Senate Republicans are working the referee as they try to salvage their shot at repealing and replacing ObamaCare.
They are specifically turning up the heat on the Congressional Budget Office (CBO), hoping to get a more favorable analysis on the next version of their healthcare bill.
The CBO’s initial score of the GOP’s healthcare bill found that 22 million more people would be left without health insurance over the next decade compared to under present law.
It was a terrible number for GOP leaders, dealing a blow to their hopes of winning over centrist Republicans.
GOP senators wanted a better number than the House bill, which the CBO found would leave 23 million more people without insurance. What they got was a similar number, which underscored fears from Sen. Susan Collins (R-Maine) and others that the legislation would leave many vulnerable people without affordable health insurance.
Now Republicans revamping their bill are pressuring the CBO to use a different benchmark for its next score.
They say the CBO used data from March 2016 in coming up with the analysis that 22 million people would lose health insurance.
By using a more recent benchmark from this year, Sen. Ron Johnson (R-Wis.) argues that number might come down by as much as 6 million.
He says that the individual insurance market is “in way worse shape today” than it was in March 2016 because many people have since dropped insurance because of rising premiums and insurance companies pulling out of markets.
“It’s completely unfair,” he said of the CBO baseline. “It’s completely penalizing the evaluation of what the Senate bill really does compared to current reality.”
CBO acknowledges that it is using the March 2016 data. But it says it is following standard procedure in doing so.
Republicans are moving their healthcare bill through the Senate under special budget reconciliation rules that prevent Democrats from filibustering the legislation. As part of that process, they passed a budget for fiscal year 2017 in January. That budget was based on CBO’s March 2016 baseline.
CBO traditionally uses the same baseline for bills passed under reconciliation as is used for the budget. This is why it used the March 2016 data as a baseline for its score on the Senate’s healthcare bill.
Senate aides agreed that the CBO used the older data based on instruction by House GOP leaders, who did not expect the process of passing the healthcare bill to drag on for so long. At a GOP retreat in Philadelphia in January, Speaker Paul Ryan (R-Wis.) outlined a 200-day agenda that anticipated repealing and replacing ObamaCare in April.
But as the Senate continues to struggle to pass its own healthcare bill, and as centrists worry over the CBO’s findings, that is looking like a costly error.
Republican senators grilled CBO Director Keith Hall over the issue when he spoke to the GOP conference on Tuesday, the day after it issued its damning report.
Sen. Steve Daines (R-Mont.) said the March 2016 data was a big part of the conversation.
“Why not use updated information?” Daines said.
Daines also criticized the CBO for not being more transparent about its methodologies.
“Let’s just say the CBO did not serve themselves very well when they were questioned by numerous Republicans including myself. It was frankly very disappointing.”
Hall, the CBO director, pushed back against GOP senators in the meeting, arguing that it could take weeks to build new models based on more recent data, setting up a contest of wills between Senate Republicans and Congress’s official scorekeeper.
“They say they haven’t done it and it will take them a while to do it. I think we’ll put a lot of heat on them to get it — at least, at least look at that,” Johnson said.
Republicans are also considering other changes to their bill to improve the insurance numbers, but the fight over the CBO baseline could be key to winning support from the conference.
Republicans need to win 50 votes from their own conference to clear their legislation through the Senate, but face defections from the left and the right. Collins and Sens. Lisa Murkowski (Alaska), Dean Heller (Nev.), Rob Portman (Ohio) and Shelley Moore Capito (W.Va.) are among the Republicans worried their bill would leave too many people with unaffordable paths to insurance.
The GOP can only afford to lose two votes, and also faces pressure from conservatives, who have other demands about the healthcare bill.
Deborah Kilroe, the associate director for communications at CBO, said the agency typically uses the same baseline as the congressional budget resolution when scoring a bill that is protected by the reconciliation instructions.
Kilroe noted that when Congress passed its budget resolution shortly after New Year’s Day, CBO had not yet issued the January 2017 benchmark that Johnson is now using in his updated analysis.
She said agencies “have not had time to undertake a follow-on analysis” of the GOP legislation using the more recent baseline.
Kilgore explained that CBO’s January projections of the total number of people who will be uninsured in future years under ObamaCare are “similar” to the estimate based on the data from March of last year.
She conceded, however, that the number of people who were projected in January to buy subsidized health insurance through government-regulated marketplaces in future years was smaller compared to the March of 2016 estimate.
If CBO uses a more recent baseline to evaluate the legislation, “it is unclear how different categories of insurance would be affected and whether the budgetary effects would differ noticeably,” Kilroe said.
Daines says the stakes are too high to let the healthcare debate be decided by what he sees as an errant score.
“It’s like these guys are reffing a football game and we’re playing basketball. I just want to have the right referee,” he said.