Thread by @charles_gaba

📣 @USCBO releases 10-yr cost estimate of @WaysMeansCmte portion of #AmRescuePlan, including the first official estimates of how much #HR369 might cost & how much it might boost #ACA enrollment:
acasignups.net/21/02/16/cbo-r…

At first glance, the CBO makes it look like #KillTheCliff / #UpTheSubs would cost $34.2 billion & would boost on-exchange enrollment by 1.7 million people.

HOWEVER, a closer look reveals it's a lot more complicated than that:

1. The $34.2B is over 10 yrs...but really only 4 yrs (2021 - 2024), since the subsidy expansion would only be for 2 yrs (for now), plus lingering impact for another 2.

2. Only one of those includes a full 12-month period of the #HR369 APTC formula being in effect, for $14B.

So parsing it out, the CBO is really estimating that for a single year, at current premiums, #HR369 (the *permanent* version of this bill) would mean around $14 billion in additional APTC subsidies & would boost #ACA exchange coverage by ~1.7 million people.

"OMG! That's $8,200 apiece, right??" NO.

Remember, ~2/3 of the total would be spent *enhancing subsidies for existing enrollees*. Only ~1/3 or so would go to the *additional* on-exchange enrollees.

As far as I can figure, right now the #ACA spends around $54B/year on subsidies for ~9.1 million on-exchange enrollees ($5,900/yr)

This would increase that to around $68B/year for around 11 million enrollees, give or take (there's a few enrollees I'm still fuzzy on) ($6,100/yr).

Personally, I think the CBO is lowballing the on-exchange enrollment boost for 2022 (2021 is a lot messier). My guess is it'll be more like ~2.5 - 3.0 million vs. 1.7 million if the bill goes through...but again, who knows?