Members of the Trump administration did their best to discredit the Congressional Budget Office’s (“CBO”) soon to be released scoring of the Republican’s legislation to repeal and replace Obamacare, the “American Health Care Act,” during appearances on several of yesterday’s Sunday talking head shows.
The CBO is expected to release its analysis of the health care bill as soon as Monday. The scoring release will reveal the CBO’s cost estimate and projected reach and limits of coverage for the GOP’s American Health Care Act. The CBO is widely expected to predict that millions of people currently insured thanks to Obamacare might lose that coverage making it more difficult to round up votes to pass the Obamacare repeal and replace bill.
The Trump administration did its best to blunt the expected bad news by saying the CBO often gets things wrong and even analyzes the wrong things. They have a point. As CNN reports, when the Affordable Care Act passed in 2010, the agency estimated 21 million would gain coverage through health care exchanges in 2016. Three years later, the agency raised the figure to 22 million. That CBO estimate was off. About 10.4 million were enrolled last year, according to the Department of Health and Human Services.
Here’s what the Trump administration had to say about the expected CBO scoring of the American Health Care Act.
On “Fox News Sunday,” White House chief economic advisor Gary Cohn said that in the past the CBO score has been meaningless because they said many more people would be insured than actually were insured under Obamacare. Cohn’s comment came in response to Fox News host Chris Wallace asking about “groups” estimating that the CBO will say that between 6 million and 15 million people will lose coverage under the Republican’s Obamacare repeal and replace plan:
WALLACE: And hello again from Fox News in Washington.
Just over halfway through its first 100 days, President Trump faces a showdown over a key legislative initiative. The house Republican plan to repeal and replace Obamacare is encountering stiff opposition from the right wing of the party. . . .
Gary, the nonpartisan Congressional Budget Office will report this week, perhaps as early as tomorrow on its assessment of the repeal and replace plan, and there are other groups that are estimating that the CBO will say that between 6 million and 15 million people will lose coverage under the Obamacare repeal and replace plan.
Will the president support a bill that throws a — millions of Americans off insurance?
COHN: Well, Chris, you have to remember where we are. We came into office with an insurance plan that doesn’t work. Obamacare just is not working. You know, in the last year alone, premiums are up 25 percent. In the third of the counties in this country, we have only one insurance provider. Therefore, American citizens don’t have a choice.
We have no choice but to make the plan better for all Americans out there. We will get a score next week. CBO will do what they need to do, we will see what the score is. In fact, in the past, the CBO score has really been meaningless. They’ve said that many more people will be insured that are actually insured. But, look, when we get the CBO score, we’ll deal with that.
On NBC’s “Meet the Press,” host Chuck Todd asked basically the same question of secretary of Health and Human Services Tom Price. Price responded much like Cohn:
TODD: We have two pieces of information we do not have yet, and yet there is already voting going on in Congress. One piece of information is the estimate of this bill of how many people would be covered, and the second is on what’s the hit to the deficit. On the coverage issue– We don’t know the financial issue yet. On the coverage issue, a couple of estimates out there, one as high as 15 million fewer people covered, according to one estimate for Brookings, that that’s what they believe the Congressional Budget Office is going to end up showing when they finally are able to come out with an estimate. . . .
PRICE: Well, I’ll tell you that the plan that we’ve laid out here will not leave that number of individuals uncovered. In fact I believe, again, that we’ll have more individuals covered, and I think we’ll have folks that are evaluating this and modeling this come out and say, “Yes indeed, this plan will, in fact, cover more individuals than are currently covered,” remembering right now the trend line is down on the number of individuals being covered, it’s not increasing.
And the CBO estimates five, six, seven years ago when this started, they estimated that over 20 million people would have coverage at the end of the ten-year window. In fact, it’s about half of that right now. So CBO has been very adept in not providing appropriate coverage statistics.
On ABC’s “This Week,” host George Stephanopoulos asked Office of Management and Budget director, Mick Mulvaney, about independent analysis of the Republican’s Obamacare repeal and replacement bill that predicts that 6 to 15 million Americans are going to lose health insurance coverage they now have under Obamacare. In his reply, Mulvaney also panned the CBO’s scoring of health insurance legislation:
MULVANEY: George, there’s a lot of moving pieces at one time. Let me see if I can break it down into smaller pieces and parts, maybe talk about a bunch of different ones.
Talk about the coverage levels, the number of people covered. We continue to think, and have for a long time, that the CBO was scoring the wrong thing. They’re scoring Obamacare as it exists today, not tomorrow. Obamacare is this close from completely collapsing.
For example, I live in South Carolina. We are down to one provider in that state. There are four or five states that I think are down to one provider. And the CBO is failing to take into consideration what happens to folks in South Carolina when there are no providers, which there may be as soon as next year.
So, we don’t think the CBO is counting correctly that way.
But at the same time, we also think they’re not counting the right thing. Go back to the original idea of Obamacare was supposed to be that people could afford to go to the doctor. They can’t. They can afford to have coverage. They can afford to have a little plastic piece of paper that says they have an insurance policy, but they can’t afford to go to the doctor.
STEPHANOPOULOS: But the president said insurance for everybody.
MULVANEY: I was on Obamacare when I was in the House. My family’s deductibles were over $15,000 a year. Other folks who don’t make as much money as I did were on the exact same plan. Do you think they could afford to go to the doctor? That’s what we’re trying to fix. Not coverage for people, not coverage they can afford, but care they can afford. When they get sick, they can go to the doctor. That’s what the Donald Trump plan is working on, and that’s where we think it is going to be wildly successful. . . .
MULVANEY: The CBO said — if the CBO was right about Obamacare to begin with, there would be eight 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, and estimating the impact of a bill of this size probably isn’t the — isn’t the best use of their time.
Now before the still Never Trumpers and other Trump haters start, remember that Obama and the Democrats bitterly complained about the CBO’s scoring of Obamacare. They called the CBO’s analysis unfair and didn’t like the way Obamacare was analyzed. Jake Tapper reported that then House Speaker Nancy Pelosi said that “it’s always been a source, yes I will say frustration, for many of us in Congress that the CBO will always give you the worst-case scenario on one initiative . . .”
There is some credence to the Trump administration’s preemptive strike against the CBO’s anticipated scoring of the GOP’s American Health Care Act as there was to the Democrats bellyaching about the Obamacare scoring. Former Director of the CBO, Robert Reischer, admits that CBO forecasts are not as black and white as people would like. They itemize costs to the government, but typically don’t try to quantify savings elsewhere. And even though the CBO tries to think 10 years into the future, longer than many lawmakers preoccupied with the next election, Reischauer says it may not be farsighted enough to provide a full accounting. And when we come to something like fundamental health reform, the real consequences will not be seen for 15, 20, 25 years.