Cost Estimate and Supplemental Analyses for H.R. 2, as posted on the website of the House Committee on Rules on March 24, 2015.
Over the 2015–2025 period, CBO estimates, enacting H.R. 2 would increase both direct spending (by about $145 billion) and revenues (by about $4 billion), resulting in a $141 billion increase in federal budget deficits (see table on page 2). Although the legislation would affect direct spending and revenues, it would waive the pay-as-you-go procedures that otherwise apply.
In addition, CBO has conducted three supplemental analyses:
The first analysis compares the budgetary effects of the bill as a whole to those of a policy that would freeze Medicare’s payment rates for physicians’ services at current levels and would make none of the changes in H.R. 2. CBO estimates that enacting H.R. 2 would cost $0.9 billion less over the 2015–2025 period than freezing payment rates for physicians’ services.
The second supplemental analysis examines the effects of the bill on deficits during the decade after 2025. However, considerable uncertainty exists about the evolution of the health care delivery and financing systems that far in the future, so a precise estimate is not feasible. In CBO’s assessment:
- Enacting H.R. 2 would raise federal costs relative to current law during the decade after 2025.
- Compared with the costs of freezing Medicare’s payment rates for physicians’ services, the budgetary effects of the legislation could represent net savings or net costs in the second decade after enactment, but the center of the distribution of possible outcomes is small net savings.
The third analysis examines the effects of the bill on monthly premiums for Part B of Medicare in 2025. (Part B is Medical Insurance, which covers doctors’ services, outpatient care, home health services, and other medical services.) CBO estimates that enacting H.R. 2 would raise basic monthly Part B premiums by about $10 in 2025. By comparison, CBO estimates that the basic monthly premium would increase by about $7.50 in 2025 if Medicare’s payment rates for physicians’ services were frozen at current levels.