The bipartisan Obamacare fix just got the best review of any healthcare bill this year

  • The Congressional Budget Office released its score on the bipartisan Alexander-Murray Obamacare fix legislation.
  • The score showed the bill would shrink the federal deficit by $US3.8 billion over 10 years.
  • The score did not include estimated coverage changes from to the funding of cost-sharing reduction payments due to CBO rules.

The Congressional Budget Office released its assessment of the Bipartisan Health Care Stabilisation Act of 2017, better known as the Alexander-Murray bill aimed at providing fixes to the Affordable Care Act.

The bill from Sen. Lamar Alexander, the chair of the Senate Health, Education, Labour, and Pension Committee, and its ranking member Patty Murray, is designed to stabilise the Obamacare exchanges over the next few years.

Here’s a quick rundown of the major findings:

  • The bill would save the government $US3.8 billion from 2018 to 2027.
  • It would not change the number of people with insurance coverage.
  • More states would take advantage of Obamacare’s innovation waivers — or so-called 1332 waivers — due to relaxed restrictions on the waivers and an expedited process.
  • Easing restrictions on catastrophic plans would decrease premiums in the exchanges and save the federal government $US1.1 billion over 10 years in decreased premiums subsidies.

The Alexander-Murray bill appropriates the CSR payments, which help offset the cost to insurers incurred by providing plans with low out-of-pocket cost to poorer Americans. Trump announced recently that he would cut off the payments, saying the administration could not legally continue to pay them, which could have significant ramifications for federal spending and the Obamacare exchanges.

But the CBO’s rules forced it to assume in its baseline that the CSRs would be paid over the next two years.

“After consultation with the Budget Committees, CBO has not changed its baseline to reflect the Administration’s announcement on October 12, 2017, that it would stop making payments for CSRs,” said the CBO report.

The CBO previously estimated that the federal government would pay $US196 billion more over 10 years if the CSR payments were cut off. According to Loren Adler, associate director at the Brookings Institutions Center for Health Policy, since Alexander-Murray appropriates the CSR payments through 2019 including Trump’s changes to the baseline would result in an additional $US10 billion in savings.

The CBO’s findings could bolster support for the bill. For Republicans, it shows that the federal government would save money. For Democrats, it provides a stable number of people insured. For both, it shows there would be some downward pressure on premiums.

As it stands, the bill is in limbo. There is enough support in the Senate to pass the legislation, but it is less clear in the House. It is also unclear whether leaders would bring the bill to the floor in either chamber. Finally, Trump’s stance on the bill remains up in the air.

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