By launching an attack on the credibility of Washington’s premier budget scorekeeper, the Trump administration signaled on Wednesday that it expects to receive a highly negative report next week from the Congressional Budget Office on the cost and likely impact of the House GOP’s plan for replacing the Affordable Care Act.
The CBO is considered the gold standard for non-partisan budget analysis and economic forecasting in the complex and politically charged world of budget politics. It’s track record over the years for forecasting government spending, assessing the likely impact of major programs and budget deals, and predicting the deficit has been solid, if far from perfect.
“CBO has I think done a very credible job, but the job itself is very difficult, and often the outcome and the forecasts are very different,” said Doug Holtz-Eakin, a former CBO director between 2003 and 2005 and a Republican policy adviser. “Yes, it is easy to predict the future. No, it is not easy to be right. That’s their job.”
Yet White House Press Secretary Sean Spicer yesterday blasted the agency for being “way off last time” in its cost estimates of President Obama’s Affordable Care Act. He stressed that the CBO’s report next week – which will likely project rising deficits and the loss of health insurance coverage for millions of Americans under the GOP plan -- should not be taken as the final word.
“If you’re looking at the CBO for accuracy, you’re looking in the wrong place,” Spicer said during a White House press briefing.
In a further slap, Spicer said the White House intends to issue its own estimate of the impact of the proposed GOP American Health Care Act. White House budget director Mick Mulvaney, a former Tea Party conservative House member who is pushing for passage of the bill, will oversee the findings. Earlier in the day, Mulvaney told MSNBC that he wasn't worried about what the CBO report would show and that "the only question about CBO: Is it going to be really good, or is it going to be great when the numbers finally come out."
Spicer’s comments touched off an uproar among economists and budget analysts, who complained that the Trump White House was once again attempting to discredit an important institution that disagreed with him, just as he has done in going after the intelligence community and the judiciary.
“I think this is clearly an attempt to dismiss in advance the likely insurance coverage estimates that CBO is going to produce showing that the large share of those losing coverage due to repeal would likely become uninsured compared to current law under the House plan,” said Edwin Park, a health policy expert with the liberal-leaning Center on Budget and Policy Priorities.
Bill Hoagland, the senior vice president of the Bipartisan Policy Center and a former Republican Senate Budget Committee staff director, said he was alarmed that Trump and his aides would attempt to undermine confidence in the CBO and threaten to throw the budget process into disarray.
“The biggest loser in all of this is a loss of trust in institutions that Trump has created,” Hoagland said in an interview. “This would be very, very damaging to the congressional budget process to undercut CBO.
A Democratic-controlled Congress created the CBO in 1974 as the ultimate arbiter of the impact of spending on the budget and deficit, and the leadership chose Alice Rivlin as the agency’s first director. Hoagland got one of his first jobs in Washington as an aide to Rivlin. Since then, he has served as a staunch defender of the agency under both Democratic and Republican directors.
Over the years, the agency has had many run-ins with the White House and the majority party in Congress over the cost and impact of huge new programs. Those disputes have ranged from the financial implications of President George W. Bush’s Medicare prescription-drug program to the cost of the wars in Iraq and Afghanistan to the Clinton administration’s failed national health care initiative to the passage of the Affordable Care Act during the first term of the Obama administration.
One storied conflict pitted then- CBO director Robert D. Reischauer, a prominent Democrat, against Clinton and his wife, Hillary over cost estimates of their proposed government-sponsored health care plan in 1994. Reischauer’s analysts added billions of dollars to the estimated long-term cost of the proposed program – a finding that opponents seized upon to help block passage.
This time it’s CBO director Keith Hall, a conservative who was handpicked for the job by the House and Senate Republican leaders, who is coming under fire from a Republican president who worries that he may provide opponents with more ammunition to block the GOP health plan. Hall, a former commissioner of the U.S Bureau of Labor Statistics, succeeded Democrat Douglas Elmendorf as CBO director in April 2015.
Deborah Kilroe, a spokesman for Hall, declined to respond to Spicer’s attack.
Spicer didn’t say precisely which forecasts he had in mind in going after the CBO, although no one questions that the agency’s initial estimates of Obamacare’s long-term cost and enrollment figures were off.
CBO’s original analysis of the 2010 Affordable Care Act provided long-term projections of enrollment that proved to be overly optimistic, although subsequent events including the 2015 Supreme Court ruling on the constitutionality of the law resulted in fewer states enrolling people in an expanded Medicaid program than originally predicted.
Moreover, CBO and the Joint Committee on Taxation estimated when the law was passed in March 2010 that it would cost $214 billion a year by 2019, although today the estimate is down to $148 billion. CBO said last week that “technical revisions” and updates to agency economic projections account for part of the downward revision in cost.
“CBO has always been criticized by lots of people, but in the end, they work for the Congress, and that’s the criticism they should pay attention to,” said Holtz-Eakin. “Their credibility wasn’t built by having press secretaries like or dislike them. It’s the quality of work they do. They’ll be fine.”