Late last week, the US House of Representatives passed a series of bipartisans bills and combined them into one large bill to help fight the opioid crisis. The Congressional Budget Office (CBO) recently published two documents (E&C Committee and W&M Committee) estimating the impact of each of the bills addressing the opioid crisis that were reported out of the House Energy and Commerce Committee and the House Committee on Ways and Means. The bills were discussed in the House Energy and Commerce Committee on May 9 and May 17, while the House Committee on Ways and Means held its hearing on opioid legislation on May 16.
CBO noted that its estimates reflect the “middle of a range of likely budgetary outcomes” and do not include the effects of interactions among the bills. The agency believes there would have been minimal impact on the estimates had they analyzed the proposals as a single piece of legislation.
CBO made further caveats in its analysis by noting, “Because data on the utilization of mental health and substance abuse treatment under Medicaid and Medicare is scarce, CBO cannot precisely predict how patients or providers would respond to some policy changes or what budgetary effects would result. In addition, several of the bills “would give the Department of Health and Human Services (HHS) considerable latitude in designing and implementing policies.”
House leaders are solidifying which bills could be scheduled on the suspension calendar and how the remaining bills will be presented for consideration by members.
CBO’s analysis of the E&C bills found that:
- Twenty of the bills would affect direct spending, making them subject to pay-as-you-go.
- Two of the bills would affect revenues, making them subject to pay-as-you-go procedures.
- Enacting H.R. 4998, the Health Insurance for Former Foster Youth Act, would increase net direct spending by more than $2.5 billion and on-budget deficits by more than $5 billion in at least one of the four consecutive 10-year periods beginning in 2029. This would be the only bill to increase net direct spending and on-budget deficits by such large amounts.
- Ten bills would authorize specified amounts to be appropriated over the 2019-2023 period. Spending from those authorized amounts would be subject to appropriation.
CBO’s analysis of the W&M bills found that:
- Four of the bills would affect direct spending, making them subject to pay-as-you-go procedures.
- None of the bills would affect revenues.
- Only one of the seven bills would increase net direct spending by more than $2.5 billion and on-budget deficits by more than $5 billion in at least one of the four consecutive 10-year periods beginning in 2029.
The bill passed now moves on to the Senate which has been taking a very slow walk on the opioid issue. With the sweeping vote of 396-14 it is hopeful that Senate will adopt this before adjuring for their truncated summer recess.