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New healthcare bill won't hurt deficit. What about your wallet?

The CBO says the Senate Finance bill will create a $81 billion surplus over 10 years. But critics say its fees, taxes, and mandates will hit Americans’ pocketbooks hard.

By Staff writer / October 8, 2009

Senate Finance Committee Chairman Sen. Max Baucus (D) of Montana, walks to his office on Capitol Hill Thursday. The final Finance Committee vote on health care legislation is scheduled for next week.

Harry Hamburg/AP

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Washington

What’s in a score?

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The Senate Finance Committee’s healthcare plan got a clean bill of fiscal health from key congressional scorekeepers – that is, it insures most Americans without adding a dime to the federal deficit, according to nonpartisan Congressional Budget Office (CBO).

But does it shift the burden of healthcare costs to players outside the Beltway? That’s the new political fault line heading into a Senate Finance panel vote, which could come as early as Friday.

The CBO score doesn’t measure the fiscal impact on families, businesses, healthcare providers, or state and local governments. What will happen to them if the bill’s new mandates, fees, taxes, and penalties become law?

Nor does the CBO score capture the cost of doing nothing.

The importance of CBO scores

On Capitol Hill, that CBO score can be a game-changer. A poor CBO score sunk the Clinton administration’s healthcare reform bid in 1994.

That’s partly why House Speaker Nancy Pelosi on Thursday asked the CBO to score three versions of a government-run public option. It is part of the House's efforts to merge the work of three committees into a single bill. She is hoping that the CBO scores will rally support for the strongest version of a public option.

"There is absolutely no question the robust public option scores very well: $110 billion [in savings]. And that is why I so strongly supported it," she told reporters at a briefing Thursday. She says that she expects the robust version of the plan to outscore the other two by $85 billion over 10 years.

Eventually, the House version of reform must reconciled with a final Senate plan. There, too, the CBO score is the basis for comparing options.

CBO’s score for the Senate Finance Committee’s version of healthcare reform, released Wednesday, projects a $81 billion surplus over the next 10 years, putting healthcare reform back in the realm of the fiscally feasible. The Senate Finance plan does not include a public option.

“CBO also finds that the plan will expand coverage to 94 percent of all Americans,” says Sen. Kent Conrad (D) of North Dakota, a member of the Senate Finance panel. “This plan won’t solve all our problems. But it is a good beginning, and it deserves our support.”

Deficit-neutral to whom?

But Senate Republicans say that a narrow focus on the federal government finances obscures the costs outside the Beltway.

"I worry that some of my colleagues will focus only on the deficit-neutral piece of CBO’s document,” said Sen. Charles Grassley of Iowa, the top Republican on the Finance Committee. “A celebration of the deficit effects masks who pays the bills.”