CBO Releases Score For House-Approved American Health Care Act

May 24, 2017
Originally published on May 26, 2017 11:20 am
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AUDIE CORNISH, HOST:

We now have a score of the health care bill recently passed by House Republicans. That's what the analysis from the nonpartisan Congressional Budget Office is called. Economists have estimated how much the bill will cost and how many Americans it's expected to cover. NPR congressional correspondent Susan Davis has read the report. She joins us now to talk about those numbers and what they mean as the bill heads to the Senate. And Susan, to start, what does the CBO say the budget impact would be if this House bill actually became law?

SUSAN DAVIS, BYLINE: Well, the first news that I think will be good news for Republicans is that it saves money. It says that it would reduce the federal deficit by about $120 billion over the next 10 years. The original forecast on the bill earlier this year said that it would leave 24 million fewer Americans insured over that same period of time, that 10-year period. This report is slightly better. It estimates only 23 million fewer Americans will be insured over the next decade. And it also forecasts that premiums on the individual market would be lower.

Now, the caveat of course, Audie, is they say premiums would be lower because of the changes Republicans made to the bill that would give states options to get waivers from the current law mandates on what insurance plans have to cover as well as how pre-existing conditions are covered.

CORNISH: Let's talk more about pre-existing conditions. How will they be affected according to this report?

DAVIS: Audie, I think this is one of the most notable parts of this update and something that we're going to be hearing a lot more about. Republicans said the changes they were making to the bill would not hurt people with pre-existing conditions or their access to coverage. Their argument is that their plan would give states more flexibility, and they included more money in what they were calling stability funds to help people buy those premiums if they needed to. CBO says very clearly that's not the case. In this report, it states that premiums for up to one-sixth of the people in the individual market could see their premiums go up, and they wouldn't be able to afford them.

In the very nerdy, wonky CBO language, they say, quote, "instability would cause some people who have been insured under current law to be uninsured." Now, the pre-existing condition protections are arguably the most popular part of Obamacare, and Republicans campaigned on keeping those protections in place. So if this is seen as an effort to weaken them, this is an area where I think we could see a huge backlash, at least politically.

CORNISH: When it comes to the politics, I know the CBO has been a bit of a political football for lawmakers. How are they reacting to the report?

DAVIS: You know, it doesn't really shift the debate. This is, as you know, one of the most partisan debates on Capitol Hill about this health care bill. You know, there's a lot of fodder in here for Democrats to continue to oppose the legislation. Republicans have been largely dismissive of it. They note that in the past, CBO forecasts have been wrong, and many of them think they'll be wrong again. For - that 23 million fewer insured, you know, Republicans will say that's because the repealing the individual mandate. And that is what they promised to do.

Their argument is that fewer people will have to buy something they don't want in the first place. House Speaker Paul Ryan put out a statement on it, and he said that the bill accomplishes their mission. And the mission as he defines it is, quote, "lowering premiums and lowering the deficit." And if that is Republicans' goal this bill does that.

CORNISH: And in the meantime, what does this mean for the Senate? They're still writing their version of the bill.

DAVIS: You know, Senate Majority Leader Mitch McConnell gave an interview to Reuters today in which he said he does not know yet how he's going to get to 50 votes. We don't know a lot about what's happening in the Senate because it's all happening behind closed doors. There's a 13-member Republican working group. They're meeting at least twice a week in private to try and craft a bill that can pass the Senate. We don't know what that bill's going to look like, but the goal is to try and have a bill and to pass it by the August recess. We do know that senators do not see the House bill as where they need to go and are going to write their own very different bill.

CORNISH: NPR congressional correspondent Susan Davis. Thanks so much.

DAVIS: Thank you, Audie. Transcript provided by NPR, Copyright NPR.