In another example of the trouble the experts are having keeping up with the GOP’s flailing attempts to repeal and/or replace Obamacare, the Congressional Budget Office has just now released its score of the revised version of Trumpcare that already crashed and burned at the beginning of the week.
To be clear, the new score does not include analysis of the highly controversial Cruz Amendment, which (contrary to a cheery assessment from the Trump administration that health-policy experts are trashing) is generally expected to make the overall bill worse for people with preexisting conditions. So it only reflects the other changes made to the original Better Care Reconciliation Act, which itself received a pretty damning score from CBO last month.
The main change is that by delaying two provisions repealing Obamacare taxes, the revised bill produces more deficit reduction ($420 billion over ten years as opposed to $321 billion in the earlier bill), and thus more money for Mitch McConnell to use in concessions to senators, particularly the moderates who are upset about Medicaid cuts. But it’s unclear how much of this “new” money has already been committed by McConnell in private negotiations that didn’t win any votes. And it’s also not clear how much deficit reduction conservatives in either congressional chamber will let McConnell give away.
Otherwise, aside from some minor differences, the bill’s estimated effects are as bad as the earlier bill’s. The same 22 million would lose health coverage. Medicaid is cut by $756 billion over ten years instead of $772 billion. Average premiums would go down relatively, but mainly in exchange for skimpier benefits. For some older people, premiums could go up a lot; for some poor people, out-of-pocket expenses could skyrocket.
There’s really nothing in this score that’s going to move any votes in McConnell’s direction, and to the extent that the impact of the Cruz Amendment could be horrific, signing onto anything like this second iteration of BCRA would be a politically dangerous crapshoot. Maybe McConnell can still spend “his” money judiciously enough to produce a third BCRA that seems slightly less toxic, without losing the conservatives who would prefer a straight repeal bill. Matt Yglesias, for one, thinks that could happen given the cagey positioning of Senate moderates. But it’s not really looking any more likely than it did yesterday.