Fiscal Fact Checker (Revisited): CBO's Record on Scoring the Affordable Care Act

Critics of CBO scoring like to cite past predictions that widely missed the mark. Sometimes, too, critics compare apples to oranges, and that is the case with the 2010 Affordable Care Act (ACA) again this week. As reported by National Journal, Congressman Phil Roe (R-TN) claims in referring to CBO's report on the fiscal cliff, "Remember that the CBO estimated two years ago that the Affordable Care Act would be $900 billion, and 24 months later it’s $1.7 trillion. And so, the policies are what need to be correct, not these estimates."

As we pointed out in March, the original CBO score extended only through 2019, whereas current scoring adds three years through 2022, while subtracting almost nothing from 2010-2011, when the ACA had relatively little activity. So in March 2010, CBO estimated gross costs of $938 billion in the 2010-2019 window. In March 2012, CBO estimated gross costs of $1.76 trillion in the 2012-2022 period. However, the 2012 score for the specific window 2012-19 (which are the common years between the two scores) was only $1.01 trillion, compared to the $931 billion from the original score, an increase of about 9 percent rather than 88 percent.

If you look at the net cost of the coverage provisions, which includes other budgetary effects related to the coverage expansions, the 2012 score is $772 billion for 2012-2019, compared to the 2010 score of $778 billion. That is a decrease of $6 billion, or less than one percent.

The evolution of the ACA's net scoring of the whole legislation has adhered similarly closely to the original projections. As we said a few months ago:

So far, there has been little change in CBO's projections of the effects of the Affordable Care Act since the original score of the final legislation. It was originally scored as reducing the deficit by $124 billion from 2010-2019 (excluding the student loan provisions) and was scored last year as doing so by $119 billion from 2012-2019. Over a comparable period of 2012-2019, the net cost of coverage provisions has gone down by $6 billion from the original score to the most recent score.


 Source: CBO