C-B-Oh No! Budget Office Holds Up Health Reform?


According to Congressional Quarterly, it looks like there's a good chance that health care reform may be being held up by inconvenient scoring from the Congressional Budget Office. As it stands, the final text of the reconciliation bill—which would amend the Senate health reform bill—has yet to be released. Seems the reason why may be that the CBO is saying that the changes House Democrats want to make would cost too much. From CQ:

Rank-and-file Democrats did not talk about the details, but said that the CBO scores had come up short. "They were less than expected" in terms of deficit reduction, said Rep. Gene Green, D-Texas, who plans to vote for the bill.

Given other recent developments, this makes a lot of sense. Democrats have admitted that they don't yet have the votes to pass the bill, but have been saying that they expect to when the time comes. Some of those expected votes are likely provisioned on hitting certain spending and deficit reduction targets—targets which, it seems, aren't being met in current drafts of the reconciliation bill.

"I'm as real as those deficit reduction projections, Bastian."

Leadership is probably constrained on the other end, too: Not only do House leaders have to hit certain spending and deficit reduction targets to appease some members, they likely have to include certain costly provisions in order to bring on others. From the sounds of it, there isn't a lot of wiggle room, and they're having trouble figuring out the right way to balance the provisions they want with the CBO's price tags.

No doubt they'll finagle and resubmit (and resubmit, and resubmit, and resubmit…) until they hit their targets. But that takes time. Which is presumably why Rep. James Clyburn, the House Majority Whip (and apparently a such a fan of The NeverEnding Story that he's pushing for a health-care themed remake set in Washington), started hinting yesterday that there may not actually be a vote by the end of the week as planned.

House leadership probably has a little bit of leeway on the timing of the vote, but delays won't help the bill's chances, and pushing past Easter could be a serious setback, perhaps even a bill-killer. Believe it or not, this debate really does have to end sometime.

I wrote about the CBO's role as legislative gatekeeper in Reason's January issue.

Update: Philip Klein has more on the specific troubles Democrats may be facing. 

NEXT: "I did not give up my First Amendment rights when my husband became a justice of the Supreme Court."

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  1. That’s Atreyu with the giant talking ferret.

    1. I’m a luck dragon!

  2. Believe it or not, this debate really does have to end sometime.

    They have until very early November.

  3. Pelosi has become like Paulus at Stalingrad. Just keep pushing forward and ignore all that is happening behind you.

      1. Not every reference to Germans in World War II is a reference to Nazis. She is not like Paulus because she plans to exterminate inferior races. She is like Paulus because she is pissing her forces away in a pointless and doomed advance.

        1. Ordered by Hitler despite Paulus’s attempt to retreat and reorganize. And thus . . . we arrive back at the Godwin.

            1. I was joking. But . . . whatever.

              1. You already spoiled his fun.

          1. I like Corning’s law better.

            “Everything posted on usenet was and continues to be complete bullshit.”

        2. Those who ignore history are doomed to parrot Godwin’s law.

        3. I was joking.

          1. Too late, MikeP. The hounds have been released.

        4. Just invoke Pickett’s Charge – no way anyone would associate *that* with anything invidious!

          1. Corning’s second law:

            “The Civil War was over slavery”

            1. That is a good one actually, except that it makes Obama Churchill.

              1. Gallipoli was WW1….

                Churchill WW2

                1. never mind….

                  Later in November 1914, First Lord of the Admiralty Winston Churchill put forward his first plans for a naval attack on the Dardanelles, based at least in part on what turned out to be erroneous reports regarding Turkish troop strength, as prepared by Lieut. T. E. Lawrence.

                2. Also, Churchill succeeded in WW2.

                  But, not being born in 1920, he did do some things in WW1 that weren’t as successful…

                  Gallipoli was one of the Allies great disasters in World War One. Gallipoli was the plan thought up by Winston Churchill to end the war early by creating a new war front that the Central Powers could not cope with.

                3. Churchill was in the government in World War One – until Gallipoli, when he quit amid the scandal of the failure there and went to fight on the Western front.

        5. Napoleon’s march to Moscow is the vibe I get.

    1. There goes John with another damn pseudointellectual metaphor. I keep waiting for Darmok and Jalad at Tanagra.

      1. sorry don’t do sci fi references.

        1. damn it… i got the refference

        2. And not everyone gives a crap what Lt. Queeg did at the Skirmish of Nosepicker’s Ditch. It’s a bit unfair to Paulus as well, who was essentially instructed by Hitler to die rather than to surrender.

          1. Paulus was a lousy commander. Everyone in the German Army knew it. He was a staff weenie who helped plan Barbarosa but had no business running an Army.

            And yes, Hitler should have listened to Manstein and let Paulus break out of Stalingrad in the fall of 1942.

            And Stalingrad is arguably the most important battle of the 20th Century. Hardly a skirmish. Just because you pride yourself on ignorance of history, doesn’t mean everyone else does.

            1. I wonder if Pelosi will be promoted to Field Marshall right before the final vote…

            2. Von Manstein’s memoir (Verlorene Siege / Lost Victories)is amazing. It’s a must read for WWII nerds.

            3. Hitler should have listened

              That’s what I said!

            4. And Stalingrad is arguably the most important battle of the 20th Century.

              I recently finished John Keegan’s Six Armies in Normandy. At the end, he makes the argument that the German defeat in Normandy outweighed the German defeat at Stalingrad in both absolute and strategic terms. Sadly, the specifics escape me this morning.

  4. Die on this hill, Democrats, die. Get creamed in November and let’s get some gridlock happening. Maybe then I can relax a little.

    1. Epi is Magua? Only then will your heart be healed? Only then when your heart will be whole?

  5. If this thing isn’t done by the time the Reps go home for Easter, its over. O. V. E. R.

    Because when they go home for Easter, they are going to be mobbed, Rosty-style, and getting those yes votes will be impossible.

    1. That is what I think. In fact, if we can get through this week, the chances of passage go down significantly.

    2. I would give a year’s pay to watch news clip after clip of Congress folks running screaming away from their constituents. Make it two years worth if they are crying!

    3. If this thing isn’t done by the time the Reps go home for Easter, its over. O. V. E. R.

      No this is never going to end. We will be talking about health care reform 200 years after the singularity…in fact i am beginning to think that the political shift to focus on health care reform is the singularity.

      History as we have known it has no meaning anymore. All wars and all peace from here forth will be predicated on the state of health care reform.

      1. We will be talking about health care reform 200 years after the singularity

        Nancy Pelosi will be a botoxed face in a jar by then.

        1. I believe it’s been decided that she’ll be kept alive in an enormous vat of taxpayer dollars, like a Guild Navigator from Dune.

      2. I don’t know how this ends. Does Obama really get up and say uncle? Does Pelosi? At some point they have to give up. But it will be so humiliating, I can’t imagine any politician doing it. But, they cannot go on like this until November. Something has got to give.

        1. Something has got to give.


          What is unsustainable about debating health care reform until our sun novas?

          1. Because eventually the rank and file will revolt. They are holding up the Congress. These people only have seven months left to steal. There are other things they want to get done. And every day this drags on is another day they can’t do the things that they want to do like get ear marks and pork for their buddies and try to look like they care and are doing something about the economy. The pressure to end this thing will get to be overwhelming at some point.

            And there is the hard deadline of the November recess. They have to stop at the election.

            1. Healthcare is our national, puss-filled cyst.

              1. RC’z law strikes again.

            2. They will keep on this until they pass a bill that has something to do with healthcare. If they get desperate enough, that might even be a actual reform bill, with deregulation and stuff. Because they’re afraid that failure to pass could kill them even more than passage of a horrific bill will.

          2. Comprehensive health care reform has a half-life measured in days. After the break, it is done.

            It is already really late in an election year to do major legislation. Nothing big will move after the break – Congress simply won’t be around much because they need to spend the summer campaigning.

            Health care has sucked all the oxygen out of the session. They have even missed their chance to fall back on something smaller.

            It is health care or nothing for Obama’s Presidency at this point. He’s got no capital left, no time left, no filibuster-proof Senate majority, and, soon, no (dominating) House majority.

  6. And every day this drags on is another day they can’t do the things that they want to do like get ear marks and pork for their buddies and try to look like they care and are doing something about the economy

    It has not stopped any of this as far as i can see.

    And there is the hard deadline of the November recess. They have to stop at the election.

    Why can’t the election be about health care reform?

    1. It will be one way or another. But, I think you are daft if you believe that we will have seven solid months of Pelosi claiming she has the votes and berating the no votes. It will come to an end. Probably shortly after Easter.

      1. John i think we are looking at the same polling data in regards to health care, Obama, and the dems in congress.

        They are all dropping and we both assume that at some point they all break below 50% or something. But there is a second possibility. That those polls are all headed to 50% and then will stay there and then we have complete political gridlock.

        I will admit that it is only a passing theory. But one i think those of us of similar political persuasion* have been neglecting. My first bit of evidence is Lewinsky which seemed to last for 4 fucking years and had no final solution. The second bit of evidence is the Iraq war which still has not resolved and it has been over half a decade. My third bit of evidence is the speed at which Washington has been switching parties and power…since newt and even you could consider Reagan it seems to be accelerating. what happens when the speed is instantaneous? Does the whole thing break and we get a third party? a revolt? or are we stable and the fight sticks at 50/50 gridlock?

        I don’t know. Is this a repeat of Carter’s 4 years or is this something new and unprecedented?

        *libertarians who give Republicans a little more credit then they are due.

        1. I am not sure what you mean. But I agree with you that power ebbs and flows a lot more than it used to. The days of one party owning the government for decades (like the Republicans before 1932 and the Democrats from 1932 to 1994) are over. I would not be shocked if the Republicans owned both elected branches come 2012 and the Democrats owned them again in 2016.

          1. I am not sure what you mean.

            I mean the health care debate is only a year old. There is no reason that it could not last 5 years or even a decade.

            And if the parties are stuck in a dead electoral heat even up to those kind of time lines there is no reason why this debate could not last forever.

            1. Because there will be a new Congress and perhaps a new speaker and majority leader come next January. And chances are very good that they will want to move on to something else. It seems pretty nonsensical to think that both parties will abandon all other priorities to fight an endless war of attrition over healthcare reform.

    2. And it has stopped this. It has totally sucked the air out of every other legislative initiative. Obama can’t do shit until this thing is settled.

      1. Long live the healthcare debate then!

  7. If this thing isn’t done by the time the Reps go home for Easter, its over. O. V. E. R.

    Yeah, folks said that the bill was dead if they didn’t get a bill by the end of the summer, by October, by the New Year, etc. That prediction is starting to look like Thomas Friedman and “the next six months are the most important.”

    1. All true. Maybe they will spend all spring summer and fall debating the same dead bill. That would be something. Eventually the media would turn on them big time. The whole country would grow so tired of the debate they would tune out destroying ratings. The media would be pissed.

      1. One word:


        1. There is a difference between something being an issue and endlessly debating the same bill about that issue.

    2. the bill was dead if they didn’t get a bill by the end of the summer.

      Yeah, but…they didn’t actually say which summer.

    3. On the flip side, the leadership has been saying that the bill would be passed by X date so many times that I think it must already be law for all the wishing.

  8. Health Care Plan Americans Can Live With!

    1. Deregulated Health insurers so that all of them can sell in any state. End the monopolies and increase competition.

    2. Turn Medicare and Medicaid over to private insurance companies to run for the poor and seniors. Private companies can fight fraud better than the government can. Medicare and Medicaid can become profitable.

    3. Get rid of the FDA and eliminate law suit protection of drug companies. Open up drug purchasing from other countries. This will force drug companies to provide safe and affordable drugs.

    4. Provide tax deductions for the poor that cannot afford insurance.

    5. No coverage for legal or illegal immigrants unless they pay for there own.

    6. Tort reform, make the loser pay the fees of the victor.

    7. Stop the practice of requiring insurance coverage we don’t need. The government mandates insurance coverage demanded by special interest groups that makes no sense for a lot of people.

    1. 5. No coverage for legal or illegal immigrants unless they pay for there own.

      So my grandma would not be covered?

      How about Nick’s grandma would she be covered?

    2. Also you forgot a big one.

      Stop taxing non-employee provided health care.

      1. Non-employer*

        Not an easy way to say this…perhaps this is why everyone seems to forget.

        Anyway poeple who get their health care from their employer do not pay taxes on it. While those who get their health care elsewhere have to pay taxes on it. This is a stupid law and by removing it would allow insurance to be decoupled from employers.

  9. “4. Provide tax deductions for the poor that cannot afford insurance.”

    Weren’t they already covered in #2?

  10. As much as I would love to see this bill die a quick and painful death, I realize how much better a long and painful death is. Not only does it keep Congress busy so they can’t screw with other things but every day that goes by saps the saps power.
    This is why I can’t totally hate passage of the stimulus bill either. As much of an abomination as it was, it cost Obama a lot of political capital. In my mind Health Care would have been a done deal if he had made that his first priority.

    1. In my mind Health Care would have been a done deal if he had made that his first priority.

      Wait…so if this wasn’t then what was his first priority?

  11. J.C.,

    I personally think you’re right, that this thing is likely to grid lock itself at a 50-50 split.

    History is on your side. The US electorate has been roughly split 50-50 since the US was born.

  12. So am I the only one who’s wondered how far this pissing contest might end up going? I mean are we going to cross the line, and it goes from being a verbal war to something a bit more literal?

    If they shove this bill through, it probably won’t start Civil War II. But somehow, I’ve started to feel like it might be a definite step in that direction.

    Or maybe it won’t, just because the real impact won’t hit until enough years later, that most of the people who now oppose it will just learn to live with it.

    Don’t know but it’s run through the back of my mind lately.

    Somehow our politicians have acquired an unsettling attitude in recent years. Yes it’s always been bad, but this has a whole new edge to it.

    If the “progressives” got Obamacare rammed through, and put their carbon tax in place right behind it somehow, I’m going to be a little nervous.

  13. Although the ideal of health reform i.e. healthcare for all is admirable, in reality this amounts to a far greater challenge than anyone could ever imagine. The United Kingdom model of the NHS is something the US should strive for, but given the situation with pharma companies and hospitals operating for profit, the industry will have to take massive changes in the philosophy of what it does, not simply a reform of its functions. Best Regards, James @ gazebo canopy

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