The Congressional Budget Office’s (CBO) estimate of the American Health Care Act (AHCA) finds it will reduce deficits by $337 billion through 2026 (read our analysis here). But what would it mean for the long term?
While CBO hasn’t yet provided second decade estimates (other than to say the bill would not be deficit-increasing), we estimate – very roughly – that the bill would save $2 trillion over two decades, including $1.6 trillion between 2027 and 2036. Including interest, we estimate 20-year savings of $2.4 trillion. However, the bill also includes several “cliffs” that if addressed could significantly reduce that estimate.
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Recently, Democratic presidential candidate Sen. Bernie Sanders released the outline of a plan to move to a single-payer health care system in the U.S. along with proposed tax increases intended to pay for the overhaul. According to the Sanders campaign, the plan would cost roughly an additional $1.4 trillion per year, or $14 trillion over ten years, and it would be financed through a combination of taxes on workers, employers, investors, estates, and high earners.
By CRFB’s rough estimates, Sanders’ proposed offsets would cover only three-quarters of his claimed cost, leaving a $3 trillion shortfall over ten years. Even that discrepancy, though, assumes that the campaign’s estimate of the cost of their single-payer plan is correct. An alternate analysis by respected health economist Kenneth Thorpe of Emory University finds a substantially higher cost, which would leave Sanders’s plan $14 trillion short. The plan would also increase the top tax rate beyond the point where most economists believe it could continue generating more revenue and thus could result in even larger deficits as a result of slowed economic growth.