CBO and the Office of the Actuary Take on Republican Myths at Energy and Commerce Hearing
At today’s hearing of the Health Subcommittee, CBO Director Doug Elmendorf and CMS Chief Actuary Rick Foster debunked several Republican myths about the Affordable Care Act (ACA).
Republican Claims of Double and Triple Counting
In response to questioning from Rep. John Shimkus:
Rep. Shimkus: My issue now is that we are triple counting…if we don’t do the Medicare cuts we are triple counting the same $500 billion.
Dr. Elmendorf: Congressman, to be clear, when we give you a cost estimate, it counts each and every part, provision, of a law once, and only once.
Republican Claims of Hidden Spending
Republicans will be marking up committee prints Thursday, March 31, 2010, to begin to repeal ACA spending in response to claims from Rep. Michele Bachman and others that the ACA contained hidden mandatory spending, along the lines of $105 billion.
Rep. Frank Pallone, Jr.: First of all, we considered a bill that would repeal funding for section 1311, the Health Insurance Exchange Planning and Establishment grants, did you know about that funding stream?
Dr. Elmendorf: Yes, congressman.
Rep. Pallone: Okay, so it wasn’t hidden. What about section 4002, the Prevention and Public Health Fund, did you know about that?
Dr. Elmendorf: Yes, congressman.
Rep. Pallone: So that wasn’t hidden either. What about funding for school-based health centers, did you know about that?
Dr. Elmendorf: Yes, congressman.
Rep. Pallone: So it seems we couldn’t slip much past you, try as Republicans think we might…I guess it was Congressman Jerry Lewis from the Appropriations Committee, he said that there is about $100 billion in new discretionary funding in the bill that of course was hidden or that we were trying to hide. But I see you mention in your testimony that $85 billion of that is what actually was just a reauthorization of existing programs like the Indian Health Service or community health centers….Is that correct?
Dr. Elmendorf: Yes, that’s right congressman.
Projections of Total Federal Health Spending are Going Down.
In response to questions from Rep. Henry A. Waxman:
Rep. Waxman: According to your letter to Senator Inouye…mandatory outlays on tax credits are projected to be about $54 billion higher over the next 10 years, while spending on Medicare and Medicaid is projected to be about $339 billion lower, for a reduction in direct spending of $277 billion from these health programs. Is that correct?
Dr. Elmendorf: That sounds right to me, congressman.
Rep. Waxman: Mr. Foster, do you agree that cost growth in Medicare is very restrained in the next ten years or so?
Mr. Foster: Yes, sir, I do.
Rep. Waxman: So we all agree that Medicare cost growth has been brought to a very low level. So low that in CBO’s baseline the triggers for the Independent Payment Advisory Board are not tripped anymore. Isn’t that correct Dr. Elmendorf?
Dr. Elmendorf: That’s right, congressman.
Republican Proposal Would Decrease the Workforce
Rep. Lois Capps: Do you agree that funding for the Affordable Care Act could help expand the number of providers in the primary care field?
Mr. Foster: I think it will.
Rep. Capps: Tomorrow we will mark up a bill to eliminate one of these workforce programs…. So at a very time when it’s being demonstrated that we can actually create more jobs and actually save more money, we are doing the reverse.