Home / health care / The CBO report for the AHCA reflects the wit & wisdom of Speaker Paul Ryan

The CBO report for the AHCA reflects the wit & wisdom of Speaker Paul Ryan


The latest CBO score on the latest version of the AHCA is out. Here are some very quick comparisons between the three CBO reports.

10 year federal deficit reduction.

  • March 13 – $337 billion.
  • March 23 – $150 billion.
  • May 24 – $119 billion.

Increase in number of uninsured under AHCA compared to Obamacare, in 2018.

  • March 13 – 14 million.
  • March 23 – 14 million.
  • May 24 – 14 million.


  • March 13 – 21 million.
  • March 23 – 21 million.
  • May 24 – 19 million.


  • March 13 – 24 million.
  • March 23 – 24 million.
  • May 24 – 23 million.

I can see why the Rs rushed off for a drink after they rammed this thing through Congress.

Here’s the March 23 CBO score for the previous version of the bill.

The March 13 score.

Net effects of HR 1628 on the budget deficit
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    Normally when you do something like this, you have the drink first and the cigarette afterwards.

  • John F

    Increase in number of uninsured under AHCA compared to Obamacare, in 2018.

    March 13 – 14 million
    March 23 – 14 million
    May 24 – 14 million

    2018 is an election year… do you think they’d really do that IN AN ELECTION YEAR????

    The sad truth is, I just don’t know. So many of them having been drinking the koolaid for so long they may just think:

    1. Everyone who loses insurance is either someone who was gonna vote Dem anyway (so no loss), or never wanted it in the first place and only got it due to the ACA mandate (so no loss, or maybe even a gain)
    2. My district is so deep red I’m 100% certain to be primaried and lose if I don’t pass this. If I do pass this I don’t get primaried and maybe my general is tighter than usual, but I should still win.

    • tsam

      2018 is an election year… do you think they’d really do that IN AN ELECTION YEAR????

      It’s worth contemplating that they don’t believe it will actually happen. They’ve built an entire economic ethos around the idea that massive tax cuts, targeted at the most wealthy, will stimulate the economy and actually increase federal revenues. So given that they have no problem with accepting magic as an economic policy, there’s no reason to think they wouldn’t pin their hopes on magic in health care policy too, right?

    • Maxwell

      This is something I truly don’t understand. When the Democrats passed ACA, they knew this would be a hard vote. And they knew it might cost them. But they figured that once the public got a look at the benefits of the law, they would come around on their objections. In hindsight, perhaps overly optimistic (and assumed too much good faith from the opposition). But as a strategy, you can say it with a straight face.

      What exactly is the GOP’s plan to sell this monstrosity? People won’t notice they lost their health insurance, or their premium increased by 800%? They’ll shrug off the costs for their no-longer-Medicaid eligible kids’ chronic treatment? This plan literally has no upside for anyone who isn’t rich enough to get the tax cuts, and even some of those people are going to be eyeing their costs a little warily.

      • tsam

        In hindsight, perhaps overly optimistic (and assumed too much good faith from the opposition).

        I think maybe they don’t quite understand the nature of the Fox News damaged mind. Some people who USE the ACA fucking hate the ACA’s living guts. Somehow they find a way to reconcile their own reliance on the program while believing the program is literally Satan. (Don’t know for sure, but I believe it has to do with a black kid in Detroit or Chicago getting diabetes treatment even though her parents aren’t obscenely wealthy) ¯\_(ツ)_/¯

      • sibusisodan

        I’m indulging in weaponised cynicism here, but: why do they need a sales strategy?

        Worst case if it passes: they lose control of Congress.

        But they’re good at being a party of obstruction. And recent history indicates they won’t be out in the cold for more than 6 years anyway.

  • Ithaqua

    wait… it INCREASES the 10-year deficit by $218 billion relative to the original while insuring only 1M MORE people in 2026?

    That’s an average of $22K / person insured / year… more than 2x the average per-capita health care expense in the U.S., per wikipedia. They’d have likely done better just to pick 1M uninsured people at random and pay their bills…

    Republicans. What can I say…

    • Gregor Sansa

      Don’t be silly. Paying for health care? Where would the tax cut money come from then?

      • Mellano

        + 3.8%

  • nobody

    Doesn’t Congress have the power to suppress CBO reports? If so why didn’t Congress just order the CBO to delay it’s report indefinitely?

    And couldn’t Congress just fire the current CBO director and install a hack to write a hack report?

  • aab84

    I know it’s not the most important issue, but I just cannot get over how politically incompetent this bill is. From a pure politics perspective, it might be the single dumbest piece of legislation ever passed by a chamber of Congress.

    It’s not hard to get the public behind a bill that screws the poor and vulnerable for the benefit of the rich. Often, you can even get bipartisan support for it. All you have to do is (1) have some plausible justification for why it’s good or freedom-y, and (2) not screw over the wrong poor or vulnerable people.

    But they’re taking away insurance from 23 million people, and the ones who will be hardest hit (old people) are the most dedicated voting group in the country. And they’re literally not even trying to sell it on the merits. They’re generating thousands of completely accurate headlines about how they will make it unaffordable to be pregnant or to have cancer, and most of them don’t even seem to realize why that’s bad for them. I’m genuinely shocked at how much partisanship and fear of their base has blinded them to broader political realities, especially in an age of tremendous Democratic enthusiasm.

    • tsam

      You might be underestimating the power of Obama. You know he’s black, right?

    • nobody

      They’llI just say it was due to Obamacare collapsing and the AHCA tried to mitigate it. And it’ll work because they want to be able to blame Democrats so they can continue to vote for Republicans for “tribalist” reasons.

      It worked in KY despite Kynect being popular and Bevins explicitly campaigning on getting rid of Kynect.

      • aab84

        According to polls, people aren’t believing that spin, though. I mean, sure, Trump’s base will. But polls say the public at large thinks it’s Trump’s job to (genuinely) fix Obamacare, and that if it collapses at this point, it’s his fault. Genuinely think this has the potential to cost them everyone outside of the crazification factor.

        • humanoid.panda

          What you don’t get is that we are doooomed forever.

        • John F

          538 has a new article out now about how Trump’s polling IS collapsing- his overall approval isn’t going down that much, but the % who “strongly approve” is collapsing- 2X as many people strongly disapprove as strongly approve. His “base” are the folks who voted for him in the GOP primary- that base is 20-25% of the voting populace.

          If his polling is still doing that 18 months from now- 2X as many people strongly disapprove as strongly approve- the GOP will be slaughtered in 2018.

    • Denverite

      This is what you get by spending seven years characterizing Obamacare as Satan’s preferred health care plan and promising to repeal the biggest atrocity since Hitler’s Purity Laws immediately upon taking office, but you’ve got to get sign off from the Freedom Caucus. You have to pass a repeal bill and this monstrosity is all that you are able to pass.

      • Failing to note that voters’ were saying Yes, we hate Obamacare! and Yes, we love the ACA! was another boo-boo.

  • DAS

    In terms of GOP strategy, I think they were caught off guard by how the media is covering the AHCA. I think they expected the media to latch onto the deficit reduction numbers, ignore people losing health insurance and portray anti-AHCA protesters as shrill communists.

    For some reason the media, Cillizza (sp?) excepted, is not 100% engaging in their usual BS. We need to figure out why that is so we can get the media to not engage in their usual BS in terms of other issues. What makes the AHCA, and our response to it, different that the media isn’t cutting the GOP the usual slack it cuts them? How do we replicate that response?

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