Critical Condition

NRO’s health-care blog.

Double Count What, Exactly?


The New York Times’s Robert Pear notes that the Senate health bill would double count proposed Medicare cuts by using them both to pay for the new health insurance subsidies and to extend the life of the Medicare trust fund from 2017 to 2026.  The analysis comes from the CBO, and was mentioned by Rich on The Corner last week.  Rich, to his credit, told us about the double count before the Senate’s final vote on the health-care package.  The Times, however, has conveniently waited until after the vote, blithely noting that CBO’s “clarification came too late to affect the outcome of debate over the legislation, passed Thursday in the Senate by a party-line vote of 60 to 39.”

The Times does provide a service in highlighting the views of CMS actuary Rick Foster on the subject.  In addition to making the point that the funds “cannot be simultaneously used” for both purposes, Foster notes that the bill’s estimated savings themselves “may be unrealistic.”  The bill’s proponents have been eager to highlight the Senate bill’s apparent deficit neutrality as evidence of fiscal responsibility.  But what we are learning from this article — after the crucial vote, mind you — is that that the bill may even be more irresponsible than the bill’s critics have claimed, as unrealistic savings that may not materialize are to be counted for two completely different purposes.  Pear quotes Senator Jon Kyl as saying about the double count that “You can’t sell the same pony twice.”  If Foster is right, however, the very pony they are double selling may not even exist.


Sign up for free NRO e-mails today:

Subscribe to National Review