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Posted Wednesday, October 07, 2009 10:18 PM

What the CBO Estimate Means for Health-Care Reform

Katie Connolly

Senate Finance Committee chairman Max Baucus might be cracking open the champagne tonight, now that the Congressional Budget Office (CBO) has released its preliminary analysis* of the health-care bill he slaved over for months. The numbers look good for Democrats. The CBO estimates that Baucus’s bill will actually reduce the deficit by $81 billion over 10 years, and will cost about $829 billion over that period. That’s  a deeper deficit reduction than previously anticipated, and the total falls well within the president’s parameters. Score one for Baucus, who probably needs an ego boost after being roundly trashed for his bipartisan efforts.

The CBO expects the bill will extend coverage to an additional 29 million Americans, bringing the total proportion of Americans with health insurance to 94 percent, which is an impressive increase over the current 83 percent. As such, it also meets Obama’s other goal of significantly decreasing the number of uninsured Americans. By 2019, about 5 million people will remain uninsured. About one third of those are expected to be illegal immigrants. The cost of the bill will be offset by cuts in payments to Medicare providers and an excise tax on so-called Cadillac insurance plans, among other measures.

According to CBO analysts, the insurance co-ops—Baucus’s much-ballyhooed alternative to a public plan—will have a negligible impact. The letter to Baucus states that they “seem unlikely to establish a significant market presence in many areas of the country or to noticeably affect federal subsidy payments.” The estimated cost of the co-ops is just $3 billion.

Why is this CBO analysis so significant? First, it likely means that the bill will have no problems passing out of the Finance Committee. Democrats already have enough votes to pass it without Republican support, and now that the bill looks to be reducing the deficit, it will ameliorate some concerns held by those wavering moderate Dems—Blanche Lincoln, Bill Nelson, and Kent Conrad. They may not be entirely satisfied with the bill, but they’ll have little reason not to let it go to the Senate floor, where a colorful debate is sure to ensue. Baucus may even pick up the vote of Republican Olympia Snowe, who so far has held her cards close to the vest. This revised version of Baucus’s bill includes several measures designed to placate Snowe, including more generous subsidies to help low-income people purchase insurance. The new price tag will likely put her mind at ease, but it wouldn't be entirely surprising if she decided to withhold judgment until the final Senate vote.

Once the Finance Committee votes (probably early next week), Senate Majority Leader Harry Reid will work with Baucus, health-committee chair Chris Dodd, and White House staffers including Rahm Emanuel, health adviser Nancy Ann De Parle, and OMB director Peter Orszag to combine the bills offered by Dodd and Baucus, and present his own leadership bill to the Senate. Reid could do this as early as next week. This is where the debate gets tricky.

Liberal Democrats will likely use the paltry assessment of the impact of co-ops as a way to revive debate on a public option. After all, the president has stressed the importance of competition in lowering the cost of health care, and now an independent authority suggests that co-ops fail to meet that goal. Democrats will probably push for a floor vote on the public option—which will no doubt be shrouded in heated debate—so that even if it fails, liberals can demonstrate to their base that they tried. Regardless of what the Senate passes with regard to a public option, Reid will still have to contend with House Speaker Nancy Pelosi in the conference process, and it’s almost a foregone conclusion that her bill will contain some form of public plan. It’s in that conference process that the public option will live or die.

Realistically, the CBO assessment represents the low end of what a health-care bill will ultimately cost. The House bill is already more expensive: it covers more Americans and is more generous. The process of merging the two bills will bring the price tag up, not down. But, fortunately for Democrats, Baucus have given them a decent amount of wiggle room.

* It's important to note that this is not the CBO's official report or "score," as it's called in Washington. That will come when Baucus's chairman's mark is translated into legislative language.

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Member Comments

Posted By: Davole (October 9, 2009 at 2:46 AM)

Currently the sleazy democrats are floating 5 Power Grab Schemes masquerading as Health Care Plans - 3 in the House, and 2 in the Senate. Why are there 5? What is this - their pathetic attempt at a high stakes shell game with the odds stacked against the American taxpayer?

Supposedly Senator Max Baucus’s proposal has been reviewed by the Congressional Budget Office (CBO). Did the CBO review the original text, or did it review the amended text? The cost of each would probably vary considerably.

Which of the 3 versions will be the one on which Congress will vote, and which of the 2 versions will be the one on which the Senate will vote? Likewise, will each of these be the original text, or else the amended version?  

Will both the original House plan and the original Senate plan be available for scrutiny by the public at least 72 hours prior to discussion?  

Will both the amended House plan and the amended Senate plan be available for scrutiny by the public at least 72 hours prior to the actual vote?  

Will both plans be written in plain English so that the average citizen can understand them, or will they be written in lawyer legalese so that changes can be introduced soon after by the courts?

Will both plans be reviewed by the CBO prior to discussion and also prior to the actual vote, so that both the public and the politicians will know what the actual cost of each bill will be?

Will Barack Obama go through both plans line by line, as he has promised, prior to discussion and also prior to the vote?

Will the members of the House and the Senate have ample time to read the complete proposals prior to the vote?

Will the members of the House and the Senate be required to read the complete proposals prior to the vote?

Why are the democrats so determined to ram these 2 bills down the throats of the public in a reckless rushed  timetable?

Why are the democrats so determined to wait until 2013 to actually begin to implement the 2 plans?

Will Barack Obama swear that he will resign if the Healthcare Bill is not at least revenue neutral, as he has promised that it would be?

Will all democrats swear that they will resign if the Healthcare Bill includes funding for abortions, and / or compels doctors to provide abortions, as Barack Obama has promised that it would not?

Will all democrats swear that they will resign if the Healthcare Bill does not allow Americans to keep their own doctors and medical insurance plans for as long as they would care to do so, as Barack Obama has promised that it would?

Will all democrats swear that they will resign if the Healthcare Bill ever allows the implementation of death panels, as Barack Obama has promised that it would not?

Will all democrats swear that they will resign if the Healthcare Bill ever denies services to the elderly, as Barack Obama has promised that it would not?

Will all democrats swear that they will resign if the Healthcare Bill does not include medical malpractice reform as Barack Obama has promised that it could?

Will all democrats swear that they will resign if the Healthcare Bill does not always include provision for purchasing medical plans across state lines, and also personal portability of medical plans?

Barack Obama and the democrats have a lot of explaining to do!

If adequate answers to these questions are not provided by the democrats, the only logical and RESPONSIBLE OPTION for the members of the House and the Senate will be to VOTE NO resoundingly!

Then they can start over again by writing a new plan with complete bipartisan input and cooperation.


Posted By: thehappyamerican (October 8, 2009 at 11:34 AM)

The numbers were doctored to be "favorable" to Democrats--every estimate the government has acted on has been wrong. This is no different.

   This is a sham and that's why the Democrats refuse to post the health bill and others on the web!

   Tell your congessment to not vote for anything he hasn,t taken time to read and understand!

  Such a practice might clog the congress! Temporarily only, though. Legislators would learn to write the bills clear and simplified.With no hidden meanings.

   The Congress has to work for us and stop working us over!