COST: Douglas Elmendorf and the Chamber of Secrets
CBO scores are like Harry Potter books for policy wonks. Everyone makes a big fuss and works themselves up into a frenzy, only to do it all over again when the next one comes out.
The latest estimate from CBO puts the cost of the Senate HELP bill at $611.4 billion over ten years—a far cry from the preliminary estimates a few weeks ago that put the costs of reform over $1 trillion. (We told you they were preliminary.)
The biggest changes? The current estimate includes provisions for a public health insurance option and details on an employer mandate that were left out of the previous score. Politico has the letter from Senators Edward Kennedy and Chris Dodd to the rest of the HELP Committee members detailing the changes.
On the public plan, Kennedy and Dodd remain somewhat vague, describing it as a "national plan" available through Health Insurance Gateways with rates negotiated by HHS—all of which is keeping with the contours of the HELP public option leaked earlier this week.
On the employer mandate, the proposal would impose an annual fee on employers of $750 for each full-time worker not offered coverage and $375 for each part-time worker. Firms with fewer than 25 employees would be exempt. The CBO estimates the fees would generate about $52 billion over 10 years—which would help pay for subsidies for low-income individuals to purchase insurance. The fees would also prevent many employers from dropping coverage—a major issue from the preliminary estimate. In total, the CBO predicts the bill (in conjunction with measures under the Finance Committee's jurisdiction) would expand coverage to 97 percent of Americans.
With Senate Finance also making progress on its portion of legislation, the latest CBO score, at the very least, provides good optics and reassuring data (after that spell of mid-June sticker shock) as Congress returns to session after the July 4th break. It shows progress from a committee dedicated to expanding coverage while controlling costs. But provisions will change, and estimates will go up and down. A CBO score is not a magic wand, but a guiding light for reform. And right now, it seems Congress is pointed in the right direction.
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