Ryan’s revisions are likely to reduce the deficit reduction figures projected last week by the Congressional Budget Office. The CBO said the bill would reduce the deficit by $337 billion during the next decade.
At the same time, many Republicans are lukewarm toward an expansion of the federal role in maternity leave policies. And then there is the cost. The Committee for a Responsible Federal Budget estimated that Trump’s plan would cost about $50 billion over 10 years.
"The policy agenda is massive," said MacGuineas on CNN Newsroom. "And they really have to make a major shift, where they start to be able to enact big pieces of legislation on the agenda, so that they show both that they can govern, and that they can get some of the things that the President and the Republican leaders ran on."
Watch the full discussion here: http://mms.tveyes.com/MediaCenterPlayer.aspx?u=aHR0cDovL21lZGlhY2VudGVyLnR2ZXllcy5jb20vZG93bmxvYWRnYXRld2F5LmFzcHg%2FVXNlcklEPTQ4MDM2NCZNRElEPTc2MzA4MzkmTURTZWVkPTcxOTcmVHlwZT1NZWRpYQ%3D%3D
The agency made encouraging predictions about the tax cuts and the deficit reduction in the President’s health-care plan, noting that it could save anywhere from $150 billion to $337 billion over the next 10 years. One early long-term estimate by the independent Committee for a Responsible Federal Budget projected that the President’s health-care plan could lead to $2 trillion in savings over the next two decades. I have been an advocate for 20-year forecasts in the past, authoring an amendment to a previous budget proposal that would require CBO to determine longer economic estimates. Policy decisions should be based on sustainable progress, not short-lived wins.
According to this report by Time earlier this year, four well-known, partisan and non-partisan tax research organizations (The Tax Foundation, Tax Policy Center, Moody's Analytics, and the Committee for a Responsible Federal Budget) concluded that the tax plan proposed by the president and mostly endorsed by the Republican leadership would fail to pay for itself.
"Projected deficits," the report says, "ranged from $2.6 trillion (in the most optimistic estimate from the Tax Foundation) to more than $10 trillion for Moody's." Even the president's 2017 budget proposals, which slash spending across the board, would still contribute significantly to the nation's debt over the next 10 years, according to a recent analysis by the Congressional Budget Office.
Maya MacGuineas, president of the Committee for a Responsible Federal Budget, a nonpartisan watchdog group, saw one hope for a tax bill. Unlike health care, everyone agrees the tax code is broken, she said, and it’s been an important part of the Republican platform for years.
“The tax code is a disaster and is desperately in need of reform,” she said. “I think they kind of have to succeed. I don’t think they can afford to not succeed right now.”
Because it’s not clear how states would set their benefit levels, it’s hard to evaluate the effect on premiums or overall federal spending, according to the Committee for a Responsible Federal Budget. If premiums fall significantly, more people may sign up, raising total spending on subsidies, CRFB said. For instance, if 5 million more people enroll, U.S. spending over the next decade would be $150 billion higher.
But the independent, bipartisan Committee for a Responsible Federal Budget on Friday published a blog on the financial impact of last-minute amendments to the bill, including the requirement that states determine essential health benefits.
According to a new report from the nonpartisan Committee for a Responsible Federal Budget, or CRFB, the passage of the AHCA would further cripple the already struggling Medicare Hospital Insurance Trust, which covers the costs associated with Part A (in-patient hospitals stays and procedures, as well as long-term skilled nursing care) for the 57 million eligible Medicare enrollees.
Of specific note, the elimination of the Medicare surtax -- a 0.9% added payroll tax on earned income above $200,000 specifically paid in its entirety by the employee -- is expected to result in a cumulative deficit to Part A of $150 billion by 2026. As a result, the CRFB estimates that Medicare's Hospital Insurance Trust insolvency date (i.e., the point at which it'll have used up all of its spare cash) will be moved forward from 2025 to 2023. That's just six years from now.
CBO Projects $50B Savings From MedMal Reform; Budget Hawk Group Estimates Impact Of Other Phase 3 Bills
The Congressional Budget Office estimates that medical malpractice legislation, which is part of Republicans’ plan to handle a raft of health care reform bills separately from budget reconciliation, would reduce the deficit by $50 billion, and the Committee for a Responsible Federal Budget estimates that four additional bills in that legislative package would modestly reduce the deficit, lower health care costs and increase coverage.
The Committee for a Responsible Federal Budget, a nonpartisan, nonprofit organization, said that changes to the bill have the potential to increase insurance coverage.
"In our assessment, the legislation would likely produce modest increases in economic growth under CBO's model," the committee said.
"Importantly, CBO's estimates do not incorporate future changes that could be made to insurance market rules, either by regulation, further legislation, or further amendments to this bill that are still being discussed," the group said. "Such changes have the potential to increase total insurance coverage relative to the AHCA. However, increasing coverage would also likely increase the total cost."
This article cites our analysis of the effects of last minute amendments on the AHCA's costs and coverage.
On the bright side for conservatives, the Committee for a Responsible Federal Budget concludes that the bill could save $2 trillion over two decades.
Tax cuts, for medical device companies and wealthy Americans—Part of Obamacare’s funding came from increased tax rates for Americans with incomes greater than $250,000, insurance companies and medical device companies. Under Obamacare, a 2.3 percent tax was added to all medical device sales. Under the AHCA, this tax would be repealed. The Committee for a Responsible Federal Budget estimates that tax cuts total $594 billion.
So while the parliamentarian is guided by past rulings, there’s still a lot of gray area, said Ed Lorenzen, a budget expert at the nonpartisan Committee for a Responsible Federal Budget.
“On a lot of places, it is a matter of a balancing test,” Lorenzen said. “The big issue is going to be, are the budgetary effects merely incidental to the provision?”
Republicans would also face a problem if there are so many Byrd violations that the parliamentarian rules that the whole bill is invalid.
"It’s sort of a weighing test of [whether] a reconciliation bill is weighed down with a large number of rule violations," said Ed Lorenzen, senior adviser at the Committee for a Responsible Federal Budget. "But that’s not [just] one or two violations, that presumably is in the category of multiple violations."
But in a recent study, the non-partisan Committee for a Responsible Federal Budget did just that. The findings are a vote for the AHCA's fiscal prudence. According to the CRFB, the new law would lower deficits from 2027 to 2036 by over $1.6 trillion, for total savings of $2.4 trillion over 20 years, including foregone interest.
So a new resolution could be the Republicans’ ticket to a fresh crack at health care and tax reform. As Ed Lorenzen of the Committee for a Responsible Federal Budget explains, such resolutions are supposed to pass in the spring before a fiscal year begins. That means now, since fiscal 2018 begins Oct. 1.
“The window is closing, in that they can’t really even start the process on tax reform until they pass a new budget resolution,” Lorenzen said.
“I wouldn’t think [this would pass Byrd Rule muster],” says Marc Goldwein, a budget expert at the Committee for a Responsible Federal Budget. But, he adds, if they can justify changing regulations to allow higher premiums on older customers (an existing provision in the law), “who knows.”
Ed Lorenzen, a CRFB colleague of Goldwein’s and a budget procedure expert, adds, “I don't think it [could survive the Byrd Rule], and most people I talk to don't think so, but there are smart Republicans who used to work in the Senate who think it could, including some who work at the White House.”
None of this would be in the service of fiscal responsibility — say, to make a dent in the national debt, which the budget’s introduction describes as “a crisis.” In fact, notes the Committee for a Responsible Federal Budget, the administration’s proposed increases in the current fiscal year would add $15 billion to the deficit to fund military operations and begin building a border wall — assuming, of course, that a reimbursement from Mexico isn’t in the mail.
As the Economist reported, this is the sort of redistributive economics that is anathema to the party of small government. The Committee For a Responsible Federal Budget reported that Trumpcare would give the richest Americans, the top .1 percent, a tax cut of $165,000.
“Unfortunately, the budget does not include any proposals on mandatory spending or revenue and does not include any proposals or projections beyond 2018,” the Committee for a Responsible Federal Budget opined. “In this sense, this budget ignores the 70 percent of spending that is responsible for 90 percent of spending growth over the next decade and tells us nothing about how the Administration will address the nation’s unsustainably rising national debt.”
“Missing from this budget are initiatives the president has publicly highlighted like tax reform and infrastructure that could profoundly affect the government’s finances, and mandatory spending on entitlement programs, which are the largest drivers of the debt and must be addressed,” said Maya MacGuineas, president of the Committee for a Responsible Federal Budget.
While the CBO analyzed the proposed American Health Care Act (AHCA) through the prism of a ten-year budget window, a new analysis by the Committee for a Responsible Federal Budget concluded that the Republican plan – for all its many flaws – would reduce the federal deficit by a net $2.4 trillion over a 20-year period.
A new report released this week by the nonpartisan Committee for a Responsible Federal Budget (CRFB) found that the Affordable Health Care Act (AHCA) would reduce the federal deficit by $2 trillion over the course of 20 years. The Congressional Budget Office (CBO) previously stated that the AHCA would produce close to $337 billion in savings over the next ten years, but the CBO has yet to release findings on what happens after the 10 year mark outside of saying that the AHCA would not increase the deficit. The AHCA has the support of both the White House and House GOP leadership.
"I think this reduces total deficit reduction somewhere in the range of $150 billion, leaving less than $200 billion in deficit reduction," Committee for a Responsible Federal Budget scholar Ed Lorenzen said.
After touting the Affordable Care Act repeal bill’s projected deficit reduction, Republicans may have less to crow about in the bill’s revised form, at least according to one bipartisan deficit hawk group.
The Committee for a Responsible Federal Budget said in a blog post Tuesday the proposed changes to the ACA repeal bill would likely cut its deficit reduction in half in the first 10 years and by a larger proportion in the second ten years.
Maya MacGuineas, president of the Committee for a Responsible Federal Budget and head of the Campaign to Fix the Debt, and Robert L. Bixby, executive director of the Concord Coalition, wrote an op-ed over Trump's "skinny budget" that appeared in The Des Moines Register.
The new legislation would also repeal the Affordable Care Act taxes this year instead of in 2018, with most of the tax benefits going to wealthy individuals. Doing so would forego an estimated $40 billion in lost tax revenue, said Marc Goldwein, senior vice president at the Committee for a Responsible Federal Budget.
“There are a lot of moving pieces here,” said Marc Goldwein, head of policy at the Committee for a Responsible Federal Budget. “But it looks like the deficit reduction will be cut roughly in half.”