CBO Scores: What are they, and do they matter for nonprofits?

When the House passed its health care bill, the American Health Care Act, back in the spring, a good deal of political hay was made over the CBO score.  Now there is a frenzy of action around a new CBO score for the Senate’s proposed health care bill. But what is a CBO score? Does it help Congress? And what good are they to nonprofits?

What is a CBO Score?

CBO stands for the Congressional Budget Office. Created in 1974, it is a nonpartisan federal agency that produces independent analyses of budgetary and economic impacts of any laws Congress hopes to pass. These “scores” answer to questions like

  • How much will it cost over the next 10 years?
  • Will it change tax revenue?
  • How will the deficit be impacted?

 Most bills will receive a CBO score, especially if they involve the budget. In the case of health care bills, the CBO will also provide additional relevant information such as what the bill could do to premium costs as well as coverage implications.  

While there is nothing that obligates Congress to consider the CBO’s analysis, they need to understand the budget implications of what they are proposing, which the CBO provides. A CBO score and analysis is a part of the standard operating procedure that Congress uses to help understand how legislation will impact the nation.

A CBO simply reports on how the federal government is (or is not) investing in our communities. But CBO is only an analysis. It does not advocate for any particular public policy positions, which is why it’s so important for nonprofits to engage with federal policy. It is up to nonprofits, as mission driven organizations, to champion public policy positions that align with our values of building strong, thriving communities.

What does the CBO score released this week say?

The CBO score regarding the Senate's health care bill primarily reports that the amount of people who are uninsured will increase by 22 million people, a significant portion of which will come from changes to rules about Medicaid eligibility, as well as reducing funding to states for their Medicaid programs.

MCN’s Minnesota Budget Project blog, Budget Bites, provides more analysis and insights into what will happen in Minnesota as a result of these bills, and sheds light on to interpret the CBO score.

Will there be future CBO scores on other bills?

The healthcare bills being debated now are major pieces of legislation with profound impacts on our communities. But there will be CBO scores on other essential legislation too, such any tax reforms or changes to entitlement programs such as SNAP and TANF, all of which will have an impact on our communities.

The CBO puts their cost estimates on their webpage, in order of date of publication. The website is searchable by legislation and by topic. You can also check in with some policy resources like the Minnesota Budget Project or the Center on Budget and Policy Priorities.

What can Nonprofits do with a CBO score?


A CBO score will help inform where and when advocacy efforts need to take place. Because, in addition to helping inform where to focus advocacy efforts, the release of a CBO score is a good opportunity to tell our stories, and make our values known to lawmakers. They, as well as media outlets, often use the release of CBO scores as a mile marker for a bill that may be on its way to becoming law.

Law makers and journalists are on the lookout for community members and organizations who have the stories that tell the real impact of public policies behind those numbers.  Even if they are not actively looking, it can be an excellent opportunity to put the issue and your organization on their radar!

Remember, though, at the end of the day, knowing what CBO score says, or even what it is, isn’t a necessity for engaging in effective federal advocacy. A CBO score is one of many ways that nonprofits can find innovative ways to tell their story and work with federal policy makers to invest in communities.


Additional Advocacy Resources:

Tell Your Story

5 Actions in 5 Days

Additional Policy Resources:

MCN’s Minnesota Budget Project

Center on Budget and Policy Priorities

Congressional Budget Office

For ways to advocate on the topic of Medicaid, check out @ThisIsMedicaid on Twitter.