Senate Democrats May Bypass Congressional Budget Office Cost Estimates on Health Care

Senate Democrats “are bracing for what they expect will be a huge price tag connected with revamping the nation’s healthcare system,” The Hill reports.

In fact, they might bypass the Congressional Budget Office (CBO) cost estimate in favor of the White House Office of Management and Budget (OMB).

The soon-to-be-delivered estimate on Democratic healthcare reform proposals is expected to be so expensive that lawmakers are talking about changing the chamber’s normal accounting procedures.

Some Democrats are arguing behind the scenes that they should not use the non-partisan Congressional Budget Office’s (CBO) cost estimate, as is custom. Instead, they would use cost estimates from the White House Office of Management and Budget (OMB).

This unusual option could give Democratic leaders hundreds of billions of additional dollars to work with as they draft their plans. But Republicans would call it an accounting gimmick and a huge spending loophole.

The big issue Democrats will highlight is that the CBO score won’t consider savings from preventive health measures in their estimates.  On that topic, Senator Barbara Boxer (D-CA):

Sen. Barbara Boxer (D-Calif.) has proposed that Congress could instead use cost estimates provided by the OMB.

“We’re going to look at OMB and CBO and make our own decision as to who is right,” said Boxer.

Boxer said she would not feel obliged to abide by CBO’s work if it does not take into account savings from preventive healthcare and other reforms.

“I haven’t seen [the CBO score] but if they don’t take into account prevention, I certainly won’t. I will not follow it  — we just heard from the CEO of Safeway, who said his insurance costs went steadily down since they instigated incentives for prevention.”

“Any scoring that doesn’t understand that, is not relevant to the way we work.”

And Mark Begich (D-AK):

“CBO doesn’t like to calculate prevention, and that’s outrageous and ridiculous,” said Sen. Mark Begich (D-Alaska), who saw the financial benefit of preventive healthcare when he served as mayor of Anchorage.

“Prevention is an actual savings; I’ve seen it in my own city and what we did there. That’s where some of this disagreement comes in.”

He said that Democrats should push back against a CBO estimate that will show a modest level of savings.

“We have to question those,” he said.

But Senate Finance Committee Chairman Max Baucus (D-MT) isn’t expected to go along with these suggestions of discarding CBO scoring.

A spokeswoman for Finance Committee Chairman Max Baucus (D-Mont.) vigorously denied that her boss is considering discarding CBO’s projections.

“It’s true that healthcare reform will save money for families, businesses and the American economy that won’t show up in federal budget scorekeeping,” said Baucus spokeswoman Erin Shields.

“But Sen. Baucus has been absolutely clear that his healthcare reform bill will be paid for and that CBO will make that determination.”

Senate Budget Committee Chairman Kent Conrad (D-ND) is also unlikely to favor an outside cost estimate.

The push within Democratic ranks to ignore CBO faces a major obstacle in Sen. Kent Conrad (D-N.D.), chairman of the Senate Budget Committee.

Conrad would have to agree to shelve the CBO cost estimate and issue his own, a seldom-used process known as directed scoring. But Conrad, a longtime stickler on budget discipline, has stated in no uncertain terms that he will not cast aside the CBO score.

“I’ve already been approached and asked on other matters to do directed scoring, which I have the power to do. I don’t do it,” Conrad said in an interview.

On balance, it should be noted that Republicans “routinely blasted CBO on this issue when they controlled Congress during the Bush administration.”

Cost estimates could start rolling in as soon as Monday.

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