2000 pages and Pronto! Budget markers are under pressure

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“It’s like watching a kindergarten class during arts and crafts,” said Zach Moller, director of economic policy for the centrist think tank Third Way and former aide to the Senate Budget Committee. “Suddenly someone spills the dough, and you have to go clean it up. And while you turn your back, someone is pulling someone else’s hair. It’s so much harder to be the adult in the room with something like that.

Economists in the budget office often have to exercise judgment on issues that can be difficult to predict. Douglas Holtz-Eakin, who was CBO director from 2003 to 2005, recalled his efforts to calculate the expected costs of an insurance program against terrorism following the September 11 attacks. The job was to estimate the frequency and magnitude of terrorist attacks in the years to come.

“You don’t want to know how many times I’ve just rolled the dice on that one,” he said. But Mr. Holtz-Eakin, now president of the American Action Forum, stressed that the budget office would not serve Congress well if it cut corners or guessed at policies where it could make hard estimates.

Sometimes the office works hard to understand the effects of a whole new policy and later finds that it was wrong. During the Affordable Care Act debate, the office felt that the law’s individual mandate to obtain health insurance would have a major effect on the number of Americans covered by the law. In 2018, he acknowledged that years of experience had shown that the impact of the provision had been considerably weaker.

Changes in health care are often particularly slow to calculate. The budget office has built a computer model that assesses the effects of public policy on health insurance rates and spending. The sophistication of this model is valuable, but its weight means the program often takes a day to run, before analysts spend weeks evaluating its output and interpreting the results, Hall said. He recalls explaining this process to frustrated Republican lawmakers during their efforts to repeal and replace the Affordable Care Act in 2017.

The latest round of changes to the social spending program concerned the regulation of prescription drug prices, a policy that could impact cost estimates for many related health programs.

When Republicans attempted to partially repeal the Affordable Care Act in 2017, the budget office came under fire for politically damaging estimates. But several CBO directors have said congressional angst is usually about the perceived slowness of the CBO process, not the fairness of its estimates.


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