Rick Klein is ABC News' Senior Political Reporter and author of The Note's morning look at the upcoming day in politics. Throughout the day, ABC News' political team contributes to The Note with the very latest news and analysis from the nation's capital.
To email Rick Klein, click here.
RECENT POSTS
- McCain Targets Ben Nelson on Health Care Vote
- 'Top Line' -- Ambassador Oprah? Senator Oprah?
- Sen. Brown: Health Care Bill Needs More Subsidies
- GOP Leaders: Obama Has ‘Emboldened Our Enemies' with Afghanistan Deliberations
- Burris Cleared of Legal Wrongdoing -- But With Swipe from Ethics Committee
- Friends, in Need: Obama Faces Backlash on Jobs, Economy
- Doug Hampton: Ensign Knowingly Broke Ethics Rules on Lobbying
- The Note's Must-Reads for Friday, November 20, 2009
- Did Illinois Guv Nod Off at Health Care Debate?
- DNC Topped RNC in Oct. Fund-Raising
THE NOTE CATEGORIES
- 2010
- Afghanistan
- Bill Clinton
- CIA
- Congress
- Democratic party
- Environment
- Financial Reform
- GOP
- Gov. Mark Sanford
- Gov. Sarah Palin
- Guantanamo
- Health Care
- Hillary Clinton
- Immigration
- Iran
- Iraq
- John McCain
- Mitt Romney
- North Korea
- Obama Agenda
- Politics Live
- President Obama
- Republican Party
- Ronald Reagan
- Sen. John Ensign
- Senate
- Sonia Sotomayor
- Stimulus
- Sunday Shows
- Supreme Court
- Ted Kennedy
- The Note
- The Note Must-Reads
- Top Line
- Vice President Biden
- Virginia
MONTHLY ARCHIVES
« Previous | Main | Next »
CBO Sees No Net Federal Cost Savings in Dem Health Plans
July 16, 2009 11:58 AM
ABC News' Z. Byron Wolf reports:
Here's a blow to President Obama and Democrats pressing health care reform.
One of the main arguments made by the President and others for investing in health reform now is that it will save the federal government money in the long run by containing costs.
Turns out that may not be the case, according to Doug Elmendorf, director of the nonpartisan Congressional Budget Office.
Answering questions from Democrat Kent Conrad of North Dakota at a hearing of the Senate Budget Committee today, Elmendorf said CBO does not see health care cost savings in either of the partisan Democratic bills currently in Congress.
Conrad: Dr. Elmendorf, I am going to really put you on the spot because we are in the middle of this health care debate, but it is critically important that we get this right. Everyone has said, virtually everyone, that bending the cost curve over time is critically important and one of the key goals of this entire effort. From what you have seen from the products of the committees that have reported, do you see a successful effort being mounted to bend the long-term cost curve?
Elmendorf: No, Mr. Chairman. In the legislation that has been reported we do not see the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount. And on the contrary, the legislation significantly expands the federal responsibility for health care costs.
Conrad: So the cost curve in your judgement is being bent, but it is being bent the wrong way. Is that correct?
Elmendorf: The way I would put it is that the curve is being raised, so there is a justifiable focus on growth rates because of course it is the compounding of growth rates faster than the economy that leads to these unsustainable paths. But it is very hard to look out over a very long term and say very accurate things about growth rates. So most health experts that we talk with focus particularly on what is happening over the next 10 or 20 years, still a pretty long time period for projections, but focus on the next 10 or 20 years and look at whether efforts are being made that are bringing costs down or pushing costs up over that period.
As we wrote in our letter to you and Senator Gregg, the creation of a new subsidy for health insurance, which is a critical part of expanding health insurance coverage in our judgement, would by itself increase the federal responsibility for health care that raises federal spending on health care. It raises the amount of activity that is growing at this unsustainable rate and to offset that there has to be very substantial reductions in other parts of the federal commitment to health care, either on the tax revenue side through changes in the tax exclusion or on the spending side through reforms in Medicare and Medicaid. Certainly reforms of that sort are included in some of the packages, and we are still analyzing the reforms in the House package. Legislation was only released as you know two days ago. But changes we have looked at so far do not represent the fundamental change on the order of magnitude that would be necessary to offset the direct increase in federal health costs from the insurance coverage proposals.
Conrad: And what about the Finance Committee package, as it stands?
Elmendorf: I can’t speak to that Mr. Chairman. We have been working with the Finance Committee and the staff for a number of months on proposals that they have been addressing. But our consultations with them have been confidential because they have not yet released the legislation, and I don’t want to speak publicly about that.
Conrad: All right. In terms of those things that are public from other plans, what are the things that are missing that in your judgement prevent a bending of the cost curve in the right way?
Elmendorf: Bending the cost curve is difficult. As we said in our letter to you, there is a widespread consensus, and you quoted some of this, that a significant share of health spending is not contributing to health. But rooting out that spending without taking away spending that is beneficial to health is not straightforward.
Again, the way I think experts would put it – the money is out there, but it is not going to walk in the government’s door by itself. And devising the legislative strategies and the regulatory changes that would generate these changes is not straight forward. But the directions that have widespread support among health analysts include changing the preferential tax treatment of health insurance. We have a subsidy for larger health insurance policies in our tax code, and that like other subsidies encourages more of that activity. Reducing that subsidy would reduce that. And on the other side, changing the way that Medicare pays providers in an effort to encourage a focus on cost effectiveness in health care and not encourage, as a fee for service system tends to, for the delivery of additional services because bills for that will be paid.
UPDATE: The word "net" was added to the headline of this posting to more accurately reflect the CBO's position.
Questions about this exchange have followed Elmendorf to the House Ways and Means Committee, where he clarified a bit, according to ABC's Lisa Chinn.
Elmendorf told members of the committee that his answer to Conrad shows only that the bill "adds to federal health spending, and that amount is difficult to offset."
In other words, it's not that the health reform bills do not lead to savings for the federal government -- just that those savings may not offset the added expense of subsidizing insurance for many more Americans.
-- Z. Byron Wolf
July 16, 2009 | Permalink | Share | User Comments (43)
You can follow this conversation by subscribing to the comment feed for this post.
This is just a preliminary report coming from an anti-Obama, slipshod office.
Posted by: matt | Jul 16, 2009 12:27:25 PM
Obama and the dems lying again? I shocked I tell you shocked. Is everyone enjoying one of the 3.5 million new jobs Obama promised?
Posted by: robtr | Jul 16, 2009 12:43:02 PM
From what I understand, the consequences of passing the bill will be the loss of 4.7 million jobs due to fines and taxes on small businesses. Also, you CANNOT keep the insurance you already have. There is a direct stipulation in this bill that prohibits it. Read the bill.
Posted by: bun | Jul 16, 2009 12:59:32 PM
THis health care legislation, if passed, will be a bigger failure than the so-called stimulus. And the so-called stimulus was a massive failure.
Posted by: Jim Fraser | Jul 16, 2009 1:02:49 PM
"Elmendorf: Bending the cost curve is difficult. As we said in our letter to you, there is a widespread consensus, and you quoted some of this, that a significant share of health spending is not contributing to health. But rooting out that spending without taking away spending that is beneficial to health is not straightforward. "
-------------------------------------
One of the MAJOR points that any gov't plan MUST address, but so far no one wants to face it! How can you "control" costs when you do not understand what the exact components of that rising cost are?
DETAILS, DETAILS, DETAILS.....
Obama has set an artificial deadline that means NOTHING! Passing some big blob that he calls heathcare, but has no REAL plan that you can use, is MEANINGLESS!
Pass legislation that includes the levels of coverage, premiums, co-pays, deductibles, maximum payouts... etc.
If we do NOT have that, Then BY DEFINITION We have no healthcare plan. It means you can't compare it to your current plan or any other plan that is available to you.
Posted by: Mike_C | Jul 16, 2009 1:03:00 PM
Matt,
The CBO is not an anti-Obama group...it is the gold standard that all Presidents are held to..in fact some feel it leans Democratic...they have no real dog in this fight...there job is to take the bills and analyze them to report on their budget impact. Period. How can yo save money by adding people to the healthcare roster? More services, les money...it ain't rocket science.
Start doing your homework...a healthcare boondoggle is headed your way because it is being rammed thru without cogent thought(if that is even possible by politicians)...they also lack the insights in the workings of the healthcare system...the head of the CBO has it right when he says finding savings in the spending is diffilcult because it is a complex process.
When it lands in your lap, you might not like what you wished for...
Posted by: MN | Jul 16, 2009 1:17:44 PM
Well put MN - would that the Matt's of this world would have the strength of character to reason rationally...
Posted by: Jane | Jul 16, 2009 1:35:17 PM
BUN has hit on an important point. Obama keeps claiming that, if you're happy with your current plan, you can keep it. However, it explicitly states on page 16 of this 1,000 page abortion that it is expressly ILLEGAL to seek private insurance coverage. Either Obama was lying or he has no idea what is in the bill. Maybe both. Why isn't the MSM making this known?
Posted by: Robert | Jul 16, 2009 1:44:37 PM
Maybe I'm just a little simple minded, but. Think about this.
There are what, 325 million of us American Citizens. What it we just set up an account for health care totaling say 1 million dollars per person. This would cover the cost of care.
Those of us who are lucky enough to have insurance, have a lifetime cap of 1 million dollars to start.
Realistically, only about 2% of us ever even come close to that amount in Health Care needs.
So I guess my question is.
Where do these figures of Trillions
of Dollars come from?
Posted by: Staz | Jul 16, 2009 1:46:41 PM
Duh! We all knew this, apparently the only group of people who did not know that health care cost will rise, not fall, under Obamacare is the White House Press Corp. Every wire and press report starts "President Obama's plan to curtail the rising cost of health insurance..".
The press has given an assumption of fact to a lie, and use outright propaganda instead of facts. They leave out the fact that the government run medicaid has had cost rise faster than private insurance. They will not give a cost of hiring hundreds of thousands of lifet-time employment union members as government workers -- hardly the efficient group of people.
Finally, if Obama is so into wellness, what happens to health care costs when everyone lives to 100 years of age? Costs do not go down, they skyrocket.
The press is clueless. Unless the White House press corp promises to go onto Medicaid, they should stop endorsing this plan without an ounce of skepticism.
Posted by: Karen | Jul 16, 2009 1:47:27 PM
No cost savings AND it still leaves many uninsured and forces even those who don't want health insurance to buy it anyway? Just a thought, but seems this isn't the best way to improve health care.
Why not just allocate billions more to expand free clinics and medicaid, grants and fed money to doctors and hospitals who treat the indigent and to expand access to free vaccination programs.
Fining people for not buying medical insurance is the wrong way to go -- for many people (young, healthy) it's cheaper to NOT buy insurance and simply pay for medical care as you go. An interest-bearing medical savings account can help people save for bigger-ticket medical care, like the birth of a child or wisdom teeth extraction, etc.
Posted by: Get girlz | Jul 16, 2009 2:10:04 PM
Wow! Talk about misinterpreting the quote from the CBO.... Man, ABC and the right wing press is really playing fast and loose with the truth!
Posted by: Mike | Jul 16, 2009 2:54:10 PM
Obama's plan does not deal with costs because Obama is not interested in reforming health care.
He is interested in providing free health insurance to the poor. Period.
All this talk of reform is just that. He tried to use cost as the basis for doing what he wanted. It didn't work. It never made sense.
The CBO figures are irrevelant. Obama has a plan, and he truly doesn't care about costs.
He does, however, care about votes, but not until the next presidential election. Democrats facing elections sooner will have to deal with him. Thank goodness for that.
Posted by: Andrea | Jul 16, 2009 2:59:46 PM
The politicians better not screw up this issue. We will not forget it and will vote next time based on sucess or failure of this bill! Parties will not suffice bad decesions.
Posted by: steve atkinson | Jul 16, 2009 3:03:59 PM
@ Robert. Where, on page 16, does it expressly say it is "ILLEGAL to seek private insurance coverage"? Thanks.
Posted by: ME | Jul 16, 2009 3:04:01 PM
Robert,
325 million people mutiplied by 1 million dollars is 325 trillion dollars.
Posted by: Greg | Jul 16, 2009 3:04:19 PM
@ Mike. What is being misinterpreted? And please interpret it correctly for me. Thanks.
Posted by: ME | Jul 16, 2009 3:08:40 PM
As soon as BO and all of the jokers that are trying to ram this political piece of trash thru, step up and say that they will switch from there special Healthcare benefits they currently enjoy, to their newly designed plan, well, then I might take another look.
Can you say Hypocrisy! Just another dump on the public, just another shell game and the heck with what it will do to damage the economy, damm the torpedo's, full steam ahead.
Posted by: Phantom | Jul 16, 2009 3:17:05 PM
It's a shame that such stupid people work in the federal government or are black politician. Some examples of this: 1. I was talking to a black lady the other day and obama was on tv talking about global warming. She said, "that nobody cares about global warming". she conveyed that global warming causes suanomies. That is plain ignorance.
2. Rational Healthcare. The only reason barac and his communist cronies want us to use government healthcare is so he can control us and also so he can put the same stupid regulators that were in charge of the sub prime mortgage meltdown in charge of Rational healthcare.
Democrats need to get a grip and fast. They will do anything to maintain control at the expense of all american's.
Posted by: rational healthcare | Jul 16, 2009 3:22:41 PM
@ME. On Page 16 of the house bill (taken from IBD)the "Limitation On New Enrollment" section of the bill clearly states:
"Except as provided in this paragraph, the individual health insurance issuer offering such coverage does not enroll any individual in such coverage if the first effective date of coverage is on or after the first day" of the year the legislation becomes law.
So we can all keep our coverage, just as promised — with, of course, exceptions: Those who currently have private individual coverage won't be able to change it. Nor will those who leave a company to work for themselves be free to buy individual plans from private carriers.
Posted by: Rus | Jul 16, 2009 4:18:45 PM
Post a comment
POLITICAL VIDEOS
THE NOTE BLOG ROLL
- ABC News -- George Stephanopoulos
- ABC News -- Jake Tapper
- ABC News Politics
- ABC News -- The Numbers
- ABC News -- The Blotter
- The American Prospect -- TAPPED
- The Atlantic -- Politics Channel
- The Boston Globe -- Political Intelligence
- Center for American Progress -- Think Progress
- Center for Responsive Politics
- The Chicago Sun-Times -- Lynn Sweet
- The Chicago Tribune -- The Swamp
- Drudge Report
- FactCheck.org
- FiveThirtyEight
- Heritage Foundation -- The Foundry
- The Hill -- Briefing Room
- The Hotline
- The Huffington Post
- The Los Angeles Times -- Top of the Ticket
- NPR -- Political Junkie
- National Review -- The Corner
- The New Republic -- The Plank
- The New York Times -- The Caucus
- Newsweek -- The Gaggle
- Political Wire -- Taegan Goddard
- Politico -- Ben Smith
- Politico -- Mike Allen’s Playbook
- PolitiFact
- Real Clear Politics
- Talking Points Memo
- Time -- The Page
- USA Today -- On Politics
- Variety -- Wilshire & Washington
- The Wall Street Journal -- Capital Journal
- The Washington Post -- The Fix
- The Washington Post -- 44

