The Congressional Budget Office says its assessments of healthcare bills floated to replace the Affordable Care Act won't count people as having insurance coverage if they have only limited benefits.
As Republicans in Congress plan how they will fulfill President-elect Donald Trump's promise to repeal the ACA immediately upon taking office, the guidance from the nonpartisan CBO sheds light on how some proposals for replacement legislation would be scored.
Various ideas for replacement have been floated, most of which use tax credits based on age or family size to help some people buy coverage on the individual market. The GOP has yet to settle on a specific plan, however.
Repealing the ACA would endanger coverage obtained under the law by about 22 million Americans, including those who became eligible for Medicaid in states that expanded their programs. Repeal would also do away with minimum coverage requirements for plans. The ACA established a set of so-called essential health benefits and also set a minimum actuarial value and banned annual and lifetime caps on coverage.
In a blog post this week, CBO analysts said the office and the Joint Committee on Taxation face several challenges in estimating how many people would buy insurance on the individual market under an alternative tax credit proposal such as Republicans have proposed.
The CBO analysts wrote that many of the replacement proposals would return most regulatory authority for nongroup markets back to the states, as it was before the ACA. This would likely result in a variety of standards.
“Without a federal standard, some states might not impose any regulations that would govern the depth and extent of coverage and that would define what insurance products qualify for tax credits,” they wrote. As a result, the CBO analysts said, “some of those insurance products purchased by people using a tax credit would probably not offer much financial protection against high out-of-pocket costs.” Such plans would not be included in assessments of private insurance coverage.
This means that estimates for how many people would receive tax credits would probably be larger than the estimate for the number of people who would obtain coverage.
