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Posts Tagged ‘cbo’

Picking Apart New CBO Numbers

The Congressional Budget Office finally released its score of the reconciliation bill, sending bloggers running to their keyboards to write up their thoughts.

Time’s Kate Pickert: “Some people say that comprehensive health care reform is like a balloon – squeeze one part and another part expands. … House Democratic leaders worked under severe fiscal constraints in designing their reconciliation package. They had to keep the legislation under $1 trillion over 10 years, make it save more than the Senate bill did, and expand coverage and affordability to satisfy House Democrats. These are not easy rules to follow, especially when the whip count is still volatile and the clock is ticking. But they followed the rules and the package could earn endorsements from some wavering House Democrats today.”

The American Spectator’s Philip Klein: “Democrats have maintained the strategy of delaying the major spending provisions until 2014 to create the appearance that the bill is cheaper over the CBO’s ten year budget window, from 2010 through 2019. In this version, the bill spends $17 billion in the first four years, while the remaining $923 billion, or 98 percent, is spent in the next six years. I’ve illustrated this tactic in the chart below.”

Hot Air’s Ed Morrissey: “Want to see what a shabby fraud these cost estimates are? Check out the line [in the CBO table] for ‘Gross Cost of Coverage Provisions’. This is why they’re delaying the start of the program, of course. If it kicked in right away, the decade-long estimate would obviously be well into the trillions. So they simply stalled it for four years, incurring just $17 billion in costs — or 1.8 percent of the total 10-year estimate — through 2013 so that wavering Democrats could go back to their districts and tell baldfaced lies to their constituents about the pricetag. A perfect ending to this travesty.”

The Washington Post’s Ezra Klein: “The question people generally ask about the final health-care reform vote is, ‘Won’t it be politically difficult for many House Democrats to vote yes?’ But with the release of the CBO report (pdf), I’d flip that question a bit: Won’t it be substantively difficult for many House Democrats to vote no?” He points out that Democrats will be loathe to vote against a bill that extends health insurance to 32 million people, ends some of the most dreaded insurance practices like discrimination based on pre-existing conditions and cuts the deficit.”

And in a separate post Klein says: “[The CBO score] moves the story from process to substance. How Congress will vote is not a good story for the Democrats. What they will be voting on is rather better, and they’re much more comfortable talking about it.”

Cato’s Michael Cannon: “As former Congressional Budget Office director Donald Marron has explained over and over, the figure that Democrats consistently cite for the cost of their bills is only the CBO’s estimate of the cost of federal spending related to the expansion of health insurance coverage. It is not the full cost to the federal government, because each bill also spends taxpayer dollars on other items.

Marron examined the CBO’s March 11 score of the bill that passed the Senate on Christmas Eve, and found an additional $96 billion of spending over 10 years. If the most recent iteration of ObamaCare is similar, then new federal spending in that bill would be approximately $1.036 trillion — pushing the total over the president’s spending target.”

The New Republic’s Jonathan Cohn: “After weeks of negotiation, [Democrats] have agreed upon a set of amendments to the Senate health care bill. The changes mean the package as a whole will cover more people, and save more money, than the Senate bill would have originally. House Democratic leaders are saying enactment would produce “biggest deficit reduction act in 25 years.” House Majority Whip James Clyburn described himself as “giddy.”

The Democrats had to confront some tough trade-offs, too. And the amendments reflect that. In order to satisfy Congressional Budget Office accounting standards for projections after 2020, they had to accelerate a tax on benefits and pull back on financial assistance for middle- and low-income Americans for later years. Still, those sacrifices have to be weighed against the other improvements the amendments make, not to mention the lawmaking opportunity it creates.”

Wonk Room’s Igor Volksy: “This package covers 32 million Americans and, as the reduction in Medicare spending suggests, begins to slow the growth in health care spending. It reverses the current trend and lowers the deficit quite substantially over the next 20 years.

So this is something to keep in mind as Republicans ignore the deficit reductions in this score and blanked cable tv to argue that the bill is full of gimmicks (because spending starts before benefits) and the government is taking over. In fact, the reverse is true. The bill reduces the deficit over the full 20 years and slows government spending (in terms of Medicare).”

Thursday, March 18th, 2010

Tags: accounting, cbo, cost, deficits, score
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Beyond the Senate Debate

Bloggers are mostly immune to the specific’s of today’s Senate debate, instead plugging away at topics of their choice, including a proposed Medicare commission, right-leaning ideas for health reform and a new CBO report.

The Washington Post’s Ezra Klein is concerned that that recent changes have “seriously weakened” the proposed new independent Medicare commission. “The big problem is that the commission is now barred from submitting reform proposals when Medicare’s five-year spending growth average is lower than the health-care system’s more generally. But Medicare’s five-year average is almost always lower than the health-care system’s. Medicare is better at containing costs. But better, in this case, is not good enough.” Klein credits The Concord Coalition’s Joshua Gordon.

John Goodman responds to criticism of right-leaning health policy ideas, noting, “there is probably no other public policy area on which there is so much diversity of right-of-center opinion than there is right now on health policy.” (emphasis his) He lists 12 different right-leaning proposals, saying the main area of agreement is Health Savings Accounts.

Louise Norris was “struck by the negativity” of the Chamber of Commerce’s proposal: “It seems that they have devoted so much time and energy to criticizing the proposed reforms that they forgot to focus on solutions of their own. It makes me wonder if they’re seeing the same problems as the rest of us: problems like 62% of bankruptcies being attributed to medical debt, and the tens of millions of Americans who have no health insurance at all.”

Also in the news is a Congressional Budget Office report on “promotional spending” of pharmaceutical companies that found they spent about $20.5 billion in 2008. Director Douglas Elmendorf says, “To place those figures in context, in 2008, promotional expenditures equaled 10.8 percent of the U.S. sales reported by the Pharmaceutical Research and Manufacturers of America, in line with most years since the early 1990s, during which time that share has remained between 10 percent and 12 percent.”

Thursday, December 3rd, 2009

Tags: cbo, health savings accounts, hsas, medicare, phrma, prescription drugs, rx, spending
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Senate CBO Score Expected This Afternoon

Citizens of the blogosphere are twiddling their thumbs waiting for the Congressional Budget Office to release a final score of the Senate health overhaul bill, which many expect when Majority Leader Reid meets with the Democratic Caucus at 5 p.m. today. In the meantime, many can’t resist guessing the outcome.

Perhaps in preparation for today’s release, Former Speaker Newt Gingrich, R-Ga., sent a letter to Speaker Pelosi, Majority Leader Reid and President Obama. Gingrich and his 50 cosigners ask the Democratic leaders to “slow down…open up…don’t break the bank.” Critical Condition’s Tevi Troy has the letter (pdf), saying “it’s worth a read.”

The Washington Post’s Ezra Klein says, contrary to claims from some Republicans that they will repeal a health reform bill if elected in 2012, “There’s just not much precedent for changes in partisan power ending in the repeal of large pieces of recently passed legislation. In part, that’s due to the nature of the Senate: Repeal requires 60 votes as surely as passage.”

Wonk Room’s Igor Volksy (who includes a shot of Reid praying) rounds up the latest rumors on how the Senate may rush to pass the bill:

Democrats are also indicating that they may “short-circuit the legislative process” to pass health care reform by December 18th, the last day Congress is in session. “The most talked about method is end running the formal conference committee process in favor of some sort of mini-conference. Democratic officials in the White House and Congress are envisioning an end game similar to the way the $787 billion stimulus package came together with congressional leaders and White House aides hashing out the differences behind closed doors.”

The New Republic’s Suzy Khimm reports on another piece of the soon-to-come bill. According to Khimm, “Amid all the concern about subsidy levels in health care reform comes word that Senate Majority Leader Harry Reid is, in fact, going to boost the financial assistance available to Americans buying health insurance. The problem? It’s not the group who needs help the most–and it may come at the expense of those who do.” Reid is expected to lower the maximum percent of income for middle-income earners and raises the percent of income spent on insurance for low-income earners.

Commentators on the right are likely to have their frustration piqued even more — Heritage’s Brian Darling explains objections to even beginning debate: “The bottom line is that Senators will be voting to proceed to a bill on Friday that they have yet to see and will have little time to read before the first critical vote. Sadly, the secretive procedure used to roll out this legislation has severely restricted the rights of Americans to participate in this process.”

And in other news, Conservative columnist Ross Douthat uses his new blog on the New York Times’ site (where his column runs) to put in his two cents on the health bills: “That means that 10 years and hundreds of billions into health care reform, two-thirds of the uninsured will have coverage — but the remainder, 18 million strong, will be paying more and getting exactly nothing in return. We’ll be effectively taxing a third of the uninsured to cover the rest. Liberals, of course, will say this just proves that we just need to spend billions more on subsidies. But I say that it makes Tyler Cowen’s alternative approach seem vastly more attractive.”

Wednesday, November 18th, 2009

Tags: cbo, gingrich, reid, secret, senate, slow down, subsidies
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CBO Strikes Again

The Congressional Budget Office released its updated cost estimate of the Senate Finance Committee bill Wednesday afternoon following hours of Twitter speculation among health policy journalists and wonks. The mood was aptly captured by Politico’s Mike Allen, who declared “CBO OMG” in his daily agenda spotlight, Politico Playbook.

CBO Director Douglas Elmendorf was even more serious than usual, and just gave a run down of the estimate that’s shorter than the official report delivered to Finance Chairman Baucus.

Heritage’s Conn Carroll: “The New York Times awarded Baucus with the headline that the White House has been searching for since the debate first began: “Health Care Bill Gets Green Light in Cost Analysis.’” Carroll says, “But this headline and the accompanying article are fundamentally dishonest,” because it’s not an official CBO score (it was a called “an analysis”), but rather the ‘Chairman’s Mark’, which is written in laymen’s terms. Carroll continues, “Not only does the Baucus bill not even really exist, just a Vapor Bill filled with conceptual language, it is about to be completely thrown out the window when Senate Majority Leader Harry Reid (D-NV) merges it with the deficit busting HELP bill to move it to the Senate floor.”

The Washington Post’s Ezra Klein: “Meet the New Health-Care System, Not That Different From the Old Health-Care System.” He goes on. “This bill will change the insurance situation for 37 million legal residents, 29 million of whom would otherwise be uninsured. That’s a big step in the right direction. But most people will never notice it. When I got an early glimpse of the Senate Finance Committee’s bill back in June, I called it “comprehensive incrementalism,” and I stick by that label. It makes a lot of things a bit better, but it’s not root-and-branch reform.”

Hot Air’s Allah Pundit on the line in the analysis “Those estimates are all subject to substantial uncertainty:” “Expect that to be a key GOP talking point given that (a) amendments to Baucus’s bill will wreak havoc with this analysis and (b) Medicare’s initial projection of $12 billion in expenditures for the year 1990 turned out to be “uncertain” too. How uncertain? Actual 1990 expenditures ended up at $107 billion, a cool 800 percent higher than Congress thought they’d be. Woe unto him who relies on any conservative estimate of how much a giant social program will cost.”

The New Republic’s Jonathan Cohn: “This is something we’ve known for a while: The Senate Finance bill isn’t as generous or as protective as it ought to be. But the fact that the measure would actually save money means, or should mean, there’s a bit more room (financially and politically) to throw additional funds at expanding/improving insurance coverage–ideally, by raising a little more money in taxes and/or offsetting savings.”

Donald Marron says the cost estimates released don’t represent the whole picture: “There is a difference between the cost of the Baucus bill ($904 billion) and the cost of its provisions to expand coverage ($829 billion). It is understandable that most commentary focuses on the health insurance provisions. But we should not forget the other $75 billion in spending on other initiatives. Dollar-for-dollar they deserve as much scrutiny as the coverage expansions.”

Wonk Room’s Igor Volksy prepared a table that compares the first Finance bill draft with the final bill.

The Atlantic’s Megan McArdle: “So most of the major components of the program are scheduled to either cost more, or raise less revenue . . . but overall, it’s generating a bigger surplus. It’s the healthcare economist’s version of “We’re losing money on every unit, but we’ll make it up in volume!”

And in a more neutral take, Jacob Goldstein of The Wall Street Journal’s Health Blog identifies “Five Key Numbers,” plus a special “bonus” number, on insurance co-ops.

Thursday, October 8th, 2009

Tags: cbo, costs, finance committee, reform
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The Tweetest Things

From this morning’s Politico front page: “Revenge is Tweet” — Kenneth Vogel reports on a new study that found almost twice as many Republican lawmakers have Twitter accounts compared to Democrats. Politico takes a closer look at some of the leading “tweeters”: Sen. John McCain, R-Ariz., Sen. Chuck Grassley, R-Iowa and Sen. Jim DeMint, R-S.C.

Validating Politico’s premise, a look at some tweets from yesterday’s Finance Committee markup: Republican John Cornyn tweeted “That was then, this is now, ” linking to a CBS News piece on “Five Health Care Promises Obama Won’t Keep”. And Grassley weighed in this morning (during the Finance markup) in his famous disjointed abbreviations: “If u hv time watch Finance Comm during amending process of Health Care. Affects 1/6th economy and evry American. Big lift for Congress.” The only Democrat who weighed in, Sen. Bob Menedez, just posted pictures of the markup scene.

Quick Hits:

CBO chief Douglas Elmendorf doles out the agency’s judgment on the original subsidies to purchase health insurance in the Finance bill.
The Kaiser Family Foundation has a new ’subsidy calculator’ that estimates premiums and government assistance under the various reform proposals. (KHN is a project of the Foundation.)
FiveThirtyEight.com’s Nate Silver examines poll numbers and asks if being part of the “Gang of Six” contributes to declining approval ratings.
James Capretta on the New Atlantis proclaims the “Death of Medicare Reform.”
The New Republic’s Jonathan Chait wonders if Republicans are committing “a long-term policy blunder” in their opposition to health reform.
CyberspacesTV won 2nd place in a video contest from the Galen Institute, which promotes free-market ideas in health policy, that looks at cancer survival rates and wait times in Canada and the United Kingdom.

Wednesday, September 23rd, 2009

Tags: cbo, finance committee, gop, grassley, medicare reform, single payer, subsidies, twitter
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Meetings, Protests, Graphics

Once again, President Obama is meeting this morning with the “gang of six” — the six Finance Committee senators who are attempting to reach a bipartisan compromise on a health overhaul bill. The Washington Post combined profiles of the key members in attendance here.

In a post titled “White House Meeting: Too Bad Comes in Six Packs,” Brad Wright uses a “beer summit” metaphor to predict that someone will come out of the meeting unhappy — Wright thinks it will be Chuck Grassley, R-Iowa, or Mike Enzi, R-Wyo.:

What will come of the meeting, we won’t know until after it adjourns, but this we do know: there’s not going to be enough beer for everyone. That means something’s got to give, and it may mean that someone winds up giving up their seat at the table.

Turning the focus outside the beltway, Andrew Biggs of AEI’s Enterprise Blog compares the current town hall protests against health reform to liberal protests of Social Security Privatization in 2005. Biggs thinks Democrats shouldn’t be surprised by the developments:

The difference between then and now is that we on the reform end of the Social Security debate simply took it for granted that unions and seniors groups would organize against us. In the health debate, conservative opposition is being generated far closer to the grassroots level, yet is being treated as a conspiracy.

James Capretta of the New Atlantis looks at a CBO letter released shortly before August recess, estimates a huge deficit over time and concludes:”Assuming a discount rate of 5.7 percent per year, the bill would add more than $10 trillion over seventy-five years in new unfunded government obligations.”

Canadian lawmaker Bob Rae on The Mark wants health reform opponents in the United States to “keep Canada out of the U.S. debate”:

Even the most conservative of political parties in Canada want to maintain the integrity of our system, just as in communities and provinces we figure out how to improve both the excellence and access of what we have. We shouldn’t be afraid of a debate or a discussion, but since “the Canadian system” has been made the whipping boy of the Republican lobby in the U.S. it’s high time we fought back, with facts, figures, and the deep reality of our shared experience with universal insurance coverage.

Jaan Sidorov of the Disease Management Care Blog hosts the most recent edition of Health Wonk Review, a biweekly compendium of health policy blogging. He calls the August recess a “faux time-out”

And finally, also from the Washington Post, a new interactive graphic comparing Congress’ health bills:

Thursday, August 6th, 2009

Tags: cbo, deficit, obama, town halls, tricommittee
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Action Swirls Around CBO Director

Congressional Budget Office Director Douglas Elmendorf, the man at the center of renewed uproar about the cost of health reform, gives readers the dirt on his meeting with President Obama and others at the White House:

I was invited to the White House to meet with the President, his key budget and health advisers, and some outside experts. The President asked me and the outside experts for our views about achieving cost savings in health reform. I presented CBO’s assessment of the challenges of reducing federal health outlays and improving the long-term budget outlook while simultaneously expanding health insurance coverage–just as we had explained these challenges in a letter to Senator Conrad and Senator Gregg last month. I also described CBO’s view of the effects of the health legislation we have seen so far, as I did last Thursday in a hearing at the Senate Budget Committee and a mark-up at the House Ways and Means Committee. In addition, I discussed various policy options that could produce budgetary savings in the long run, drawing on CBO’s Budget Options for Health Care released in December, our letter to Senators Conrad and Gregg last month, and my comments last Thursday. Other participants in the meeting expressed their own views on these various topics.

Also, an intriguing post from Andrew Biggs at AEI asks if changing Peter Orszag’s job from head of CBO to director of the Office of Management and Budget was Obama’s “worst personnel move.” According to Biggs:

The problem isn’t with Peter himself, who has both strong technical abilities and (rarer still) the ability to make complex points understandable to the press. As an advocate for his positions, he is extremely effective. The problem is that Obama’s health plans need a favorable CBO score a lot more than they need another effective advocate, and right now they’re not getting much joy from the CBO under current director Doug Elmendorf.

Related, Politico Pulse this morning reports:

Want to make (Budget Commitee Chairman Kent) Conrad speechless? Ask him about Peter Orszag’s comment Tuesday that the so-called doc fix — a $245 billion proposal to raise fees for doctors treating Medicare patients — would not be covered by Obama’s pledge to fully pay for health care reform. Orszag told reporters on a conference call that the administration always assumed the money would need to be spent to avoid a scheduled 21 percent reduction in doctor’s fees. … “That is an interesting concept,” Conrad said. So is fair to say you don’t agree with him? “Just call the CBO,” Conrad said as he booked out of an exit off the Senate floor. “I’m advising you to talk to others, you know. Call objective third parties and ask them.”

Meanwhile, Obama is scheduled to hold a prime-time news conference this evening to discuss his goals for a health overhaul as what appears to be part of a broader effort to pressure Congress. Time’s Karen Tumulty reports, “With Congress looking less and less likely to make Obama’s deadline for House and Senate passage by the August recess, however, there are signs that he is shifting into a different gear. One close Obama ally predicted to me: ‘He’s going to become increasingly specific–and increasingly persistent–about the things he does and doesn’t want’ in the health care bill.”

Keith Hennessey has “20 questions” for Obama’s presser, like “Experts across the policy and political spectrum say that repealing or limiting the tax exclusion for employer-provided health insurance is a good way to bend the health cost curve down. Some powerful unions oppose this change. Your position has so far been ambiguous. Do you think this change would be good policy? Are you willing to support it if it attracts Republican votes?”

Elsewhere, the Heritage Foundation has a new paper from James Sherk and Robert Book that argues “Congressional rhetoric to the contrary, much of the burden of paying for an employer mandate will fall on ordinary Americans, and lower-income workers will be hit the hardest.”

Think Progress says that insurer lobby AHIP is recycling the strategy used against Michael Moore’s SiCKO documentary to stake out their position on the current overhaul legislation.

The Washington Post’s Ezra Klein looks at Republican National Committee Chairman Michael Steele’s speech Monday opposing Democratic health reform efforts. Klein notes, “At one point, a questioner asked whether Republicans support covering everybody. ‘I don’t do policy,’ replied the leader of the Republican Party.”

Wednesday, July 22nd, 2009

Tags: cbo, elmendorf, employer mandate, obama
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Who’s Writing Fiction?

A new study about the effects of a public plan option has policy folks on both sides of the debate up in arms.

On Heritage’s The Foundry, Nina Owcharenko and Greg D’Angelo write: “Here’s brand-new analysis (.pdf) from The Heritage Foundation — conducted by The Lewin Group— shows that the public plan component within the House Democrats’ health reform bill is in conflict with how the Congress and the President are selling their reform plan.”

They say that House Tri-Committee bill estimates that 88 million people with employer-sponsored insurance would be transitioned to the public plan option adding, “In his address President Obama asserted that, ‘If you like your current insurance, you keep that insurance. Period. End of Story.’ But what the President forgot to tell you is that his assertion is only true if the story were fiction.”

Philip Klein of the American Spectator has more: “The reason for the dramatic shift is that the Lewin Group has anticipated that with government setting lower reimbursement rates for doctors, hospitals and other health care providers, the government plan will offer lower premiums than private plans.”

Lewin had previously provided an estimate of the potential impact of a public plan option in April.

Almost immediately, Rep. Pete Stark, D-Calif., fired back:

“The Lewin Group is paid to produce estimates favorable to each client’s position. As a wholly owned subsidiary of UnitedHealthcare, the country’s largest private insurance company, the Lewin Group’s so-called ‘analysis’ is suspect. The Heritage Foundation got the study they paid for, but it is pure fiction.

The Congressional Budget Office found that H.R. 3200 increases employer-sponsored insurance and less than 10 million people would choose the public health insurance option by 2019.”

Stark’s office provided a side-by-side comparison (.pdf) of selections from the Lewin Group study and the CBO analysis.

Our own senior correspondent, Julie Appleby, tells us one of the major differences between the CBO analysis and Lewin’s is that Lewin assumes all employers are allowed to join the exchange, where the public plan is offered, in the third year. The House proposal says larger employers — those with more than 20 workers — would be allowed into the exchange at the discretion of a new Health Choices Commissioner in the third year . The commissioner could rule either way. Also, it isn’t clear if employers would flock to the exchange, even if they are allowed. Much would depend on what other options are available, the premium costs in the exchange and the relative health of each employers workforce. Large employers with younger, healthier workers may still find it less expensive to self-insure. Already, insurers have warned against allowing large employers into the exchange for that reason, so they may fight efforts to open the exchange to larger employers. On the other hand, if prices in the exchange are more attractive than outside, large employers may push the commissioner to let them in.

(note: just last week, Julie and Mary Agnes Carey took an in-depth look at what the bills would do to insurance options.)

Meanwhile……on other fronts:

Following concern late last week about the cost-containment provisions of legislation under consideration by congress, the Obama Administration reemphasized its proposal to create a new commission to oversee Medicare costs. Wonk Room’s Igor Volsky looks at the proposal and concludes:

The challenge lies in pleasing the CBO — which finds savings by following Potter Stewart rule life: “I know it when I see it.” However, since the MedPAC-like proposal is predicated on the President accepting its recommendations and Congress not voting them down, (and MedPAC is only required to not “increase in the aggregate level of net expenditures under the Medicare program,”) the CBO — which rarely defines the criteria of savings — is unlikely to “see” savings.

Speaking of CBO, Director Douglas Elmendorf posted on Saturday explaining the agency’s revised scoring of the House Tri-Commitee bill. Elmendorf notes that the figures could change, in part because they are based on committee staff specifications instead of the bill’s legislative language , and he adds: “In addition, the figures do not include certain costs that the government would incur to administer the proposed changes and the impact of the bill’s provisions on other federal programs, and they do not reflect any modifications or amendments made after the bill was introduced.”

Monday, July 20th, 2009

Tags: cbo, costs, public plan
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CBO Director Shakes Things Up

Yesterday’s testimony from Congressional Budget Office Director Douglas Elmendorf sent waves through health reform’s spectators when Elmendorf, testifying before the Senate Budget Commitee, said the bills currently under consideration in Congress do not contain “the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount.” (You can view his testimony in full here.)

On his blog, Elmendorf expanded on his responses:

In CBO’s estimates, the increase in spending for Medicare and Medicaid will account for 80 percent of spending increases for the three entitlement programs between now and 2035 and 90 percent of spending growth between now and 2080. Thus, reducing overall government spending relative to what would occur under current fiscal policy would require fundamental changes in the trajectory of federal health spending. Slowing the growth rate of outlays for Medicare and Medicaid is the central long-term challenge for fiscal policy.

As soon Elmendorf’s words were uttered, opponents of health overhaul were quick to point to agreement with their positions and advocates rushed to walk back the damage.

“The Verdict is In”

Heritage’s Conn Carroll: “The independent verdict on Obamacare is in: Instead of saving the federal government from fiscal catastrophe, the health reform measures being drafted by congressional Democrats would worsen an already bleak budget outlook, increasing deficit projections and driving the nation more deeply into debt. This runaway spending, coupled with the Democrats plans to raise taxes, will kill our struggling economy and leave us with double digit unemployment for years to come.”

The Corner’s Yuval Levin on what he called “The Emperor’s New Clothes”: “At some point someone with a calculator was bound to come along and point out the problem with that logic. The Congressional Budget Office is the natural candidate, but has found itself in a tough political spot, as the intense and plainly declared wishes of the Democratic leadership are in conflict with plain facts. CBO has offered some clear but quiet objections this spring and summer, often hidden in complicated tables of figures. But today, the agency has stepped up and cleared its throat. … Not a great day for Obamacare, but a good one for CBO, and for honesty in Washington.”

Hot Air’s AllahPundit (who doesn’t give his/her real name): “In McClatchy’s new poll, the split between those who think expanding coverage is top priority and those who think top priority is controlling costs is now just two points, within the margin of error — even as the number who say the country’s on the right track has dropped 12 points since June, confirming the Hotline poll from yesterday. Like [fellow blogger] Karl says, the mask is off and The One’s political capital is at ebb tide. If fiscal conservatives can’t stop ObamaCare now — or at least vastly improve it — then we never will.”

“The Least Surprising Revelation of the Day”

The Washington Post’s Ezra Klein: “In the least surprising revelation of the day, the Congressional Budget Office doesn’t see much in the way of savings coming from health-care reform in the next 10 or so years. This is because the bills under consideration do not save much money in the next 10 or so years.” Klein then proposes “rules” for politicians commenting on the CBO report.

The New Republic’s Jonathan Cohn: “Elmendorf had warned Congress that the reform bills he’d seen wouldn’t do enough to control costs. And, for the record, he’s probably right about that. … Still, the legislative process is far from finished. There are plenty of opportunities to make reform focus more on cost control and plenty of people trying to do just that, although the political obstacles they face are considerable. … One last point: Do remember that even if reform ends up without game-changing cost control, it may create political conditions that make future cost control more likely. That seems to be happening in Massachusetts, which enacted sweeping coverage expansions a few years ago.

“Wonk Room’s Igor Volsky: “Part of Elmendorf’s message is painfully obvious: investing in health care reform by providing Americans up to 400% of the federal poverty line with subsidies is going to cost the federal government a good deal of money — somewhere between $1 trillion and $1.5 trillion, to be exact. Progressives have always argued that in order to reduce the growth of health care costs in the long term and avoid the kind of catastrophic spending levels that could swallow-up our entire economy, we’re going to have to bring everyone into the health care system.”

Friday, July 17th, 2009

Tags: cbo, costs, elmendorf, health care costs
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On Scoring, the Public Plan and Patriotism

A late-morning roundup today, while Kate Steadman is away:

On the National Journal’s Expert Blog, Marilyn Serafini asks, “What are the best and worst ways to address drug costs as part of health care reform?” and, so far, has responses from Billy Tauzin, John Goodman and John Rother.

The Washington Post’s Ezra Klein believes that there are “five more important pieces of health-care reform that aren’t the public plan.”

Matt Yglesias has advice for Sen. Max Baucus, whom he calls the “single most important person in Congress on this issue. He could just decide not to listen to the insurers no matter how much money they have.”

Greg D’Angelo on Heritage’s The Foundry casts his eye on the CBO’s score of the HELP bill and concludes: “it’s not yet clear exactly just how many uninsured Americans would–at the end of the day– actually obtain coverage under the plan or what the final cost would be to American taxpayers.”

On American Spectator’s ‘The Right Prescription‘ blog, Robert M. Goldberg reacts strongly to an a June 22 post by Karen Davis on Commonwealth Fund’s blog, which invokes Abraham Lincoln in calling for health insurance cooperatives and some sort of national public plan:

“As President Lincoln emphasized in his Gettysburg Address, the U.S. is guided by the philosophy of ‘government of the people, by the people, and for the people.’ What is needed in health care is a similar philosophy: a health system that is truly for the people …

Two choices have been put on the table—a cooperative health care system designed and governed by consumers, and a public health insurance plan designed and offered by government acting in the public interest. Both could work if they are given sufficient authority to act in the public interest. Adopting a new cooperative health system would be difficult, and its long-term impact and sustainability would be uncertain. Still, both alternatives embrace a philosophy of people-centered health care and both are worthy of debate and consideration. Incorporating elements of both into health reform may well point the way forward.”

Goldberg plays off the patriotism angle and has a suggestion for “people who support a public plan:”

“[They] should enroll themselves and their families in one now. Further, any legislation that includes a public option such require members of Congress to give up their current health care and participate in one form of public health care.

Patriotism demands no less.

Indeed, enrolling in Medicaid or some variant now would give a public option the leadership and head start it needs to give the private plans a run for their money. If healthcare under a public option is so ‘patient-centered, accessible, and coordinated’ and delivers high-quality, high-value care, why shouldn’t Karen Davis, Henry Waxman, President Obama and others enroll or at least take the pledge to ‘go public?’”

KHN: Kaiser Health News

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