What the CBO score means for Republicans' health care bill

The Congressional Budget Office (CBO)'s analysts have given the evidence necessary for the House Freedom Caucus to gain substantial changes in the GOP House American Health Care Bill.  This also provides reasons for the GOP leadership to reduce or alter the CBO.

Though bipartisan, the CBO is an imprecise organization with an inherent liberal bias that colors its projections.

When analyzing Obamacare, the CBO estimated that 20 million would be on Obamacare this year, but only half that number are actually using the exchanges.  Further, of the approximately 20 million additional people with insurance, almost 15 million have been added via expanded Medicaid.  The federal cost estimates have been off by up to 50% also, as the CBO accepted faulty assumptions provided by MIT's Professor Jonathan Gruber.

The CBO has estimated that the GOP bill will result in 14 million fewer insured next year, 20 million fewer by 2020, and 24 million fewer insured individuals by 2026 compared to the existing law.  This means that fewer people will purchase Obamacare.  However, it does not guarantee that they will not buy other policies, if available.

The CBO conclusion makes sense under the predicates that the left would use.  If you stop the requirement (mandate) to purchase health insurance, then fewer people will buy it.

The CBO estimates a rise in insurance premiums of 15% in 2018 and 20% in 2019, which begins to decline by 2020.  It ignores the effect of tax credits upon the incentive to purchase private coverage.  It totally misses the fact that with high deductibles and limited acceptance by providers, many policy holders do not have effective health insurance coverage.

The CBO does recognize a savings of $337 billion over ten years through this plan, but this number may be low.  Projections of such activity are rarely accurate so far out.  Few programs created by the federal government have come in at the level originally estimated.  Just examine Medicare, Medicaid, and Social Security, for instance.  Additionally, none of these programs operates exactly as planned, nor are they free of corruption and misuse.

Clearly, the GOP leadership will be forced to sunset the Medicaid expansion sooner than 2020.  The bill will have to limit the tax credits for private purchase to those who actually pay federal income taxes, reducing the entitlement.  Further, Republicans may have to find a way to insert the ability to purchase across state lines in this bill.  The bill will not become law in its present state.

The aim has been to get this done through reconciliation, which limits provisions of the law.  The Senate parliamentarian has power to rule on items, but there is some ability for the president of the Senate to ignore these rulings.  Alternately, there are calls for the Senate to end the filibuster, but this is problematic for the future, when Democrats might be in control.

Betsy McCaughey, the former lieutenant governor of New York, responsible for the intellectual arguments that helped defeat Hillarycare in the 1990s has analyzed the GOP bill.  She also gave an accurate analysis of Obamacare.  She did advise candidate Donald Trump, so she is not unbiased.  She finds this bill to be an improvement over Obamacare in many ways.  There is room for improvement.

Her views on this bill follow:

First, it removes many (but not all) of the taxes imposed, which will allow greater consumer choices.  Second, it is a jobs bill in that the removal of the business mandate will allow small companies to expand their hiring of full-time employees.  Third, the tax credits will allow many to purchase private policies they desire.  The regulatory management must be reduced to encourage this. 

McCaughey does have concerns that the continuation of similar premiums despite increased risks will moderate the premium cost containment.  Under this plan, the government can supplement the losses of the insurers.

Fourth, the Medicaid containment through block-granting allows reduction of cost increases.  It also allows more innovation.  Finally, the loss of insured numbers is wrong in McCaughey's view, since the GOP grandfathers those on Medicaid for several years.

Paul Ryan has put a positive spin on the CBO scoring, but there will be calls for amendments to the bill.  There is a political balancing act between moderate Republicans who want to soften the effect of change and conservatives seeking total repeal of Obamacare.  A middle ground will now move toward the conservatives.  Donald Trump is anxious for a deal and will compromise, bringing the House leadership along.  The CBO scoring gives Trump leverage in this regard.

For years, the Republicans have promised repeal of Obamacare.  That was easy to deliver when Obama could veto the legislation.  Now that the health care law is failing due to high deductibles and premiums and less insurance company participation, a solution is critically needed.  However, no one wants to own this problem.

Failure to act quickly will doom the private health care system.  Then the Democrats are victorious as they seek governmental control of health care.  It is time to find common ground between Republicans, since no Democrats will help.  Our nation awaits brave statesmen.

The Congressional Budget Office (CBO)'s analysts have given the evidence necessary for the House Freedom Caucus to gain substantial changes in the GOP House American Health Care Bill.  This also provides reasons for the GOP leadership to reduce or alter the CBO.

Though bipartisan, the CBO is an imprecise organization with an inherent liberal bias that colors its projections.

When analyzing Obamacare, the CBO estimated that 20 million would be on Obamacare this year, but only half that number are actually using the exchanges.  Further, of the approximately 20 million additional people with insurance, almost 15 million have been added via expanded Medicaid.  The federal cost estimates have been off by up to 50% also, as the CBO accepted faulty assumptions provided by MIT's Professor Jonathan Gruber.

The CBO has estimated that the GOP bill will result in 14 million fewer insured next year, 20 million fewer by 2020, and 24 million fewer insured individuals by 2026 compared to the existing law.  This means that fewer people will purchase Obamacare.  However, it does not guarantee that they will not buy other policies, if available.

The CBO conclusion makes sense under the predicates that the left would use.  If you stop the requirement (mandate) to purchase health insurance, then fewer people will buy it.

The CBO estimates a rise in insurance premiums of 15% in 2018 and 20% in 2019, which begins to decline by 2020.  It ignores the effect of tax credits upon the incentive to purchase private coverage.  It totally misses the fact that with high deductibles and limited acceptance by providers, many policy holders do not have effective health insurance coverage.

The CBO does recognize a savings of $337 billion over ten years through this plan, but this number may be low.  Projections of such activity are rarely accurate so far out.  Few programs created by the federal government have come in at the level originally estimated.  Just examine Medicare, Medicaid, and Social Security, for instance.  Additionally, none of these programs operates exactly as planned, nor are they free of corruption and misuse.

Clearly, the GOP leadership will be forced to sunset the Medicaid expansion sooner than 2020.  The bill will have to limit the tax credits for private purchase to those who actually pay federal income taxes, reducing the entitlement.  Further, Republicans may have to find a way to insert the ability to purchase across state lines in this bill.  The bill will not become law in its present state.

The aim has been to get this done through reconciliation, which limits provisions of the law.  The Senate parliamentarian has power to rule on items, but there is some ability for the president of the Senate to ignore these rulings.  Alternately, there are calls for the Senate to end the filibuster, but this is problematic for the future, when Democrats might be in control.

Betsy McCaughey, the former lieutenant governor of New York, responsible for the intellectual arguments that helped defeat Hillarycare in the 1990s has analyzed the GOP bill.  She also gave an accurate analysis of Obamacare.  She did advise candidate Donald Trump, so she is not unbiased.  She finds this bill to be an improvement over Obamacare in many ways.  There is room for improvement.

Her views on this bill follow:

First, it removes many (but not all) of the taxes imposed, which will allow greater consumer choices.  Second, it is a jobs bill in that the removal of the business mandate will allow small companies to expand their hiring of full-time employees.  Third, the tax credits will allow many to purchase private policies they desire.  The regulatory management must be reduced to encourage this. 

McCaughey does have concerns that the continuation of similar premiums despite increased risks will moderate the premium cost containment.  Under this plan, the government can supplement the losses of the insurers.

Fourth, the Medicaid containment through block-granting allows reduction of cost increases.  It also allows more innovation.  Finally, the loss of insured numbers is wrong in McCaughey's view, since the GOP grandfathers those on Medicaid for several years.

Paul Ryan has put a positive spin on the CBO scoring, but there will be calls for amendments to the bill.  There is a political balancing act between moderate Republicans who want to soften the effect of change and conservatives seeking total repeal of Obamacare.  A middle ground will now move toward the conservatives.  Donald Trump is anxious for a deal and will compromise, bringing the House leadership along.  The CBO scoring gives Trump leverage in this regard.

For years, the Republicans have promised repeal of Obamacare.  That was easy to deliver when Obama could veto the legislation.  Now that the health care law is failing due to high deductibles and premiums and less insurance company participation, a solution is critically needed.  However, no one wants to own this problem.

Failure to act quickly will doom the private health care system.  Then the Democrats are victorious as they seek governmental control of health care.  It is time to find common ground between Republicans, since no Democrats will help.  Our nation awaits brave statesmen.

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