Another Take on the Cost of That House Health Care Bill

A few days ago we noted the split between major papers and the Associated Press about how to characterize the cost of the health care reform bill put forward by House Democrats. Not wanting to be left out, the D.C.-based publication Roll Call has now waded into the fray, too.

In its analysis, based on data from the Congressional Budget Office, Roll Call concludes that the gross cost of the bill is “more than $1.6 trillion.” That suggests it’s following the same logic used by the AP, which tallied up expenditures from the public exchange, Medicare adjustments and other sources to arrive at a $1.65 trillion total. (An AP spokesman said the organization’s $1.5 trillion figure “comes from our reporters being conservative and careful, rounding broadly.”) The Roll Call analysis is reasonably detailed, and it explicitly states, as the AP did in a follow-up story, that it is incorporating Medicare provisions that aren’t included in other estimates.

The inclusion of those Medicare provisions seems to have the effect of driving up projected gross costs while bringing down net expense, which raises a question about which of those figures media outlets should give most attention too. (The CBO, tasked with acting as a sort of institutional budget hawk, is most concerned with net cost.) And the fact that some outlets are including the Medicare figures, while others aren’t, prompts a question about which changes constitute “reform,” and which are just routine legislative tinkering. The lack of consensus on these points suggests again that media outlets should do more to explain the complexity, and the contingency, of these numbers.

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Greg Marx is an associate editor at CJR. Follow him on Twitter @gregamarx.