COEUR d’ALENE — The number of people without health insurance could reach the tens of millions in just a few years if a Republican plan to replace the Affordable Care Act is implemented, according to the Congressional Budget Office.

That kind of stress could put further pressure on many hospitals struggling already, said Jon Ness, CEO of Kootenai Health.

“It would be in the best interest of all Americans for our national leaders to slow down and develop a thoughtful and balanced plan to move us forward,” Ness said in an emailed statement. “Over 50 percent of hospitals in 2016 didn’t make a profit. Taking away coverage from millions of patients will increase financial instability and place a large burden on emergency departments. This will be especially felt at community-owned hospitals like Kootenai, who will care for these patients regardless of their ability to pay.”

The uninsured estimate comes from the Congressional Budget Office — a nonpartisan group of economic and budgetary analysts who estimate the fiscal impact of proposed legislation — in a report released Monday that details the possible effects of the American Health Care Act. The act, introduced by House Republicans last week, focuses on budgetary changes and is the beginning of the GOP’s three-part plan to replace the Affordable Care Act.

The head of Heritage Health in Coeur d’Alene, CEO Mike Baker, wanted to steer clear of controversial waters, but emphasized the need for a sensible approach moving forward.

“We don’t want to weigh in on the politics,” Baker said. “What we need is good health care policy that provides access to primary care. Any step backward is a huge challenge.”

Included in the report is an analysis of how passage of the American Health Care Act would impact the number of uninsured individuals, in comparison to the numbers should the Affordable Care act remain in place.

If the bill passes, the Congressional Budget Office estimates 14 million more people would be uninsured by 2018.

“That increase would consist of about 6 million fewer people with coverage obtained in the nongroup market, roughly 5 million fewer people with coverage under Medicaid, and about 2 million fewer people with employment based coverage,” the report states.

By 2026, according to the report, an estimated 52 million people would be uninsured. If the Affordable Care Act were to remain law, however, the number of uninsured people in the same year is estimated to be 28 million people.

Baker told The Press unlike Washington and some other states, Idaho did not choose to expand Medicaid access for its citizens, which means Idaho could see a smaller increase in uninsured if the bill is adopted and those expansions are repealed. But, he added, the state already has a high pool of uninsured residents. In 2016, 10,000 of Heritage Health’s 30,000 patients had no health insurance.

“Any increase beyond what we have now is going to be detrimental to everyone’s ability to provide health care,” Baker added.

The Congressional Budget Office report also estimates passing the American Health Care Act would reduce federal deficits by $337 billion over a 10-year period. Reductions in Medicaid spending and from elimination of the Affordable Care Act’s subsidies for nongroup health insurance would, according to the report, account for the largest savings.