Good News on Healthcare

| Thu Jul. 2, 2009 11:20 AM EDT

When Republicans passed the Medicare prescription drug bill in 2003, they didn't really need to worry much about how to finance it.  Their plan was straightforward: first, have the administration lie repeatedly about the cost of the bill and make sure Congress never knew about it.  Second, don't worry about financing it anyway.  Just blow another hole in the deficit and move on.

Democrats, bless their goo-goo little hearts, are doing their best to actually pay for their healthcare reform project.  That would make things hard enough, but unfortunately, they're making things even more difficult for themselves via some fairly stunning incompetence at getting cost estimates out of the CBO.  In turn, Republicans are twisting the CBO estimates to make them look even worse than they are.  This isn't especially highminded of them, but hey — politics ain't beanbag, and Dems know how the CBO scoring process works as well as anyone.

Anyway, today we have new cost estimates.  Sort of.  To get them, though, you have to paste together several items.  Ezra Klein tries to explain:

The short version is this: CBO estimates that by 2019 the bill will cover 21 million people at a cost of $597 billion. But — and this is important — the HELP Committee's bill doesn't include the Medicaid expansion, because Medicaid is under the sole jurisdiction of the Finance Committee. But if Medicaid is expanded to 150 percent, it will cover an additional 20 million at a cost of about $1 trillion. Add in the savings that Finance is expected to get from reforming Medicare and you're looking at a bill that will cost $1 trillion to $1.3 trillion and cover 42 million people (which would mean 97 percent of the legal population in 2019 would have health insurance) by 2019.

The headlines will still probably get this wrong because it requires putting together several different numbers.  And Republicans will undoubtedly try to twist the numbers to their advantage — which is exactly what you expect an opposition party to do.  Democrats have really made a hash out of these competing estimates, leaving themselves open to all sorts of attacks they wouldn't have to put up with if they'd produced some reasonably clean bills for CBO to score.

But anyway, this is where we're at now.  The difference between this estimate and the previous ones appears to come mostly from the addition of an employer mandate, and covering 97% of the population for a little over $100 billion per year is probably quite doable if this is where things stay.  Add a strong public option and the cost might even come down some more.

Read the whole post for more, and read Jon Cohn for a different take on the same numbers.  It's too bad it's taken so long to get here, but it's basically good news.

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