Saving Elmendorf a Beating

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Senator Kent Conrad today made an unusual request of the Congressional Budget Office: a 20-year cost estimate on the latest draft of Senate Finance Committee Chairman Max Baucus’ bill reforming the nation’s health care system. “We’ve got to have somebody look at this objectively and try to tell us: do we bend the cost curve the right way,” Conrad told reporters just off the Senate floor today. “I mean really when you think about it that is absolutely key to this whole effort. If we’re not bending the cost curve the right way it’d be a profound mistake.”

Indeed, none of the other four bills that have been marked up have shown long term savings by the CBO. And the agency, headed by Doug Elmendorf, has taken a beating by Dems and outside groups for refusing to score savings that an emphasis on prevention might bring about and, as the Institute of Medicine put it, “stingy” scoring.

While the Office and Management and Budget, a division of the White House, will put out its own scoring – those estimates are usual perceived as skewed to whatever end the president wishes. The CBO, meanwhile, is viewed as more objective and thus their endorsement much sought after. Conrad’s request hints that the CBO’s 10-year score of Baucus’ bill doesn’t yet show cost savings. Estimating 20 years out is hard to do and often unreliable but if the CBO comes back with a score that shows significant savings Baucus can declare victory and Elmendorf will be saved from another round of recriminations.

Baucus today said he expects to unveil his final draft of the legislation tomorrow ahead of a mark up scheduled for next week. And David Axelrod, the President’s top political adviser, came to the Hill to walk Dem senators through the current polling numbers on health care. “This is a real struggle and David’s in there, Axelrod, saying we’ve got to try and get something,” said West Virginia Senator Jay Rockefeller after sneaking out early from the lunch meeting. “So the new bench mark is: well, if we can do something, if we can do anything, then we can say that we did health care reform. And that’s a very large moral, theoretical, philosophical, practical and political question.”

Axelrod, on his way out, took exception to Rockefeller’s characterization of his remarks: “Our goal is not motion for motion’s sake. Our goal is to help people who have insurance gain some stability and to help people who don’t have insurance get insurance at a price that they can afford.  You have to be very focused on those goals.”

The sticking point du jour is affordability: whether, say, a family of four making $65,000 a year would be able to afford $8,500 premiums. “Obviously affordability is something that we’re going to pay great attention to,” Axelrod said before climbing into an SUV with dark-tinted windows that would bear him back to the White House.

Echoed Senator Chuck Schumer, a New York Democrat, “that’s something that we’re looking at very seriously right now.”

Even as Dems contemplated what the political landscape might look like if they don’t get a bill or if they go it alone (or essentially alone if they just get Maine Republican Olympia Snowe’s vote), Baucus remained convinced he can still deliver GOP support. “I think there’ll be Republican support when the bill is reported out of committee at the very latest,” he told reporters after the lunch. “Now maybe earlier there may be a Republican or two who might announce support, I don’t know, but I think by the time we report the bill out we’ll have Republican support.”

But, in trying to lure Republicans, Baucus may be bleeding Dems — many of whom gave him an earful at a meeting last night. “No way in its present form would I vote” for Baucus’ bill, Rockefeller told a conference call with reporters this afternoon.