WASHINGTON — The nonpartisan Congressional Budget Office said on Thursday that the latest version of a Senate bill to repeal and replace the Affordable Care Act would leave 15 million people without health insurance next year, rising to 22 million in 2026 — another blow to the legislative push that President Trump is trying to revive.
The increase in the number of people who are uninsured was the same as the 22 million more people who would be uninsured in 2026 under an earlier version of the bill that was analyzed in June.
The newest score of a replacement for the Affordable Care Act came after a marathon bargaining session Wednesday night with balking senators that ended inconclusively. On Wednesday, the budget office released its analysis of a separate bill that would repeal large parts of President Barack Obama’s signature health care law without a replacement. That analysis concluded that such a move would increase the number of people without health insurance by 32 million in 2026.
Senators were set to leave for the weekend on Thursday afternoon after a demoralizing week of fruitless negotiations, capped by news that one of their most prominent colleagues, Senator John McCain, Republican of Arizona, has brain cancer. The majority leader, Senator Mitch McConnell of Kentucky, appears determined to force the Senate to vote next week on a procedural motion to begin debating health care, but he still is short of the 50 votes he needs.
The latest analysis may be incomplete. It did not include a provision that would allow insurers to offer low-cost, stripped-down insurance plans, an idea that has been pushed by Senator Ted Cruz, Republican of Texas, and could be critical to winning the votes of Mr. Cruz and another conservative, Mike Lee of Utah.
Mr. Cruz’s proposal was included in a version of the bill released last week, but it has been assailed by the insurance industry. While the provision was omitted from the latest version of the bill that was released on Thursday, it remains under consideration to be part of the repeal legislation, a Republican congressional aide said.
The budget office released its analysis as Senate Republicans are struggling to keep alive their longtime goal of repealing the Affordable Care Act — and to settle on a strategy for achieving that aim. But its conclusions are not likely to help.
The budget office did have good news about the latest version’s fiscal impact: it would reduce federal budget deficits by a total of $420 billion over 10 years, about $100 billion more than an earlier version of the legislation. The change resulted mainly from the fact that Senate leaders decided to keep two taxes on high-income people that would have been eliminated by the previous version of the Senate bill.
The latest version of the Senate bill would increase average insurance premiums by 20 percent next year, the budget office estimate, but it would reduce premiums after 2019, so that in 2026 premiums for a typical “benchmark plan” would be 25 percent lower than under current law.
That is not all good news. One of the main reasons for the lower premiums is that the typical insurance plan would, according to the budget office, “pay for a smaller share of the total cost of covered benefits.” In other words, out-of-pocket expenses from deductibles and co-payments would grow.
Moreover, the budget office said, even though average premiums for a standard benchmark plan would decline after 2019, many older people would face substantial increases in premiums.
For example, it said, the net premium — after tax credits — for a midlevel “silver plan” for a 64-year-old person with annual income of $26,500 would be $5,500 a year in 2026, or more than three times the amount projected under current law.
In June, Senate Republican leaders rolled out a bill to repeal and replace the health law, hoping to finally deliver on their promise to dismantle the existing law. But since then, Mr. McConnell has come up short in trying to marshal the support to push a version of his legislation through the chamber.
This week, after his latest effort to pass a bill collapsed, Mr. McConnell laid out a new approach — repealing the health law without immediately providing a replacement — and pledged to hold a vote to begin debate on health care next week.
But on Wednesday, Mr. Trump urged senators to provide a replacement to go with a repeal of the health law, putting new life into the effort to revise Mr. McConnell’s bill that earlier in the week had seemed dead.