CBD'OH!: What We Have Here Is a Failure to Communicate

by Tim Foley

categories: Enemies of Reform, Obama and Congress

Published June 16, 2009 @ 08:29PM PT

By now, you’ve probably heard of the too expensive, too ineffective, too liberal, too “everything that’s wrong with America today” plan from the Senate Health, Education, Labor and Pensions Committee.  You probably also heard about the spanking it was given by the nonpartisan Congressional Budge Office in a formal memo “scoring” the legislation.  Here’s the problem – they didn’t score the bill.  They scored about 2/3 of the bill.  Remember how your dad always told you that you shouldn’t rush something just because it’ll take longer to do it right the first time?  Turns out he was on to something.

The actual report from CBO is very upfront in admitting, “It is important to note, however, that those figures do not represent a formal or complete cost estimate for the draft legislation, for reasons outlined below.”  (emphasis theirs)  I saw analysis by Ezra Klein before I even had a chance to read what CBO had to say.  Ditto Jon Cohn, who emphasized how preliminary this draft is, ending with the admonition, “For now, let the architects finish their work. Then look at the price tag.”  Paul Krugman says, “This was a failure of communication, partly the result of an attempt at bipartisan outreach, rather than a failure of policy.”

Doesn’t matter.  The enemies of reform are having a field day with a score from the CBO, however much it leaves out, that seems to cost too much and help too little.  And of course, they’re not above making it sound even worse than it is.

To quickly summarize what it leaves out, the CBO projections:

• Doesn’t mention the public health insurance option whatsoever.  Depending on how it’s structured, it may or may not reduce overall expenditures.  (This is a weird case where conservatives are hoping the public plan would have a lot of people in it, but do a terrible job.)
• Doesn’t include any mention of the employer mandate, aka Pay or Play, which is one of the major revenue sources that makes the whole proposal work.
• Presumes an “individual mandate” for people to buy insurance or pay a penalty that’s more of a mild suggestion than a mandate with teeth.
• Doesn’t include any increase in Medicaid eligibility (technically, this can’t be in the HELP bill.  It will only be in the Finance bill.  But it will be in the Finance bill and make millions living at or under the poverty line eligible for Medicaid).
• Presumes everyone under 500% of the federal poverty line in the Exchange or Gateway gets a subsidy, although the current word out of HELP is that it’ll be 400%
• Leaves out the provisions whereby children can stay on their parents’ plans until the age of 27 – a provision which would have a major effect on coverage and what the federal government is paying.

So basically, we have all the stuff that’s going to cost money, only some of the stuff that’s going to save money, and few of the options that will cover more people in the Kennedy draft.  Although we know where he’s planning from his principles document, it’s not in the bill.  So the CBO treated over 1/3 of the bill as though it doesn’t exist.

Other than that, this CBO projection is great.

But as I said, in terms of politics, it doesn’t matter.  The scuttlebutt is that the same Republicans who are now crying “How can we spend so much and achieve so little!” even though they’re in the room and know exactly what got left out of the draft bill are the same ones who goaded Chris Dodd and the Democrats to get CBO to score an incomplete draft.  They’re the ones reveling in the embarrassment.  Democrats are feeling like Daffy Duck in the old “Wabbit Season!  Duck Season!” sketch – they just fired a gun in their face for no real reason.

Republicans are yucking it up, but they may not have the last laugh.  The great taboo – a bill that was scored over $1 trillion over ten years – has already been broken, and it wasn’t even for the real bill.  Kennedy’s full bill will cover a lot more people.  They might even spin this as an improved bill.  And when the House and Senate Finance Committee bills get their first score, the news reports will be much better.  So there may just be an opportunity to build momentum here…

…if we just make it through the next two news cycles.

(Photo credit:  Kenyee on Flickr.)