. All rightsreserved. This material may not be published, broadcast, rewritten,or redistributed.