You had to figure the vaunted Congressional Budget Office (CBO) projections about the initial iteration of the GOP’s healthcare reform efforts were not going to do Republicans any favors – at least the ones supporting the current bill.
And sure enough, when the CBO issued its findings on Monday, they generated a headline that writes itself. As Reuters slugged it, “Millions more uninsured under GOP plan: report”
The spectacular being the enemy of the thorough in the ratings-driven and left-leaning establishment media, you can fully expect this single element of the CBO findings to dominate coverage for days to come.
Democrats should by all accounts remain silent in this debate – since they are the ones who rammed through the disaster known as Obamacare and were beaten last fall in large part because of it. But of course, from the moment this healthcare reform bill was unveiled, they have nevertheless been depicting it as worse than Obamacare – less coverage at a higher cost. Both assertions turn out to be untrue.
The CBO concluded that the bill will reduce premiums, lower taxes, and shrink federal budget deficits to the tune of $337 billion over ten years.
It is important to stipulate that, like most economic forecasts, CBO estimates are just that – estimates – and while politicians on both sides of the aisle use them for partisan purposes, the final results of any analysis that seeks to predict human behavior are as inherently flawed as those by experts who predict the stock market or sports. The CBO is hardly infallible.
Who really knows how many people will opt in and opt out of the new system ? It is impossible to predict with any degree of certainty what kind of coverage people will buy when the federal government no longer requires every person to spend their money on policies that include, for example, maternity and newborn care, HIV screening and extensive pediatric services – among over 70 requirements – whether you want them or not.
Indeed, considering the individual and business mandates of Obamacare will end when this new bill becomes law, it is actually quite obvious millions will “lose” their coverage because they will choose not to buy in. Many millions who were mandated to purchase health insurance under the current law did not do so – particularly the young and healthy – because they calculated that the “risk” of saving money but going uninsured outweighed the “reward” of paying a high premium to be covered. In the end, it has been that refusal by millions of the young and healthy to subsidize the old and sick that has put Obamacare into its death spiral.
There are many acts still to come in this drama. Republicans are calling the American Health Care Act the first stage of a three-stage process. The second stage is when HHS Secretary Tom Price, himself a doctor, will put his imprint on healthcare reform at the regulatory level. And the third stage will include elements of reform not included in this bill, most prominently attempts to make insurance plans available across state lines.
The fact remains that, no matter the CBO scoring and the plan’s current flaws and its final provisions, this reform effort represents a leap forward from Obamacare. How much more effective it will be depends on the ultimate shape of this bill and the reforms that follow it. And for the likes of President Trump, Speaker Paul Ryan and their GOP colleagues who know they will assume ownership of the healthcare issue when this process is complete, there’s still miles to go before they sleep.