James Pethokoukis

Politics and policy from inside Washington

What Ben Nelson didn’t tell Nebraskans

December 31, 2009

Suddenly down some 30 points to a hypothetical 2012 challenger, Ben “60th vote” Nelson — a guy who won his 2006 race with 64 percent — is taking to the airwaves to explain his decision to vote for ObamaCare.

But in a TV spot, Nelson failed to tell his fellow Nebraskans that while the Senate bill supposedly improves the U. S. fiscal picture, it employs some Enron-esque bookkeeping tricks to get there.

The Patient Protection and Affordable Care Act promises to cut the federal budget deficit by $132 billion over the next decade, according to the Congressional Budget Office. That’s not a huge amount given that healthcare spending drives the government’s long-term fiscal woes, but it’s something. Indeed, at first glance the tab for expanded health insurance coverage appears more than met through a mix of Medicare spending cuts and payroll tax increases.

Yet this minor bit of fiscal prudence is a mirage. The act would reduce Medicare spending on hospital stays by $245 billion from 2010-2019, while increasing tax revenue by $113 billion. So on paper, Medicare’s hospital insurance trust fund would be some $358 billion to the better, boosting its long-term solvency. But the government then takes that $358 billion and uses it to pay for increased, non-Medicare healthcare spending — leaving $358 billion worth of IOUs in the Medicare trust fund. If not for that $358 billion shift, the act would worsen the deficit by $226 billion over the next ten years.

It’s a clever trick that takes advantage of the CBO’s treatment of both the Medicare and Social Security trust funds as essentially off-balance sheet vehicles. Money owned to them is not treated by the CBO as the same as money owed to Treasury bondholders. The former is treated as a mere obligation, the latter a concrete liability. Yet both are future claims on taxpayer resources.

And that’s not the only bit of chicanery: 1) There’s a similar $50 billion double-counting trick with the Social Security trust fund. 2) CBO healthcare scoring assumes a huge reduction in government payments to doctors even though a separate bill moving through Congress would restore the $250 billion cut.3) The payroll tax hike isn’t indexed for inflation, generating unrealistically high revenue forecasts. 4) And as Andrew Biggs of the American Enteprise Institute notes, the cost-cutting Medicare advisory commission would merely limit spending growth to pretty much the current baseline forecast (GDP plus 1 percent) which translates into $62 trillion of additional deficits over the next 75 years.

(Then again, budget scoring overall is dodgy. John Williams of Shadow Government Statistics calculates that using Generally Accepted Accounting Principles as public corporations do, the total 2009 budget deficit would be roughly $8.8 trillion, not the $1.4 trillion reported on a cash basis.)

Nope, Ben Nelson didn’t tell deficit-fearing Nebraska voters any of that.

Comments

Nelson is a disgrace. He provided the crucial 60th vote for the budget-busting-government-control fiasco of Obamacare. He sold that vote for millions of dollars. And he betrayed his supposed committment to right to life principles by accepting watered down abortion language in the health care legislation. Three strikes and you’re out, pal.

Posted by Bill, Fairfax, VA | Report as abusive
 

Nelson did what every turn coat does to explain their treachery by inventing reasons why he did it. EVERYONE knows that the HCR bill is an accounting fantasy! But to use any part of this accounting fraud as a reason to vote for it is ludacris. He could have used the “Humanitarian” angle or the “Poor People” angle but to use the most egregious lie is an insult to the people of Nebraska. When it takes in taxes and Medicare cuts for ten years but only begins to pay out expenses for six years, any plan would look good.

Posted by inspectorudy | Report as abusive
 

Is there a recall process in Nebraska?

Posted by robert boni | Report as abusive
 

Can someone please post Nelson on Craigslist and Backpage under Escorts–will bottom for $$ Use me and abuse me, I’m your Senate Slut. Someone out there with some photoshop ability, maybe?

Posted by Jerry | Report as abusive
 

Can we stop saying that the government is using Enron-esqe accounting practices. I’ve heard this a number of times regarding the health bill. The reality is Enron used government-esque accounting practices to bilk employees and investors of billions of dollars. Just like the government has raided the Social Security trust fund for years.

Posted by JC | Report as abusive
 

vote every one of those kleptocrats that voted for this governement totalitarian take-over out of office!

Posted by rich | Report as abusive
 

Did Nelson defend his deal for Nebraska on Medicaid funding? What did he say? I’d be interested in how he defended that, and whether his defense is something people in the other 49 states would appreciate.

Posted by hoipolloi | Report as abusive
 

Social Security and Medicare are mere obligations not concrete liabilities. This has been established in case law. Eventually younger voters will reject this “eat your young” mentality. Unfortunately, folks have lowered their savings rate in anticipation of benefiting from these ponzi schemes that will soon blow up.

Posted by Cliff | Report as abusive
 

There is a great deal more fraud in the works as well. For example, there is a mechanism to save money by NOT readmitting patients to the hospital if they bounce back. Either those people will certainly die and the hospitals and doctors will ALL be sued back to the stone age or the patients will indeed be readmitted as obviously necessary: OOPs! Zero savings. The very idea that bureacrats are to decide who gets to be admitted to the hospital is insane. Just don’t call them “Death Panels” or you will be ridiculed as a far-right totalitarian, fear monger and a hick from flyover country. They also tried (Congress) to set up an “independent” panel to issue imperial guidelines for the practice of medicine—a panel that could not be dismantled by future legislatures. Although illegal and unconstitutional, look for that “savings panel” to be created in conference.

Posted by Daybro | Report as abusive
 

Senator Ben Nelson and some 30 others Congresscritters accepted a bribe for their vote. Just because Harry Reid was the one making the bribe doesn’t change its nature – it was dishonest. ANYONE who accepted – or offered – a bribe (“special favors”) to pass this freedom-destroying bill should be arrested, charged with the crime, and once proven guilty (there’s not much doubt), hung from the ceiling of the Rotunda as a reminder to the rest. Too bad none of us have the conviction of our Founding Fathers.

 

I have a great Idea about health care.How about taxing the Insurance companies and insisting they pay for your health care according to the coverage,not the fine print.I had some minor health issues that required me to have some test a couple years back.I pay my own health coverage through my employer the cost is about 10k.According to the coverage page I have a maximum out of pocket expence of 1k. My part of the expenses was about 8k after all the disallowed charges and deductibles and other b.s. I spent more than the insurance company. Add insult to injury when I approched my doctors with how about they charge me the rates they gave the insurance company and I could save money by just payin for my health care and dropping theInsurance companies.The doctors simply said they couldn’t do that if I pay cash I have to pay the ficticious retail sum of which the insurance only paid about forty percent of the part they were billed.They have a contract with the insurance company they get pateints by heavily discounting the fees to the insurance company and if they charged me that amount the insurance companies would dump them.Sum it up I pay 60% more for the services than the insurance company if I pay cash on the spot. All of this is to force me to carry insurance and pay 10k a year for nothing except a discounted rate.

Posted by Dale Simmons | Report as abusive
 

I am just sorry my Sen. Nelson (FL) didn’t hold out for more than a little Medicare Advantage money. Why should my state taxes go up to pay for Medicaid if Nebraska’s doesn’t.

Posted by Richard | Report as abusive
 

Assuming we’re in agreement that Enron-esque bookkeeping tricks are wrong, can we conclude that such bookkeeping tricks are to be rigorously prosecuted wherever they crop up, all the way back through various Middle Eastern war budget scandals? Eventually, even, maybe to Enron itself?

Because that really hasn’t happened yet. There’s always the specter of gay marriage, godlessness and abortion in need of more urgent debate.

Posted by The Bell | Report as abusive
 

you assholes have no solution to the health care problem – only bitching & moaning.
the only way to compete in the GLOBAL market is to eliminate the healthcare burden from corporations, and pay for it by raising taxes and outlawing for-profit insurance companies. period!
raise the taxes, especially on the filthy corrupt immoral rich. 90%.

Posted by dgmxz | Report as abusive
 

I fear for America. THE GREAT GIVE AWAY! The people who want everything for free are the first to riot in the streets and burn the city. If your illegal you are entitled to nothing but expulsion. America is collapsing under the socialist give away policies of Obama and the utterly repugnant greed and corporate theft of Wall St and the Bank Mafia.
I am Australian living in Queensland Australia and I can see clearly from here the pending financial collapse of a great nation into mass chaos. WW3 is next, God help the free.

Posted by Ronnie Bell | Report as abusive
 

I agree with ” dgmxz” all the way….

Quit your bitching unless you have a solution to the problem..as the saying goes,”if your part of the problem, then your not part of the solution”.

Posted by janeycat | Report as abusive
 

Janeycat and dgmxz, you are morons. You want a solution that actually works? Tort reform. Allowing insurance to be sold across state lines. Period. Costs will go down. I look forward to your explaining the problems with this solution. Your stupidity is shown by the following quote: “eliminate the healthcare burden from corporations, and pay for it by raising taxes”. It is paid for one way or the other by the corporations, either directly or through taxes…what kind of ninny thinks inserting the government makes anything more efficient or better, when the evidence to the contrary is overwhelming?

Posted by anb | Report as abusive
 

1. permit all health insurance companies to operate in the entire country. Allow them to refuse anyone they want. Have a pool of “high risk” patients who are subsidized by all the other insurance premiums.

2. Allow Insurance companies to operate and be sued in the state they are incorporated, to reduce medical judgments. Take government out of the process of regulating companies, but make very public any consumer complaints, for shoppers.

3 Reduce medicaid and medicare fraud by having incentives for individuals to report fraud.

4. Tax incentives for homeowners to allow sick or disabled folks to live in and get some care.

Posted by Keating Willcox | Report as abusive
 

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