The 3 key things to watch for in CBO's looming AHCA score

Topics: Health Care Reform, Politics and Policy, Federal Government, Health Care Legislation, Finance, Costs and Prices, Health Care Spending

By Heather Drost, managing editor

The Congressional Budget Office (CBO) is expected Wednesday to release a score of the House-approved American Health Care Act.

This is not the first CBO score for the AHCA: The office on March 13 projected the bill would decrease the number of U.S. residents with insurance by 24 million by 2026, while reducing federal budget deficits by $337 billion over a 10-year period. On March 23, CBO updated its score to account for newly added manager's amendments that lowered the bill's reduction of the federal deficit to $150 billion over a 10-year period.

But in early May House GOP lawmakers amended the AHCA further, and on May 4, they voted to pass the bill without a final score from CBO. The highly anticipated score will answer several key questions about the AHCA's future and its potential effect on the uninsured population.

Here are the top three things we are looking out for:

1) What would happen to premiums and plan quality? Recent amendments would give states more flexibility in setting coverage standards and insurers more flexibility over how they charge certain enrollees. For instance, the MacArthur amendment would allow states to apply for waivers to opt out of the ACA's essential health benefits, let insurers impose health status underwriting on individuals who do not maintain continuous coverage, and allow insurers to charge older enrollees more for coverage. We will be watching to see exactly how those changes will affect projected premiums and the scope of coverage.

2) How many people could lose/gain insurance coverage? CBO last projected that AHCA would leave 24 million fewer Americans without insurance in 2026. Some experts have said the MacArthur amendment's insurer underwriting waiver could increase the number of uninsured U.S. residents by making coverage unaffordable, particularly for those with pre-existing conditions. Further, some experts are skeptical that new funding added to the bill will not be enough to cover those individuals' health care costs. Though not everyone feels the same, as Margot Sanger-Katz reports for the New York Times' "The Upshot," some experts believe the number of uninsured could stay the same or increase slightly. We will be watching to see if the latest amendments increase or decrease CBO's projected uninsured numbers.

3) Will the House have to re-vote on the AHCA? News broke earlier this week that House leaders were waiting to send the AHCA to the Senate until the CBO score arrived because the bill's overall effect on the federal deficit could determine its fate in the Senate. If CBO determines that the updated AHCA does not reduce federal spending by at least $2 billion (and, in particular, that each half of the bill that will be separately considered by Senate committees reduces deficits by at least $1 billion), then the bill would not be able to pass in the Senate through the budget reconciliation process.

Follow us on Twitter @AHLAlerts for the latest news on the CBO score, and be sure to check back in with us tomorrow for a full break down of the score and what it could mean for the AHCA's future.