The House just passed the new health care bill to replace the Affordable Care Act. It’ll now move to the Senate, but it’s already gotten a lot of opposition, and rightfully so: it’s pretty awful and the Congressional Budget Office (CBO) didn’t even score it. Here’s what that means and why you should care.
The CBO is a federal agency that analyzes and estimates the impact of different pieces of legislation so that Congress can make an informed decision when they vote. It offers estimates of how much the bill will cost and who would be affected by it. The CBO did analyze the first version of the American Health Care Act back in March. But that version was so bad, Republicans gave up on it and made some changes, which is what the House voted on today. The problem is, there is no new CBO score for this updated bill.
It’s unusual to vote on a health care bill without knowing its CBO score, but here we are. Vox further explains why this is problematic:
It’s notable that we haven’t heard one member of Congress say, “I like the idea of this bill, but I’ll wait until we see the CBO score to make up my mind.”... There is not a CBO score that suggests this bill achieves House Republicans’ objectives. At this point, Republicans seem more concerned with moving something out of their chamber than they do with what that something is. That is a risky and potentially embarrassing move. The CBO score will come out sooner or later, and Republicans might be faced with defending a bill they don’t like much at all.
In short, they voted on and passed a bill that we don’t even know much about, which is kind of important considering the first version estimated that 14 million more people would be uninsured next year. It’s also worth noting that, while we don’t have anything from the CBO, some non-government entities have released their own analyses and found that the situation is pretty bleak. We’ve given you a breakdown of some of the most significant problems with it here. Still, it would be nice to know what the official estimates look like.
When asked about the importance of having a CBO score, Press Secretary Sean Spicer dismissed it, saying the CBO was “way, way off” back in 2010, when the CBO scored the Affordable Care Act. But that’s not really true.
While some estimates were off, like the number of people who would get policies through the exchange marketplace (the CBO estimated 23 million in 2016, the actual number was 10.4 million), their big picture predictions were pretty spot on. As factcheck.org put it, “the CBO actually nailed the overall impact of the law on the uninsured pretty closely.”
For example, the CBO predicted that people under the age of 65 who lacked insurance would drop to 30 million by 2016, and according to the data, that number was at 27.9 million last year.
With the original version of the AHCA, the CBO estimated that by 2026, 24 million more people would be uninsured. It also estimated that, over the next decade, federal deficits would be reduced by $337 billion, a big chunk of that coming from cuts to Medicaid. There’s no update on those figures, but we know the new bill calls for $880 billion in Medicaid cuts over the next decade. Overall, its outlook is pretty grim for health coverage. Paul Markovich, the chief executive of Blue Shield of California, said the AHCA “could return us to a time when people who were born with a birth defect or who became sick could not purchase or afford insurance.”