Aides to U.S.
President Donald Trump on Sunday attacked the credibility of the
nonpartisan agency that will analyze the costs of a replacement for
Obamacare, as the White House sought to quell opposition from many
Republicans.
The
Congressional Budget Office, which provides official estimates of the
budget impact of proposed legislation, is expected to issue a report as
early as Monday that will assess the healthcare legislation put forth by
Republican House of Representatives leaders.
The
report could influence sentiment toward a bill that is already under
fire from both Democrats and many conservative Republicans, especially
if it suggests the legislation would reduce the number of Americans with
health coverage or that it would worsen U.S. budget deficits.
In
a series of television interviews, White House budget director Mick
Mulvaney and top White House economic adviser Gary Cohn said that the
CBO is focusing on the wrong metrics with the estimates it will provide
on the number of people who are insured. Cohn and Mulvaney said CBO
should instead should analyze whether patients can actually afford to go
to a doctor.
“I love the folks at
the CBO, they work really hard, they do, but sometimes we ask them to do
stuff they’re not capable of doing, and estimating the impact of a bill
of this size probably isn’t the – isn’t the best use of their time,”
Mulvaney told ABC’s “This Week” program.
Speaking
on Fox News, Gary Cohn, director of the White House National Economic
Council, said: “We will see what the score is, in fact in the past, the
CBO score has really been meaningless.”
“They’ve
said that many more people will be insured than are actually insured.
But when we get the CBO score we’ll deal with that,” Cohn said.
The
Trump administration’s criticisms of the CBO are unusual. Prior
administrations, both Republican and Democratic, have steered clear of
attacking the credibility of the agency, which many lawmakers regard as a
neutral arbiter. The CBO’s current director, Keith Hall, was appointed
by Republicans in 2015.
Republicans have long opposed Obamacare,
formally called the Affordable Care Act, on the grounds it was
government overreach and led to higher insurance premiums. The 2010 law,
Democratic President Barack Obama’s signature legislation, provided 20
million previously uninsured Americans with health coverage.
The
credit rating agency Standard & Poor’s has estimated 6 million to
10 million people could lose health insurance coverage under the
Republican plan.
Senator Bernie
Sanders, who ran for president in 2016 as a Democrat, said it was
“cowardly” for Republicans to proceed with a healthcare bill without CBO
estimates, telling CBS’ Face the Nation show: “This is a disgrace.”
In
recent weeks, Trump administration officials and Republican lawmakers
have criticized what they said were overly optimistic estimates from the
CBO of the number of Americans who would sign up for health insurance
on government-run exchanges.
CBO
estimated in 2013 that 22 million people would be purchasing insurance
through the exchanges in 2016. But only 10.4 million were signed up for
these plans by the middle of last year, according to Department of
Health and Human Services data.
The
House Republican legislation would scrap tax penalties for Americans
without health insurance, roll back an expansion of Medicaid insurance
for the poor, and replace Obamacare’s income-based subsidies with a
system of fixed tax credits to help people buy private insurance on the
open market.
Last week, ratings
agency Standard and Poor’s estimated that 6 million to 10 million people
could lose coverage if the Republican plan passes.
Cohn
also disputed the notion that millions of people on Medicaid, the
government health care system for the poor, would become uninsured as
Obamacare’s expansion of the program is rolled back over a period of
years. He said that many of these people would be transitioned into new
private and employer-sponsored plans that would become more affordable
under the Republican plan.
House
Speaker Paul Ryan, the Republican plan’s top backer in Congress, said he
is “certain” that the CBO will show a reduction in the number of
Americans with coverage.
“You know why? Because this isn’t a government mandate,” Ryan told NBC’s Meet the Press.
But
conservative Republicans said they could not support the plan without
significant changes. Republican Representative Jim Jordan of Ohio, a
founder of the conservative House Freedom Caucus, said it does not go
far enough to meet Republicans’ promise to kill Obamacare.
“We
told them we were going to replace it with something that would bring
down the cost of insurance. That’s what we told them,” Jordan told Fox
News Sunday. “This legislation that the speaker’s brought forward
doesn’t do that.”
Cohn and Mulvaney also said that the Trump administration was open to changes in the bill.
Republican
Senator Tom Cotton of Arkansas said the plan as written would not pass
the Senate and could put the Republican House majority at risk.
“I
believe it would have adverse consequences for millions of Americans
and it wouldn’t deliver on our promises to reduce the cost of health
insurance for Americans,” Cotton said.
