Former Congressional Budget Office Director Douglas Elmendorf's view is that it’s “absurd that Congress would vote on a bill of this importance without having a CBO estimate,” | Getty Former CBO director: Voting without score is ‘a terrible mistake’

House Republicans voting Thursday on legislation to repeal and replace Obamacare without a revised score from the nonpartisan Congressional Budget Office are making “a terrible mistake,” a former CBO director warned.

“The members will have to explain why they supported something with a range of effects that people aren’t gonna like,” Douglas Elmendorf, who headed the agency from 2009 to 2015 during former President Barack Obama’s administration, said in an interview. “At least if they waited for the estimate, they could make further changes to the bill that might respond to concerns. To go ahead with a vote before you know the effects of what you’re voting for is a terrible mistake.”


Republicans are expected to vote Thursday afternoon on a new version of the American Health Care Act. The original bill died in the House in March over opposition from moderate and conservative members of the Republican caucus without making it to the floor for a vote.

But with an impatient White House eager to finally land a major legislative victory for President Donald Trump, House Republicans are expected to vote along party lines to advance the bill before a revised score is issued by the CBO.

“For the House leadership to proceed to a vote without an estimate, they are essentially arguing that the bill is so much like the previous one they don’t need an estimate, and yet, it is so much different that many more people should vote for it,” Elmendorf said. “I don’t see how you can argue that combination of things at the same time with a straight face.”

While Elmendorf’s view is that it’s “absurd that Congress would vote on a bill of this importance without having a CBO estimate,” Douglas Holtz-Eakin, who served as the CBO director from 2003 to 2005 during President George W. Bush’s administration, said it’s not uncommon to vote on unscored legislation.

“I don’t view this as a particularly unusual event,” Holtz-Eakin said in a separate interview. “They scored the base bill, and everyone knows what that looked like.”

The CBO had projected that the original AHCA would cover 24 million fewer people than Obamacare covers over the next decade, and 14 million fewer by 2018 — although it also estimated that the bill would reduce the deficit by $337 billion in the next 10 years.

White House spokeswoman Sarah Huckabee Sanders defended the pace with which Republicans are moving, telling reporters on Thursday that the forthcoming CBO projection will be “inaccurate” anyway.

“It’s impossible to score,” she said.

A GOP aide noted the bill has been scored twice and said “only narrow changes” have occurred since it was scored in March. “This isn’t the final bill or the final vote. It’s only the first step in the legislative process,” the aide said. “It will be changed by the Senate.”

Holtz-Eakin argued that with three additional amendments: “We know the budget consequences perfectly: They cost $23 billion. That’s the primary job of CBO, and everyone knows the answer.”

“These are not big changes and there are not big populations involved,” he said. “It’s not gonna change the bill very much. So I think they basically know what they’re voting on. It’d be hard not to.”

Elmendorf, however, suggested that view is dumbfounding.

“This bill will have profound effect on millions of Americans, and to proceed to a vote without having any reputable estimate of just how many people will be affected, in what ways and what that will cost them and the government astounds me,” he said. “I think it is totally inappropriate for the House to vote today before a CBO estimate is available for a bill of this magnitude. This is not a post office-naming bill. This is an overhaul of the U.S. health care system, and to proceed to a vote without any serious estimates of what it will do to the country is unbelievable to me.”

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South Carolina Sen. Lindsey Graham similarly signaled that Thursday’s vote could prove costly and expressed skepticism about its prospects of advancing.

“A bill — finalized yesterday, has not been scored, amendments not allowed, and three hours final debate — should be viewed with caution,” Graham advised.

Elmendorf and Holtz-Eakin, meanwhile, wholly disagree on the current political strategy of House Republicans to hold a floor vote before the legislation is scored again, but both defended the institution they served, which has been under attack by the current administration for its projections.

“I think it is entirely fair to take issue with the CBO score on the merits, on whether you agree or disagree with the research basis and the sort of judgments they make,” Holtz-Eakin said. “I think it is entirely unfair to question the integrity of CBO, the professionalism and overall excellence of CBO. And so, for those who don’t like the score and attack the CBO as an institution, as a nonpartisan institution, as a professional organization, I think that’s wrong.”

Heather Caygle contributed to this report.