Reading the BCRA CBO Score

The Congressional Budget Office is due to release their score on the Senate’s BCRA bill at some point today. Here are a few things to remember as you read the score.

  • Look at the effects at 10 years and beyond
    • The bill is designed to push the Medicaid cut backs to the right hand side of the budget window and then accelerate those cuts compared to the AHCA.
    • Senator Murphy (D-CT) has asked and received assurance that the CBO will score coverage losses past 10 years
    • I think that topline coverage losses will be a bit less from Medicaid in window but match AHCA within two years out of window
  • Is the 6 month auto-denial period being scored?
    • This is the Senate Republican replacement of the individual mandate
    • It was not written into the bill released on Thursday
    • If CBO scores it how do they score it against both the individual mandate and the 30% single year premium bump.  The CBO thinks the individual mandate is reasonably effective at keeping healthier people in the pool while the 30% premium bump is an adverse selection magnet.
  • What are they projecting with the 1332 waivers on steroids
    • Current law places strong guidelines on approval of state waivers.  States must meet or beat default ACA on coverage, actuarial value, benefits and cost.
    • Senate BCRA only requires a 1332 waiver to beat default coverage on federal cost.
    • These make the MacArthur/Upton amendments simple modeling exercises
    • How do they project market functionality in extreme 1332 states?

 

 






23 replies
  1. 1
    JPL says:

    Senator Murphy (D-CT) has asked and received assurance that the CBO will score coverage losses past 10 years

    Good!

  2. 2
    ThresherK says:

    @JPL: Both Murphy and Blumenthal are doing that whole governance thing. I know it’s a bit out of fashion, but we like them that way.

    Kitting out an old Windows laptop with Ubuntu for Spousal ThresherK. Let’s see how it goes. (It’s much nicer than her current “old Windows laptop husband setup with a Linux”.)

  3. 3
    raven says:

    Someone on Joe said that the CBO score would not be released today?

  4. 4
    Ohio Mom says:

    Does anyone doubt that with the provision that if you miss a payment, you are uninsured for six months, that insurance companies will start to misplace an awful lot of checks from people say, in the middle of chemo? Other games will be played with payments made online. They are more creative than I am.

    I’m thinking the USPO might be looking at a bonanza in certified mail receipts.

  5. 5
    D58826 says:

    The GOP could pass a bill making ALL medical ins. in the country illegal and 48 Goopers in the Senate would have an orgasm when voting Yes. The usual 4 suspects would have ‘concerns’ and then vote for it. Kellyanne would go on TV and say black is white, the earth is flat and no one will lose coverage. Her comments will be treated by the VSP as serious analysis. And on election day in 2018 the GOP will pick up half doz. Senate seats.
    Same analysis but slightly different numbers for the House. Same result in 2018.

    And it doesn’t really matter if Kennedy retires today. Given the ages of some of the justices Der Fuhrer will get to pick 2-3 more judges between now and 2020. And he is busy moving the district and circuit courts hard right. If Der Fuhrer is removed from office the Pence choices would be just as bad. It isn’t a question of will the independent judiciary die, just a question of how soon.

  6. 6
    MomSense says:

    So one of the most vocal Republicans against the AHCA BCRAp bills is Gov. Kasich. His website was hacked.

  7. 7
    zhena gogolia says:

    @ThresherK:

    Those are my Senators. I’m gonna ask if we can secede.

  8. 8
    Morzer says:

    @Ohio Mom:

    Does anyone doubt that with the provision that if you miss a payment, you are uninsured for six months, that insurance companies will start to misplace an awful lot of checks from people say, in the middle of chemo?

    I wouldn’t be surprised to see active forgery of the sort that the banks indulged in when swindling people out of their homes and savings.

  9. 9
    cmorenc says:

    @D58826:

    And it doesn’t really matter if Kennedy retires today. Given the ages of some of the justices Der Fuhrer will get to pick 2-3 more judges between now and 2020. And he is busy moving the district and circuit courts hard right. If Der Fuhrer is removed from office the Pence choices would be just as bad. It isn’t a question of will the independent judiciary die, just a question of how soon.

    With a majority block of SCOTUS members of the same mindset as the four who were ready to rule Obama’s ACA act unconstitutional from the get-go, it may not matter whether the ACA gets repealed or not, or the horrific GOP replacement plan gets passed – the new majority will set about destroying the legal foundation upon which the federal government can implement any feasible health-care plan that doesn’t amount to an entirely federal Medicare-for-all plan. And to the extent the new majority is intent on rolling back constitutional law to pre-New Deal status, and tearing the foundation out from underneath every progressive accomplishment since FDR and the New Deal, even Medicare isn’t safe from hard-right ideologues who enjoy the comfort of generous, secure private health insurance themselves.

    A hard-right SCOTUS can become the protector of GOP congressional majorities against public outrage, since SCOTUS won’t let them do what they don’t want to do anyway.

  10. 10
    But her emails!!! says:

    @zhena gogolia:

    Those are my Senators. I’m gonna ask if we can secede.

    Nah. That’s a sucker’s bet. The goal should be to get them to kick the entire Northeast out of the union along with the West Coast in exchange for a cash payment and tax breaks on existing and future Trump properties in those states. Secession just leads to piles of burning, radioactive rubble.

  11. 11
    JMG says:

    @cmorenc: The next Democratic President with a Democratic Congress should make it clear the Court will be packed to reverse its theft by McConnell. There are no more norms in American politics, and if the poli sci scholars feel bad about that, tough. When we have the votes use ’em. Look, if people are going to vote their tribal (polite word for racial) identity over their own health, there’s nothing anyone can do and we will complete our spiral into a Third World nation with endemic political violence and state suppression of dissidents in short order. But I doubt that will happen in unanimity. Won’t take many switchers.

  12. 12
    🌎 🇺🇸 Goku (aka Junior G-Man) 🗳 🌷 says:

    @JMG: But remember, they’re the Real Americans! My god, I got to get out of this country

  13. 13
    D58826 says:

    @cmorenc: shorter version – Lochner era 1897-1937
    Here is wiki but lots of other stuff on Google. Only changed after FDR’s ill advised threat to pack the court. Gave rise the the saying ‘switch in time saved 9’

    https://en.wikipedia.org/wiki/Lochner_era

  14. 14
    D58826 says:

    OT but a couple of things on our endless war.

    WASHINGTON (AP) – Marine Gen. Joseph Dunford has arrived in Afghanistan to weigh next military options, meet with coalition leaders.

    https://twitter.com/ZekeJMiller/status/879308855238430722

    and

    Trump has three options in #Afghanistan. Winning isn’t one of them, says RAND’s @Jim_Dobbins. http://r.rand.org/4rol

    Can’t cut/paste but the choices are:
    1. losing quickly by withdrawing
    2. losing slowly by maintaining current force levels
    3. not losing and reaching a stalemate for the foreseeable future by increasing troop levels.
    4. There is a 4th option not listed in this study – negotiate an honorable withdrawal (Vietnam comes to mind)
    If as Einstein said the definition of insanity is doing the same thing over and expecting as different result what is it to do the same thing over 16 times and counting?
    https://twitter.com/search?src=typd&q=afghanistan

  15. 15

    @D58826:

    3. not losing and reaching a stalemate for the foreseeable future by increasing troop levels.

    This is overly optimistic.

  16. 16
    But her emails!!! says:

    @D58826:
    4. There is a 4th option not listed in this study – negotiate an honorable withdrawal (Vietnam comes to mind)

    Isn’t that just number 1?

  17. 17
    D58826 says:

    Aside from the fact that I would not believe Ari Fleischer if he said the sun was coming up in the east I suspect this twitter storm is long on ‘numbers’ short on facts. Or as Mark Twain once said ‘Figures Don’t Lie, But Liars Do Figure’:
    1. between 1983 and 2001 spending went from 19 billion to 129 billion. Well aside from a growing and aging population every one with an IQ above that of a rock has heard of inflation. And that medical care inflation runs about twice that of thew rest of the economy.
    2. today it is 329 billion. Repeat one above and add in the near depression that Ari’s boss inflicted on the economy.
    3. Whither the program will REALLY expand to 500 billion in 2027 under the GOP, Ari still has not addressed the impact of an aging population and inflation.
    4. According to With Obamacare medicaid will grow to 624 billion in 2026. Again probably true but will be covering at least 24 million more people and good old aging population and inflation.
    5. He also throws in the good old chestnut about spending always going up in DC. But seems to leave out one of the prime culprits – DOD and the wars his boss started but could not figure out how to finish.
    The comments on ‘what we can afford’ – more war/wall street bailouts – vs what we can’t afford – education, healthcare, etc – says it all
    suhttps://twitter.com/AriFleischer/status/879123168291692552

  18. 18
    D58826 says:

    @But her emails!!!: option 1 would be leave quickly and damn the consequences. Option 4 at least lets you try and get whatever you can and gives more time to get the folks who supported you to a safe place. But in the end the result is the same. Just the time line.

  19. 19
    D58826 says:

    @🐾BillinGlendaleCA: see Einstein quote. And it is the Rand analysis not mine.

    I make no claim to being an expert on Afghanistan but something like 70% of the population is ethnically Pashtun. The other 30% are several ethnic groups bundled under the term Northern Alliance. I don’t know if they are really an alliance of common long term goals or just an alliance of people who hate the Pashtuns more than they hate each other (my guess). The Taliban are mostly Pashtun. Northern Pakistan is Pashtun.
    So it seems to me that you are trying to defeat 70% of the population, with a secure cross border sanctuary, with 30% of the population whose only common interest (other than stealing the US blind) is a hatred of the Pashtun majority. And if I remember my history correctly Afghanistan is as much a western made up country (Britain and Russia) as is Syria and Iraq.

  20. 20
    rikyrah says:

    DT: Russia please hack!
    Fox: Yay!
    DT: They didn’t hack!
    Fox: Nope!
    DT: They did, Obama’s fault!
    Fox: Yup!
    DT: I’m guilty!
    Fox: Not a crime! https://t.co/aVneohIi9E
    — Beau Willimon (@BeauWillimon) June 25, 2017

    Fox’s Brit Hume: Even if the Trump campaign did collude with Russia, “it’s not a crime” https://t.co/NeVTEJWMol
    — Media Matters (@mmfa) June 25, 2017

    really odd recent trend of right-wing pundits saying Collusion Is Actually Fine 🤔🤔🤔 pic.twitter.com/ROvfV0Naqz
    — Brendan Karet 🚮 (@bad_takes) June 25, 2017

  21. 21
    smintheus says:

    How do they project market functionality in extreme 1332 states?

    I’d also like to know how they evaluate the results for the rest of the nation as a consequence of extreme 1332 states. Several analysts have said that a single state’s 1332 waiver can have egregious results throughout the US because EHB are tied to (a) the benefits that employers’ insurance policies must provide, and (b) the provision that eliminated the annual/lifetime caps on benefits.

  22. 22
    Mike in DC says:

    @D58826:

    Well, much like in Vietnam, we can’t roll into Waziristan, encircle the Taliban and force their surrender, disarming them, shutting down the madrasas, etc. So they win by just sticking around. More to it than that, of course, but the fact that the opponent can never be decisively defeated is a huge negative.

  23. 23
    The Golux says:

    @ThresherK: @zhena gogolia: I was tickled to death when Chris Murphy beat Nancy Johnson in the fifth district in 2006, and I’ve only liked him more every day since.

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