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Senate GOP to CBO: "I Forgot!"


So the latest #BCRAP b-crap being pulled by the Senate GOP is that they supposedly "forgot" to include the Cruz-Lee Amendment with the rest of the revised BCRAP bill that they sent over to the Congressional Budget Office to score next week. Topher Spiro of the Center for American Progress posted a twitter thread this morning which started off like so...

1: Senate Republicans are about to do something unprecedented that will break the Senate.

2: They claim they forgot to send the Cruz amendment to CBO on time. I think it was purposeful.

Now, this raised my eyebrows because I hadn't heard about this tidbit; when I asked for clarification, Spiro responded:

there was some mixup - McConnell staff blaming Cruz staff and vice versa. All staged.

Regardless of whether you buy the "it was an honest mistake" claim (which is clearly bullshit; there's no possible way that Mitch McConnell "FORGOT" to include a major change in the bill when sending it to the CBO), it's really the rest of the thread which is more disturbing:

3: The Cruz amendment is not a small technical tweak. It would radically disrupt insurance markets.

4: Republicans don’t want to wait for a CBO score, even though they (in my view deliberately) caused the delay.

5: Instead, they’re going to use a Price score. Think about that.

6: This is very dangerous. They’re going to vote on legislation without having any idea of the impacts whatsoever.

7: But it’s worse than that: they’re casually destroying the very idea of nonpartisan, objective analysis.

And yes, this part of his thread has been confirmed:

Senate Republicans may not use the Congressional Budget Office (CBO) to score a version of Sen. Ted Cruz’s (R-Texas) controversial amendment that was included in the updated Senate healthcare bill.

Instead, a member of Senate GOP leadership said analysis from the Trump administration — including the Health and Human Services Department and the White House Office of Management and Budget — might be used instead of the nonpartisan CBO.

That could provide a much more favorable analysis for the bill. The CBO found that the House bill repealing and replacing ObamaCare would lead to 23 million people being uninsured over a decade. Analysis from HHS found the number to be 13 million.

And why are they blowing off the CBO's analysis of the Cruz amendment? Simple: The CBO already warned them back in December that they'll have no part in the Republican Party's bullshit:

...In response to a future policy that had minimal federal or state regulations, CBO and JCT expect that some new insurance products would be offered that limited coverage to the amount of the tax credit. Some of those insurance products purchased by people using a tax credit would probably not offer much financial protection against high out-of-pocket costs. Depending on the size of the tax credit, however, the depth and extent of coverage and the premiums of plans could vary. As discussed in another blog post about how CBO defines and estimates coverage, CBO does not count plans that have very limited benefits in measuring the extent of private insurance coverage; in such an assessment, it counts only people with a comprehensive major medical policy as having private insurance.

Under such proposals, CBO and JCT would separately estimate the number of people who would receive the tax credits and, if policymakers expressed interest in such estimates, the number of people who would purchase private insurance in the nongroup market that met a broad definition of coverage. In that case, the latter estimate of the number of people with coverage would probably be smaller than the estimate of the number of people who would receive the tax credit.

SHORTER CBO: When Donald Trump and Paul Ryan start lying about having "insured" eleventybillion more people for 1/10th of the cost of the ACA, don't expect us to back up your nonsense.

It's important to reiterate that the head of the Congressional Budget Office, Keith Hall, is not only a Republican, but was hand-picked by Mitch McConnell, Paul Ryan and, yes, HHS Dept. head Tom Price to head up the department.

I've been warning about exactly this scenario since a few days after the election last year:

Given Trump's long, disturbing history of flat-out misstatements (aka "making sh*t up out of whole cloth"), and the type of sycophants he's likely to put into place, I can't guarantee with any certainty that the numbers spouted off by them are going to bear any connection with reality. Maybe they'll be accurate. Maybe they'll be off slightly. Maybe they'll be completely removed from any actual numbers. Who the hell knows?

Earlier today it was reported that Ben Carson was being considered for HHS Secretary. Then the rumor mill turned to Bobby Jindal. At the moment, I'm hearing it could be Rep. Tom Price, who (like pretty much every other GOP member of Congress) despises the ACA. That doesn't guarantee that he'll Make Sh*t Up, of course, but under a Trump regime, anything's possible. Anything.

So, to reiterate: The Senate GOP will be using an analysis of their ACA replacement bill put together by Tom Price, who despises the ACA.

THIS Tom Price:

Trump's Cabinet pick invested in company, then introduced a bill to help it

Rep. Tom Price last year purchased shares in a medical device manufacturer days before introducing legislation that would have directly benefited the company, raising new ethics concerns for President-elect Donald Trump's nominee for Health and Human Services secretary.

THIS Tom Price:

Trump’s HHS Nominee Got A Sweetheart Deal From A Foreign Biotech Firm

When tiny Australian biotech firm Innate Immunotherapeutics needed to raise money last summer, it didn’t issue stock on the open market. Instead, it offered a sweetheart deal to “sophisticated U.S. investors,” company documents show.

...One of the beneficiaries was Rep. Tom Price, a Georgia Republican poised to become secretary of the Department of Health and Human Services, which regulates pharmaceuticals.

THIS Tom Price:

Rep. Tom Price was paid by a drug company while they were under investigation for kickbacks

...Yes, Rep. Tom Price received $2,000 for undisclosed work done for a company on September 2, 2014 and on January 9, 2015 that company had to pay the Federal Government $39 million for “improper kickbacks in the form of speaker fees.”

THIS Tom Price:

Top Price Contributor Allegedly Leaned On Employees To Support PAC

...The PAC was operated by Georgia-based MiMedx, whose CEO Parker H. “Pete” Petit is among the top individual contributors to Price, a Georgia congressman and Trump’s pick for Health and Human Services secretary. Federal campaign finance records show MiMedx, through its PAC, chief executive and his relatives, has contributed more than $40,000 to Price’s campaign and joint fundraising committees since 2014. With combined PAC and individual donations, the company was ranked as Price’s top contributor for 2015-2016 by the nonpartisan Center for Responsive Politics.

THIS Tom Price.

THIS Tom Price.

THIS Tom Price.

You get the idea.

UPDATE: In the comments below, Larwit1512 accuses me of "blindly reposting" analysis from the Center for American Progress and the Congressional Budget Office regarding their projections of how many people would likely lose their healthcare coverage by 2026 if the #BCRAP bill were to become law.

As I noted in response, I've openly stated several times that I'm a bit bothered by some of the assumptions in the CBO score: First, the assumption that most of the 19 states which haven't expanded Medicaid under the ACA as of yet would do so if the ACA is left as is:

In its March 2016 baseline, CBO projected that under current law, additional states will expand their Medicaid programs and that, by 2026, roughly 80 percent of newly eligible people will reside in states that have done so. Under this legislation, largely because states would pay for a greater share of costs for enrollees, CBO expects that no additional states would 32 expand eligibility, thereby reducing both enrollment in and spending for Medicaid, compared with the amounts anticipated under current law.

With population growth and so on, the assumption by the CBO is that upwards of 15 million people who otherwise would be enrolled in Medicaid would lose coverage by 2026 (those are important clarifiers). As I've noted before, CAP's analysis estimates around 5 million people who otherwise would have Medicaid via ACA expansion across those 19 states who would lose it under BCRAP. Obviously if none of those 19 states were to expand Medicaid in an ACA world, those 5 million people wouldn't be at risk of losing it under BCRAP...because they never would've received it in the first place.

However, it's not that simple. First of all, there are several states among that list which I'm pretty damned sure will come around over the next 9 years if the ACA is left intact: Kansas came within a couple of votes of doing so recently, Maine will do so in a heartbeat the moment they're rid of their "Mini-Trump" Paul LePage, and the Governors of both North Carolina and Virginia are champing at the bit to do so. Other states are less likely, of course, but by the same token, the CAP analysis spreads the 15 million out fairly evenly since they don't know which states the CBO thinks would or wouldn't expand. That means that the numbers in some fo the other states might be even higher in place of the non-expansion states which wouldn't do so.

I've already addressed the other concern--that the CBO used the March 2016 baseline instead of the January 2017 baseline. In short, they did that because Paul Ryan specifically instructed them to do so.

So, what would happen if the CBO did use January 2017 as their new baseline? Well, my guess is that they probably would come up with a "lost coverage" total somewhat lower than 22 million...probably 4-5 million fewer, coming in at perhaps 17 million. This is nothing shocking; I've already said so before.

If you further assume that there's no chance in hell that any of those states would even consider expanding Medicaid, then yeah, you could probably knock another few million off the tally, bringing it down to perhaps 14 million or so.

To which my response is: a) That'd still be pretty horrific, and b) That's all irrelevant now, because the Cruz-Lee amendment would blow all of these numbers out of the water anyway.

Why? Because, again, as noted above:

CBO does not count plans that have very limited benefits in measuring the extent of private insurance coverage; in such an assessment, it counts only people with a comprehensive major medical policy as having private insurance.