Must-Read: David Anderson: Reading the BCRA CBO Score

Must-Read: David Anderson: 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… https://www.balloon-juice.com/2017/06/26/reading-the-bcra-cbo-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?