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1 Additional follow-up about the Budgetary Treatment of Cost-Sharing Reductions 1 (September 27, 2018)

handle is hein.congrec/cboafbt0001 and id is 1 raw text is: 






O        CONGRESSIONAL BUDGET OFFICE                                 Keith Hall, Director
         U.S. Congress
         Washington, DC 20515



                                    September 27, 2018



        Honorable Mark Meadows
        U.S. House of Representatives
        Washington, DC 20515

        Re: Additional Follow- Up About the Budgetary Treatment of Cost-Sharing
        Reductions

        Dear Congressman:

        In a September 6, 2018, letter, you asked for additional information related to
        your earlier questions about the budgetary treatment of payments for cost-sharing
        reductions (CSRs) provided by insurers in the marketplaces established under the
        Affordable Care Act. 1 Specifically, concerned about the sequence of events, you
        asked about when the Congressional Budget Office undertook its analysis of
        health insurance premiums and when the agency decided how to incorporate that
        information into its baseline projections published in April 2018.

        CBO analyzed how premiums for 2018 had been affected by the lack of CSR
        payments in all states and the implications for the agency's baseline projections
        before those projections were finalized in March 2018. To do so, it consulted
        extensively with state insurance regulators, state-based marketplaces, and
        insurers. In fact, insurers' plans had become public knowledge well before that
        date. Also, before finalizing its baseline in March 2018, CBO fully considered the
        relevant statutory language and precedent and how to interpret them with respect
        to incorporating its analysis into the baseline.

        The approach CBO used allows the baseline projections to reflect what is actually
        happening in insurance markets, rather than the alternative of assuming the
        continuation of direct payments that were not being made.





        ' See Congressional Budget Office, letter to the Honorable Mark Meadows following up
        about the budgetary treatment of cost-sharing reductions (July 20, 2018), www.cbo.gov/
        publication/54191, and letter to the Honorable Mark Meadows about the budgetary
        treatment of cost-sharing reductions (June 8, 2018), www.cbo.gov/publication/53961.


www.cbo.gov

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