"The one thing I'm certain will happen is CBO will say, well, gosh, not as many people will get coverage. You know why? Because this isn't a government mandate," Ryan told ABC's John Dickerson. "You get it if you want it. That's freedom."
"How many people are going to lose coverage?" Dickerson asked.
"I can't answer that question. It's up to people," Ryan said. "People are going to do what they want to do with their lives."
Q: How many will lose coverage under GOP health plan?
Paul Ryan: “I can't answer that question. It's up to people.”pic.twitter.com/hqgWoSfDIE
— Bradd Jaffy (@BraddJaffy) March 12, 2017
Ryan agreed with President Donald Trump's characterization that the 2018 midterm elections will be a "bloodbath" for Republicans if they don't pass the bill.
“I do believe that if we don't keep our word to the people who sent us here, yeah,” Ryan said.
On Friday, Ryan said the Congressional Budget Office will likely estimate that millions of people would lose health insurance under the American Health Care Act.
"Our goal is not to show a pretty piece of paper that says, ‘We’re mandating great things for Americans,'" he said. "We always know, you’re never going to win a coverage beauty contest when it’s free market versus government mandates."
Secretary of Health and Human Services Tom Price nevertheless said on Sunday that he thinks coverage is "going to go up" after the repeal, dismissing a report from the Brookings Institute estimating that at least 15 million people will lose coverage under the bill.
"I believe, again, that we’ll have more individuals covered," he said. "I firmly believe that nobody will be worse off financially in the process that we’re going through."