Budget office comes under White House fire
Congressional watchdog is preparing its judgment on health-care bill’s impact
WASHINGTON— U.S. President Donald Trump showed an affinity for “working the referees” in his race to the White House, criticizing a federal judge as biased, panning polls as rigged and even questioning the aptitude of the nation’s intelligence agencies.
Now, with Trump’s administration aggressively pitching the House Republican plan to repeal and replace the Affordable Care Act, Capitol Hill’s official scorekeeper — the Congressional Budget Office (CBO) — is coming under intense fire. As it prepares to render its judgment on the cost and impact of the bill, the nonpartisan agency of economists and statisticians has become a political pinata — and the latest example of Trump’s team casting doubt on benchmarks accepted as trustworthy for decades.
“If you’re looking to the CBO for accuracy, you’re looking in the wrong place,” Sean Spicer, the White House press secretary, said Wednesday, arguing that the agency’s failure to accurately project enrolment in the Act’s online marketplaces had essentially killed its credibility.
Spicer’s criticism echoed that of some House Republicans, who raised questions this week about the CBO’s record.
The reason for their umbrage is clear: The CBO’s official judgment on the American Health Care Act, as the Republican legislation is known, is expected to be released Monday and it is more than an intellectual exercise. It could make or break the bill.
Budget rules that Republicans are using to bypass a possible Democratic filibuster in the Senate stipulate that the health-care legislation must not add to deficits over the span of a decade. If the CBO predicts that it would, Senate Democrats could block the bill. More broadly, a judgment by the CBO that the Republican plan would strip health care from millions of people could have politically disastrous effects.
Analysts at the Brookings Institution said Friday that the plan could increase the ranks of the uninsured by more than $15 million (U.S.) — and said the CBO estimate might put that figure considerably higher.
Created by Congress in 1974, the agency provides forecasts that are the foundation of the budget process.
The White House’s attack has sparked backlash among economists, former CBO directors and some lawmakers who see its disparagement as a sign that long-standing legislative traditions are eroding.
“Undermining the credibility of CBO when policy-makers need it most harms Congress’ ability to do its job and the long-run effectiveness of both political parties,” said Alice M. Rivlin, CBO’s founding director.
But the CBO’s mandate is not iron- clad. Douglas Holtz-Eakin, a conservative economist who led the CBO from 2003 to 2005, also defended its credibility, but he noted that Congress remained the ultimate arbiter if it so chose. While it rarely happens, the Senate Budget Committee could decide to make its own determination about the bill’s economic effects.
Lawmakers have not mused publicly about such a move, which would probably set off a political firestorm.
According to Steve Bell, a former Senate Budget Committee staff director in the 1980s, ignoring CBO forecasts for the health bill would dampen hopes for major legislation on taxes or infrastructure because the public would no longer be able to believe government estimates about the cost of such programs.
“Down that path lies serious corruption,” said Bell, who now works at the Bipartisan Policy Center.
After Newt Gingrich, the former House Speaker and an adviser to Trump, said this year that the CBO was a “left-wing, corrupt, bureaucratic defender of big government and liberalism,” Keith Hall, its Republican-appointed director, defended its work.
“We try very, very hard to be independent and non-partisan,” he said at a news briefing in January.
Analysts contend that the CBO’s forecasts for the Affordable Care Act were mixed and that the health law was a challenge because it was such a moving target. A 2015 report by the Commonwealth Fund, which supports health policy research, found that the CBO had overestimated insurance-marketplace enrolment and marketplace costs by about 30 per cent and had underestimated Medicaid enrolment by 14 per cent.
The missed mark for marketplace enrolments, the report said, stemmed largely from a miscalculation that many employers would drop employee-provided health care and send workers to Affordable Care Act exchanges. They mostly did not.
“The CBO’s projections were closer to realized experience than were those of many other prominent forecasters,” the report concluded.
In response to questions from Congress last week about its record as a forecaster, the CBO said the cost to the federal government of the Affordable Care Act’s insurance-coverage provisions had actually proved to be lower than the agency projected. That was probably because of lower-than-expected enrolment and a slowdown in the growth of health care costs, the CBO said.
Some Senate Republicans argued that the figures should be heeded.
“What matters in the long run is better, more affordable health care for Americans, not House leaders’ arbitrary legislative calendar,” Sen. Tom Cotton of Arkansas said in a post on Twitter in which he questioned why the House was considering the bill when the CBO had not scored it.