CBO to stop scoring some parts of the health law

Jun 5 2014

The congressional budget analysts announce that they will continue to track the financial impact of the marketplaces and the Medicaid expansion program, but not some of the other smaller changes made under the law. Meanwhile, a new strategy for employers who provide health care is coming under scrutiny.

The Hill: CBO Throws In Towel On Scoring ObamaCare
Congressional budget scorekeepers said they can no longer measure the fiscal impact of many provisions of ObamaCare because the task is impossible. In a little-noticed footnote from April, the Congressional Budget Office (CBO) said it will continue to assess the effects of the law's exchange subsidies and the Medicaid expansion, while not tracking others. "The provisions that expand insurance coverage established entirely new programs or components of programs that can be isolated and reassessed," the office wrote (Viebeck, 6/4).

The New York Times: Risking A Health Insurance Strategy The I.R.S. May Not Approve
[A defined contribution health plan] largely frees the company from the headaches of arranging health coverage by reimbursing employees for insurance they buy on their own. At the same time, it allows the company to help its employees find affordable, often cheaper, options on the individual market through Zane. And, importantly, it promises that the contribution the company makes to its employees' coverage is tax-free for the employees and excluded from payroll taxes for the employer. That, however, is a promise Zane Benefits may not be able to keep. In a technical guidance issued last year and reiterated in May, the Internal Revenue Service issued a clear warning about such health reimbursement arrangements, according to eight health and tax lawyers as well a half-dozen lobbyists and analysts who have followed the Affordable Care Act's adoption (Mandelbaum, 6/4).

Also, as the law is implemented, some Republicans on Capitol Hill are starting to tread a bit more carefully on their plans for replacing it. And a legislative battle may be brewing over one health program as Congress tries to put together a tight budget --

The Associated Press: House GOP Conflicted On Health Law Alternative
House Republicans are united as ever in their election-year opposition to "Obamacare," but they're increasingly divided over their promise to vote this year on an alternative to it. The disagreement comes amid a shifting political calculus around President Barack Obama's health care law. Millions are enrolled for medical insurance through the law's exchanges, and an all-out repeal has become less practical and popular. Some Democrats have begun promoting the measure in campaign commercials, and some Republicans are treading more carefully in belittling the program (Werner, 6/4).

CQ Healthbeat: Advocates Press For Budget Transfers To Help Health Research Agency
Advocates for a federal agency charged with studying how to improve the practice of medicine are worried that it may lose out to better known health programs in the battles over the tight fiscal 2015 federal budget. The groups are working to build a case for the Agency for Healthcare Research and Quality, which draws much of its funding through a system of intramural transfers, known as TAPs, rather than through more straightforward annual appropriations. House GOP appropriators proposed getting rid of the AHRQ the last time that they marked a draft Labor-Health and Human Services-Education bill, a fiscal 2013 version that advanced only as far as subcommittee level in 2012 (Young, 6/4).

Meanwhile, money from the health law will fund a major study to find a way to prevent falls among seniors --

Kaiser Health News: PCORI, NIH Announce Plans For $30 Million Study On Falls
The nation's largest and most intensive study of how to best prevent seniors' injuries from falling will begin next year under a $30 million grant announced Wednesday by the Patient-Centered Outcomes Research Institute and the National Institutes of Health. ... The Patient-Centered Outcomes Research Institute, which is providing the funding for the study, is an independent organization created by the federal health law to provide strict research on the efficacy of care options to help patients and their health care providers make informed decisions (Jaffe, 6/5).