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Takeaway: Number of uninsured comes down about 1 million; deficit reduction goes from $150B to $119B

This afternoon, the CBO released its updated score of the American Health Care Act, the vehicle for repeal of the Affordable Care Act. This score acts as an update to the one issued on March 23, 2017 and is necessary to include three amendments that were added to the bill in April and May.

These amendments are:

  • Amendment #32 (Palmer/Sweikert) which created a $15 billion Federal Invisible Risk Sharing Program to provide payments to health insurers  to pay claims for certain high cost individuals beginning with plan year 2018.

  • Amendment #33 (MacArthur/Meadows) which would permit states to waive certain ACA requirements. This amendment would permit states to establish a new age ratio beginning with plan years beginning Jan. 1, 2018; allow states to set standards for essential health benefits beginning Jan. 1, 2020; permit states that have a high risk pool program to permit states to allow insurers to use health states as a rating factor.

  • Amendment #34 (Upton)  which would add $8 billion to funds already designated in the AHCA for assist with high cost premiums and out-of-pocket expenses

The major score components of the AHCA as compared to the March 23, 2017 report:


Note: The CBO is still using the March 2017 baseline that includes rather optimistic projections on insurance coverage especially in the nongroup market.

Because the CBO score did not include these three amendments, there had been some speculation that the House would have to vote again because this new CBO score would not produce deficit savings necessary to comply with the budget resolution’s reconciliation instructions. With a deficit reduction of $119 billion, the House appears to be safe from consideration of the same bill until the Senate pitches it back to them later this summer.

The release of the CBO score allows the Senate to begin work in earnest on their changes to the AHCA. As we have mentioned previously.

Read the original note on the March 23, 2017 CBO score here.

For more information on how the CBO defines insurance and what it means to their scores click here.

More to come as we analyze the CBO’s approach with respect to state based waivers...In the meantime, call with questions.

Emily Evans

Managing Director

Health Policy