During an interview with the Washington Examiner on Wednesday, Office of Management and Budget Director Mick Mulvaney trashed the Congressional Budget Office (CBO) as partisan and made a case that the country would be better off without it.
“At some point, you’ve got to ask yourself, has the day of the CBO come and gone?” Mulvaney said. “Certainly there is value in having that information, especially if they could return to their nonpartisan roots. But at the same time you can function, you can have a government, without a Congressional Budget Office.”
Mulvaney honed in on the CBO’s recently released analysis of the American Health Care Act (AHCA), passed by House Republicans last month and vociferously supported by President Trump. The nonpartisan office estimated that the AHCA will cost 23 million Americans their health insurance while dramatically increasing costs for older Americans and people with pre-existing conditions, in part because of the bill’s $834 billion cut to Medicaid over the next decade.
“Did you see the methodology on that 23 million people getting kicked off their health insurance?” Mulvaney said. “You recognize of course that they assume that people voluntarily get off of Medicaid? That’s just not defensible. It’s almost as if they went into it and said, ‘Okay, we need this score to look bad. How do we do it?’”
Mulvaney characterized the CBO’s analysis of coverage losses as “just absurd” and said, “ To think that you would give up a free Medicaid program and choose instead to be uninsured is counterintuitive.”
The CBO, however, doesn’t assume that people will “give up Medicaid.” Instead, it assumes people will lose Medicaid coverage nonvoluntarily because of eligibility lapses, raises at their jobs, and other developments that under the House Republican plan will cause them to become ineligible. Vox explains:
The AHCA would effectively end the Affordable Care Act’s Medicaid expansion by freezing federal support for it starting in 2020. Under current law, the federal government initially paid 100 percent of costs of Medicaid expansion beneficiaries, a percentage set to wind down to 90 percent in 2020 and stay at that level permanently. Under the AHCA, the federal government would keep paying for people who signed up for Medicaid expansion coverage before January 1, 2020, but not anyone who signs up after that.
Over time, this would also lead people currently enrolled to lose their benefits, and they wouldn’t be able to go back on the program thereafter. The AHCA drops funding for enrollees whose eligibility lapses for two or more months, and many working poor people cycle in and out of Medicaid as their income changes: They get a raise and no longer qualify for Medicaid; then they lose that job or take a pay cut and enroll again.
Mulvaney’s vision for a post-CBO America would involve his office taking the lead on estimating the impacts of major legislation — “I would do my own studies here at OMB as to what the cost and benefits of that reg would be,” he said.
But the danger of that approach was illustrated just last week by Trump’s budget proposal, which included a glaringly basic arithmetic error involving double-counting the estimated economic impact of tax cuts. Instead of acknowledging that double-counting the $2 trillion in savings was a mistake, Mulvaney told reporters that he and other Trump administration officials who worked on the budget did it on purpose.
When the first version of the AHCA was unveiled in March, Mulvaney tried to discredit the CBO before it even had a chance to release its analysis of the bill, arguing on ABC’s This Week that the CBO’s analysis of the Affordable Care Act (ACA) was off.
It wasn’t. FactCheck.org concluded that despite overestimating the number of people who who get subsidized insurance through ACA exchanges, the CBO “actually nailed the overall impact of the law on the uninsured pretty closely.”
The CBO “predicted a big drop in the percentage of people under age 65 who would lack insurance, and that turned out to be the case,” FactCheck.org wrote. “CBO projected that in 2016 that nonelderly rate would fall to 11 percent, and the latest figure put the actual rate at 10.3 percent.”
In short, Mulvaney, Health and Human Services Director Tom Price, and other AHCA-supporting Republicans are attacking the CBO simply because of its tough assessment of their preferred health care plan, which involves a huge tax cut for the rich.
What Republicans like Mulvaney are saying about the CBO during the Trump era is the opposite of what GOP members of Congress said when Bill Clinton was president. In the 1990s, Congressional Republicans demanded that the CBO score President Clinton’s budgets, dismissing his Office of Management and Budget as partisan.
During congressional testimony last week, Mulvaney, defending Trump’s budget proposal, made a case that the fiscal interests of the unborn should take precedence over the lives of present-day Americans — or at least those who rely on food stamps to eat or public schools to educate their children.