More media misrepresent scope of preliminary CBO analysis of health bill
Research ››› ››› JOCELYN FONG
In reporting the CBO's conclusion that a Senate draft health-care bill would leave many uninsured, Glenn Beck, Sean Hannity, David Brooks, and USA Today did not note that the CBO did not assess several provisions that are expected to be added to the bill and that, according to the CBO director, "could ... have substantial effects on our analysis."
Following the release of the Congressional Budget Office's June 14 preliminary analysis of the Senate health committee's draft health-care reform bill, Fox News' Glenn Beck and Sean Hannity, New York Times columnist David Brooks, and USA Today cited or otherwise referred to the CBO's conclusion that the draft bill would cost $1 trillion while leaving "about 36 or 37 million" people uninsured. However, like ABC's Jake Tapper and The New York Times, these media did so without noting, as stressed by CBO Director Douglas W. Elmendorf in a letter accompanying the CBO report, that "those figures do not represent a formal or complete cost estimate for the draft legislation" [emphasis in original].
In his letter to Sen. Edward M. Kennedy (D-MA), who is co-sponsoring the bill, Elmendorf wrote that "[t]he draft legislation released by the HELP [Health, Education, Labor and Pensions] Committee ... indicates that certain features may be added at a later date. Because they are not reflected in the current draft, however, CBO and the JCT [Joint Committee on Taxation] staff did not take them into account." In particular, Elmendorf wrote: "The draft legislation ... indicates that the committee is considering whether to incorporate other features, including a 'public health insurance option' and requirements for 'shared responsibility' by employers. Depending on their details, such provisions could ... have substantial effects on our analysis."
Indeed, "requirements for 'shared responsibility' by employers" -- also known as an employer mandate -- are specifically intended to expand insurance coverage to the currently uninsured.
According to the summary of the HELP Committee's draft bill, the "Shared Responsibility of Employer" provisions would require employers to either subsidize at least a certain amount of employees' health benefits or make payments to the Department of Health and Human Services for those employees. As Ezra Klein wrote in a June 16 post on his Washington Post blog, "The employer and individual mandates ... are particularly key to increasing the number of Americans with health insurance." CBO, Klein noted, "ran its estimates with no employer mandate and an individual mandate with a laughably small penalty," while "HELP is writing a bill with a strong employer and individual mandate."
The following media cited CBO's analysis without indicating that its conclusions do not take into account key provisions that are expected to be included in later versions of the health-care bill:
- During the June 16 edition of his Fox News program, Hannity asserted that "[t]he American people aren't getting informed about the cost" of health-care reform. He later added: "We know that the Democratic plan is going to cost at least a trillion, that the legislation will leave 36 million uninsured, and 23 million Americans will give up the health coverage they currently have."
- During the June 16 edition of Fox News' The O'Reilly Factor, Beck stated: "If you look at the CBO numbers, this is going to cost us an extra trillion dollars in debt -- this is the Congressional Budget Office numbers -- trillion dollars in debt in the next nine years, and it's only going to leave 39 million people without health care as opposed to 45."
- Discussing health-care reform with Times columnist Gail Collins on The New York Times' The Conversation blog, Brooks stated that "[t]he cost issue is the deal-breaker for me, as it should be for everyone. Just look at how badly the Kennedy-Dodd bill fared when it was scored by the Congressional Budget Office -- a modest net increase in the number insured along with a whopping $1 trillion increase in deficit. I don't know about you, but to me that's not a tradeoff worth making."
- In a June 17 article about an interview with Elmendorf, USA Today reported that CBO "said insurance expansion proposed by Sen. Edward Kennedy, D-Mass., would cost $1 trillion and leave 37 million people uninsured."
From the June 16 edition of Fox News' Hannity:
HANNITY: I said, throughout the campaign, journalism in America is dead, and I really stand by that today. I don't think the American people -- we have this big health-care reform debate going on. The American people aren't getting informed about the cost, about the intricacies of the policy, right?
SANDRA SMITH (Fox Business reporter): Well, here's the thing is that President Obama, during his campaign, everything was against Bush. Everything targeted Bush. With W out of the office, he's got to target somebody. And he's looking to the network to -- maybe he's looking for a villain, and Fox News is just that for him.
HANNITY: Well, here's what we know. He wants to cook the books. He doesn't want to use what formerly was the gold standard, ladies and gentlemen, the CBO numbers. He wants to use political numbers -- the Office of Management and Budget, OK?
And this is what we know: We know that the Democratic plan is going to cost at least a trillion, that the legislation will leave 36 million uninsured, and 23 million Americans will give up the health coverage they currently have.
NICOLLE WALLACE (former Bush White House communications director): Yeah, look, here's their political problem. I think they've got two. One, they're really good at fighting the Democrats. I mean, you know, they squashed dissent, they leave them out of the table, and they let [House Speaker] Nancy Pelosi [D-CA] do their dirty work.
But they are now fighting the doctors, and any person that I know relies on their doctor for a credible response to health-care policy. And I think most people don't understand how tied health-care politics and health-care policy are. The doctors oppose the central element of Obama's plan.
HANNITY: Twenty-three million. But this is more spending, more taxes, more debt, and he uses the same tactics. Sandra, he's scaring people. It's going to be like GM. You're going to be bankrupt.
WALLACE: It's fear mongering.
From the June 16 edition of Fox News' The O'Reilly Factor:
BECK: Now, listen, what Obama is doing and all of the progressives -- I mean, we played a segment last night on television -- and they all had -- they're all saying this in their little caucuses that this is just the first step to getting rid of the private-sector health care.
If you look at the CBO numbers, this is going to cost us an extra trillion dollars in debt -- this is the Congressional Budget Office numbers -- trillion dollars in debt in the next nine years, and it's only going to leave 39 million people without health care as opposed to 45.
From the June 16 post on The New York Times' The Conversation blog:
David Brooks: As for health care, I completely agree with you about comparative effectiveness. I interviewed Gail Wilensky, a very smart analyst, yesterday and one of her points is that while there is no single fix that will transform health care, comparative effectiveness approaches are essential if we're to bring the system toward sanity. One of her other points, by the way, was that the plans now being hatched will expand coverage and be partially paid for by whacking Medicare payments to hospitals, but that they are not addressing the underlying structural issues that inflate costs.
Which brings me to my core concern. I want the health care system fixed. I want more people covered. But I am not willing to bankrupt the nation to get there. The cost issue is the deal-breaker for me, as it should be for everyone. Just look at how badly the Kennedy-Dodd bill fared when it was scored by the Congressional Budget Office - a modest net increase in the number insured along with a whopping $1 trillion increase in deficit. I don't know about you, but to me that's not a tradeoff worth making.
From the June 17 USA Today article:
Wringing savings from the system will be difficult, Elmendorf said. For instance, although Obama recently called attention to huge regional variations in medical spending, the director said that's due to engrained ways of treating patients.
"That's how these differences seem to have developed," he said. "That ship cannot be turned on a dime."
Elmendorf's non-partisan agency will estimate the cost of every health care proposal. On Monday, it said insurance expansion proposed by Sen. Edward Kennedy, D-Mass., would cost $1 trillion and leave 37 million people uninsured.
Top Republicans on the congressional budget panels, who are opposed to Obama's health care overhaul, said Elmendorf is being an honest broker.
"The CBO has put up a lot of red flags about the whole approach to the health care reform effort," said Sen. Judd Gregg, R-N.H.