An important component of the longer-term analysis is that, beginning in 2019, the reconciliation proposal would change the annual indexing provisions so that the premium subsidies offered through the exchanges would grow more slowly; over time, the spending on exchange subsidies would therefore fall back toward the level under H.R. 3590 by itself.
This means that the increase in affordability tax credits provided by the reconciliation package starting in 2014 would disappear only a few years afterwards. That is a pretty big caveat. Given that this reconciliation bill does not include a public option, Medicare buy-in, a national exchange, a higher medical loss ratio, all-payer, or direct Medicare drug price negotiations, and is unlikely to keep the National Insurance Rate Authority, and now add the fact that the much touted increases in affordability tax credits are only temporary, and it becomes apparent that this reconciliation package is a tremendous wasted opportunity.
Way to go, House Democrats! You basically get one bill a year that can't be filibustered, and this is all you can think to do with it to "improve" the Senate health care bill?