Congressional Budget Office is threat to health care reform

Original Link: http://www.politico.com/news/stories/0609/23853.html

By JULIAN E. ZELIZER

The most potent threat to the Obama administration’s fledgling health care plan may come not from the insurance industry or skeptical doctors but from the Congressional Budget Office.

Earlier this week, CBO released preliminary estimates suggesting that the health care

proposals — the most ambitious currently under discussion — from the Senate Health , Education, Labor and Pensions Committee would cost $1 trillion and trim the number of uninsured by only 16 million.

With a few more reports like this, CBO could quickly prove more damaging to the administration’s health care efforts than could Republican attacks about “socialized medicine.”

The last Democratic president found out the hard way. CBO proved a major thorn in President Bill Clinton’s side when his administration pushed health reform in 1993-94. Because of pay-as-you-go budget rules in place at the time, any new spending proposals had to be matched by offsetting cuts. CBO, under the directorship of the widely respected Robert Reischauer, repeatedly frustrated the administration by casting aspects of the plan in politically unappealing ways. Clinton’s proposed employer premiums were labeled a tax, which then-Republican National Committee Chairman Haley Barbour and legions of GOP lawmakers and candidates seized on to repeatedly bash the president.

Sixteen years later, the Obama administration is pushing an ambitious and expensive health care overhaul just months after enactment of its massive economic recovery program that has already caused the size of the budget to explode. As CBO estimates about the high cost of the health care proposal emerge in coming months, Republicans will continue to pound Democrats about the impact on the deficit — the one issue on which the GOP finally seems to be gaining some political traction.

And if the long-term CBO cost estimates climb too high, Republicans might be able to prevent Democrats from using the budget reconciliation process to protect health care from a filibuster in the fall.

The most profound challenge to President Barack Obama’s health care plan that CBO represents is its reputation for nonpartisan economic analysis. Once a figure is floated, it can be difficult for the administration to counteract politically. Trying to dispute technical details from CBO can quickly make voters’ eyes glaze over.

Obama can’t get trapped into a dry debate that is just about the numbers. Whatever form his final proposal takes, his best bet will be to keep public attention focused on the major objectives behind health care reform and the vital changes that will result from overhauling the system. This is what presidents can do well: shape the agenda and define a bill, rather than engage in an econometric numbers game with the experts huddled in CBO.