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Trumpcare’s Biggest Uncertainty: Its Economic Impact

The official government weighers have weighed in. Yesterday, the Congressional Budget Office and the staff of the Joint Committee on Taxation released their estimate of the financial impact of the Republican plan to replace Obamacare—and what an impact it has! (Or may have!)

(Or who knows?)

On the plus side, the CBO/JCT says the “legislation would reduce federal deficits by $337 billion over the 2017-2026 period”—though most of that savings would come from proposed cuts to Medicaid and from nixing certain subsidies that taxpayers now receive with Obamacare.

On the (more) negative side, the plan, if enacted, would cause an additional 14 million Americans to lose their health insurance by next year, relative to current law—and push that figure up to 24 million by 2026—the government accountants said.

On the side that’s somewhere in the middle—think of it as the Möbius strip portion of the legislation—premiums would go up for a few years (until 2020), then go down.

But mostly, the government bean counters said, the effects of the GOP’s American Health Care Act are on the undecided side. “The ways in which federal agencies, states, insurers, employers, individuals, doctors, hospitals, and other affected parties would respond to the changes made by the legislation are all difficult to predict,” they wrote—as is the plan’s larger impact on the economy. “Because of the very short time available to prepare this cost estimate,” the agencies continued, “quantifying and incorporating those macroeconomic effects have not been practicable.”

Naturally, politicians on both sides of the aisle have jumped to highlight the stats that feed the narratives they’re selling.

What few seem to be emphasizing, though, is the most compelling takeaway of the CBO/JCT report, in my view: that no one quite knows what impact Trumpcare would have were it to become the law of the land. (The government’s financial arbiters use the word “uncertain,” or a form of it, 10 times in their 37-page report.) Which means that rushing the bills through the reconciliation process—a legislative E-ZPass lane that sharply limits debate and vetting—is an exercise in recklessness, if not outright cynicism.

The Republicans control the White House and both chambers of Congress. They’ve earned the right to craft policy for the nation. But when that policy has the power to radically change the lives of tens of millions of Americans—and in ways that no one can fairly predict—it makes good honest sense to air it out a bit before turning it into law, doesn’t it?

Just a thought, anyway.

This essay appears in today’s edition of the Fortune Brainstorm Health Daily. Get it delivered straight to your inbox.