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Top Republican legislators have spent months now attacking the Congressional Budget Office. House Speaker Paul Ryan derided the agency's Obamacare numbers as "bogus," speaking to reporters at an event in Massachusetts Thursday.
The CBO directors are fighting back. All eight signed on to a letter Friday to raise a "strong objection to recent attacks on the integrity and professionalism of the agency."
The letter continues:
Relying on CBO’s estimates in the legislative process has served the Congress — and the American people — very well during the past four decades. As the House and Senate consider potential policy changes this year and in the years ahead, we urge you to maintain and respect the Congress’s decades-long reliance on CBO’s estimates in developing and scoring bills.
This is the first time, I'm told, that all eight former directors have signed on to a joint letter. The group includes those appointed by Republicans and Democrats. The former directors have kicked around the idea of a letter for the past month or so, as they watched the attacks mount from the sidelines. They made a decision to write this letter about a week ago.
There is a reason this letter is addressed to congressional leadership rather than to the White House. President Trump has also been quite critical of the CBO. The White House released an entire video last week dedicated to criticizing the office's work on health care.
But the former CBO director I spoke with said this wasn't about the White House. Their big concern is the attacks from Congress, which oversees the office and appoints its director (currently Keith Hall). Those attacks have become especially fierce over the past few weeks, as my colleague Tara Golshan writes:
Rep. Tom Garrett (R-VA) even accused the CBO of conspiring against congressional Republicans, saying the office purposely released an updated negative report of the Obamacare repeal bill on the same day the House’s archconservatives filed a motion to force a floor vote on the bill. Others, like Rep. Tom MacArthur (R-NJ), point to the CBO’s projections for Obamacare back when the law was passed, which overestimated how many people would be insured.
The CBO directors don't expect to become a regular presence in the fight over the office's numbers. One reason there was some hesitation to put out the letter is that they didn't want to commit to an ongoing feud with Congress — but felt the attacks had become fevered enough to warrant a response.
As the former CBO director I spoke with put it to me, "We believe in the norms of our political system. And we believe, strongly, that the CBO is one of those norms."
Chart of the Day: Senate health bill would be unaffordable for low-income, elderly Americans
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Low-income Americans pay more under Senate bill. Loren Adler and Paul Ginsburg run the numbers, and estimate that out-of-pocket health spending would rise sharply for Americans earning less than $25,000 or so. The biggest hike would be on older Americans. Adler and Ginsburg, in an analysis for the USC-Brookings Schaeffer Initiative for Health Policy, find that "the magnitude of this change stems in large part from the elimination of the ACA’s cost-sharing subsidies." Read the full report here.
Kliff’s Notes
Your daily top health care reads, with research help from Caitlin Davis
Today's top news
- “Cloud of confusion hangs over health-care bill”: “Senate Republican leaders’ latest attempt to salvage support for a GOP health-care bill floundered Thursday as leaders struggled to explain to rank-and-file members what exactly they would be voting on next week.” —Kelsey Snell and Amy Goldstein, Washington Post
- “GOP Floats Proposal to Ease Medicaid Cuts”: “Senate Republicans, scrambling to win support for their health-care bill, pushed a measure Thursday that they said could ease the impact of the bill’s Medicaid cuts on low-income people.” —Louise Radnofsky and Kristina Peterson, Wall Street Journal
- "White House enlisting conservative groups to pressure GOP senators on health care bill": “The White House is quietly seeking to pressure senators to support the GOP health care bill with a network of grassroots and pro-life organizations.” —Josh Dawsey, Politico
Analysis and longer reads
- “These Americans Hated the Health Law. Until the Idea of Repeal Sank In.”: “When President Trump was elected, his party’s long-cherished goal of dismantling the Affordable Care Act seemed all but assured. But eight months later, Republicans seem to have done what the Democrats who passed the law never could: make it popular among a majority of Americans.” —Katie Zernike and Abby Goodnough, New York Times
- "Medicaid expansion boosted mental health coverage in four states": “The GAO looked at four states that expanded Medicaid: Iowa, New York, Washington, and West Virginia. It found that in 2014, 1 in 3 expansion enrollees got behavioral health treatments.” —Robert King, Washington Examiner
- "Trump Plan Might Cut Expenses For Some Insured Patients With Chronic Needs": “Out-of-pocket expenses could shrink under a Trump administration draft executive order that would change Internal Revenue Service rules about what care can be covered before the deductible is met in plans linked to health savings accounts, or HSAs.” —Michelle Andrews, Kaiser Health News
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