Washington Health Policy Week in Review
A Scoring Problem for the CBO

By Drew Armstrong, CQ Staff

April 30, 2009 -- What's a big obstacle to getting a health care overhaul bill out of the Senate? The Congressional Budget Office (CBO), according to Finance Committee Chairman Max Baucus.

The Montana Democrat has repeatedly said he's having trouble getting congressional actuaries to score savings in the health proposals he's shown them—partly because many are new ideas without economic data to help generate a score, and in other cases because they are ideas that almost everybody believes will eventually lower spending. Apparently, the CBO's strict scoring rules won't allow for a savings-friendly interpretation.

"The slight challenge we have is getting numbers and estimates from CBO," Baucus said. Scoring savings is a necessity for offsetting a health bill's costs, and Baucus says he is continuing to push the CBO to show savings where it can.

"Otherwise, health care reform is in jeopardy," he said at a hearing today. He added that legislation would be a tough sell to the public if lawmakers and congressional actuaries can't deliver on one of President Obama's key promises—that a health care overhaul would lower spending growth.

But for now, the actuaries are a tougher sell. "The learning curve for all of us is fairly steep," Baucus said.

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