GOP Doesn't Account for Health Care Repeal Cost

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Updated 2:50 p.m. Eastern Time

House Republicans announced Monday that they would vote to repeal health care reform legislationnext week. The legislation that they would repeal, according to an estimate by the non-partisan Congressional Budget Office, would reduce the budget deficit by $143 billion over a decade.

According to the rules laid out by the incoming House Republican majority, the House must pay for all new legislation that increases federal spending - and a repeal bill, of course, is a form of legislation. That would suggest that they must come up with $143 billion to make up for the cost of repealing the health care bill.

The GOP solution? To exempt repeal from that rule.

On page 26 of the GOP rules package, which will be voted on tomorrow, is word that Republicans can "exempt the budgetary effects of legislation repealing the Patient Protection and Affordable Care Act and the Health Care and Education Affordability Reconciliation Act of 2010."

(Also exempt, incidentally: The cost of extending the Bush-era tax cuts and the estate tax under the tax deal worked out late last year, changes to the Alternative Minimum Tax, the cost of a 20 percent gross income deduction for small businesses, and the cost of implementing trade agreements. In addition, tax cuts in general do not have to be paid for.)

Republicans defend the exemption by arguing, in effect, that the CBO estimate doesn't reflect the full reality of the health care reform legislation. Shortly before the bill was signed into law, CBO director Douglas Elmendorf noted that the reform bill "would maintain and put into effect a number of policies that might be difficult to sustain over a long period of time." The bill's opponents seized on that comment to argue that the cost savings in the bill are an illusion.

Republicans have been careful to stress that they are not questioning the legitimacy of the CBO, one of the few organizations that both parties can (usually) agree on. When discussing the estimate last year, soon-to-be Budget Committee Chairman Paul Ryan said that the CBO is full of "great professionals" who "do their jobs well."

"But their job is to score what is placed in front of them," he said. "And what has been placed in front of them is a bill that is full of gimmicks and smoke and mirrors."

In an email, Michael Steel, spokesman for incoming House Majority Leader John Boehner, suggested that it doesn't make sense to pay for repealing a bill that isn't actually going to save any money.

"No one believes that the job-killing healthcare law will lower costs, because it won't," he said.

Democrats, by contrast, say Republicans are trying to make an end run around their own ostensible commitment to fiscal restraint.

Vince Morris, a spokesman for Louise Slaughter (D-N.Y.), told Politico that the provision "allows Republicans to pretend that their campaign promise to repeal the health care bill will have no cost."

UPDATE: Asked about the budget implications of repeal Tuesday afternoon, Incoming House Majority Leader Eric Cantor said: "I think most people understand that the CBO did the job it was asked to do by then the Democrat majority and it was really comparing apples to oranges because it talked about ten years worth of tax hikes and six years worth of benefits. Everyone knows beyond the ten-year window this bill has the potential to bankrupt this federal government as well as the states."