The Congressional Budget Office and the staff of the Joint Committee on Taxation (JCT) have completed an analysis of H.R. 3, the Elijah E. Cummings Lower Drug Costs Now Act, as posted by the House Committee on Rules on December 6, 2019 (Rules Committee Print 116‑41), and including modifications discussed with staff.
CBO and JCT estimate that enacting the current version of H.R. 3 would increase direct spending by about $40 billion and increase revenues by about $46 billion over the 2020-2029 period. The net effect would be to reduce unified federal deficits by about $5 billion over that 10-year period.
The largest effects on spending over that period would result from two sets of provisions, CBO and JCT estimate:
The price negotiation provisions would lower spending by about $456 billion, and
The provisions providing dental, vision, and hearing coverage under the Medicare program would raise spending by approximately $358 billion.
The estimates are uncertain. For example, the price negotiation process could be implemented in ways that differ from CBO’s interpretation, and manufacturers might respond to it differently from what CBO has projected.
The estimates in Table 1 account for interactions among various provisions of the bill. Specifically, the estimates of title II reflect the impact of title I; the estimate of title III reflects the impact of titles I and II; and the estimate of titles V, VII, and VIII reflects the impact of the first three titles. CBO has not estimated the effects of H.R. 3 on spending subject to appropriation; but those effects could be substantial.