The Bipartisan Health Care Stabilization Act of 2017 would make several changes to the state innovation waiver process established by the Affordable Care Act (ACA), appropriate money for cost-sharing reductions (CSRs) through 2019, require many insurers to pay rebates to individuals and the federal government related to premiums in the nongroup health insurance market for 2018, allow anyone in the nongroup market to purchase a catastrophic plan, and require some existing funding for health insurance marketplace operations to be used specifically for outreach and enrollment activities for 2018 and 2019.

On net, CBO and the staff of the Joint Committee on Taxation (JCT) estimate that implementing the legislation would reduce the deficit by $3.8 billion over the 2018-2027 period relative to CBO’s baseline. The agencies estimate that the legislation would not substantially change the number of people with health insurance coverage, on net, compared with that baseline projection. Enacting the legislation would affect direct spending and revenues; therefore, pay-as-you-go procedures apply.

CBO and JCT estimate that enacting the legislation would not increase net direct spending or on-budget deficits in any of the four consecutive 10-year periods beginning in 2028.

The legislation would impose an intergovernmental and private-sector mandate as defined in the Unfunded Mandates Reform Act (UMRA). CBO estimates that the cost of the mandates would fall below the annual thresholds established in UMRA ($78 million for intergovernmental mandates and $156 million for private-sector mandates, respectively, in 2017, adjusted annually for inflation).