CBO score to be released Wednesday could make or break AHCA

A financial analysis of the American Health Care Act, slated to be released Wednesday by the Congressional Budget Office, could decide the fate of the bill in its current form — and if it continues on to the Senate or returns to the House to be reworked.

House Speaker Paul Ryan, R-Wis., told reporters he is confident the AHCA will meet the mark to be considered under a special budget reconciliation process in the Senate, according to a report from Bloomberg Politics. The CBO score will be instrumental in gauging if the bill meets those requirements.

Here are three things to know about what could happen to the AHCA based on the CBO score.

1. The bill must reduce the federal deficit by at least $2 billion over 10 years to meet budget reconciliation requirements, according to Bloomberg Politics. If the CBO finds this is not the case, the bill will return to the House. If the CBO finds the AHCA will reduce the deficit by at least $2 billion, the bill must also meet additional requirements to be considered under reconciliation, including restrictions on non-budgetary provisions or provisions with little fiscal impact. The last CBO score of the bill released in late March estimated it would reduce the federal deficit by $150 billion over the next decade.

2. The new CBO estimate is hotly anticipated because last-minute amendments to the AHCA could reverse its effect so the bill instead adds to the deficit. The biggest change was the addition of a waiver program, laid out in the MacArthur amendment. This amendment would allow states to seek federal waivers to opt out of the ACA's essential health benefits requirement and its community rating rule, which bars insurers from charging more based on beneficiary age, gender and health status.

An estimate from the Committee for a Responsible Federal Budget projected that the MacArthur amendment alone could add between $30 billion to $300 billion in costs based on how many states file for waivers. The CRFB projection suggests every 1 million additional enrollees would increase the cost of the AHCA by about $30 billion over 10 years. If only 1 million more people enroll, the AHCA more than meets reconciliation requirements. However, if 5 million more people enroll, it would cost $150 billion, potentially jeopardizing the fate of the bill.

3. Many are awaiting the CBO's estimates on what will happen to insurance coverage, according to Bloomberg. Previous estimates of the AHCA projected 14 million people would lose health insurance in the first year and up to 24 million would lose coverage by 2026. While potential coverage increases or decreases have no effect on the budget reconciliation process, coverage numbers hold a lot of weight politically.

 

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