Real CBO BCRA Headline: No Individual Market Losses In 2018, But Up 1 Million From 2017
Josh Archambault, Contributor
When the Congressional Budget Office (CBO) released its score of the Better Care Reconciliation Act (BCRA), headlines flashed that 22 million Americans would lose their health coverage. According to its analysis, there will be 7 million fewer people in the individual health insurance market in 2026 if BCRA passes, with the remainder of projected coverage changes coming from those transitioning off Medicaid.
But a cursory look at the CBO’s own data raises serious questions about its headline conclusion and should make many in Congress ask CBO some tough questions.
CBO’s projected Medicaid losses have their own problems. For example, 5 million are projected to “lose” Medicaid expansion coverage in states that never expanded Medicaid in the first place. Another 7 million are projected to “lose” Medicaid coverage because the individual mandate goes away, even though the individual mandate does not apply to almost all of those currently on or eligible for Medicaid.
But CBO’s projections for the individual market are perhaps the most bizarre. According to the CBO, roughly 19 million Americans are expected to buy insurance in the individual market in 2018 if the BCRA becomes law.
CBO states that BCRA is responsible for a 7 million person reduction from what would happen under current law (the Affordable Care Act), based on CBO’s 2016 baseline estimates.
The only trouble? CBO updated its baseline estimates in January 2017 to account for how much lower the actual Obamacare exchange enrollment has been, much lower than it previously anticipated as recently as last year.
The result: In January 2017, CBO projected that just 19 million Americans will buy insurance in the individual market under current law (the ACA) in 2018.
That means CBO projected the BCRA would reduce individual insurance coverage by 7 million in 2018, despite the fact that the exact same number of people are projected to have individual insurance in 2018 under the ACA, under CBO’s revised 2017 baseline.
Importantly, that’s still 1 million more people than the 18 million Americans currently in the individual market.
The CBO headline should read: BCRA projected to have no individual insurance coverage losses in 2018 (compared to CBO’s 2017 projections) and total individual market projected to increase by 1 million over the current year.
Here is the question: Why isn’t CBO being more transparent with Congress on how both the AHCA and BCRA have similar individual market coverage as its projections of the ACA from January of this year?