Former CBO official: Senate healthcare bill could cost $1.6 trillion

Senate Democrats' newly unveiled healthcare bill could cost as much as $1.6 trillion over the next decade, nearly double the amount the Congressional Budget Office first predicted, a former CBO official said Friday.

In an estimate released this afternoon by the conservative-leaning American Enterprise Institute (AEI), departed CBO analyst Joseph Antos stressed his former employer's prediction that the bill would cost $848 billion actually depends on future Medicare cuts and reforms Congress is unlikely to authorize or enforce.

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Foremost among those assumptions, Antos said, is the so-called "doc fix" that lawmakers have debated vigorously this fall. The CBO expects changes to Medicare reimbursements payments to hospitals and physicians to save the federal government $245 billion over 10 years, but Antos contends Congress will never pass those rules -- and thus, will end up losing money over the long term.

Antos' AEI report also anticipates Senate Majority Leader Harry Reid's bill would increase the deficit by about $270 billion over the next 10 years. While the official CBO score hints the opposite is true, Antos suggests lost or increased payments to Medicare recipients will ultimately shift the healthcare bill's overall cost curve in the wrong direction.

However, it should be noted that the CBO admitted these limitations in its analysis of Reid's proposal, released earlier this week.

"These longer-term calculations assume that the provisions are enacted and remain unchanged throughout the next two decades, which is often not the case for major legislation," explained CBO Director Douglas Elmendorf, specifically noting the same concerns about lawmakers' ability to pass and enforce both the "doc fix" and other Medicare payment provisions.

"The projected longer-term savings for the legislation also assume that the Independent Medicare Advisory Board that would be established by the bill is fairly effective in reducing costs—beyond the reductions that would be achieved by other aspects of the bill—to meet the targets specified in the legislation," Elmendorf added.