Attack on CBO Seen as Disturbing New Development
Republicans’ rollout of Obamacare repeal legislation has provoked one of the most brutal public beatings of the Congressional Budget Office in recent memory.
The trigger? The release of a cost estimate of Republicans’ budget reconciliation legislation that would partially repeal and replace a major portion of the 2010 health care law ( PL 111-148 , PL 111-152 ).
The common defense when grilled on what CBO would show? Slam the nonpartisan scorekeeper. But former CBO employees and directors said that doing so could have devastating consequences down the road.
Prior to the Monday afternoon release of the score, which predicted an added 24 million Americans would lose health insurance under the GOP plan by 2026 compared to current law, Speaker Paul D. Ryan, correctly predicted CBO’s score would show fewer Americans would have health insurance if the GOP plan was enacted.
White House Press Secretary Sean Spicer lambasted the CBO, saying in a Wednesday briefing that “if you’re looking to the CBO for accuracy, you’re looking in the wrong place.” Ryan, R-Wis., argued producing a score that would look good on paper was impossible: “So there’s no way we can ... compete with on paper a government mandate with coverage.”
House Majority Whip Steve Scalise, R-La., said the House wouldn’t wait for “unelected bureaucrats” before advancing the bill.
On Sunday, Health and Human Services Secretary Tom Price called into question CBO’s accuracy by pointing to previous estimates on the 2010 health care law he said were inaccurate. Then, on Monday, the former Georgia Republican congressman proclaimed: “We disagree strenuously with the report that was put out."
“The CBO looked at a portion of our plan, but not the entire plan,” Price said during an impromptu press conference outside the White House with Office of Management and Budget Director Mick Mulvaney.
Broadly, the message was clear from Republicans: Don’t let the score make up your mind. Their appeal is couched in a complicated strategy. Both Price and Ryan have argued the budget reconciliation bill is simply the first in a three-step policy approach, with a regulatory overhaul to come second. Third, as Price described it on NBC’s "Meet the Press," are “the other pieces of legislation that are required that can't go through on the first part.”
But CBO supporters say they're wrong to attack the nonpartisan agency.
“We need CBO, Washington needs CBO, they all need CBO and they have done nothing to earn this disrespect. They’ve done a great job trying to stay nonpartisan and credible. And if you succeed in demolishing the credibility of CBO, well, then what? A scorched earth policy doesn’t leave you with much,” said Robert L. Bixby, executive director of the Concord Coalition, a longtime fiscal hawk group.
Pre-Attacking a Score
It’s not surprising to see the CBO under fire when big legislation is in play, said former CBO directors and employees.
But this criticism is unique, some experts say, in two ways. Some say it’s unusual to attack a score before it comes out.
Others say this assault is different because it’s not just from the White House, which would be in a position to buck Congress’ number-cruncher. It’s also coming from House Republicans, whose party leadership played an essential role in appointing CBO Director Keith Hall, who is a Republican. In fact, Hall was appointed to the position by Ryan and Sen. Orrin G. Hatch, R-Utah, with the full-throated endorsement of then-House Budget Chairman Price.
Mulvaney was among the most forceful in his CBO criticisms. In an interview with George Stephanopoulos, host of ABC's "This Week,” Mulvaney attacked the agency's record on assessing the impact of Obamacare when asked whether CBO would report fewer people with health insurance under the GOP health legislation, if enacted.
“If the CBO was right about Obamacare to begin with, there would be 8 million more people on Obamacare today than there actually are. So I love the folks at the CBO. They work really hard. They do, but sometimes we ask them to do stuff they're not capable of doing,” Mulvaney said.
“And estimating the impact of a bill of this size probably ... isn't the best use of their time,” Mulvaney added.
That remark triggered gasps from many in the budget world, including Peter Orszag, former director of both CBO and OMB, who tweeted he was “speechless” over Mulvaney’s suggestion.
“That was a ridiculous statement by Director Mulvaney. Because it betrays a complete lack of understanding of the importance of good information to effective decision-making by the Congress,” said Douglas Elmendorf, who was CBO director from 2009 to 2015. A Democrat, Elmendorf was appointed when Democrats were in control of Congress.
“Director Mulvaney was essentially saying he doesn’t want any information because his mind is made up,” Elmendorf said. “That is not a position that should be taken by a leader of our government.”
Elmendorf, who oversaw CBO when the health care law score was produced, defended it and the conclusions CBO reached at the time.
“This is not a line of work where anyone can be completely accurate,” Elmendorf said. “The question is whether CBO’s estimates are accurate enough to provide important guidance to the Congress. And time and again CBO has passed that test by a mile.”
A Weakened Congress?
Philip Joyce, a CBO expert and former staffer who wrote a book on the agency and is senior associate dean and professor of public policy at the University of Maryland School of Public Policy, told CQ that one key consequence down the road could be the weakening of Congress’ ability to check the executive branch.
“I think the thing that is particularly short-sighted about this is that if you are, especially the majority, but Congress as an institution, you actually want to have a strong, credible CBO. Because that’s what helps you when Congress invariably gets into battles with the executive branch,” Joyce said.
Ultimately, several CBO experts interviewed by CQ agreed that the conflict landing in CBO’s lap is exacerbated by the fact that the legislative vehicle Republicans are using to move a major health policy overhaul — budget reconciliation, which only requires a simple majority in both chambers — is exceedingly limited.
“There are things you can’t do in reconciliation and so you’re limited, and so that creates part of the dilemma that Mr. Ryan has,” said G. William Hoagland, senior vice president at the Bipartisan Policy Center.
At the end of the day, Hoagland said, he expects a broad health care overhaul will require cooperation across party lines — which means this likely won’t be the only piece of legislation over which a score will be debated.
“If it’s going to have any sustainability long term . . . then it seems to me the only approach is to reach across the aisle and build something that does have more than 60 votes,” Hoagland said.