Letter To The Honorable Mitch McConnell, Republican Leader

Letter

The Obama administration's chief actuary at the Centers for Medicare and Medicaid Services (CMS) notified Republican leaders Saturday that the "very tight time frame" and "complexity" of the Democrats' health spending bill would prevent them from fully analyzing the costs and efficacy of the bill before the House voted on the legislation. The letter was in response to a request from House and Senate Republicans.

The Chief Actuary, Richard S. Foster, wrote: "In your letter, you requested that we provide the updated actuarial estimates in time for your review prior to the expected House debate and vote on this legislation on March 21,2010. I regret that my staff and I will not be able to prepare our analysis within this very tight time frame, due to the complexity of the legislation."

Foster and his staff analyzed the Senate-passed bill and determined that it bent the cost curve up, estimating in a January 8 report that national health expenditures would increase by an estimated total of $222 billion, and that the additional demand for health services "could be difficult to meet" and "could lead to price increases, cost-shifting, and/or changes in providers' willingness to treat patients with low-reimbursement health coverage." Foster, in his letter today, expects the new health spending bill to be "generally similar."

Congressman John Boehner (R-West Chester) said: "The House of Representatives should not vote blindly on an issue that is so important to every American. We deserve to have all the facts about how much this bill raise health care costs before we vote. The decision to press ahead and jam this bill down the throats of the American people is just one more example of arrogance and irresponsibility from Washington Democrats."

Senate Republican Leader Mitch McConnell said: "Americans deserve to have a full analysis of this bill, but won't because of the mad dash forced by the Democrat leaders in the House. We now know that even the Obama administration's chief actuary predicts more government spending, more price increases for consumers and less care for low-income patients. This debate was supposed about lowering costs for Americans not making things worse."

The letter to CMS was signed by McConnell, Congressman John Boehner, Senate Republican Whip Jon Kyl, House Republican Whip Eric Cantor, Senate Budget Committee Ranking Member Judd Gregg, Senate Finance Committee Ranking Member Charles Grassley, Senate Health, Education, Labor and Pensions Committee Ranking Member Mike Enzi, House Budget Committee Ranking Member Paul Ryan, House Ways and Means Committee Ranking Member Dave Camp, House Energy and Commerce Committee Ranking Member Joe Barton, and House Education and Labor Committee Ranking Member John Kline.

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Full text of the letter to Republican leaders follows:
The Honorable Mitch McConnell
Republican Leader
United States Senate

Dear Senator McConnell:

This letter is in preliminary response to your inquiry of March 19 requesting an updated analysis by the Office of the Actuary of the Patient Protection and Affordable Care Act (as passed by the Senate) as it would be modified by the "Amendment in the Nature of a Substitute to H.R. 4872, the Reconciliation Act of 2010" (as released by the House Committee on Rules on March 18). The request was made jointly by yourself and 10 other members of the House and Senate Republican Leadership.

In your letter, you requested that we provide the updated actuarial estimates in time for your review prior to the expected House debate and vote on this legislation on March 21,2010. I regret that my staff and I will not be able to prepare our analysis within this very tight time frame, due to the complexity of the legislation. We will, however, continue working to estimate the financial, coverage, and other impacts of the health reform package and will provide these results to you as quickly as possible.

As you know, the Office of the Actuary has assisted Congressional Administration policy makers on health legislative and policy initiatives for many years, including the original Medicare legislation in 1965, all subsequent amendments to this program, Medicaid amendments since 1976, and the Clinton Administration's proposed Health Security Act in 1993-94. Our goal has always been to provide independent, objective technical information for use by policy makers as they deliberate Medicare, Medicaid, and national health reform proposals.

We issued an analysis of the Senate Patient Protection and Affordable Care Act in a memorandum dated January 8, 2010. While it is reasonable to expect that our updated analysis of this legislation, as modified by the reconciliation amendments, would be generally similar to the results in the January 8 memorandum, I cannot confirm this expectation without a full evaluation of the amendments and re-estimation of the provisions.

I am sending a similar letter to House Republican Leader Boehner, and, for expediency, will email copies to the other cosigners of your request. I am sorry that we cannot respond more quickly. Please let us know if you have any other questions we can assist with.

Sincerely,
Richard. S. Foster
Chief Actuary

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