Republicans pounce on estimate for healthcare plan

The report yesterday became fodder for Republicans who believe the Democrats’ approach would cover too few at too high a cost, while committee Democrats rushed to declare that the budget office’s findings were so incomplete as to be misleading.

Committee Democrats, in a group press conference conducted in the absence of Kennedy, who is battling brain cancer in Hyannis, said they are still discussing important sticking points with Republicans, so major aspects of the proposal were not figured into coverage estimates. One reason they said it was incomplete, though, was that it did not include a planned Medicaid expansion, which would increase the number of people covered but also inflate the bottom line.

Meanwhile, the CBO priced a draft Senate Finance Committee plan at more than $1.5 trillion, according to an aide. But Democrats said they were working on a more modest version that would cost less.

The skirmishes over the cost estimates underscored the tension building around the healthcare bill and the enormous political stakes involved for Democrats, as the White House and congressional leaders shovel increasing amounts of political capital onto an expensive and complex issue. A bill of the breadth they are contemplating is likely to cost at least $1.5 trillion. And President Obama has repeatedly said that all of it must be paid for within a 10-year budget window.

Senator Chris Dodd, who has stepped in for Kennedy, tried to sound reassuring at the press conference. He said turning back was not an option.

“If it was that easy, this would have been done years ago,’’ he told reporters.

But Senator Tom Harkin, Democrat of Iowa, seemed nervous. He said he was worried that a bill with enough compromises and special provisions designed to attract bipartisan support might not move the nation’s healthcare system in the right direction.

“I kind of wake up at night thinking, ‘My gosh, we could wind up with a more convoluted system than we have now,’ ’’ he said. “We could just be multiplying the points in our system that create waste and abuse and cost us so much money.’’

Harkin praised Dodd for pinch-hitting as Kennedy’s deputy, but he also said it was “depressing’’ that the Massachusetts senator, long a leader on healthcare and a forger of consensus on difficult legislation, couldn’t be there to help because of his health.

“We always say around here, ‘If you want to get a bill through, give it to Kennedy,’ ’’ he said. “He knows how to get things done. He just knows how to make the deals and get everyone together.’’

But for Democrats leading the effort to overhaul healthcare, the financial news only got worse yesterday. Douglas Elmendorf, the CBO director and the final arbiter of the cost of any proposal, acknowledged on his blog that if Congress does nothing, healthcare will continue to grow at an unsustainable pace. But he warned that cost-saving measures will be hard to calculate, making it harder to offset the cost of expanding coverage.

Elmendorf’s comment suggests the CBO will continue to price Democratic proposals at a high level.

“Experts generally agree that changes in government policy have the potential to produce substantial savings,’’ he wrote. “However, turning that potential into a reality in a sector that accounts for one-sixth of the US economy is likely to be a prolonged and difficult process.’’

Elmendorf also threw cold water on the value of the health industry’s promise to Obama - a pledge much ballyhooed by the administration - to help lower health costs by $2 trillion over the next decade. In a letter to Representative Dave Camp of Michigan, the ranking Republican on the House Ways and Means Committee, he said only some of the industry’s proposed savings measures would affect federal spending, and most were too vague for the CBO to determine how much money they might save.

Senator Chuck Grassley of Iowa, the ranking Republican on the Finance Committee, who last month scorned the industry’s promises as “fairy dust,’’ said in a statement: “The headlines generated by the White House event even a month ago don’t get us much closer to affording health reform today.’’

After answering question after question from a throng of reporters outside the Senate Democrats’ weekly luncheon yesterday, Finance Committee Chairman Max Baucus looked weary but sounded patient. “This is the most complicated effort I’ve ever undertaken in my life,’’ he said.