WASHINGTON - The Congressional Budget Office report on a Republican health care bill set off an intense reaction in Washington, and some on both sides of the debate are playing loose with the facts.
Republicans are overlooking President Donald Trump's promise to deliver "insurance for everybody," which the CBO makes clear will not happen if the legislation becomes law. Democrats are assailing Republicans for "attacking the messenger," seeming to forget all the times they assailed the budget office themselves.
The Congressional Budget Office is respected for nonpartisan rigor in its estimates of the costs and impacts of legislation. But no projection is infallible, particularly when it comes to large, complex programs. For example, the agency in 2010 overstated the number of people expected to buy insurance under President Barack Obama's health care law, misjudging how many would join because of the threat of tax penalties.
Yet, CBO's neutrality has been valued by both parties -- though not always at the same time. It depends whose ox is being gored.
A look at statements in the debate and how they compare with the CBO's estimates and the underlying facts:
"We're going to have insurance for everybody. There was a philosophy in some circles that if you can't pay for it, you don't get it. That's not going to happen with us." -- to , Jan. 15.
It estimates the bill would leave 14 million fewer people insured in the first year, 24 million fewer by 2026.
In the first year, the biggest reason more people are uninsured would be repeal of penalties Barack Obama's law imposes on those deemed able to afford insurance but who don't buy it. Still others would decide to forgo coverage because of higher premiums or do without Medicaid.
In following years the main reason for a drop in the number of insured would be that the Republican bill scales back Medicaid for low-income Americans. Altogether, CBO estimates 52 million people would be uninsured by 2026, a vast distance from "insurance for everybody."
, White House press secretary, Tuesday: "Having a card and having coverage that when you walk into a doctor's office has a deductible of $15,000, $20,000 a year isn't coverage. That's a car. That doesn't get you the care you need."
He's wrong about deductibles under Obama's law.
Out-of-pocket expenses for consumers are limited. Deductibles, copayments, and coinsurance together can't exceed $7,150 this year for an individual plan sold through HealthCare.gov or similar state markets. For a family plan it's $14,300. After that, the insurance plan pays the full cost of covered benefits.
In addition, more than half of customers in these plans get subsidies to help with their out-of-pocket costs.
, Senate Democratic leader: "CBO is virtually unassailable. Everyone, Democrats and Republicans, whether it be George Bush, Barack Obama or anyone else has gone along with CBO. ... CBO speaks the truth. They've been speaking the truth for decades and to try to attack CBO is simply attacking the messenger." -- Comments to reporters Monday.
, House Democratic leader, on Republican reaction to the CBO: "Some of them are trying to pin a rose on this report and make it sound like it's a good thing and the others of them are trying to discredit the CBO, but it's completely wrong, completely wrong. ... Numbers are quite elegant things, you know. They speak very clearly." -- Comments to reporters Monday.
Democrats have not hesitated to attack this messenger when its conclusions have not suited them.
"The Congressional Budget Office never gives us any credit," President Obama said in 2009 when the CBO pointed to the expense of Democratic health overhaul proposals. Complained Pelosi at the time: "The CBO will always give you the worst-case scenario."
Again in 2014, Pelosi did not consider CBO's numbers "elegant," or correct, when they forecast job losses from a Democratic effort to raise the minimum wage. She accused the CBO of making arguments that "contradict the consensus among hundreds of America's top economists" and said it "ignored new perspectives in the wide array of analysis on the minimum wage."
People covered under the law "can expect to have great health care. It will be in a much simplified form. Much less expensive and much better ... lower numbers, much lower deductibles."
It says cost-sharing payments in the individual market, including deductibles, "would tend to be higher than those anticipated under current law.' Cost-sharing subsidies would be repealed in 2020, 'significantly increasing out-of-pocket costs for nongroup (private) insurance for many lower-income enrollees."