Politico posted a leaked memo, allegedly from Congressional Democratic leadership to members, that seem to make it clear that the majority knows its health-care bill is not deficit neutral.
At one point, the memo warns members not to discuss details of the CBO score, and specifically mentions avoiding discussion of a CBO disclaimer that its cost estimates include only mandatory, and not discretionary funding (the discretionary funding required to administer the bill would indeed raise its costs significantly):
We have increasingly noticed how right-wing fringe trying to pick apart the CEO score. We cannot emphasize enough: do not allow yourself (or your boss) to get into a discussion of the details of the CBO scores and textual narrative. Instead, focus only on the deficit reduction and number of Americans covered. There are two CBO letters Republican operatives have already begun distorting in their pursuit of killing our reform efforts: 1) CBO’s March 11, 2010 letter to Leader Reid analyzing the Patient Protection and Affordable Care Act as passed by.the Senate, and 2} CBO’s letter to Leader Reid (November 18, 2009) with the initial score of the Patient Protection and Affordable Care Act. I list these letters only to warn you of coming attscks from right-wing operatives and Republican sympathizers in the media. Those anti-reform extremists are making a last-ditch effort to derail reform. Do not give them ground by debating details. (For example, the March 11 letter has estimates of discretionary costs not accounted in the total). Again, instead focus only on the deficit reduction and number of Americans covered. In the critical remaining hours of debate we must drive the narrative of “health reform is deficit reduction.”
Later, in what would be an even bigger indication that Democrats are being purposefully dishonest about the cost of the bill, the memo says that a permanent “doc fix” is being negotiated between the AMA and the White House for later this spring, but that it should not be discussed because it would “complicate” the narrative that the bill cuts deficits:
. . .[M]ost health staff are already aware that our health proposal does not contain a “doc fix.” Some Republicans have repeated CBO’s November 18 letter that says “the sustainable growth rate (SGR) mechanism governing Medicare’s payments to physicians has frequently been modified (either through legislation or administrative action) to avoid reductions in those payments, and legislation to do so again is currently under consideration in Congress.” The inclusion of a full SGR repeal would undermine reform’s budget neutrality.
. . .As most health staff knows, Leadership and the White House are working with the AMA to rally physicians support for a full SGR repeal later this spring. However, both health and communications staff should understand we do not want that policy discussed at this time, lest it complicate the last critical push to pass health reform. When media raise the issue of the SGR, only say that Congressional leaders are working with the physician community on this issue. We do not yet want to discuss specifics about what inflationary measure (indexed to growing health costs) would replace the SGR. Congressional leaders and the White House Administration officials will hammer out those details in coming months.
I use all the “alleged” and “seem” language here because, frankly, the memo seems too good to be true. But if it is the genuine article, wow. Just wow.
UPDATE: As I feared, Democrats are calling this memo a hoax. Politico has pulled it until they can “absolutely verify the document’s origin.”