House Republicans say they’re confident that the Congressional Budget Office will not conclude that their new health care bill would throw millions of people off their insurance plans.
But if that is the conclusion, some members are already laying the groundwork to argue that the CBO, and not their bill, is in the wrong. Even before the score for the American Health Care Act is out, some of the bill’s supporters are coming up with reasons to ignore the budget office’s findings if the result isn’t good.
“First of all, that’s not going to happen,” said Rep. Richard Hudson, a member of the Energy and Commerce Committee, when asked how Republicans should respond to an estimate showing millions would lose their care. “Second of all, the CBO number is a false argument the Democrats have created. They didn’t have support for their bill. This bill is going to save hundreds of millions of dollars.”
That approach mirrors comments from Donald Trump’s White House. On Wednesday, press secretary Sean Spicer said that “CBO was way off last time,” and that “if you are looking there for accuracy you’re looking in the wrong place,” citing its estimates on the Affordable Care Act. (The CBO estimated before Obamacare was implemented that it would ensure up to 24 million people; it only ensured 11 million people, according to US News & World Report.)
The fight matters because the CBO has long been understood on Capitol Hill as the gold standard for evaluating the impact of congressional legislation. If Republicans ignore or attack the CBO’s projections — as many are already signaling they will — then it suggests they’ll be quick to dismiss an analysis that Paul Ryan’s bill will deprive millions of their insurance.
By contrast, if Republicans recognize the CBO’s numbers as valid, then a negative score from the agency could stop their march toward a health care overhaul.
Either way, a CBO assessment is coming. The independent budget office — led by a director chosen by Tom Price, the secretary of health and human services, while Price was in Congress — is expected to come out any day now with its independent analysis of the cost and coverage of Ryan’s bill.
Other independent analyses have found the bill would have devastating impacts on the insurance market. A preliminary analysis from the ratings agency Standard & Poor's found between 6 million and 10 million people would lose their insurance under the plan.
But Republicans are optimistic that CBO’s estimates will be different. “We’ve been working very closely with CBO and we're anxious to see their numbers, but we believe this will bring down costs,” said Rep. Cathy McMorris Rodgers.
But what if CBO finds millions of people will lose their health care?
“I don’t think that’s going to be the case,” McMorris Rodgers said, declining to elaborate.
The House GOP’s internal divide over CBO’s worth
Not every Republican was prepared to dismiss CBO’s estimates as entirely meaningless.
For instance, Rep. Tim Murphy said “we’ll have to revise” the bill if it shows that millions will lose their health care. Rep. Tom Reed similarly argued that Republicans should be sensitive to CBO’s conclusions.
“Of course, if [CBO] comes back and says that, we will have to reconsider and it will impact the process,” Reed said in an interview, though he added that he thinks “we will land in a good place for the score."
And in the Senate, some Republicans were also quick to endorse the budget office’s analysis as valid. “If you're speaking of the tax cuts within the legislation, I think we need to see what the CBO score is,” Sen. Bill Cassidy said on Fox News on Wednesday. “Obviously, we want fiscal soundness, so that's going to be important."
Still, other Republicans seem prepared to lay the groundwork to diminish the importance of the budget office rather than to adjust their plans in response to its estimates.
Their ranks included Rep. Kevin Brady, who argued that the budget office badly blew its Obamacare estimates before that bill’s implementation.
“If you're asking us to follow the Democrat approach of a bad bill proved with a bad CBO analysis, preceded by a badly estimated CBO letter, we're not following that approach,” Brady said.
Rep. Chris Collins also argued that CBO’s estimates wouldn’t capture that the Trump administration could implement the law in a way that prevents fewer people from going without insurance. He also noted that the CBO estimates wouldn’t take stock of potential future bills Republicans could pass to ensure that Americans have health care.
“The estimates of the coverage don't look into what Tom Price can do as head of HHS or what might happen with other legislation, perhaps with bipartisan support,” Collins said.
Democrats were quick to rip their colleagues as preferring to ignore the reality that CBO’s numbers would represent. Rep. Joe Kennedy argued that early analyses had found that up to 15 million families would lose health care under Ryan’s plan, and seemed confident that the independent budget office would agree.
“When they’re confronted with the objective evidence that says that’s what [Ryan’s bill] does, I’d like to think they’ll go back to the drawing board,” Kennedy said in an interview. “But I don’t have any confidence that’s what they’ll do.”
But Republicans weren’t interested in entertaining that scenario. “They’re not going to come out and say that because the bill doesn’t do that,” said Rep. Joe Barton when asked how Republicans would respond if the CBO says Ryan’s bill takes health care from millions.
And if they do?
“They won’t. I’ve read the bill. We maintain Medicaid expansion, I think generously so,” Barton said. “So that’s not going to happen.”
Tara Golshan contributed reporting to this story.