In an earlier post I speculated a bit on what mischief Kent Conrad might get up to to monkeywrench healthcare reform efforts. I wrote that before I found out precisely how far he's already gone to kill Democratic healthcare reform.
Instead of measuring the impact of health care reform over ten years, the CBO will use a 20-year window, Sen. Kent Conrad (D-N.D.) told reporters Tuesday. "You have to do that if you're going to know whether you're bending the cost curve," he said.
He wants the timeline to apply to the Senate Health Committee and the House bills, as well. "Everything needs to be scored in a similar way," he said.
He added, significantly, that the bill would not need to be paid for with spending cuts and revenue increases over the 20-year period. Rather, Conrad stressed that ir would merely need to show that it was reducing the rate of the increase iin health care costs and it would only need to be paid for over the first decade to meet his criteria.
The CBO has been largely dismissive of reforms that Democrats insist will lead to cost savings, such as prevention efforts or the establishment of an independent commission to set Medicare reimbursement rates. At the same time, the White House has taken drug-price negotiations and other cost-saving efforts off the table in deals with industry groups.
The upshot: CBO is likely to estimate that the second decade of the reform bill's life will add to the deficit, giving fuel to critics who say it is too expensive. It would also force backers of the bill to trim subsidies, increase revenue somehow, or break Obama's pledge.
That's way outside usual procedure for the CBO, which always uses a 10 year window for projections--a timeframe already problematic. But it's also a significant departure for Kent Conrad, as Ezra Klein points out:
The first came earlier this year when Conrad modified Obama’s first budget. Obama had eliminated a couple of Bush-era gimmicks that made the deficit appear smaller than it really was. Bush, for instance, shortened the budget window from 10 years to five, so the total deficit sounded smaller. Obama’s budget returned it to the traditional 10. And then Conrad changed it back. The Politico reported that Conrad made this decision "because of the uncertainty of long-range forecasts." Others thought he did it to hide the size of the deficit. In any case, 10 years, as the alert reader will notice, is less than 20 years. If 10 years was too long a time period for certainty, then it is difficult to see how 20 years could possibly be acceptable.
The second came in 2003, when Conrad voted for the Medicare Modernization Act, better known as Medicare Part D. The Congressional Budget Office estimated that the bill would increase the federal deficit by $421 billion and reduce federal revenue by another $174 billion. The total cost to the deficit, then, neared $600 billion. Conrad not only accepted the CBO’s 10-year time frame, but he voted for the bill. His press release enthusiastically touted the fact that the bill would "bring more than $70 million to North Dakota hospitals over the next ten years."
Conrad’s record in the Senate, then, would lead you to believe a couple of things. For one, he distrusts long-range projections. Even 10 years is too uncertain. He also believes some priorities overwhelm deficit concerns, health-care coverage being one of them. But when faced with a health-care reform that will be deficit neutral within the 10-year time frame, he is demanding that it instead be measured against an even more uncertain 20-year time frame, and by an agency that he claims underestimates savings. The CBO’s scores are terrible, in other words, and come in such small portions!
Kent Conrad doesn't want comprehensive healthcare reform that really works, and he's doing his damnedest to empower the Blue Dogs and his fellow ConservaDems to kill it.