How one Congressional Budget Office score salvaged Max Baucus’ day and possibly his bill.
When Senate Finance Chairman Mac Baucus finally revealed his long anticipated bill, his Democratic colleagues treated the proposal like the open salvo in barter exchange and Baucus like a used Turkish rug merchant they were sure was out to swindle them. Immediately, counter bids began flying: 400% of the poverty level, 450; a public plan; triggers; less cuts to Medicare Advantage; more help on Medicaid. Progressives hated it, MoveOn eviscerated it; the House was leery. After all that trouble, countless hours of negotiation not a single Republican signed up. Was there no one who liked Max Baucus’ bill?
By his 12:45pm press conference Baucus, in a rumpled grey suit with two broken buttons on his left cuff, was on the defensive. “I think I’ve come up with a good balanced bill that can pass the Senate,” he stammered out five times in 22 minutes.
After he left the podium his bleary-eyed staff took his place to answer reporters’ technical questions. More than an hour into the background briefing an aide walked over to one of the speakers and whispered in his ear. The briefer sprung up in his seat as if he was a string doll and someone had pulled the thread taut. “I’ve just been informed that the CBO has released the score and the chairman’s mark comes in at $774 billion over 10 years,” he declared.
More than 50 blackberrys whipped out simultaneously and a murmur rippled across the room as reporters exchanged surprised whispers: ‘It draws down the deficit nearly $50 billion the first decade!’
‘And 0.5% of GDP in the second decade. Do you know how much that is? That must be nearly $1 trillion.’
‘It covers 94% of the uninsured – minus illegal immigrants – in the first decade.’
The momentum had audibly shifted.
All these months, Baucus has been preaching to reporters that his bill would “bend the cost curve” – not the sexiest topic of what is already one of the driest of policy subjects. “The goal that we have to keep our eye on throughout all of this: how do we lower the rate of increase on health care spending in America?” Baucus told a gaggle of reporters in June, just before he missed his first deadline. “And there are various provisions that we’re going to put in here to help accomplish that, so we don’t just pass a bill and find, ‘My gosh ten or 11 years from now the rate of spending isn’t lowered at all.’ It has to be deficit neutral over 10 years so we have to look at ways to pay for this bill and also bend the cost curve.” It doesn’t get the blood flowing – “You lie! – like illegal immigrants or abortion. And there’s no alluring face to sell it: grandma and her death panels, sick children or stoic doctors and nurses. But in the end it is the most fundamental challenge to the system: a system that everyone has been predicting for decades will collapse under the weight of its own bills and the impetus, according to President Obama, for doing such an ambitious health care bill in such a bad economy.
More than any other part of the bill — covering the 47 million uninsured, the millions more underinsured — bending the cost curve, making the system solvent and self-sustainable for he nation’s children and grandchildren, will go farther in convincing moderate Dems and Republicans to vote for this thing. Asked Wednesday morning – before the CBO report came out – what his biggest problem with the bill was, Indiana Senator Evan Bayh, who heads a group of 17 Democratic moderates, said: “Number one, we’ve got to get the deficit under control and we’ve got to use honest accounting to ensure that it’s actually fully paid for and hopefully gets the deficit down over time and certainly doesn’t make it any worse.”
Standing 20 feet away, Ohio Republican George Voinovich, who is retiring from the Senate next year and flirted briefly with becoming an active negotiator, was echoing a similar sentiment. “The question I’m asking is: where’s all the money coming from? That’s the biggest issue I’ve got with this. How do you pay for this?” Voinovich demanded. “The president said not another dime on the debt. Well, that’s easy to say but to do some of those things that are going to bring the costs down gives a lot of people heartburn.”
This piece also gets conservative Republicans – at least the ones who proclaim themselves the defenders of small government and deficit hawks – the most flummoxed; much in the same way Clinton made them nervous when he tackled welfare reform, once a signature GOP issue. Indeed, the Republican reaction was a bit ironic with senators crying foul at the idea of, gasp, shrinking the size of government. “This partisan proposal cuts Medicare by nearly a half-trillion dollars,” railed Senate Minority Leader Mitch McConnell. Echoed Senator John Cornyn, head of the NRSC, “One financing proposal is to cut as much as $500 billion from Medicare. In other words, Democrats… want to accelerate Medicare’s bankruptcy in 2017 by using it to pay for this bill. How is that logical?”
Next week will see the bill put through the ringer of committee amendments followed by another round of amendments on the Senate floor. The final bill may look nothing like this one but, despite all the foot dragging, Baucus has produced something that none of the other four bills could achieve: an offset piece of legislation that actually addresses the greater problem of long term costs. And that gives Baucus the auctioneer’s gavel when the bartering begins in earnest.