Cost prognosis is murky

As the frantic scramble continues to gather 216 votes for health care reform — a vote expected today — Democratic leaders are touting the cost estimates released Thursday by the Congressional Budget Office.

Those estimates say the latest reform plan will cost $940 billion over 10 years. But, due to tax hikes and cuts in Medicare programs, the net impact to the federal treasury will be a reduction to the federal deficit of $138 billion over the next decade, the CBO says.

Congressman John Salazar leaned on those numbers to justify his announcement last week that he intends to vote “Yes” on the latest reform plan. He called it “probably the single largest deficit reduction measure I will probably ever vote on.”

Salazar’s overuse of qualifiers is understandable, given the fact that the CBO carefully qualified its own report. It is “a preliminary estimate” and the CBO has “not thoroughly examined the legislative language,” the agency’s director said.

The Washington Post, which backed the revised plan Friday, analyzed the CBO report and concluded there were a lot of “ifs” in it.

For one thing, the analysis noted, there is no way of accurately predicting how much it will cost to provide subsidies for people who can’t afford health insurance. That will depend on many unknowns, such as future insurance costs and how many employers continue to provide health insurance for their workers.

Even more uncertain is what Congress will do. A great deal of the deficit reduction depends on future members of Congress cutting Medicare and implementing a tax on “Cadillac” health care plans. But the current Congress has been reluctant to do those things, and there’s no guarantee that future members will do so.

We’re glad the CBO was especially cautious in one important respect. It didn’t project large savings from programs aimed at testing different strategies to see which are most cost effective. Those programs are critical for determining the best ways to deliver health care in the future. But predicting actual savings from them is all but impossible.

If Democrats do muster enough votes to pass the health care bill today, Americans must demand that lawmakers enact the programs required to ensure the promised deficit reduction occurs.


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