{
  "asOf": "2026-10-21",
  "status": "partial-working-estimate",
  "unit": "USD billions at the saved 2030 reference basis; not calendar-year cash forecasts",
  "fullPlanCostBillion": null,
  "completeFundingGapBillion": null,
  "netHouseholdSavingsBillion": null,
  "comparisonsAreAdditive": false,
  "comparisons": [
    {
      "id": "patient-payments",
      "title": "Patient payments already included in care",
      "scope": "Five selected community groups: work/public coverage overlap, Medicare and Medicaid together without work coverage, Medicare without work coverage, Medicaid without work coverage, and uninsured people. These are modeled coverage groups, not all households or all eligible residents.",
      "assumptions": "The saved 2030 comparison projects the selected historical service and payer records using its population and spending factors. It includes agency home care, additional equipment/medical services and paid-independent home bundles once. It does not establish the clinical share of mixed support bundles or create a new support entitlement.",
      "limits": "These payments are already inside the conditional care estimate. Do not add them again. They exclude institutional patient payments and premiums. Ending a patient bill is not the same as net household savings: new taxes, consented premiums, ended premiums and paid refunds must be matched to the same household and year.",
      "sourcePath": "docs/policy/analysis/health-cash-completion-results.json",
      "methodPath": "docs/policy/analysis/health_cash_completion.py",
      "rows": [
        {
          "label": "Existing patient payments already represented",
          "valueBillion": "220.1522984523787254436",
          "sourceField": "patient_payments.total_reference_billion"
        }
      ]
    },
    {
      "id": "work-coverage-entry",
      "title": "A separate test: the whole work-covered group enters",
      "scope": "Employer/union coverage months without Medicare or Medicaid, after the source model's specialist-arrangement exclusions. Includes dependents and retirees, not just workers. The 2030 projection represents 147.561 million annual coverage equivalents, not a forecast of new enrollees. Institutional residents and other-private coverage are outside this group.",
      "assumptions": "This exposure test moves the entire modeled group, not a selected take-up rate. It reuses ten service groups, a net-drug spending proxy, service-specific zero-charge demand responses and separate access-demand additions of 2.5% for medical care and 4% for drugs. These additions use the original base, not compounded growth. Gross operations use the inherited care × 0.03 / 0.97 convention, not a validated staffing budget.",
      "limits": "Not predicted enrollment, a full cost bound or a net federal funding gap. Do not automatically add this case to another subtotal or subtract unmatched all-sector employer credits or premiums. Actual entry could have a different health mix. Remaining benefits, delivery capacity, setup, retained support and matched cash/baseline effects are not fully priced. No staffing savings or provider-return guarantee is assumed.",
      "sourcePath": "docs/policy/analysis/health-employer-entry-care-results.json",
      "methodPath": "docs/policy/analysis/health_employer_entry_care.py",
      "rows": [
        {
          "label": "Existing patient and private payments changing payer",
          "valueBillion": "1384.385062664484120268",
          "sourceField": "pressure.existing_transfer_billion"
        },
        {
          "label": "Modeled additional care",
          "valueBillion": "387.8356157993979585423903384",
          "sourceField": "pressure.added_care_billion"
        },
        {
          "label": "Selected additional plan-care responsibility (sum above)",
          "valueBillion": "1772.220678463882078810390338",
          "sourceField": "pressure.incremental_plan_care_billion"
        },
        {
          "label": "Separate gross operations convention",
          "valueBillion": "54.81094881847057975702238159",
          "sourceField": "pressure.incremental_gross_operations_billion"
        }
      ]
    }
  ],
  "unknowns": [
    {
      "title": "Additional care and delivery capacity",
      "detail": "What more is needed to deliver the complete treatment bundle, timely access and adequate local care, beyond work already priced or funded. Existing demand allowances are not proof that all needs are met.",
      "valueBillion": null
    },
    {
      "title": "Implementation after reuse",
      "detail": "The net cost of adapting benefits and payment systems, connecting programs, moving coverage safely, testing readiness and closing old contracts. Existing systems are not free to adapt. Do not stack old startup allowances.",
      "valueBillion": null
    },
    {
      "title": "Matched cash and shared funding",
      "detail": "Employer credits, collections, household consent, refunds and joint tax receipts for the same people and years, after housing and other platform commitments. The 2029–2038 cash estimate must also include temporary payments and ongoing interest.",
      "valueBillion": null
    }
  ],
  "evidence": [
    {
      "label": "AHRQ: 2024 MEPS household file documentation",
      "url": "https://meps.ahrq.gov/data_stats/download_data/pufs/h256/h256doc.shtml",
      "use": "Historical community coverage and spending, not future take-up or legal eligibility."
    },
    {
      "label": "CMS: national health expenditure projections",
      "url": "https://www.cms.gov/data-research/statistics-trends-and-reports/national-health-expenditure-data/projected",
      "use": "Saved 2025–2034 projection factors; not a score of Attractor."
    },
    {
      "label": "CBO: single-payer modeling methods (2020)",
      "url": "https://www.cbo.gov/system/files/2020-12/56811-Single-Payer.pdf",
      "use": "Transported demand assumptions, not an endorsement, provider fee schedule or estimate of this plan."
    }
  ],
  "evidenceNote": "Original analytical results retain their historical labels. They are separate conditional comparisons, not additive budgets or booked receipts. Null means unknown, not zero. Source pins and method paths identify the saved evidence, not a claim that source data were refreshed for this page.",
  "sourceResults": {
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      "date": "2026-10-20",
      "status": "Conditional 2030-reference reconciliation, not matching-year cash or a full score",
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        "health-support-calibration-results.json": "1a20edb3b811c732f26d426fecf073a46b1ea99ef55e6f0232a22df89daf6fd9",
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      },
      "patient_payments": {
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            "patient_billion": "6.57126683539222818"
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            "patient_billion": "111.387458330751968"
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        "exclusions": "Institutional patient payments, premiums, newly demanded care, household taxes and refunds",
        "added_plan_cost_billion": "0",
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      "status": "Conditional full work-no-public cohort entry exposure, not forecast or full bound",
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}