Capitolworks: Just the Facts...What the CBO Score Truly Means

We are all anxiously awaiting the Congressional Budget Office’s “score” of the American Health Care Act (AHCA) to be made public sometime this afternoon. However, some might wonder why this “score” or said differently, the total amount of cost/savings, is so important if the House already passed the AHCA.

Here are just a few brief points to help you better understand why we are so interested in the CBO outcome and how it might affect the health reform process moving forward.

1) The score will serve as a framework for Senate GOP lawmakers as they work to negotiate their version of repeal. This is because, among other procedural issues, the Senate must develop a health care bill that matches the House’s federal revenue/spending amounts. This score will therefore provide a better understanding of the economic parameters they have to work within.

2) There is a chance that the score will not meet the revenue goals that the Senate must reach in order to utilize reconciliation to pass their bill. You may remember from Capitolworks: Just the Facts previous posts that the rules of reconciliation differ between the two chambers and there is a chance that the House bill, as currently constructed, would not pass the Senate rules. Why is it important for the House bill to meet the Senate’s rules? Expediency, mostly. If the House can deliver a bill to the Senate that meets their unique reconciliation goals, then the Senate can make minor changes to the bill knowing that they have the privilege of using reconciliation. This would also help both the House and Senate avoid a conference made necessary when bills from the two chambers have differences and must become one.

If the House’s bill does not meet the Senate’s rules, the House GOP may be forced to go back and work on their bill and set another vote. This is something that many House members are hoping to avoid given the contentiousness of the bill and the upcoming recess where they will once again face constituents on this issue.

3) Finally, it is anticipated that the score will evidence the many millions of people that would lose coverage under the AHCA and therefore provide a basis for those opposed to the bill to emphasize in their opposition. The score of the first House bill illustrated drastic reductions in the number of individuals who would receive coverage and services, and most pundits are projecting that the second bill will only increase those numbers. This, of course, would strengthen the opposition's' arguments but to what end no one could say.