The debate over health care has once again raised the specter of the role of the Congressional Budget Office (CBO) with Members of Congress and the President assaulting the office because they don’t like their non-partisan projections that are not favorable to their bill. It’s an old Washington parlor game but if you looked closely, some of the conservatives in Washington assaulting the CBO now have been willing to embrace the same CBO as the ultimate truth-teller.
In 2014, CBO had projected the child welfare bill, H.R. 4980, the Preventing Sex Trafficking and Strengthening Families Act, as reducing or cutting spending by $1 million over five years and $19 million over ten years. The legislation extended the two Title IV-B programs for three years. In fact, it dropped $15 million a year for kinship navigator and family finding initiatives and didn’t add any new money and instead created several new directives on states.
The CBO calculations held enough credibility that a voice vote on that bill was blocked in July 2014 when conservative Senator Tom Colburn (R-OK) heralded CBO data and accuracy when he block passage stating, “the spending in this bill largely occurs in the first three years, while the reductions in mandatory spending do not provide savings until the second half of the ten-year window. As a result, this bill violates budget point of order 302(f).”
While the CBO projections on Better Care Act are in the hundreds of billions and three or four million dollars is a rounding error, the small calculation on the 2014 child welfare bill was taken so seriously that Senator Coburn’s hold on the legislation was not overcome until a deal was negotiated with him on an unrelated bill a month and a half later. (It was no small irony that on the very same legislative day that Senator Coburn blocked the child welfare bill the Senate approved $225 million for Israel’s iron dome defense system without any offsets.)
Similarly, last year’s CBO analysis of the Families First Act indicated that enacting H.R. 5456 would not increase net direct spending and on-budget deficits by more than $5 billion in the first three consecutive 10-year periods beginning in 2027. By the fourth 10-year period, the bill’s net costs inflated would exceed $5 billion. In other words, by 2067 it might exceed $5 billion out of the likely $200 plus trillion spent in that time frame. Although, it was not the ultimate reason for that bill’s failure to pass, the issue and CBO calculation was raised, at least temporarily, by Senate Budget Chair Mike Enzi (R-WY) as another reason to block the bill.
To be certain CBO can be tough. During the original ACA debate in 2009-2010 CBO did not score some of the health care prevention funding as saving health care costs. Something some health care experts did dispute. Similarly, child welfare advocates have had difficulty in arguing the benefits of prevention funding impact. In those instances, many of today’s CBO critics become CBO-believers.