Senate Majority Leader Mitch McConnell on Capitol Hill in Washington. Image: AP Images

The Senate’s health care bill proposal would mean 22 million fewer people would have health insurance, according to estimates from the Congressional Budget Office delivered on Monday. That projection is just about one million fewer than an earlier version of the bill passed by the House, which the Senate initially set out to drastically revamp, and which President Trump called “mean.”

The 49-page report from Congress’s nonpartisan budget oversight arm is likely to make it difficult for the bill to pass easily through the Senate, as GOP lawmakers had hoped it might perhaps as soon as this week.

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The CBO found that the proposal would save the government $321 billion over the next decade, largely due to $772 billion in Medicaid cuts. That’s $202 billion more than the savings anticipated from the House bill.

But in dismantling large parts of the Affordable Care Act, the Senate bill would increase the number of people who are uninsured by 22 million, leaving 49 million uninsured by the year 2026. Under the current law, the office estimated that number would instead be just 28 million.

In undermining the ACA, the Senate bill eliminates enforcement of the health care mandate, and replaces federal subsidies with smaller tax credits that will make it more difficult for older populations to access insurance. It also repeals many of the taxes that helped to pay for the ACA’s benefits.

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The new analysis could play a major role in determining whether this version of the bill gets passed: Several moderate GOP members have signaled that their decision on the bill will come down to how it will affect Americans who have gained coverage through the ACA.

With just a 52-seat majority, for the bill can pass, only two Republican senators can cast a nay vote against it to win the 50 votes necessary. So far, at least four have indicated they are undecided.