A Few Tricks to Make Your Deficit Look Smaller
I'm sure Peter Suderman will have more later, but here are a few things worth noting about the CBO's preliminary analysis (PDF) of the Senate health care bill as modified by the reconciliation bill Democrats have put together:
1. The Medicare savings, which may not actually materialize because they depend on reimbursement changes Congress has been loath to maintain in the past, total about $500 billion during the first decade, compared to total deficit reduction of $130 billion.
2. The reconciliation bill includes changes to student loan programs that CBO estimates will reduce spending by $19.4 billion during the first decade. By contrast, the "doc fix" that was originally envisioned as part of the health care package, since it deals with Medicare payments to physicians, was carved out and placed in a separate bill. It costs more than $200 billion.
3. CBO warns that it "does not generally provide cost estimates beyond the 10-year budget projection period" and that its projections for the second decade are subject to "an even greater degree of uncertainty" than its projections for the first 10 years. It estimates that the unmodified Senate bill "would have a total effect during that [second] decade that is in a broad range between one-quarter percent and one-half percent of gross domestic product." The changes in the reconciliation bill, it says, would "further reduce federal budget deficits in that decade, with a total effect that is in a broad range between zero and one-quarter percent of GDP." When the range of numbers in a projection includes zero, it seems fair to say the projection is not very helpful as a guide to policy decisions. Yet the Democrats have transformed these highly uncertain projections into a seemingly precise and reliable dollar figure: $1.2 trillion in deficit reduction during the second decade.