Guy
Benson | @guypbenson | Posted:
Feb 22, 2019 10:35 AM
I
realize that Republicans' failed "repeal and
replace" adventure feels like ancient history at this point --
especially with Democrats increasingly embracing their next reckless healthcare
scheme -- but going back to review the record can occasionally be quite
illuminating. You may recall that one of the rhetorical lynchpins of the
Left's anti-repeal fear mongering was the ubiquitous assertion that
"millions" would "lose healthcare" if the GOP had succeeded
in their legislative effort. I spent quite a lot of energy during
that debate debunking various claims
and checking facts. One of the major points I
emphasized was that the projections of "lost coverage" relied on extremely questionable analyses
from the nonpartisan Congressional Budget Office:
Fully 73
percent of "lost" coverage would arise from individuals
making a choice to exit the marketplace after the federal government ceased
requiring every American to purchase insurance. CBO
analysts apparently believe the mandate has mystical influence over consumers' decisions,
unlike other incentives built into Republican bills -- such as a surcharge for
non-continuous coverage, or a six-month waiting period to obtain plans for
people with nonexistent or lapsed coverage. The folly of this approach is
exposed by the second factor Roy mentions, which accounts for almost all of
CBO's remaining coverage differential between Obamacare and various replacement
plans: The "outdated baseline." What does that mean? Put
simply, CBO has always vastly overestimated how many people would be compelled
by the individual mandate tax to purchase plans. Even
as their projections have been disproven by actual Obamacare sign-ups, CBO
hasn't sufficiently updated their expectations to reflect, well, reality.
They've instead rooted their latest analyses in 2016 projections
that have already been debunked by real-life results, to the tune of millions
of people.
My
point was that of the big, scary "lost coverage" number (in the
ballpark of 23 million people), almost all of it was based on a combination
of (a) estimates of people
choosing to forego Obamacare plans if they weren't required to buy them, and (b) CBO's
wildly and provably inaccurate enrollment projections. In the excerpt above, I
reference "Roy," as in healthcare wonk Avik Roy, who'd been beating the drum on this
very same issue. Another flaw he raised was CBO's
bizarre assumption that if Obamacare's individual mandate tax were repealed,
millions of people would supposedly drop their Medicaid coverage, which was
costing them nothing out-of-pocket. Anyway, I've rehashed these arguments
because new government data confirms that CBO's number crunchers were, indeed, catastrophically wrong:
A new
report from government actuaries has revealed that the
Congressional Budget Office was scandalously off in its estimates of the impact
of Obamacare's individual mandate, a miscalculation that has had significant
ramifications for healthcare and tax policy over the past decade. CBO
estimates about the importance of an individual mandate to a national
healthcare scheme prodded President Barack Obama into including the unpopular
provision into the law in the first place. The mandate projections also played
a key role in President Trump's two major legislative initiatives. The fact
that the CBO assumed 14 million could lose coverage mainly due to the
elimination of mandate penalties helped kill the effort to repeal and replace
Obamacare...the CMS report revealed that 2.5 million more people would go
without insurance in 2019 due to the repeal of the individual mandate's
penalties, and the impact would be "smaller" thereafter...Medicaid
enrollment is [now] assumed to be unaffected.
In
guessing the enrollment impact of axing the individual mandate tax on both the
exchanges and Medicaid, CBO was off by more than...15 million people.
"While any CBO analysis of the Republican bills was likely to project
large coverage losses due to the cuts to Medicaid and subsidies, if CBO had
more realistic assumptions about the mandate, the numbers would have been
significantly smaller, and perhaps left more room to convince centrist
Republicans to get on board," Klein writes.
He also points out how CBO's absurdly inaccurate analysis actually helped the GOP make the math work on tax reform. The tax law repealed Obamacare's central mandate, which created new (on-paper) revenues to play with. Between Obamacare's passage, the unsuccessful repeal fight, and tax reform, CBO's flagrant misjudgment on this crucial issue has now reverberated in significant ways, for years. Klein concludes, "given the outsized influence that the CBO has on policymaking in Washington, the CBO's misfire on the individual mandate should be a major story." Yes, it should be, especially as it pertains to the pressing question of how we move forward from here: Where Are the 'High Crimes'? Pat Buchanan
He also points out how CBO's absurdly inaccurate analysis actually helped the GOP make the math work on tax reform. The tax law repealed Obamacare's central mandate, which created new (on-paper) revenues to play with. Between Obamacare's passage, the unsuccessful repeal fight, and tax reform, CBO's flagrant misjudgment on this crucial issue has now reverberated in significant ways, for years. Klein concludes, "given the outsized influence that the CBO has on policymaking in Washington, the CBO's misfire on the individual mandate should be a major story." Yes, it should be, especially as it pertains to the pressing question of how we move forward from here: Where Are the 'High Crimes'? Pat Buchanan
While
the CBO fulfills a vital role in the realm of American governance, it's clear
that some reforms are desperately needed. Some of these suggestions seem
like a good place to start.
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