CMS score of House bill may not be finished before weekend vote

Medicare's chief actuary told The Hill on Thursday that it is unclear if he will have a cost estimate of the House healthcare reform bill before a scheduled vote this weekend.

The Congressional Budget Office (CBO) has put the cost of the measure at $894 billion over 10 years, noting that it would reduce the deficit by $30 billion over the same time period. Republicans believe the price tag of the bill is much higher.

But it doesn't sound like Rick Foster, the chief actuary for the Centers for Medicare and Medicaid Services (CMS), will deliver his cost estimate before Saturday's vote.

In an e-mail to The Hill, Foster said, "We're currently working on estimates and analysis for H.R. 3962. We're trying to have it ready before the House vote, but I don't know if we'll succeed. There are a number of new or modified provisions in the bill, compared to its predecessor H.R. 3200, and the legislative language has only been publicly available for a short time."

House Republicans are pressing for the CMS score estimate. Six Ways and Means Republicans introduced a measure this week calling for a vote to be postponed until CMS issues its score of the bill.

Regardless of what Foster concludes, Congress is bound by CBO estimates. However, a high CMS score could persuade some Democratic centrists to vote no.

Six years ago, Foster attracted national headlines by accusing then CMS Administrator Tom Scully of threatening to fire him if he released his cost estimate of the 2003 Medicare prescription drug bill.

Scully denied Foster's allegations.

Foster estimated the prescription drug bill would cost more than $550 billion over 10 years while CBO concluded it would cost less than $400 billion over a decade.

Some healthcare experts and lawmakers said at the time that if Foster's cost analysis had emerged before the final vote, the prescription drug bill would not have passed Congress.