BY PETER SULLIVAN - 08/29/18
A recent study concluding
that Sen. Bernie Sanders's
(I-Vt.) “Medicare for all” bill would cost $32 trillion has set off a furious
debate over the cost of the plan.
But there's one
estimate that would make an even bigger splash: the score from the nonpartisan
Congressional Budget Office (CBO).
However, it does not
appear that CBO is working on a spending estimate, despite a request from
Sen. John Barrasso (R-Wyo.),
who asked for a cost analysis in September in order to highlight the steep
costs for Medicare for all, also known as single-payer.
Barrasso told The Hill
last week that he doesn’t recall receiving a response from the CBO, suggesting
that his request was not accepted.
The CBO declined to
comment, but former directors said the fact that passing single-payer
legislation is not a priority for the Republican-controlled Congress means the
CBO is unlikely to devote time to scoring the bill.
Doug Elmendorf, a
former CBO director, said the budget scorekeeper is required to provide
estimates only for bills that have made it out of committee and that other
measures it scores are usually the priority of a chairman or ranking member.
Elmendorf, who was CBO
director from 2009 to 2015, noted that “it would take months” for the CBO to
score a bill as complex as single-payer.
“You have to ask yourself,
‘Is there likely to be serious legislative action on it?’ And clearly the
answer to that is no,” said Robert Reischauer, who was CBO director in the
1990s before becoming head of the Urban Institute.
CBO staff are busy
working on more pressing legislation, Reischauer said. “The cost estimating
units are usually operating at full or over capacity,” he said. “It isn’t like
they can accept all requests.”
The release of the
crucial spending analysis is therefore likely to wait until sometime when the
measure is moving through Congress and appears to have a chance of passage.
Republicans have been
pointing to Democratic calls for single-payer as a key rebuttal in this year’s
midterm campaign, part of an effort to push back against Democratic attacks on
GOP bills to repeal ObamaCare. A CBO score before the Nov. 6 elections would
give Republicans a key analysis to point to on the campaign trail.
The releases of CBO
estimates were defining moments in last year’s debate over Republican efforts
to repeal ObamaCare, with the analyses showing that millions of people would
lose coverage under the GOP-backed legislation.
A CBO score would
likely prove pivotal again with Sanders’s single-payer plan, as opponents have
criticized the trillions of dollars in new government spending that would be
required.
Reischauer said that
in this case, “opponents or people who want to embarrass advocates of the plan
want it and nobody else does.”
The release of an
outside study from the right-leaning Mercatus Center at George Mason University
in late July gave a taste of the frenzy that would occur over the release of a
CBO score of single-payer legislation.
Republicans seized on
the Mercatus study’s finding that a single-payer, government-run health
insurance system for all U.S. residents would cost the government an additional
$32 trillion over 10 years.
Speaker Paul Ryan (R-Wis.)
called the cost “absurd.” The Republican National Committee cited the study to
say that Sanders’s plan would “bankrupt taxpayers.”
Barrasso pointed to
the Mercatus study as fodder for the GOP in the absence of a CBO analysis.
“There have been a
number of different reports out there, $32 trillion,” Barrasso said. “It looks
like we have some pretty solid numbers on how expensive it is.”
But Sanders also
touted the report, just a different aspect of it. He pointed to the finding
that total U.S. spending on health care, as opposed to just the government’s
share, would decrease by $2 trillion over 10 years under his legislation.
Elmendorf,
highlighting the consequential decisions that go into any CBO score, said that
the agency might not estimate the bill’s effects on total U.S. health-care
spending, since its core mission is to examine spending by the government.
Leaving that part of the analysis out would deprive Sanders of a key argument
for his bill.
“I think they would do
it if they had enough time,” Elmendorf said.
http://thehill.com/policy/healthcare/404004-why-cbo-wont-estimate-cost-of-bernie-sanderss-medicare-for-all-bill
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