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May 27, 2009 at 08:00 PM
The Congressional Budget Office says health reform proposals raise complicated questions about how the federal budget should treat items such as health exchange
Many proposals include provisions that would create an exchange that consumers could use to buy individual or small-group health coverage, and a new “public health insurance” option for working-age adults who are not eligible for Medicare or Medicaid, the CBO says in discussion of budget treatment of health insurance proposals.
When considering treatment of exchanges, for example, “in CBO’s view, the answer partly depends on whether individuals and firms would direct their payments *to exchanges* that in turn would pay insurers, or whether individuals and firms would make their payments via the exchanges to the insurers themselves,” the CBO says. “In the former case, the answer would also depend on whether the exchanges were considered to be federal entities . . . or not.”
Payments to federal entities should be reflected in the federal budget, but payments to insurers, or to exchanges that were not federal entities, should be excluded from the federal budget, the CBO says.
