<Li> Ongoing insistence, despite CBO assertions to the contrary, that the exchanges are unstable or in a "death spiral". </Li> <Ul> <Li> Social Security expenditures would decrease due to earlier mortality: "CBO also estimates that outlays for Social Security benefits would decrease by about $3 billion over the 2017--2026 period ." </Li> <Li> Medicaid expenditures would increase due to reduced access to birth control . "By CBO's estimates, in the one - year period in which federal funds for Planned Parenthood would be prohibited under the legislation, the number of births in the Medicaid program would increase by several thousand, increasing direct spending for Medicaid by $21 million in 2017 and by $77 million over the 2017--2026 period ." </Li> <Li> Two reports from the Center for Budget and Policy Priorities concluded that the ACHA would have shifted $370 billion in Medicaid costs to the states, which would have then be forced to cut coverage and services, and would make health insurance far less affordable in high - cost states, particularly 11 states in which tax credit would have been more the halved . </Li> <Li> Every year one in 830 uninsured Americans die in a way which could have been prevented with better health care . A Congressional Budget Office report suggests an extra 16 million people would be left uninsured leading to 19,277 preventable deaths . Other uninsured people would develop painful chronic conditions or permanent disabilities which could have been prevented with health insurance . </Li> </Ul> <Li> Social Security expenditures would decrease due to earlier mortality: "CBO also estimates that outlays for Social Security benefits would decrease by about $3 billion over the 2017--2026 period ." </Li> <Li> Medicaid expenditures would increase due to reduced access to birth control . "By CBO's estimates, in the one - year period in which federal funds for Planned Parenthood would be prohibited under the legislation, the number of births in the Medicaid program would increase by several thousand, increasing direct spending for Medicaid by $21 million in 2017 and by $77 million over the 2017--2026 period ." </Li>

Who voted for the american health care act