Friday, March 10, 2017

Rushing the ACA Repeal through the House without a Budget Score, and More

Abbe Gluck

The GOP Obamacare repeal this week raced through the two House committees with oversight at breakneck pace-- with essentially a one-day committee markup, with not a single change to the bill emerging from the markup.  The GOP for years has been saying they could do health care better than the Democrats, and yet when given their chance they have shown themselves more eager to do something quick than to do something well considered. Is this really what they have been waiting this long to do?

Perhaps the greatest evidence of the current jam-it-through strategy is the fact the House Republicans allowed the committees to vote the bill out without the Congressional Budget Score--that is, without knowing its effect on the federal budget and the broader market.  For a bill of this magnitude, not getting the score before the vote was highly unorthodox .
In King v. Burwell, the 2015 ACA challenge, Chief Justice Roberts said a lot of things right. But he did make one crucial mistake: implying the ACA was not deliberated. The ACA wasn’t properly cleaned up, but it was excessively deliberated. Tthe ACA went through countless hours of markup, amendment and change. And it was scored before the main drafting committees (Senate HELP and Finance) voted on it, so that the committee members accountable for their votes, as well as the American people, would know the implications of the bill being sent to the full body.

The GOP has not made itself similarly accountable, and now, together with White House Press Secretary Sean Spicer, GOP representatives have taken to the media to discredit CBO--which has been a nonpartisan, respected congressional institution for decades and is led now by a Republican--presumably laying the groundwork for a budget score of the repeal that they won't like (because it will reveal how many millions will be harmed by the repeal with no countervailing economic benefit for the country) .  It's yet another chapter in the Administration's effort to discredit any outside source that could provide a check- -with actual facts--on the Administration's claims and agenda. First it was the media, now it's CBO.
I develop these arguments further here, in the LA Times, with  Dean Sherry Glied. Here is an excerpt, please link the link for the full op-ed.:
Someone who believes he’s lost weight isn’t afraid to step on a scale. Why, then, won’t Republicans let the Congressional Budget Office provide a cost estimate, or score, for their Affordable Care Act replacement?
Early reviews of the proposed legislation reveal that it would harm low-income populations — and the states left holding the bag for those populations — as well as likely further destabilize insurance markets. It would radically change the healthcare system. But neither Congress nor the American public knows the exact implications.

Republican sidelining of the CBO is especially galling since the party likes to sell itself as the one that cares about dollars, cents and deficits. In fact, Republicans passed a rules package last month that required the CBO to more carefully document how legislation affects the deficit. At the same time, they specifically exempted ACA repeal from that requirement. They want us to have faith in their repeal without even having the CBO complete its standard analysis.

Republicans claim they want to repeal the ACA because it has been an economic “disaster.” All right, then — on what measure would their bill count as an improvement? The number of people covered? No one has suggested that the Republican proposal would preserve coverage for all of the 20 million Americans who got insurance under the ACA, never mind the millions more who could still benefit from it. If the advantage is an economic one, the CBO should be allowed to do the books.


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