![]() The agencies ground their coverage estimates on that widely accepted definition, which encompasses most private health insurance plans currently offered in the group and nongroup markets. Effects on Health Insurance CoverageĬBO and JCT broadly define private health insurance coverage as consisting of a comprehensive major medical policy that, at a minimum, covers high-cost medical events and various services, including those provided by physicians and hospitals. CBO has not completed an estimate of the potential impact of the legislation on discretionary spending, which would be subject to future appropriation action. 1628 would not increase net direct spending or on-budget deficits in any of the four consecutive 10-year periods beginning in 2027. 1628 would affect direct spending and revenues. Pay-as-you-go procedures apply because enacting H.R. The largest increases in the deficit would come from repealing or modifying tax provisions in the ACA that are not directly related to health insurance coverage-such as repealing a surtax on net investment income, repealing annual fees imposed on health insurers, and reducing the income threshold for determining the tax deduction for medical expenses. ![]() Those savings would be partially offset by other changes in coverage provisions-spending for a new Patient and State Stability Fund, designed to reduce premiums, and a reduction in revenues from repealing penalties on employers who do not offer insurance and on people who do not purchase insurance. ![]() The largest savings would come from reductions in outlays for Medicaid and from the replacement of the Affordable Care Act’s (ACA’s) subsidies for nongroup health insurance with new tax credits for nongroup health insurance (see figure below). The provisions dealing with health insurance coverage would reduce the deficit, on net, by $783 billion the noncoverage provisions would increase the deficit by $664 billion, mostly by reducing revenues. 1628 would reduce direct spending by $1,111 billion and reduce revenues by $992 billion, for a net reduction of $119 billion in the deficit over that period. Effects on the Federal BudgetĬBO and JCT estimate that, over the 2017-2026 period, enacting H.R. In addition, the agencies expect that some people would use the tax credits authorized by the act to purchase policies that would not cover major medical risks and that are not counted as insurance in this cost estimate. ![]() In comparison with the estimates for the previous version of the act, under the House-passed act, the number of people with health insurance would, by CBO and JCT’s estimates, be slightly higher and average premiums for insurance purchased individually-that is, nongroup insurance-would be lower, in part because the insurance, on average, would pay for a smaller proportion of health care costs. (CBO issued a cost estimate for that earlier version of the legislation on March 23, 2017.) 1628 that was posted on the website of the House Committee on Rules on March 22, 2017, incorporating manager’s amendments 4, 5, 24, and 25. That amount is $32 billion less than the estimated net savings for the version of H.R. 1628 would reduce the cumulative federal deficit over the 2017-2026 period by $119 billion. CBO and JCT estimate that enacting that version of H.R. 1628, the American Health Care Act of 2017, as passed by the House of Representatives. CBO and the staff of the Joint Committee on Taxation (JCT) have completed an estimate of the direct spending and revenue effects of H.R.
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