On health, Senate awaits go from green eyeshaders

They don't vote or hold a veto pen, yet Congress' number-crunchers wield oversize influence on President Barack Obama's health overhaul agenda.

Doubt it, consider this - lawmakers are anxiously awaiting Congressional Budget Office calculations on the Senate health care bill, and debate on the historic measure can't start in earnest until the agency renders its verdict.

In a flurry of proposals and numbers, Senate Majority Leader Harry Reid, D-Nev., has been seeking the CBO's answers for weeks, even as the House passed its own version of legislation extending health coverage to tens of millions of uninsured Americans and enacting tough new restrictions on insurance companies.

Reid's bill and the accompanying CBO analysis are expected next week. If the budget office says the bill is too expensive or doesn't reduce the deficit, moderate Democrats could flee and Republicans would have fresh ammunition. If the numbers are on target, Reid will have a stronger hand to corral support as debate begins.

The wait has been lengthy precisely because Reid is aiming to ensure that when the budget office releases its analysis it hits certain marks.

The complex legislation, which Reid is taking a free hand in writing based on two committee-passed bills, must not exceed Obama's specified price tag of $900 billion over 10 years, and it must not add to the deficit. Ultimately it must be able to get the 60 votes needed to advance in the 100-member Senate.

"We've sent them a list of options; they raise questions. We answer them, we raise other questions, they answer them. The goal is to put together the best bill possible," Reid spokesman Jim Manley said Friday. "Senator Reid made a decision a while ago that he wants to get this right before taking it to the floor."

Senators wanted more generous subsidies to help lower-income people afford insurance; Reid has weighed that. Making subsidies more generous or scaling back a tax on high-value insurance plans that's unpopular with union members and some Democrats would require more money. Reid began considering a new Medicare payroll tax on people earning more than $250,000 a year, as The Associated Press first reported this week.

CBO must do the math in response to each new idea from Reid, then redo it as Reid tweaks his proposals.

CBO director Douglas Elmendorf declined in an interview Friday to comment on the process with Reid, but noted that his agency's role was to analyze proposals, not make recommendations. He said his analysts were churning out reports as fast as they could without sacrificing quality.

"The health reform proposals that we're seeing this year are mostly very complicated and touch on many aspects of the federal budget and the economy, so that makes them more difficult to analyze," Elmendorf said, "both because there are more pieces to keep track of, and because the interaction of the pieces can be very important, but is not something for which we have a lot of good experience or evidence."

The influence of the budget office has been on display throughout the health overhaul debate. As Congress' nonpartisan scorekeeper its pronouncements - formal, informal or even just rumored - can make or break legislation, sending lawmakers scurrying back to the drawing board to start over. That happened over the summer when an unwelcome $1.6 trillion price tag on options before the Senate Finance Committee sent senators looking for new solutions.

In Washington parlance, the CBO's analysis of a piece of legislation is called a "score." So ask any senator their opinion of the health care bill and they'll likely tell you that they're "waiting for the score" before they can say.

CBO is known for its evenhandedness, even when its answers aren't to the liking of one party or another, or provoke grousing from lawmakers that its approach is too conservative. The agency also frequently comes in for some of the blame if things aren't moving fast enough for lawmakers' liking.

"We've waited three weeks now for CBO," the No. 2 Senate Democrat, Dick Durbin of Illinois, told reporters earlier this week when asked about timing.

Former CBO officials say such complaints comes with the territory.

"There's a psycho-social role for CBO being the dog that gets kicked in the process," former CBO director Douglas Holtz-Eakin, a fellow at the Manhattan Institute, said Friday.

"I honestly always took it as business. It wasn't personal," he said.

The CBO was created by Congress in 1974 and its director is appointed jointly by the Speaker of the House and the president pro-tempore of the Senate to serve a four-year term. The agency has about 250 employees, around 50 of whom are at work on the health care legislation.