CBO Initial Estimates of Health Reform

The cost of health care reform is hugely important. But even more important, legislatively speaking, is the CBO’s estimates of cost, since that’s what binds legislators. Jon Cohn reports on their preliminary work:

The good news for reformers is the CBO’s determination that expanding health-insurance coverage would cost a lot less than many outside experts had predicted. Instead of a politically daunting $1.5 trillion, the CBO figures the price tag will be closer to $1 trillion, at least under certain parameters. But the reason for the lower estimate is a bit unsettling. Even with a requirement that everybody obtain insurance–a so-called individual mandate–the CBO assumes a that between a quarter and a third of the uninsured still wouldn’t have coverage. That would leave the country short of universal coverage, the goal Obama and his allies have repeatedly cited.

Also:

The same sources who provided these numbers say that CBO is also tipping its hand about a few other things–like whether information technology, data on the effectiveness of treatments, and other delivery reforms can save money and whether the money people pay for insurance should count as a tax. But, in those cases, the deliberative process isn’t as far along. Instead, CBO officials and staff are consulting widely–with congressional staff, outside experts, etc.–about how to make assessments as fairly and accurately as possible.

Reformers are going to be pushing for forward-leaning estimates of the savings available through delivery reform. The CBO has traditionally been hesitant on that score, but I don’t believe they’ve ever looked at the issue in such an intensive and detailed way. I’ll just note that I think it was a shame that so much high dudgeon was expended on catigating Barack Obama’s mandateless primary-era plan for failing to achieve universal coverage when it turns out that a mandateful plan doesn’t achieve it either.