Answers to Questions for the Record following a Hearing Conducted by the House Committee on the Budget on the Budget and Economic Outlook: 2018 to 2028 V. 1

1 Answers to Questions for the Record following a Hearing Conducted by the House Committee on the Budget on the Budget and Economic Outlook: 2018 to 2028 1 (July 26, 2018)

handle is hein.congrec/cboqwqrf0001 and id is 1 raw text is:

. n JULY 26, 2018

Answers to Questions for the Record Following a Hearing
Conducted by the House Committee on the Budget
on The Budget and Economic Outlook: 2018 to 2028

On April 12, 2018, the House Committee on the Budget convened a hearing at which Keith Hall,
Director ofthe Congressional Budget Office, testified about The Budget and Economic Outlook:
2018 to 2028.' After the hearing, Congressman Palmer submitted questions for the record. This
document provides CBO's answers. It is available at www. cbo.gov/publication/54206.

Question. How is CBO's new decision to assume funding for cost-sharing reductions (CSRs)
through higher premiums and larger premium tax credit subsidies rather than through
a direct appropriation consistent with Section 257(b)(1) of the Balanced Budget and
Emergency Deficit Control Act (BBEDCA), which states that under the budgetary baseline,
funding for entitlement authority is assumed to be adequate to make all payments required
by law? How is any potential assumption that Congress will NOT appropriate CSR funds
directly consistent with the requirement of Section 257(b)(1) of BBEDCA to assume
funding to make all payments?
Answer. CBO's treatment in the baseline of payments for CSRs both reflects the reality of
how the CSRs are being funded and is consistent with the requirements of BBEDCA.
Background. Insurers that participate in the marketplaces established under the Affordable
Care Act (ACA) are required to offer CSRs to eligible people. CSRs decrease deductibles and
other out-of-pocket expenses like copayments. To qualify for CSRs, people must generally
purchase a silver plan through a marketplace and have income between 100 percent and
250 percent of the federal poverty guidelines (also known as the federal poverty level).2
Before October 12, 2017, the federal government reimbursed insurers for the costs of
CSRs through direct payments. However, on that date, the Administration announced
that, without an appropriation for that purpose, it would no longer make such payments to
insurers. Because insurers are still required to offer CSRs and to bear their costs even without
direct payments from the government, most have covered those costs by increasing premiums
for silver plans offered through the marketplaces for the 2018 plan year, and CBO expects all
insurers to do so beginning in 2019.

1. See testimony of Keith Hall, Director, Congressional Budget Office, before the House Committee on the
Budget, The Budget andEconomic Outlook: 2018 to 2028 (April 12, 2018), www.cbo.gov/publication/53722.
2. For additional information about CSRs and their budgetary treatment, see Congressional Budget Office,
Federal Subsidies for Health Insurance Coverage for People Under Age 65: 2018 to 2028 (May 2018), pp. 8-9,
www.cbo.gov/publication/53826, and letter to the Honorable Mark Meadows regarding the budgetary
treatment of cost-sharing reductions (June 8, 2018), www.cbo.gov/publication/53961.

What Is HeinOnline?

HeinOnline is a subscription-based resource containing thousands of academic and legal journals from inception; complete coverage of government documents such as U.S. Statutes at Large, U.S. Code, Federal Register, Code of Federal Regulations, U.S. Reports, and much more. Documents are image-based, fully searchable PDFs with the authority of print combined with the accessibility of a user-friendly and powerful database. For more information, request a quote or trial for your organization below.

Short-term subscription options include 24 hours, 48 hours, or 1 week to HeinOnline.

What Is HeinOnline?

Purchase Access

Contact Us

Log In

NEED HELP?

CONTACT US

Get started

Subscribe to our Newsletter