Scoring the CBO Score

Amid all the spinning and sparring over the Congressional Budget Office’s assessment of health care legislation, a couple of stories stand out for bringing much-needed context to the proceedings.

The Washington Post did a smart analysis, pointing out what should be obvious but too often goes unsaid: despite all the hype around the 25-page “score” of the proposal, no one really knows for sure how the math will shake out.

Budget experts generally have high praise for the work of CBO analysts, the non-ideological technocrats who crunch the numbers to estimate the fiscal impact of legislation. But their work is often more art than science, and although the forecasts that accompany legislation are always filled with uncertainty, this one contains more than most.

The Post piece goes on to spell out some of that uncertainty, in the kind of detail that most readers can make sense of, without getting lost in the weeds.

For example, the legislation contains subsidies for those who would not be able to afford health coverage on their own — but the cost of those subsidies could vary a lot depending on how much other elements of the legislation change the price of health insurance, such as through provisions requiring minimum coverage levels.

There’s also a bit of he-said, she-said in here, but it’s the kind that we can live with, serving, one hopes, to cool any pol’s claim to know exactly what’s going to happen.

Some health experts have argued that the agency was too conservative in its approach and that those programs could lead to vast savings in the cost of health care and make the legislation a boon for the federal budget.

But budget experts are more wary, concerned that the programs could just as easily produce few savings, or even cause higher costs.

The New York Times also takes a healthy step back on this one, pointing out in its scrub of the numbers that it isn’t just magic that made the health care bill come out costing pretty much exactly what President Obama wanted it to cost.

Congressional Democrats have spent more than a year working with the nonpartisan budget office on the health care legislation, and as they fine-tuned many of the bill’s various provisions in recent weeks, they consulted repeatedly with its number-crunchers and the bipartisan staff of the Joint Committee on Taxation.

In other words, the overall numbers were never going to miss the mark. Whenever the budget office judged that some element or elements of the bill would cause a problem meeting the cost and deficit-reduction targets, Democrats just adjusted the underlying legislation to make sure it would hit their goal.

That’s a nice bit of perspective in a debate that’s generating a lot of noise at the moment.

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Holly Yeager is CJR's Peterson Fellow, covering fiscal and economic policy. She is based in Washington and reachable at