The Congressional Budget Office (CBO), will release their updated study of the American Health Care Act (AHCA) on Wednesday, May 24. Technically the House is still holding the bill pending the CBO before it is sent to the Senate. There has been some wild speculation that the House may have to re-vote again if the bill does not provide enough cuts but that seems highly unlikely. More likely is the issue of whether or not it increases the numbers of uninsured and by how much. When the score is released the Senate can begin to move on actual language of a repeal bill.
The CBO analysis will provide more detail on how the latest House amendments will impact on the coverage levels, costs and savings. The original CBO score of the AHCA indicated that 14 million more people would be uninsured next year and 24 million more would be uninsured by 2026 with cuts to Medicaid of $880 billion by 2026.
The CBO score will also allow a review of which provisions of the House bill would violate the Byrd Rule which limits reconciliation bills. The Byrd rule prohibits provisions that are considered “extraneous” to reconciliation (the main mission of deficit reduction). Some of the House bill’s language that strikes regulation of the insurance industry could fall short of what is a complicated rule that is ultimately decided by the Senate parliamentarian.
A new study by the Center for Health Policy at the Brookings Institution shows states would be losing more than $17 billion in Medicaid spending through the per capita cap if the American Health Care Act (AHCA) had been in effect. The analysis, Effects of the Medicaid Per Capita Cap Included in the House-Passed American Health Care Act, examined Medicaid data and calculated the effects had the cap been in place starting in 2004.
Under the AHCA, the per capita cap would calculate health care costs in 2016 for each of five groups: children, the elderly, disabled, adults on Medicaid due to the ACA, and all other adults. This 2016 base would be adjusted by an inflation factor each year times the number of people in each category. That formula would result in each state eligible for a maximum amount of federal Medicaid dollars. If any state reached that federal amount in a year the state would have to pay for anything above that cap.