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How CBO and JCT Analyze Major Proposals

That Would Affect Health Insurance Choices
When tasked with analyzing major legislative proposals that would affect health insurance
choices for people under age 65, the Congressional Budget Office and the staff of the Joint
Committee on Taxation embark on a process to develop a cost estimate that reflects the
middle of the distribution of potential outcomes. CBO focuses on estimating the effects on
coverage, premiums, and federal spending, and JCT estimates the tax-related budgetary
effects. (The process applies to proposals that would make changes within the existing
insurance market but not to proposals that would eliminate private insurance.)


REVIEW THE PROPOSAL


                  0
 Congressional Budget Office
sar Analysis for the U.S Conigress


SRead the draft proposals, beginning with
   informal ones as ideas take shape and ending
 with a final version of the legislative language.


2 Analyze the policy
    specifications in the drafts.





 Improvin
                  •               I














                      Clarify any
                      ambiguities by
                   asking the authors
                   about their intent.


4 Identify how the proposal
    would change federal laws
and interact with state laws.


If the models produce results that are unexpected
       or not in line with historical outcomes and
          economic theory, revisit the approach.


MODEL THE EFFECTS

  OF THE PROPOSAL


    Having included inputs for insurers' 42   Estimate spending for Medicaid,            Estimate federal spending
     and state governments' decisions about  I2 the Children's Health Insurance           overall, and estimate federal
coverage and benefits, model individuals' and  Program, and other programs using     revenues using JCT's tax models.
employers' health insurance decisions over program-specific models.
the projection period using HISIM2.


For more information, see Congressional Budget Office, Methods for Analyzing Health Insurance Coverage, https://go.usa.gov/xppAM.

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