The CBO scores the Better Care Reconciliation Act of 2017

JUNE 26 — On Tuesday, the Congressional Budget Office released their preliminary report on the Senate’s health care bill to repeal and replace Obamacare, the Better Care Reconciliation Act. The report comes in a time of turmoil for Senate Republicans, who are currently divided on opinions of the bill, a rift which will likely determine its future when it arrives at the Senate floor for voting. Until then, let’s break down the CBO’s report:

  • The BCRA will reduce the cumulative federal deficit by $321 billion over the 2017-2026 period. This is $202 billion more than the estimated net savings of the House bill, which was passed in May.
  • “The Senate bill will increase the number of people who are uninsured by 22 million in 2026 relative to the number under current law, slightly fewer than the increase in the number of uninsured estimated for the House-passed legislation.” The CBO approximated that the number of uninsured would be 23 million more relative to current law for the American Health Care Act.
  • In terms of reducing the federal deficit, the largest savings would be derived from Medicaid. Spending on the program would decline by 26% in comparison to current law. This factor will contribute to reasons more people will opt out of buying health insurance in the future.
  • The largest increase in deficits would come from repealing or modifying tax provisions in the Affordable Care Act that are not directly related to health insurance coverage.
  • Under this legislation, the non-group insurance market would continue to be relatively stable. However, in certain locations, especially sparsely populated ones, insurers would choose not to participate in the non-group market. Alternatively, insurance would be offered with very high premiums.
  • In 2018 and 2019, premiums under the BCRA would be higher than they are under current law. This is primarily because the penalty for not having insurance, an addition of the ACA, would be eliminated, inducing fewer healthy people to sign up. In 2019, however, federal funding, as well as variations in the market, will begin a trend in the reduction of premiums.
  • In 2020, average premiums for single individuals would be about 30% lower than under current law but not for citizens who receive a lower income. Premiums and deductibles would generally be higher for this sector of the population, which will ultimately discourage them from purchasing insurance.
  • By 2026, premiums for single individuals would be approximately 20% lower than in the current law. Federal funding to reduce premiums would have lessened.
  • Out-of-pocket spending would be affected for people living in states modifying essential health benefits (EHBs) with waivers. People who utilized services or benefits no longer included in the EHBs would experience increases in premiums and out-of-pocket spending. Alternatively, they may choose to forgo those services to save costs.
  • Though states would not be able to eliminate the coverage of essential health benefits, through waivers, they could redefine what constitutes an essential health benefit. Enrollees could see increases in out-of-pocket spending because annual or lifetime limits would be allowed.

Over the next few weeks, these are the estimates that senators will be working with as they review the BCRA, and unfortunately, it appears that the people hurt the most by said estimates are those amongst us who have the greatest need.

For more information on the CBO and its scoring method, please feel free to refer to our article breaking down its score of the American Health Care Act: