A pair of senators who also happen to be doctors delivered their prognosis on Obamacare Tuesday, concluding the outlook is “not so good.”

In a new report obtained by The Daily Caller, “Prognosis: Outlook Not So Good,” Oklahoma Sen. Tom Coburn and Wyoming Sen John Barrasso, both medical doctors, give the president’s signature health-care law a check up.

“For millions of Americans, Obamacare itself has become a pre-existing condition that has limited their access to quality, affordable health care. As we warned in our previous reports, Obamacare is fundamentally flawed,” Coburn said Tuesday. “The law strengthens the hand of government and weakens the hand of doctors and patients. Obamacare is cutting choices, not costs, and costs will likely continue to rise.”

The senators’ report chronicles the myriad problems with the the law and follow the pair’s previous three reports in 2010 and 2012 about the law’s potential impact. According to Coburn and Barrasso, the problems with Obamacare were “foreseeable and preventable,” and that they warned about the things that are happening today.

“As physicians, we support real health reform that lowers costs and increases access to high quality health care,” they write. “Many of the policies within the ACA increase costs and lower the quality of health care. Despite President Obama’s efforts to delay the negative impacts of the law, Americans are already feeling its effect — and the majority of Americans continue to disapprove of the law.”

In their report, the pair go through each of their past predictions and conclude, for the most part that their initial expectations were accurate or continuing to develop.

• “We warned millions of Americans could lose their health insurance plans.”
• “We warned the law’s new mandates would increase health costs.”
• “We warned 16 million Americans would be forced into Medicaid.”
• “We warned short-term fixes threaten seniors’ long-term access to care.”
• “We warned patients with pre-existing conditions still face care restrictions.”
• “We warned the individual mandate will fail with the IRS as the enforcer.”
• “We warned a new IRS tax would harm small businesses.”
• “We warned the ‘employer mandate’ would lower incomes and result in hundreds of thousands of jobs being lost.”
• “We warned the law included a risky insurance scheme that would cost taxpayers.”
• “We warned the law includes hundreds of billions of dollars of tax hikes.”
• “We warned the new insurance cooperatives would waste taxpayer dollars.”
• “We warned the medical device tax would stifle innovation.”
• “Patient-Centered Outcomes Research Institute could be used to deny payments.”

According to Barrasso the report again shows the problems with the law, which he says should be repealed and replaced “with step by step reform that focuses on care instead of coverage.”

“As doctors, we know that Americans should be in charge of their own healthcare decisions — not Washington,” he said. “Over the past four years, we’ve highlighted the negative side effects of the healthcare law for patients, providers and taxpayers. Our new report confirms again exactly how Americans across the country are losing their insurance plan, watching their costs increase, and paying higher taxes.”