Senate Democrats wary of health care deficit spending

Senate Majority Leader Harry Reid got rolled yesterday on Senator Debbie Stabenow’s proposal to increase Medicare payments to doctors by $247 billion over 10 years. Thirteen Democratic senators voted nay, while Reid said that he had been assured by the American Medical Association that the measure would get 27 Republican votes. Senate majority leaders are supposed to know how to count; Reid evidently was wrong about how 40 senators would vote—some kind of record, perhaps.
 
The larger point is that 13 Democratic senators refused to support a measure that would vastly increase the federal budget deficit but that would not be counted in the Congressional Budget Office scoring the cost of the larger health insurance bill which the Democrats want to pass. They were acting, knowingly or not, in line with the recommendations of William Galston, deputy domestic adviser in the Clinton White House, who wrote earlier this week in his New Republic blog warning Democrats not to game the CBO scoring game. Galston pointed to one provision which, under CBO scoring, would be counted as reducing spending but which over the longer haul would increase it (because it counts premiums paid in over a five-year period when none of them would be paid out as a savings for the government). More Senate Democrats than I (or Reid) expected seemed alert to such considerations yesterday—a sign that Democrats may not find it as easy to put together a big health insurance bill as conventional wisdom around town believes.  

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