The nonpartisan budget shop’s projections on health care enrollment rankled opponents of Obamacare.
The Congressional Budget Office, which has been threatened with staff cuts by Republican lawmakers upset with its forecasts on the impact of repealing the Affordable Care Act, known as Obamacare, is pushing back against its critics.
Keith Hall, the Republican-appointed director of the nonpartisan arm of Congress, wrote a letter on Aug. 24 to Rep. Tom MacArthur, R-N.J., describing the research methods CBO uses to produce “objective, impartial and nonpartisan” analysis. Hall defended the agency’s past projections on likely enrollment numbers and costs of the politically toxic Affordable Care Act. MacArthur helped design legislation that would have repealed and replaced Obamacare, but the GOP’s bid ultimately failed.
“When approaching budgetary and economic questions and cost estimates, the agency’s analysts—who have a detailed understanding of federal programs and the tax code—carefully read the relevant research literature and extensively examine data collected and reported by the government’s statistical agencies and private organizations,” Hall wrote. “The analysts seek out information from people with diverse perspectives on the issues. The agency encourages open discussion of the analytic issues.”
All CBO reports are reviewed in draft “by people at different levels in the organization, and, typically, the analytic reports are also reviewed by outside experts,” Hall added, noting that the reviews avoid persons with outside political activities. “Employees prize those attributes that bolster the integrity of their analysis, and their interactions continually reinforce the culture.”
Specifically, the CBO chief responded to the lawmaker’s concern about the benchmark his analysts used in scoring the impact over the next decade of the House-passed American Health Care Act that would repeal Obamacare.
“After consulting with the budget committees, CBO and the staff of the Joint Committee on Taxation measured the costs and savings in the estimate for the AHCA relative to CBO’s March 2016 baseline projections, with adjustments for legislation that was enacted after that baseline was produced,” Hall wrote in a letter copied to House and Senate leaders of both parties.
Using that very typical approach, he said, the two teams “projected that the share of people with health insurance would be 90 percent in 2016 and throughout the following decade. As measured in the National Health Interview Survey, conducted by the Census Bureau, the share turned out to be 90 percent in 2016. Under the Republican bill, CBO and JCT projected, the share would fall to 83 percent in 2020, 82 percent in 2021 through 2025, and 81 percent in 2026.”
Doing the same analysis based on a January 2017 baseline would not, Hall said, provide clarity on “how different categories of insurance would be affected and whether the budgetary effects would differ noticeably.
Similarly, Hall explained why the agency did not fulfill MacArthur’s request that it estimate the average effect of the bill on health insurance premiums in certain states, saying “it would be too imprecise.”
CBO “makes no policy recommendations,” Hall stated, “because choices about public policy inevitably involve value judgments that the agency does not and should not make.”