CAN'T FOLLOW THE ACTION WITHOUT A PROGRAM.

On Friday, I wrote a post trying to explain the importance of the Congressional Budget Office to health reform, and arguing that their new books of health care policy analysis and options were actually critical documents -- not because they laid out scoring methods that agreed with the opinions of reformers, but because they gave reformers insight into how the CBO would score a bill. (Yeah, I know this is getting deep in the weeds.) Their analysis might still be a minefield, but at least reformers now had a map. The example I used was 1994, when the CBO's score put the final nail in the coffin of the Clinton plan. Out in California, Anthony Wright gives another:

During California's reform debate earlier this year, the state's CBO-equivalent, the LAO, was asked to evaluate AB x1 1 (and then later, SB840) [the health reform bills]. It was expected--after all, anything that goes on the ballot is required to have an LAO analysis in the voter guide. When nobody knew what the LAO would say, because there was no previous engagement with the drafters of health reform. It's like turning in a test, and having no idea what criteria the teacher would be using to determine a grade. (We had a problem with the analysis--of what was asked: risks without context, without benefits--and what was not asked: the comparison with the status quo.)

What the CBO has published is like getting the teacher's manual to the class textbook. We may not like the answers, but at least we know what their assumptions are. There is a more transparent process, which also allows us to perhaps challenge some assumptions: Can we count savings from preventative care efforts? What are the assumptions of the rate of growth of health costs over five years? What is the CBO's understanding of the status quo?

It's sort of boring, but important. The difference between trying to sell a bill that is revenue neutral -- or even, in the long-run, positive -- and trying to sell a bill that adds hundreds of billions to the deficit is immense. That's true for talking to the public, and true for getting votes: Blue Dogs and fiscally conservative Republicans are far likelier to sign onto a bill that has the CBO's Seal of Good Housekeeping.