The official $1.1 trillion price tag for the House Democrats’ health care bill excludes dozens of unfunded programs that could drive up costs when future congresses look to fund them.
Republicans said the health care bill includes two dozen programs whose funding is listed as “such sums as may be necessary.” That amounts to legislative jargon, they said, for “We’ll bill you later.”
The list of projects ranges from the “No child left unimmunized against influenza” project to 10 programs in the Indian health care system. There are also programs to encourage people to go into nursing and to spur states to restrain medical-malpractice lawsuits.
The tactic is far from new and has been used for years by Republicans and Democrats alike. The health reform examples are just the latest of what has become known as “fuzzy math” - the sort of budgeting that has been drawing extra scrutiny as the economy sputters, federal spending balloons and deficits deepen.
Republican leaders said leaving appropriations for a later date meant lawmakers were voting blind this weekend on health reform in the House. “How can members of Congress cast informed votes on a bill when there is no way to know the true cost to the American taxpayer?” said Rep. Jerry Lewis of California, the top Republican on the House Appropriations Committee.
But Democrats said leaving spending decisions up to future congresses is standard operating procedure under both parties and is the only way to let the appropriations committees weigh priorities. They said authorizing a program doesn’t mean it will get money, and they pointed to a host of programs that have never gotten off the ground because Congress has never funded them properly.
“If you’re calling these fuzzy math, then every authorization bill is fuzzy math,” said a Democratic aide, who requested anonymity. “It’s not fuzzy math at all. It’s not math. That’s the way Congress works. You authorize a program, and the appropriators appropriate for it.”
Until Saturday’s late-night health vote, much of the criticism for fuzzy calculations has been aimed at the administration’s calculation of jobs “saved or created” by the $787 billion stimulus package.
Late last month, Vice President Joseph R. Biden Jr. seemed to stumble over the math, touting that 1 million jobs have been created so far - but immediately adding that those calculations can’t be expected to be “100 percent accurate.”
The official tally is 650,000 jobs saved or created by stimulus investment, but Mr. Biden said the indirect effect of the spending means the real number is much higher.
It is in Congress, though, where bills get written, that creative math is elevated to an art.
Douglas Holtz-Eakin, former director of the Congressional Budget Office and chief policy adviser for Sen. John McCain’s presidential campaign, said that’s true of the health care bills winding their way through the Capitol.
He said Democrats are counting on spending cuts that “are political fiction,” adding that by imposing a new surtax but not indexing for inflation they’ve invented yet another budget boondoggle future congresses will have to adjust every year.
“The Senate and House health bills are exercises in budget gimmicks,” he said.
Congressional Republicans said one problem lies in the holes left by the “such sums as may be necessary” language.