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Kent Conrad Erecting New Procedural Hurdles to Health Reform

This is a bit in the weeds, but you should go read Ryan Grim’s story about Kent Conrad directing the CBO to score health care reform in a 20-year budget window rather than the usual ten. This will tend to make the score less accurate, since projections get more and more uncertain the further you go out. It will also make it harder to pass a health care bill. But it will disadvantage the more-liberal House bill more than it disadvantages the Senate bill. And I think it’s usually best to assume that members engage in these kind of procedural moves because they understand their impact — Conrad is trying to kneecap the liberal version of health reform, and considers making it harder to pass any kind of health reform an acceptable price to pay to meet that goal.

Officially, though, we’re just supposed to think that Conrad really, really hates budget deficits. But as Ezra Klein notes, Conrad’s record doesn’t totally support that:

The first came earlier this year when Conrad modified Obama’s first budget. Obama had eliminated a couple of Bush-era gimmicks that made the deficit appear smaller than it really was. Bush, for instance, shortened the budget window from 10 years to five, so the total deficit sounded smaller. Obama’s budget returned it to the traditional 10. And then Conrad changed it back. The Politico reported that Conrad made this decision “because of the uncertainty of long-range forecasts.” Others thought he did it to hide the size of the deficit. In any case, 10 years, as the alert reader will notice, is less than 20 years. If 10 years was too long a time period for certainty, then it is difficult to see how 20 years could possibly be acceptable.

The second came in 2003, when Conrad voted for the Medicare Modernization Act, better known as Medicare Part D. The Congressional Budget Office estimated that the bill would increase the federal deficit by $421 billion and reduce federal revenue by another $174 billion. The total cost to the deficit, then, neared $600 billion. Conrad not only accepted the CBO’s 10-year time frame, but he voted for the bill. His press release enthusiastically touted the fact that the bill would “bring more than $70 million to North Dakota hospitals over the next ten years.”

Conrad’s record in the Senate, then, would lead you to believe a couple of things. For one, he distrusts long-range projections. Even 10 years is too uncertain. He also believes some priorities overwhelm deficit concerns, health-care coverage being one of them. But when faced with a health-care reform that will be deficit neutral within the 10-year time frame, he is demanding that it instead be measured against an even more uncertain 20-year time frame, and by an agency that he claims underestimates savings. The CBO’s scores are terrible, in other words, and come in such small portions!

To be fair to Conrad, the vast majority of soi disant “deficit hawks” on the Hill are huge hypocrites, much worse than Conrad. Conrad didn’t vote for the 2001 Bush tax cut, the invasion of Iraq, the 2003 tax cut, or the Kyl-Lincoln estate tax cut all of which attracted Democratic support, typically from the kind of members who complain about deficits. So in the scheme of things, he really is a committed deficit hawk. Still, per Ezra’s post there’s still lots of wiggle-room in this commitment, and the latest twist makes very little sense on the merits.

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Note that the theory that the CBO underestimates the cost savings in health reform isn’t just some nutty theory. Among others, the Institute of Medicine agrees. I think there are sound reasons for the CBO to be conservative in its approach, but we should keep in mind the fact that the CBO’s approach is deliberately designed to be conservative.