House Speaker Paul Ryan isn’t planning to make any major changes to Republicans’ Obamacare-replacement plan despite a politically difficult estimate of its effect on health coverage. “It is clear that this bill is not consistent with the repeal and replace principles for which I stand,” Representative Rob Wittman, a Virginia Republican, said in a statement. In addition to decreasing coverage, insurance premiums will continue to rise in the near term and will only fall later. The long-term picture also poses political risk to Republicans. The number of Americans without coverage would rise to 24 million in 2026 under the plan, bringing the U.S. uninsured rate to a record 19 percent. Senator Susan Collins, a Republican from Maine, said the CBO “estimate that millions of Americans could lose their health insurance coverage if the House bill were to become law is cause for alarm.