Brian Blase, a senior fellow at George Mason University's Mercatus Center, said CBO overestimated exchange enrollment in part because the agency overestimated how effective the individual mandate would be at getting "relatively healthy people with middle class income to buy coverage in the exchanges." As for CBO's underestimate of Medicaid and CHIP enrollment, recent research by MIT economist Jonathan Gruber suggested that a significant number of people who enrolled in Medicaid after the ACA already had been eligible under pre-ACA rules—an effect that CBO did not entirely anticipate.
Make no mistake, although the bureaus strew words like “cooperatively” throughout that website, all the changes they are making are the result of government enforcement actions.
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Some Republican lawmakers and members of the Trump administration say CBO's estimates are not reliable.
In a statement, the White House said, "The CBO has consistently proven it cannot accurately predict how health care legislation will impact insurance coverage. C.) said, "If you were on the fence, you were looking at this as a political vote, this CBO score didn’t help you." And Sen.
"There was a lot of outreach and publicity, and people started coming in," she explained.
CBO's projections also were made before the Supreme Court's 2012 decision in , which made the ACA's Medicaid expansion optional.Robert Reischauer, who directed the CBO from 1989 to 1995, put it well when he recently told NBC News that CBO was both imperfect and essential. Instead of leaders relying on the traditional playbook for physician alignment, they must take more active steps.Download the research report to learn 15 core attributes of a high-performance physician network to learn how to best approach physician strategy.But policymakers also need some sort of analysis to help them make decisions. Yes, if I had to make policy." Hospital and health system leaders cannot respond to the demands of population health and consumerism without forging effective physician partnerships.And while CBO's ACA projections were off in some areas, a 2015 analysis by the Commonwealth Fund suggests they were more accurate than several other forecasts by independent experts. As practice economics deteriorate and MACRA forms the core of physician payment, more physicians are proactively seeking formal relationships with health systems.Any CBO analysis starts with a close reading of the legislation being scored.