CBO estimates $553 billion price tag for healthcare provisions in reconciliation package
The provisions would increase coverage for millions. House leaders indicate they want a decision this month.
Photo: Michael Duva/Getty Images
If healthcare provisions in the reconciliation bill are passed, deficits would increase by $553.2 billion from 2022 to 2031, according to cost estimates from the Congressional Budget Office.
The number of people without health insurance would decrease by about 3.9 million people, CBO Director Phillip Swagel said in the October 19 letter to Rep. Jason Smith, R-Mp., Ranking Member of the Committee on the Budget for the House.
By 2031, 23.6 million people under the age of 65 would be uninsured, compared to 27.7 million people today. An estimated 4 million would gain coverage under Medicaid.
The CBO looked at certain healthcare provisions in the proposed $3.5 trillion reconciliation bill that continues to be debated by Congress. These provisions include reducing premium costs, expanding tax credits for low income populations, initiating a special rule for individuals on unemployment and closing the Medicaid coverage gap.
The estimated net increases in the deficit for each of these provisions are:
- $209.5 billion to improve affordability by reducing premium costs.
- $323.1 billion to expand the health insurance premium tax credits for populations who are at 138% of the federal poverty level and for closing the Medicaid coverage gap for states that haven't expanded Medicaid.
- $10.6 billion to cover the special rule for individuals receiving unemployment compensation.
- $10.8 billion for modification of employer-sponsored coverage affordability.
The special rule for people getting unemployment applies to those who get a premium tax credit for health insurance through the Affordable Care Act that equals the difference between the benchmark premium and a maximum contribution specified as a percent of household income.
The provision for employer-sponsored coverage applies to the percent of income an individual pays for coverage. The provision in the reconciliation bill decreases the percent of income required to get subsidized coverage through the ACA, from 9.5% of income to 8.5%. Employees whose contribution exceeds 8.5% can purchase subsidized coverage under the provision.
WHY THIS MATTERS
The reconciliation package would increase the number of Americans under the age of 65 who have health insurance coverage. Other proposals would add vision, hearing and dental benefits to original Medicare and would give Medicare the ability to negotiate drug prices.
The Senate and the House have passed a budget resolution for FY 2022 that authorizes the $3.5 trillion reconciliation bill. Passage has been along party lines. But within the Democratic Party there is disagreement on the price tag. Near unanimous Democratic support is needed for enactment of the reconciliation package.
House Speaker Nancy Pelosi has indicated October 31 as the date for a breakthrough in the reconciliation stalemate, according to Intelligencer, but Politico said today that Pelosi and Majority Leader Chuck Schumer want to get a framework of a pared-down social-spending package together by the end of the week.
THE LARGER TREND
The Congressional Budget Office was asked for information about the cost estimate for the healthcare provisions in the reconciliation legislation. The CBO said it has not yet completed a cost estimate of the full reconciliation bill.
ON THE RECORD
Ways and Means Committee Chairman Richard E. Neal, D-Mass., and Energy and Commerce Committee Chairman Frank Pallone, Jr., D-N.J., said: "Today's CBO analysis confirms that the Build Back Better Act would have a transformative benefit for millions of hardworking Americans by expanding access to affordable healthcare coverage. The independent analysis found that approximately 4 million uninsured Americans would gain coverage and 7.6 million more would obtain subsidized coverage through making the Affordable Care Act's premium tax credit enhancements permanent and closing the Medicaid coverage gap."
Twitter: @SusanJMorse
Email the writer: susan.morse@himssmedia.com
