There have been a lot of raised eyebrows about congressional Republicans rushing out an Obamacare repeal-and-replace bill before it could be “scored” — that is, evaluated for its impact on federal spending and revenues and health-care coverage — by the nonpartisan Congressional Budget Office. Generally, CBO scoring would be a foundational step before trying to advance legislation significantly overhauling an industry that constitutes 20 percent of the national economy. One reason for the hastiness is that Republicans wanted to get something out there before its members go home for a long and potentially protest-filled Easter recess and perhaps come back gun-shy. Another is that they are on a self-imposed (and potentially self-imploding) timetable to get health care out of the way so they can deal with other legislative priorities, including a giant tax-cut bill.
But it is the third reason for not waiting on CBO that is looking most compelling right now: Republicans are terrified that CBO’s numbers will paint a disastrous picture of the American Health Care Act’s impact. The bill has problems enough without being described by Congress’s own hirelings as a bill that blows up budget deficits, throws many millions of people out of their health insurance, and, perhaps most importantly, undermines the tax cuts and defense-spending increases Republicans are itching to enact by setting a baseline that already looks bad.
Indeed, as Jennifer Haberkorn reports, there is so much Republican angst over what CBO might say that there is a sudden barrage of advance criticism of the agency, which is likely to reveal its score later this week or early next week:
Anticipating that their plan will leave fewer Americans insured than Obamacare and potentially cost the federal government more, Republican leaders on Tuesday launched a preemptory strike against forthcoming predictions from Congress’s independent scorekeeper, the Congressional Budget Office.
“If you go back to what CBO predicted would be covered on the exchanges today [under the ACA] they’re only off by only a two-to-one ratio,” Energy and Commerce Chairman Greg Walden (R-Ore.) told reporters. CBO said “21 million projected would be covered, but only 10 million people are covered.”
When former House Speaker Newt Gingrich called for the abolition of CBO back in January, most observers probably chuckled at the old bomb-thrower insisting that an objective assessment of GOP plans would screw everything up. Now that’s rapidly becoming the conventional wisdom. Keep in mind that Republicans, after taking control of both congressional chambers in 2014, hired CBO’s current director, George W. Bush administration veteran Keith Hall. It’s safe to say that Hall hardly resembles Gingrich’s description of CBO as a “left-wing, corrupt, bureaucratic defender of big government and liberalism.”
So what’s the solution? Republicans seem to have found an alternative source of authoritative-sounding numbers that is more ideologically reliable: the Office of Management and Budget, which is directly under the control of the president.
Republicans are going so far as releasing their own estimates. The Office of Management and Budget, part of the Trump White House, is expected to issue its own estimates of the plan, according to several Republican senators.
This helps explain why Trump’s OMB director, Mick Mulvaney, is suddenly being described as a “player” in the GOP’s very crowded health-care-policy arena. As budget maven Stan Collender pointed out when Gingrich proposed eliminating CBO, such a step would quite literally turn the clock back to those pre-1974 days when OMB was the only “scoring” entity, and Congress had no independent source of information. In the end Congress can use whatever numbers it chooses. But trying to boost the credibility of its agenda by cooking the books is probably not going to be a very persuasive approach.
One would normally think Mulvaney had enough on his plate — developing Trump’s first budget, for example — without having to leap into the middle of the health-care fray. That’s how panicked Republicans have become by the consequences of their shoddy work on repealing and replacing Obamacare. It’s one thing to work the refs when you are in danger of losing a game. It’s another thing altogether to fire and replace the scorekeeper while the ball’s in play.