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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