The partisan Bipartisan Health Care Stabilization Act of 2018 bill is basically the Republican sponsors asking Democrats to punch themselves in the face repeatedly. It is an attempt at a legislative swirlie.
The big elements of the bill that make this a swirlie attempt are:
- Funding reinsurance to bring down premiums for upper middle class families
- Funding CSR that increases net of subsidy premiums for subsidized individuals while decreasing premiums in non-Silver Switch states for upper middle class families
- Massive expansion of Hyde’s reach
There are other elements which I think are completely plausible parts of an agreement.
The Congressional Budget Office turned around a rapid analysis of the bill and they have the highlights in their supplemental letter:
estimated that enacting the BHCSA would increase the deficit by $19 billion over the 2018-2027 period relative to CBO’s baseline, primarily because of the cost of subsidizing reinsurance or invisible high-risk pool programs in the nongroup health insurance market….
You requested an alternative estimate of section 602(b) of the bill, which would appropriate such sums as may be necessary for payments for cost sharing reductions (CSRs) authorized by section 1402 of the AffordableCare Act (ACA). Specifically, you asked that CBO and JCT provide an alternative estimate that reflects the fact that insurers are not being separately reimbursed through an appropriation for the costs of CSRs….
CBO and JCT estimate that appropriating CSR payments for 2019 through 2021 would, on net, reduce the deficit by $32 billion over the 2019-2027 period relative to the alternative benchmark. In addition, CBO and JCT project that the number of uninsured people would increase by less than 500,000 in 2019 and by between 500,000 and 1 million in 2020 and 2021. Most of those uninsured people would have incomes between 200 percent and 400 percent of the FPL…
This is the two baseline problem. The CBO is mandated by law to assume that entitlement programs will be funded. From that assumption, paying CSR has no new budgetary effect. The only big cost of the bill would be an additional $35 billion dollars in reinsurance made available with a total spend of $19 billion due to some lack of uptake and revenue/APTC feedback. This would lead to lower premiums and higher enrollment.
However we have a real, pragmatic baseline of reality as it is today; CSR has mostly been rolled up into premiums. This led to the Silver Loading and Gold Gapping where people who earn between 200% to 400% Federal Poverty Level (FPL) ($24,040-$48,080 for a single individual) got really good deals on subsidized Bronze and Gold plans this year. This reality is the alternate analysis. And from there, funding CSR takes $32 billion dollars out of the ACA.
So the bill is a net cut to the ACA and a major reduction in female reproductive autonomy. And shockingly there is no Democratic support for this bill.
JMG
In the Fraud Party in a nation where fraud dominates politics, Collins is certainly in the top 10 of frauds, individual division.
JGabriel
No Democratic support, yet Republicans are calling it the “Bipartisan Health Care Stabilization Act”?
I can hear Orwell laughing all the way from his Oxfordshire grave.
Lapassionara
Thanks, David. This helps me wade through the thicket.
Jim, Foolish Literalist
from principled independent stalwart Susan Collins? Why I’m schocked
Another Scott
Still no deal on the budget yet (as of 8:39 PM). TheHill:
I wouldn’t be surprised at all to see yet another CR, but one really can’t tell.
I can’t tell from the story what, if anything, is going to be done about Obamacare, but it seems like they want to try to force the Hyde stuff through as a price for any fix (at least as part of the budget).
Cheers,
Scott.
Matt McIrvin
It’s both kinds of party, country AND western!
schrodingers_cat
From the early morning thread, my 4 point agenda to deal with the Rs
1. Ds present a united front.
2. We don’ pay attention to elite media blather headed by the Nazi Times and its acolytes like the The Atlantic, NPR, PBS etc. They are not our friends and they lean R or are R
3. Always assume the worst from the elected Rs.
4. Cremate bipartisanship and scatter its ashes in the water body of your choice.
? ?? Goku (aka Amerikan Baka) ? ?
@schrodingers_cat:
Hear, hear on all of your points but especially this one. I want to make America a de facto one party state, but one through legitimate democratic means, unlike the GOP.
p.a.
@JGabriel: They don’t have to fool Orwell, they just have to fool the American media.
Emma
@schrodingers_cat: All motions seconded.
Major Major Major Major
@Another Scott: oh, is there yet another self-inflicted budget crisis? Whee.
Fair Economist
@schrodingers_cat:
I thought we had regulations against dumping toxins in bodies of water.
Omnes Omnibus
@schrodingers_cat:
Wouldn’t it be easier to just drown it or beat it to death with a baseball bat? I care little about the ceremony as long as it’s dead.
Major Major Major Major
@Fair Economist: not for long.
schrodingers_cat
@Omnes Omnibus: Hindu last rites. Return the deceased to the elements.
Omnes Omnibus
@schrodingers_cat: I know. Hence my second sentence. I am not a religious person. I am culturally Protestant; it ends up being more a way viewing the world than a belief system.
schrodingers_cat
@Omnes Omnibus: Same here, not a religious person either, but as you were saying culturally Hindu. I like the idea of not holding on, even to a dead person’s ashes. You mourn and then you move on.