CBO Director Douglas Elmendorf and study author Phil Ellis testified before the Senate Committee on Health, Education, Labor, and Pensions (HELP) on the new draft of the Kennedy health care legislation today. The old version of the bill was estimated to cost $1 trillion over 10 years and would insure only one third of the 47 million uninsured Americans.
This version, which includes language for a government-run option, would cost substantially less, at $597 billion, and insure a far larger number of those currently uninsured. But neither version accounts for likely expansion of Medicaid, which the CBO estimates would cost an additional $500 billion for the feds, and likely much more for the states:
It found that the cost of such an expansion "could vary in a broad range around $500 billion over 10 years." But the catch is that such an estimate is of the anticipated federal cost of the Medicaid expansion. In actuality, the federal government typically pays around 57 percent of the cost of Medicaid, while the remaining 43 percent is picked up by the states. So what's the full cost of a Medicaid expansion at both the federal and state level?
Read Philip Klein's whole post for a full accounting of what burden the expansion of Medicaid would place on already cash-strapped states.
In the course of the hearing, Sen. Orrin Hatch said, "We're spending over a trillion dollars and we don't even have any ideas about who's gonna be covered."
Sen. Chris Dodd, who is guiding the Kennedy legislation in Kennedy's absence, offered this telling retort:
"Looking back over the past eight years, we've done a lot of legislation here where actually bills have been passed before we knew the numbers. I'm not trying to use historical precedent for all of this but..." he said, trailing off before thanking the CBO for its work in coming up with estimates for the in-progress legislation.
I'm not sure, "Hey, we've been as much, if not more, irresponsible in the past" should be the rallying cry for this complete overhaul of the health care economy, but Dodd can hardly be blamed for following the lead of the President and Democratic leaders.
In his health care town-hall style meeting in Virginia last week, Obama himself pressed the case for rushing complicated legislation before we know the numbers. Because, after all, the numbers might make people less willing to vote for it:
And for those who say, well, you know what, this is something that is very complicated so we shouldn't rush into it -- that's what happens in Congress all the time. They have hearings, they write white papers, and then suddenly the lobbyists and the special interests start going at it, and the next thing you know, another 10 years has gone by and we still haven't done anything.
That's not what's going to happen this time. I am going to keep on pressing until we get it done this year.
Democratic leader Rep. Steny Hoyer laughed at the notion that he would read what was in the health care bill before voting on it, when asked about it Tuesday:
"If every member pledged to not vote for it if they hadn't read it in its entirety, I think we would have very few votes," Hoyer told CNSNews.com at his regular weekly news conference....
In fact, Hoyer found the idea of the pledge humorous, laughing as he responded to the question. "I'm laughing because a) I don't know how long this bill is going to be, but it's going to be a very long bill," he said.
When is Douglas Elmendorf running for Senate? He seems to take this stuff rather more seriously than many of those doing the questioning.
