The Congressional Budget Office is back in the news, what with all this fuss about repealing Obamacare and replacing it something or another that in any case isn’t to be called Trumpcare, and we’re heartened to see their reassuring initials again. Back when political news was mostly a boring affair about arcane accounting questions the boring bureaucrats of the CBO were always in the lead or at least third paragraph of every story, but that was before the political news became more entertainingly about the latest “tweets” and the accusations of treason being flung from both sides, so lately we find ourselves missing the old days.
That good ol’ CBO finds itself back in the news because of its long-awaited “scoring” of the first of three promised phases of repeal of Obamacare and replacement with something that nobody is calling Trumpcare. The report contains plenty of argumentative ammunition for the Democrats who are unanimously opposed to the plan, possibly enough to scare some of the Republicans with whetted thumbs against the political winds, and a few big numbers that speak well for the first phase of the scheme but might embolden its conservative critics. All in all it was the desultory conclusion that you’d expect from a numbers-crunching bunch of boring bureaucrats, which is what the CBO is paid to be, and within a certain margin of error involved in all human undertakings we’re inclined to accept their findings.
One finding is that 24 million fewer Americans will have health insurance over the next decade if the current proposals of repeal and replace are enacted, which is a number hard for the most pro-reform media to spin, and which the anti-reform media gleefully headlined. The pro-reform forces therefore questioned the supposedly boring objectivity of the bureaucrats at the CBO, rightly noting its past errors in overstating the benefits and understating the costs of Obamacare, but they’ve conveniently forgotten how that happened. We were among the anti-Obamacare voices who noted that the CBO was diligently “scoring” those costs and benefits according to the pie-in-the-sky assumptions and spreadsheet legerdemain that the Democratic administration and Democratic majorities in Congress had described, and that the CBO had made that disclaimer quite clear, and when you take into account that the CBO’s forecasts couldn’t have taken into account subsequent Supreme Court decisions and other events they did about as well as anybody. If the current Republican administration and Republican administrations in Congress didn’t offer such helpful guidelines we can hardly blame those boring bureaucrats as the CBO.
Even without any helpful guidance from the Republicans the CBO has concluded that the first part of more or less Grand Old Party’s three-phase plan would lower federal deficits by a not insignificant $337 billion, given the nation’s poor fiscal health, and would eventually reduce the average American’s health insurance premiums by 10 percent, which by the now the average American would not consider an insignificant sum. The Republicans should be able make some political hay out of those numbers, but at the moment they’re busy discrediting everything the CBO says, and the eventual part will only play out long after the next election cycle and just before the president’s reelection race. The CBO’s past miscalculations were based on the garbage-in-garbage-out assumption of the Democrats who front-loaded their carefully planned Obamacare with early benefits and defrayed costs, while the CBO’s current calculations reflect the Republicans’ longstanding preference for paying up front, and although that makes for good policy we can’t fault the CBO if it makes for lousy politics. If the American public isn’t taking a longer range view of the situation, neither can we fault the CBO for that.
So far as we can tell from the CBO reports and everything else we read and hear and see this Obamacare thing has made things better for some people and worse for others and on the whole worse all around, and we’re quite sure this three-phased real and replacement with something that won’t be called Trumpcare might prove better but surely won’t be perfect. We’re holding out hope that nuns won’t be forced to pay for contraceptive coverage and monogamous married couples won’t have to fork out for sexually transmitted disease plans and teetotaling types aren’t hit up for alcoholism treatment, and that the the youngsters who only need catastrophic care can pay on the cheap, and that the daredevils can continue to defy the actuarial tables, but by now we have to admit that the benefits won’t come without costs, that those costs are actually figured in the long term that people rarely consider, and even those boring bureaucrats at the CBO can’t make any reliable predictions.
We always liked those old-fashined Republicans who used to acknowledge such uncertainties, but these days the party is represented by President Donald Trump and his campaign promises that everyone was going to be covered and the government would pay for it and premiums would go down and care would go up and everything would be great. He was never clear about the details, and being a big picture guy he seems to have left those details up to those Republican establishment guys he ran against, and they seem to have some old-fashioned ideas about paying up front and letting some number of Americans that might approach 24 million go without health insurance, and although there are philosophical arguments to made for that which the CBO can’t score he doesn’t seem able to make it, and this repeal and replace thing seems to be the very first time in his life that he doesn’t want his name on something.
As bad as Obamacare was we’ll still expect something better, but not matter what happens we won’t blame those boring boring bureaucrats at the CBO.
— Bud Norman