On Monday the Congressional Budget Office (CBO) released its evaluation of the updated draft of the Better Care Reconciliation Act (BCRA) health care bill crafted by Senate Republicans. CBO estimates that 22 million more Americans would be uninsured, and federal spending would be reduced by $321 billion within the next decade.

Senate Republican leaders previously added a provision to the bill establishing an individual mandate to encourage maintenance of health insurance coverage. Both the ACA and the House-approved American Health Care Act (AHCA) include an individual mandate, but this item was absent in the original Senate draft bill.

Under the new BCRA continuous coverage mandate, starting in 2019, enrollees buying health insurance from the individual market must maintain coverage for at least a year in order to enroll again. If a person’s coverage lapses for more than 63 days, then they will be subjected to a six-month waiting period before being able to resume coverage. The continuous coverage mandate was rated as moderately effective by CBO, which anticipates that it would only slightly increase the number of insured individuals between 2018 and 2026.

The Senate vote on the BCRA has been postponed until after the Fourth of July. The BCRA requires 50 votes in order to pass.