Lawmakers will undoubtedly concern themselves with many policy objectives as they consider modifications to the AHCA. They would be prudent, however, to ensure that anything signed into law repairs some of the fiscal damage done by the ACA. This will require them to be cognizant of real-world fiscal effects that may not be fully captured in Congress’s current scorekeeping methods.  Three factors contribute to confusion about the ACA’s damaging fiscal effects: 1.) Many of the provisions designed to finance its expansion of insurance coverage haven’t borne fruit, 2.) Scorekeeping rules Congress imposes on the Congressional Budget Office require the CBO to compare the effects of legislation to a baseline that differs from actual law in various critical respects, and 3.) Misinterpretation of intermittent CBO reports over the past several years on the evolving cost estimates for the ACA’s coverage expansion.

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The AHCA will suffer its share of criticism and praise as it moves through the legislative process. Secretary Tom Price has stated this is merely round one in the effort of reform. The next two phases will involve broader regulatory patches and targeted legislation. Initially, from a regulatory perspective, the first draft has the potential to eliminate $3.4 billion in costs and create more than 72 million hours of paperwork savings. This could generate tangible benefits to insurers, businesses, and ultimately, patients. Consider a law that imposed $53 billion in costs and 176 million paperwork burden hours. Even a 20 percent to 30 percent cut could create tremendous regulatory cost reductions.

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Given by a drop-off in enrollment after President Trump took office, total sign-ups for Obamacare health plans fell this year for the first time, a new report released by the Trump administration Wednesday indicates.

A total of 12.2 million Americans enrolled in a plan through one of the healthcare law’s marketplaces during the 2017 open enrollment period, according to the report, which provides a final tally of this year’s signups.

The 2017 final figure, which updates a preliminary report released last month, was down from 12.7 million in 2016.

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