CBO is out with its rough estimates of the Senate Finance bill as it looks now, following the amendments made during the recent markup hearings. Here's my initial take, informed loosely by a few conversations with experts and insiders:
The good news, substantively and politically, is that CBO expects the measure would reduce budget deficits by $81 billion over the next decade and by even larger sums in the following decade. (It won't say exactly how much it expects the bill to reduce deficits over the following decades, given that it's hard to be specific with such long-range estimates.)
The coverage news is not quite so good--although, to be honest, it's better than I expected, given the rumors running around today. CBO estimates that, as of 2019, 94 percent of legal non-elderly residents and 91 percent of all non-elderly residents would have insurance.
That's significantly lower than the projections from the House bill, which would result in corresponding figures of 97 percent and 94 percent. In raw numbers, it's the difference between 25 million people (Senate Finance bill) and 17 million (House bills) still uninsured ten years from now.
Of course, those numbers involve a lot of uncertainty. Their significance is that they correspond to a particular level of benefits and financial assistance, at least in the calculations of the CBO.
And this is something we've known for a while: The Senate Finance bill isn't as generous or as protective as it ought to be.
But the fact that the measure would actually save money means, or should mean, there's a bit more room (financially and politically) to throw additional funds at expanding/improving insurance coverage--ideally, by raising a little more money in taxes and/or offsetting savings.
Remember, the difference between covering people at the level of the Senate Finance bill and covering something close to all legal residents* is maybe $150 billion over ten years. That's not a lot of money in the grand scheme of things.
More analysis to come, probably tomorrow...
*As always, I'd much prefer to cover all residents, including those here illegally.
Update: Wonk Room has a nice comparison chart of the scores before and after the amendments. Ezra Klein has found one rather worrisome passage. And Chris Frates has a really important caveat. Note that I also have updated this item, to clarify meaning and to emphasize this is very much an initial, tentative take. .
Print
COMMENTS (3)
Mr. Cohn, a very young man, may be pleased with the latest projections, as they indicate good coverage of those with whom he most identifies. But the Senate bill grossly distorts the relative treatment of the old (over 65) and the nearly old (55-65). Indeed, the relative difference can only be described as an inverted cliff, with the nearly old in a very deep troph and the old up on the mountain Make no mistake, for the nearly old, health care reform (as opposed to insurance reform) provides almost no benefit. I'm not sure what this means for the Democrats, or progressive politics generally, but it cannot be good. If and when health care reform is adopted, the nearly old will eventuall ... view full comment
Mr. Cohn, a very young man, may be pleased with the latest projections, as they indicate good coverage of those with whom he most identifies. But the Senate bill grossly distorts the relative treatment of the old (over 65) and the nearly old (55-65). Indeed, the relative difference can only be described as an inverted cliff, with the nearly old in a very deep troph and the old up on the mountain Make no mistake, for the nearly old, health care reform (as opposed to insurance reform) provides almost no benefit. I'm not sure what this means for the Democrats, or progressive politics generally, but it cannot be good. If and when health care reform is adopted, the nearly old will eventually realize they are paying a high cost, and they won't be happy.
The Senate Finance bill has at its heart the 40 percent excise tax on high premium plans. This accounts for approximately 200 billion of its scorable savings by CBO. Interestingly, today 154 House Democrats sent a letter to the Speaker stating that they would never vote for a health are reform bill that has a tax on health insurance plans. Labor Unions lead by the AFL and SEIU are adamently opposed to this tax because many union health plans would be over the premium limits in the bill. The Joint Tax Committee has released income distribution charts showing that 56% of this tax would hit those making under $100,000. Fourty percent of the tax burden would fall on those making $75,000 o ... view full comment
The Senate Finance bill has at its heart the 40 percent excise tax on high premium plans. This accounts for approximately 200 billion of its scorable savings by CBO. Interestingly, today 154 House Democrats sent a letter to the Speaker stating that they would never vote for a health are reform bill that has a tax on health insurance plans. Labor Unions lead by the AFL and SEIU are adamently opposed to this tax because many union health plans would be over the premium limits in the bill. The Joint Tax Committee has released income distribution charts showing that 56% of this tax would hit those making under $100,000. Fourty percent of the tax burden would fall on those making $75,000 or less. This is a stotally regressive tax that would hit working people, particularly union members and many who live in high cost areas like New York City.
The Baucus bill has many, many other significant, structural problems including the excise taxes on insurers, phrma, and medical device industries which CBO assumes will be passed on individuals. So the cost curve will be bent, but in the wrong direction. And many of these taxes are front loaded beginning in 2011.
Finally, the entire structure of the connector in the Finance Committee has collapsed with the removal of the individual mandate which in the first year has no penality. The free rider provision is a joke and analytically destroyed by the Center for Budget Priorities. $843 billion over a real six year scoring window to leave 25 million uninsured. Great Job!!
Well, OK - you smarty pants posters are a bit of a buzz kill I have to admit, especially you lawphd with your CBP stuff and sobering reminder about we New York City types (but then I knew that was coming, we're hosed on that front no matter what happens Home Boy). Yes, I'm still wondering where the public option is in all these calculations and seriously, is this just yet another pay day for the loathsome health insurance leeches or WTF?
BUT damnit I'm going to remain pleased and excited anyway. We have Big Mo now, no question.
Our side has had a fair amount of discipline in rough seas during this process and lets admit that its paying off, OK? When those first CBO figures came out this summ ... view full comment
Well, OK - you smarty pants posters are a bit of a buzz kill I have to admit, especially you lawphd with your CBP stuff and sobering reminder about we New York City types (but then I knew that was coming, we're hosed on that front no matter what happens Home Boy). Yes, I'm still wondering where the public option is in all these calculations and seriously, is this just yet another pay day for the loathsome health insurance leeches or WTF?
BUT damnit I'm going to remain pleased and excited anyway. We have Big Mo now, no question.
Our side has had a fair amount of discipline in rough seas during this process and lets admit that its paying off, OK? When those first CBO figures came out this summer, I thought it was a blessing and would help us make a better bill and I still think I'm right. Let's hope we can keep it up and not choke now. Yes, I'd certainly prefer unions to hate this less, I'm with those guys 98% of the time on everything.
But overall, I'm determined not to Eeyore this terrific news to DEATH like wonks tend to do.