By Mara Lee
Democrats in the Senate had asked the nonpartisan agency to estimate outside the typical 10-year budget window, because the Better Care Reconciliation Act bill changes the growth rate for the per-capita cap in the ninth year.
The CBO report may make it more difficult for GOP leadership to line up moderate votes to pass the bill, and they may have to scrap the bill’s proposed change to a lower inflation rate in 2025 to ensure passage.
Until then, the cap for the federal contribution is expected to be higher than projected growth for the elderly and disabled, and lower than the growth rate for healthy children and adults. All groups would have growth pegged to medical inflation, but the elderly and disabled would have medical inflation plus one percentage point. In 2025, that growth rate would be limited to general inflation, which the CBO projected would be 2.4% annually.
“In later years, [the] gap would continue to widen because of the compounding effect of the differences in spending growth rates.”
Disabled children are exempted from any cap in the bill.
The agency did not make an estimate for how the declining federal commitment to Medicaid would affect coverage, but said: “enrollment in Medicaid would continue to fall.”