Budget Neutrality May Not Be Possible Under ACA Repeal-and-Delay Plan
<p>As Congress considers options to repeal and replace the Affordable Care Act (ACA), it will need to confront the federal budget “scoring” process, whereby the Congressional Budget Office provides its best estimate of the 10-year impact of legislation on the federal deficit.</p><p>But as the RAND Corporation’s Christine Eibner explains in a new <em>To the Point</em> post, bills scored as deficit-increasing can be difficult to pass under congressional rules. With discussion of delaying repeal of the ACA’s coverage expansions for two to three years, Republican lawmakers may be setting up a “budgetary cliff,” says Eibner, by taking credit for the savings and leaving the costs of any replacement plan for future legislation.</p>
<p>“Many coverage expansion provisions included in leading replacement policies will increase federal spending or reduce tax revenue,” she says. “Depending on the ultimate cost of a replacement plan, finding sufficient savings to offset these costs while maintaining budget neutrality could exacerbate the already daunting challenge of achieving consensus on a replacement.”</p>