GOP Calls Health Reform Budget 'House of Cards'

When the Congressional Budget Office released its preliminary cost assessment for the Democrats' health care reform proposal Thursday, the estimate came in at $940 billion in new federal spending over 10 years -- just under the $1 trillion mark that fiscally conservative Democrats had identified as their cut off point for supporting the measure.

But by Friday, House Republicans had culled through the numbers and called a press conference to point to what they called Democrats' use of "budget trickery" to drag the bill's price tag to its more politically palatable number.

GOP members took issue with several budget-related items in the bill, including Democrats' plans to increase taxes and impose fees in all of the first 10 years of reform, but to implement health insurance exchanges, where consumers could shop for coverage, four years into the process.

"Hiding spending does not reduce spending," said Rep. Paul Ryan of Wisconsin, the Republicans' top man on the Budget Committee. "We all know this bill is a budget Frankenstein. It is a house of cards. It is going to give us a huge deficits now and even larger deficits in the future."

No feature of the bill seemed to anger Republicans more than an item that is missing from the original bill-- a plan to increase payments to doctors who treat Medicare patients. Without the measure, known as the "doc fix," payments to those physicians will drop by 21 percent.

Republicans say the cost of the "doc fix" should be included in the health reform measure since the overall package deals with extending the solvency of Medicare. Democrats counter that Congress addresses the issue every year and they should not have to include the fix in a one-time reform package.

House Speaker Nancy Pelosi confirmed Friday that she will address the doc fix in a separate bill later in the year, a move that Ryanl said is happening only to make the health care bill appear to cut the deficit, when it otherwise would not.

To illustrate his point, the congressman asked the CBO to estimate the budget impact of including the doc fix in health care reform. In a letter responding to Ryan, CBO said it would cost about $208 billion over the first 10 years of health care reform, and would take the overall plan from cutting the deficit by $130 billion to increasing the deficit by $59 billion.

"They're hiding the true cost of this bill," said Rep. Dave Camp (R-Mich.).

The Republican whip, Rep. Eric Cantor of Virginia, said that Democrats had resorted to "budget trickery" because, by his count, they do not yet have the votes to pass health reform through the House. He noted that Rep. Joseph Cao, the only Republican to vote with the Democrats last November, "is a firm no."

"We are fighting hard to make sure we're doing everything we can to fight this bill." Cantor said. "This type of fiscal chicanery does not do a lot to give the public a lot of confidence in what the Democrats are about."