An obscure U.S. agency, the Congressional Budget Office, has been thrust into the midst of the contentious Washington political debate over the fate of the country’s health care policies.

Many Americans outside of official Washington likely have never heard of the 42-year-old agency, a group of about 235 non-partisan budget analysts and economists with advanced university degrees.

But the CBO has emerged as a key stumbling block in the path of President Donald Trump and congressional Republicans as they try to repeal and replace the national health care reforms championed by former president Barack Obama, a law popularly known as Obamacare.

The CBO regularly turns out apolitical reports analyzing budgetary and economic issues facing Congress as it considers what programs to approve, how much they would cost in coming years and what effects they might have on U.S. economic fortunes and the country’s 325 million citizens. Depending on its findings, both Republican and Democratic lawmakers have over the years praised or attacked its findings.

It was in this analysis role that the CBO concluded Monday that 24 million Americans would lose their health insurance by 2026 if Trump and his Republican colleagues in Congress are successful in overturning the seven-year-old Affordable Care Act that was Obama’s signature legislative achievement.

Thrown into doubt

The CBO concluded that the government would save $337 billion with passage of the Republican plan, but it was the possibility of the loss of insurance for millions of Americans that drew the most attention. Trump, in his long run to the White House, had promised “insurance for everybody,” but the CBO conclusion threw that vow in doubt.

Key Trump administration officials, including Health and Human Services chief Tom Price and budget director Mick Mulvaney, immediately assailed the CBO conclusion, even though Republican congressional leaders had two years ago hand-picked Keith Hall, a conservative-leaning economist, as the CBO director.

At the time, Price said Hall’s “vast understanding of economic and labor market policy will be invaluable to the work of CBO and the important role it will continue to play as Congress seeks to enact policies that support a healthy and growing economy.”

On Monday, Price quickly rebuffed the agency’s analysis of the Republican repeal effort.

“The CBO report’s [insurance] coverage numbers defy logic,” he said, adding that the review did not cover all aspects of the proposed Republican changes in the law.

‘Just absurd’

Mulvaney declared the report “just absurd.”

CBO reports are often considered as independent and divorced from the often contentious political fights in Washington over the latest legislative proposals. But even before the CBO report was released late Monday, the White House had sought to undercut what it expected would be an adverse conclusion about its efforts to overturn Obamacare.

Trump spokesman Sean Spicer said last week that the CBO had greatly over-estimated the number of Americans who would buy insurance under Obamacare.

“If you’re looking to the CBO for accuracy, you’re looking in the wrong place,” Spicer contended.

Meanwhile, opposition Democrats called the CBO finding about millions of Americans losing their health insurance coverage under the Republican plan a signal for the Trump administration and its supporters in Congress to abandon their repeal effort.

“The Republicans’ own hand-picked CBO director confirmed what Democrats have said all along,” said Senate Minority Leader Charles Schumer. “Trumpcare would be a nightmare for the American people, causing tens of millions to lose coverage.”

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