CBO: House Drafts of Health Bill Within Obama's Spending Limit

By Lori Montgomery
Washington Post Staff Writer
Saturday, October 17, 2009

Preliminary estimates from the Congressional Budget Office show that House leaders are within striking distance of drafting a health overhaul that fits within President Obama's $900 billion limit, but the new numbers have done little to unite the chamber's Democrats around a legislative plan.

Speaker Nancy Pelosi (D-Calif.) has been working for weeks to smooth over disputes about the final shape of the package while slicing billions of dollars from the approximately $1.2 trillion bill three House panels approved in July. As part of that process, Pelosi asked the CBO to analyze competing versions of a slimmed-down package that would extend health coverage to millions of Americans.

The report, delivered privately this week to House leaders, predicts that one proposal, which would create the government-run insurance plan preferred by liberals, would cost around $905 billion over the next decade. An option costing $859 billion would both create a government-run insurance plan along the lines preferred by rural moderates and more dramatically expand Medicaid, the government health plan for the poor that is funded partly by the states.

Brendan Daly, a spokesman for Pelosi, said the numbers confirm "that the coverage provisions of the House bill will be under $900 billion and we will have a public option." He said, though, that "no final policy decisions have been made on how to proceed." House leaders do not expect to vote on health care until next month.

The original House blueprint proposed to expand Medicaid eligibility for the poor and to subsidize private insurance for people at slightly higher incomes who lack access to affordable coverage through an employer. To get costs down, lawmakers squeezed the subsidies, along with tax credits for business, and reduced the number of people who would get insurance. The compromise packages would extend coverage to 95 percent of Americans by 2019, compared with 97 percent in the original bill and to 83 percent today, the CBO said.

The report is preliminary and does not analyze other chunks of the package, such as tax increases and changes in Medicare spending, nor does it project an impact on the federal deficit.

House and Senate Democrats have agreed to act separately on an expensive provision, once included in the House plan, that would block scheduled pay cuts for doctors who treat Medicare patients. Its price tag is nearly $250 billion over the next decade.

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