Health Care Industry Anticipates CBO Score For House-Approved Bill

Two former directors of the non-partisan agency give their perspective on why the report matters.

The Republicans' first legislative effort was pulled from the House floor for lack of support only minutes before a scheduled vote in March.

The Congressional Budget Office, the nonpartisan group that analyzes the potential impacts of legislation in Congress, released its new report on the legislation previously passed by the GOP-controlled House of Representatives.

The CBO's report also found that that some state markets could be destabilized, meaning it would be more costly for sicker people to purchase insurance; the options they could afford are so barebones that the CBO doesn't even consider them as insured.

Imagine this ad running against and endangered House Republican who voted for the AHCA: "Congressman X voted for Donald Trump's health care plan before he even knew what the bill would do".

That was sharply different from Republican House Speaker Paul Ryan's take.

The CBO is an important political tool for both sides in the health-care debate, since it puts real numbers to a complicated bill.

The House bill would reduce taxes by around $1 trillion over the coming decade, the budget office said, largely on higher income people and health care industry firms.

The budget office projected that premiums in those states would be lower for healthy people than under current law because their coverage would be narrower, but did not estimate an amount. And that really hurt that bill's chances.

The newer version of the American Health Care Act managed to pass in the House without those voting ever having seen the revised CBO estimate, which is akin to a surgeon closing his eyes and hoping he removes a tumor, and not your stomach.

Hospitals could lose significant revenue because far fewer people will have insurance and insurers are anxious about the affordability of the tax structure and proposed major changes in Medicaid financing.

"Average premiums for insurance purchased individually - that is, nongroup insurance - would be lower, in part because the insurance, on average, would pay for a smaller proportion of health care costs", the CBO said.

Kliff: I don't I'm feeling very great because this just isn't a good report for Republicans.

Fiscal conservatives in the Senate, where the House bill is expected to undergo major changes, are likely to embrace that figure as they begin negotiations on the legislation.

Watch for: How preexisting conditions exacerbate this.

In March, the budget office said the House legislation would increase premiums by an average 15 percent to 20 percent over the next two years, but push premiums 10 percent lower than they'd otherwise be by 2026. But insurance policies are cheaper because, on average, they would provide less benefits, the report said.

Older people with an annual income of $75,000 or more would get fewer to no subsidies under the Republican bill.

To qualify, an individual must get insurance through the HealthConnector and have a household income up to 400 percent of the federal poverty level. In 2018, 14 million more people would be uninsured if the bill became law.

The legislation would reduce the federal deficit by $119 billion over 10 years.

No Democrats voted for the plan to replace the Affordable Care Act, and they slammed their Republican counterparts for voting on the legislation before the analysis was completed. Within hours of the House passing the controversial repeal and replace bill, Republican senators announced that they wouldn't vote on the House bill, but would instead start from scratch on their own bill.

Watch for: Why this deficit goes down.

The largest increases in the deficit would come from repealing or modifying tax provisions in the ACA that are not directly related to health insurance coverage-such as repealing a surtax on net investment income, repealing annual fees imposed on health insurers, and reducing the income threshold for determining the tax deduction for medical expenses.

  • Larry Hoffman