Incomplete scoring of a legislative proposal. Lots of explanations and recalculations. Concern about the timeline to pass a bill. Smells like a health reform debate!
Yesterday, the Congressional Budget Office released an analysis of the preliminary bill coming out of the Senate Health, Education, Labor and Pensions (HELP) Committee. The big issue is that it would cover about 15 million of the uninsured, far less than what people are aiming for as part of a comprehensive proposal
It’s not that the numbers are preliminary. It’s that they are wrong. As both Ezra Klein and Jonathan Cohn point out, the CBO numbers, by focusing on a partial bill, don’t take into account major provisions of the bill that weren’t ready for review at the time. According to the CBO estimates, available at The Atlantic website here.
The two major engines of coverage expansion are:
* setting a standard for employers to contribute to the health care of their workers, so more people get and keep their on-the-job coverage, and
* extending Medicaid to subsidize the coverage of lower-income families that otherwise can’t afford it.
Neither component was in the bill analyzed by CBO.
It’s like trying to see how fast a runner is, but only if he had not one but both legs amputated. Given how all these component interact with one another, it’s hard to see any usefulness in these numbers.
If our experience in California is any guide, there will be lots of disputes with CBO in the future about how to properly model the impact of a proposal. This is just something else entirely.