CBO Issues Cost Estimate for Special Needs Plans Reauthorization Act
H.R. 3168
Special Needs Plans Reauthorization Act of 2017
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As ordered reported by the
SUMMARY
H.R. 3168 would permanently authorize insurers to offer special needs plans (SNPs) for institutionalized beneficiaries through the
CBO estimates that enacting H.R. 3168 would increase direct spending by
CBO estimates that enacting the legislation would not increase net direct spending or on-budget deficits by more than
beginning in 2028.
H.R. 3168 contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act (UMRA).
ESTIMATED COST TO THE FEDERAL GOVERNMENT
The estimated budgetary effect of H.R. 3168 is shown in the following table. The costs of this legislation fall primarily within 550 (health).
By Fiscal Year, in Millions of Dollars
2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2017-2022 2017-2027
CHANGES IN DIRECT SPENDINGa
Estimated Outlays 0 0 6 13 13 14 14 14 15 15 15 46 119
a. H.R. 3168 also would require the Government Accountability Office to issue several studies about SNPs and their enrollees, which would cost about
BASIS OF ESTIMATE
Special needs plans (SNPs) are private health insurance plans in the
at the end of calendar year 2018.
H.R. 3168 would permanently authorize SNPs for institutionalized beneficiaries and would extend until
Based on analysis of information from stakeholders, CBO concludes that managed LTSS plans enroll a small number of individuals who otherwise would receive informal, nonfederally financed care in the community. Once those individuals are enrolled in a managed LTSS plan, they would receive Medicaid-financed LTSS for the first time.
Compared to current law, CBO estimates that the number of people who would receive Medicaid-financed LTSS under H.R. 3168 would grow over time. That increase would rise to about 1,200 by 2027. CBO estimates that expansion of participation in Medicaid-financed LTSS would increase federal Medicaid outlays by
fee-for-service sector.
H.R. 3168 also would require GAO to prepare three reports on the MA program, with
particular focus on SNP benefits and enrollees. Based on the scope of the reports and the
cost of similar activities, CBO estimates that implementing those provisions would cost
about
availability of appropriated funds.
PAY-AS-YOU-GO CONSIDERATIONS
The Statutory Pay-As-You-Go Act of 2010 establishes budget-reporting and enforcement
procedures for legislation affecting direct spending or revenues. The net changes in outlays
that are subject to those pay-as-you-go procedures are shown in the following table.
CBO Estimate of Pay-As-You-Go Effects for H.R. 3168 as ordered reported by the
By Fiscal Year, in Millions of Dollars
2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2017-2022 2017-2027
NET INCREASE IN THE DEFICIT
Statutory Pay-As-You-Go Impact 0 0 6 13 13 14 14 14 15 15 15 46 119
INCREASE IN LONG-TERM DIRECT SPENDING AND DEFICITS
CBO estimates that enacting the legislation would not increase net direct spending or
on-budget deficits by more than
beginning in 2028.
INTERGOVERNMENTAL AND PRIVATE-SECTOR IMPACT
H.R. 3168 contains no intergovernmental or private-sector mandates as defined in UMRA.
CBO estimates that the state share of increased Medicaid spending for extended enrollment
in certain SNPs would total
significant flexibility in Medicaid to adjust their financial and programmatic
responsibilities, such additional expenditures would not result from an intergovernmental
mandate as defined in UMRA.
PREVIOUS ESTIMATE
On
H.R. 3168, except that it would permanently authorize D-SNPs and SNPs that enroll
beneficiaries with certain chronic conditions. CBO estimates that permanently authorizing
D-SNPs would increase the number of people who would receive Medicaid-financed
LTSS relative to the temporary extension of the authority included in H.R. 3168. As a
result, section 201 of S. 870 would increase federal Medicaid outlays by
over the 2017-2027 period than H.R. 3168.
ESTIMATE PREPARED BY:
Federal Costs:
Impact on State, Local, and Tribal Governments:
Impact on the Private Sector:
ESTIMATE APPROVED BY:
Deputy Assistant Director for Budget Analysis
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