On April 9th, Washington Post budget reporter Lori Montgomery prominently featured a new white paper criticizing the finances of health reform. Because the paper was written by Charles Blahous, a policy analyst approved in 2010 by President Obama as the Republican trustee for Medicare and Social Security, the story received widespread attention.
Montgomery described the study thusly:
[Blahous’s] analysis challenges the conventional wisdom that the health-care law, which calls for an expensive expansion of coverage for the uninsured beginning in 2014, will nonetheless reduce deficits by raising taxes and cutting payments to Medicare providers.
The 2010 law does generate both savings and revenue. But much of that money will flow into the Medicare hospitalization trust fund — and, under law, the money must be used to pay years of additional benefits to those who are already insured. That means those savings would not be available to pay for expanding coverage for the uninsured.
Jonathan Chait, Brian Beutler, and Ezra Klein argue that Blahous’s hefty white paper is really a numerical polemic that repackages arguments and budget information debated when the Affordable Care Act was passed two years ago. Talking with Chait, Blahous’s counterpart Democratic Medicare trustee (and 1989-95 Congressional Budget Office director) Robert Reischauer acerbically noted:
Chuck’s ‘revelation’ is not a new charge. Some argued this point when the ACA was enacted. It remains as misleading today as it did earlier.
I agree with the critiques. I’m more struck by something organizational, not the rather familiar substance of these arguments….
No one who follows such issues was surprised that Paul Van de Water of the Center for Budget and Policy Priorities offered a detailed critique:
…Until opponents of health reform latched onto the notion, no one accused CBO of faulty accounting.
For example, the Balanced Budget Act of 1997 and the Deficit Reduction Act of 2005 — both of which Republican Congresses approved — included Medicare savings that were counted as reducing the deficit and improving Medicare’s financial outlook. The Senate Republican Policy Committee rightly claimed credit for this result, and no one made charges of double-counting.
And, just last month, House Budget Committee Chairman Paul Ryan (R-WI) touted how his budget plan would both “shore up Medicare” and reduce projected deficits. No one discounted his Medicare savings because of supposed double-counting.
No organization on the conservative side of the political spectrum was available to play a similar role in defending, refining, or rebutting these points. For example, Blahous released this paper via the Mercatus Center at George Mason University. That Center includes interesting scholars such as Tyler Cowen. Its focus is obviously quite different from CBPP’s focus on the mechanics of fiscal policy.
CBPP is avowedly liberal. This perspective makes itself felt in many ways. Yet CBPP is different from many other liberal organizations. It plays a different role. Its comparative advantage resides in its ability to offer credible, technically tight analyses of public assistance, taxation, and deficit policy issues that policymakers, reporters, advocates, and researchers across the political spectrum could reliably turn to in understanding the financial impact of technical changes in food stamp policy or the budget impact of different inflation measures on Social Security benefits between now and 2050. CBPP has earned influence and genuine authority because performs these tasks well.
Across the political spectrum, I can identify many talented individual scholars, policy wonks, and commentators. I really can’t identify a conservative counterpart to CBPP that plays a similar organizational role or has similar legitimacy on the nuts and bolts of its budget policy work. That’s not a role filled by CATO or by the Heritage Foundation. (A friend suggests that the Committee for a Responsible Federal Budget sometimes plays this role.)
When Republicans such as Paul Ryan offer budget proposals or describe the budget impact of proposed tax cuts, many people—liberals, of course, but also many others and most among the press—react with the sense that the numbers won’t quite add up. Critical details will be missing. Moreover, there will be few authoritative conservative sources available to explain how these details could be filled in or to identify the relevant tradeoffs.
The same is true when Republicans wish to critique Democratic policies. I helped to cover health reform for the New Republic. When competing arguments emerged regarding the fiscal stability of the CLASS act, it was hard to identify a conservative organization with the expertise and the standing to challenge CBO estimates that, in fact, turned out to be over-optimistic.
Both Democrats and Republicans have skilled political and policy advocates. Yet the two parties approach the craft of policy analysis rather differently these days. Since Democrats are the party of activist government, it’s perhaps unsurprising that Democrats place greater emphasis on the accompanying technocratic crafts.
This difference in orientation is telling. When Republicans recapture the presidency, in 2012 or later, they may wish to do more than overturn what they dislike from the Obama years. They may wish their team had credibly locked down the nuts and bolts of its policy agenda with greater granularity than they have done so far.