Insurance for everybody.

When President Donald Trump made that boast in January, in an interview with The Washington Post , nobody took it literally. But Trump had promised universal coverage many times before, suggesting, at the very least, he wanted to replace Obamacare with something that would provide better coverage to more people.

His allies said similar things. Just this past Sunday, Health and Human Services Secretary Tom Price vowed that even more people would have insurance if the repeal went through.

Mondays report by the Congressional Budget Office revealed that boast and seven years of similar Republican arguments to be fraudulent. It also called into question whether the GOPs real mission with repeal is to help people get health care or simply to shrink government programs, reduce taxes and protect the haves at the expense of the have-nots.

Everybody knew that the CBOs estimate of the American Health Care Act, which two House committees approved last week, would be dismal. Even before the report was out, Republicans had begun trying to discredit the agency, by pointing out past errors and arguing that mere coverage numbers didnt tell the real story about the Affordable Care Act or how Republicans proposed to supplant it.

But the CBO report was much worse than expected. The Republican bill would cut $880 billion from Medicaid over 10 years, steer federal tax credits away from lower-income consumers and undo some of the Affordable Care Acts changes to the insurance market including the individual mandate that imposes financial penalties on people who decline to get coverage.

Together, the CBO predicted, these changes would produce an immediate spike in the number of uninsured, with 14 million losing coverage in just the first year. The CBO went on to say that it expects premiums to come back down afterward, but the number of people without coverage would continue to rise eventually reaching 52 million in 2026, or 24 million more than what the CBO expects if the Affordable Care Act remains in place. In other words, the CBO thinks the number of uninsured would nearly double.

For all the talk about the CBO getting Obamacare wrong, its estimate on the total uninsured was off by only 20 percent. Even if the CBO is making a bigger error this time, and over-estimating the coverage loss from the Republican proposal by a quarter or more, the number of people who stand to lose insurance is still really high. As Sen. Lindsey Graham (R-S.C.) put it, If theyre half right, thatd still be a lot of people who are uninsured.

Grahams concern, which at least two other senators echoed on Monday, is a big political warning sign, because Republicans have only two votes to spare if they want repeal to pass the Senate. But the more important implications are human, not political.

Research has indicated that, as a result of the Affordable Care Act, Americans overall have better access to care and more financial security which is to say, people who need to get medical care are more likely to do so without going into financial distress. Those stories about people grateful for their coverage are real and emblematic of many more, even as others are legitimately aggrieved about what the law has done. With numbers like the CBO is predicting, that progress would be sure to unwind.

The Trump administration was in no mood to admit any of this and, shortly after the CBO report came out, Price issued a statement, We think that CBO simply has it wrong. Then, a mere few hours later, Politicos Paul Demko reported that an internal White House estimate actually predicted 26 million people would lose coverage. (The White House said its internal projection was merely an attempt to predict what the CBO would say, and not its actual view of what would happen particularly if the entire Republican agenda, including follow-up legislation, were to become law.)

Republicans also argued that people would lose coverage primarily because, without the individual mandate, theyd choose not to have coverage. In reality, the CBO predicted that some people would drop coverage voluntarily, without the mandate in place, but others would have to give it up because the exodus of healthy people from the rolls would drive up premiums.

And that would be only in the early years anyway. Later on, itd be higher premiums for older people and, mostly, cutbacks in Medicaid driving the big spike in the uninsured.