Thursday, January 6, 2011

Bringing Back the Doc Fix Whopper

CBO's first guess at the budget impact of ACA repeal is out, and, no surprise, it's sort of the opposite of the fiscal impact of passing the thing in the first place.  Jon Cohn has a quick analysis.

How do the supposedly deficit-opposing Republicans deal with it?  Two ways: by simply refusing to believe it, and by trotting out misdirection and long-disproved junk from the original debate.  My favorite (so far), the one that gets the chutzpah award for the day, is this from Speaker John Boehner:
CBO can only provide a score based on the assumptions that are given to them. And if you go back and look at the health care bill and the assumptions that were given to them, you see all of the double-counting that went on, you see the fact that the doc fix wasn't even part of the bill.
The doc fix, as many have explained, wasn't counted in the CBO score of the health care bill because it has essentially nothing to do with the health care bill.  Here's Ezra Klein back in April of last year:
What some Republicans are trying to do is add the doc fix into the Affordable Care Act. That is to say, they are trying to add the repeal of a Republican policy passed in 1997 into the cost of a Democratic bill being passed in 2010. But that's a bit like adding the cost of the Iraq War onto the bill, or maybe the Bush tax cuts. It's true that those were misguided, costly policies. But they're not part of the Affordable Care Act. They're part of the baseline that the Affordable Care Act changes.
Now, Republicans responded to that by making what I think is a far-fetched claim that any future health care costs should be counted against the ACA.  Passing health care reform fails to permanently fix this problem, leaving it for future Congresses to deal with; yes, the problem already existed, but proper health care reform would have fixed it and absorbed those costs, which would then show up as a cost of the bill.  As I said, I think that's far-fetched, but at least there's a bit of logic there.

However, the argument, such as it was, for including the doc fix as a cost of ACA really doesn't work for ACA repeal.  In fact, by that logic, the doc fix should count as a cost of repeal.  Think about it.  CBO, in its estimate today, didn't include the doc fix.  Republicans believe that in fact Congress should keep passing this measure; everyone agrees, as Klein points out, with the underlying policy on payment rates.  So, since ACA repeal also doesn't solve that problem, it should surely be counted against the fiscal effect of repeal.  The argument for including it in repeal undermines the argument for including it in scoring the bill in the first place.

Now, granted, the argument was goofy to begin with.  But as bad as it was, invoking the doc fix to claim that CBO is wrong about the effects of repeal is either laziness or chutzpah on a whole new level.


  1. Wow, comment deleted? What for?

  2. AB,

    Not me, the's been happening, alas, every once in a while lately. Don't know why. Try reposting? (Please; it was a worthwhile comment, although one I'm going to disagree with). You might want to split it in half and try that way; that seems to work sometimes.


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