According to a highly anticipated report from the Congressional Budget Office, the GOP Senate health care bill would cause 22 million people to lose coverage by 2026. The government would save $321 billion over the next ten years.
The CBO’s analysis of the Senate bill, called the Better Care Reconciliation Act, will have important implications for its passage. The number of Americans who would lose coverage could be critical to whether moderate senators vote for the bill. As Vox’s Dylan Scott wrote, based on these numbers, the Senate parliamentarian could decide whether the bill runs afoul of the Byrd Rule, which prohibits regulatory changes “extraneous” to the budget process from being passed through reconciliation on a simple majority vote.
As a general rule, regulatory changes would likely not be permissible under the Byrd Rule, as he said. Especially if no states took those waivers — as some moderate House Republicans suggested — then there would be no budgetary impact, and the provision would likely be struck.
But if the CBO concludes that a number of states would take the waivers, and the resulting impact on the federal budget is sizable enough, the parliamentarian may be able to justify the waivers under the Byrd Rule. The bill does make a specific pot of money, $8 billion, available only to states that seek waivers.
“It’ll come down unfortunately to CBO, when they put out the cost estimate on that bill,” Hoagland said. “Is it big or is it small?”
The CBO is a nonpartisan budget agency that projects how bills would affect the country. You can read the full text of the Congressional Budget Office cost estimate here, or below.