The Congressional Budget Office’s analysis of the latest version of Republicans’ plan to repeal and replace Obamacare has found a very big problem with the bill: It may be unworkable.
The finding, pointed out by Axios health care editor David Nather, is on page eight of the CBO report on the recently revised Better Care Reconciliation Act:
The limit on out-of-pocket spending in 2026 is projected to be $10,900. (Under current regulations, the limit on out-of-pocket spending is defined by a formula based on projections of national health expenditures.) Therefore, plans with an actuarial value of 58 percent and a deductible of $13,000 would exceed that limit and would not comply with the law unless the formula used to calculate the limit was adjusted.
In short, the BCRA makes changes to regulations that will cause annual deductibles for individual market health plans to skyrocket — to $13,000. But other regulations set the legal limit on annual out-of-pocket spending to $10,900. This means the BCRA’s health plans could actually violate the law.
Republicans could amend their bill to fix this — if they choose to push forward with the BCRA, which for now looks like it’s not going to pass. But for now, it’s an embarrassing finding by the CBO.
This speaks to the haphazard approach that Republicans have taken to designing their health care bill. Over the past few months, they’ve had to balance competing interests — particularly the moderate senators who want to avoid steep coverage losses versus more conservative senators who want to repeal as many Obamacare regulations as possible, even if it leads to projected coverage losses. Republicans have also tried to push their bill through a reconciliation process that makes it so they only need 50 senators to pass the bill but limits how far-reaching the legislation can be. And they’ve done all of this in a relatively short time frame.
Together, all of this has led to a messy, secretive process. The result, apparently, is a bill that may not be workable.