Leading Edge Policy & Strategy
Thinking About the Future of Health Care and Health Information Technology Policy
A) Purpose and Context of CBO Scoring
B) Components of Costs
C) Components of Savings
D) Components of Revenues
E) Effects on Deficit
F) Number of Insured
A) Purpose and Context of CBO Scoring

CBO assists the House and Senate Budget Committees, and the Congress more generally, by preparing reports and analyses. In accordance with the CBO's mandate to provide objective and impartial analysis, CBO's reports contain no policy recommendations.

To assist the Budget Committees and the Congress with enforcement of the budget resolution, CBO analyzes the spending or revenue effects of specific legislative proposals. (For proposals that would amend the Internal Revenue Code, CBO is required by law to use estimates provided by the Joint Committee on Taxation.) It prepares cost estimates of pending legislation and tracks the progress of such legislation in a scorekeeping system. CBO's cost estimates and scorekeeping system show how individual legislative proposals would change spending or revenue levels under current law and help to determine whether those budget effects are consistent with the targets in the Congress's most recent budget resolution. As required by the Unfunded Mandates Reform Act of 1995, CBO includes in cost estimates an assessment of whether legislation contains federal mandates and provides an estimate of the costs imposed by those mandates on state, local, and tribal governments and the private sector.

By statute, CBO's baseline projections must estimate the future paths of federal spending and revenues under current law and policies. The baseline is therefore not intended to be a prediction of future budgetary outcomes; instead, it is meant to serve as a neutral benchmark that lawmakers can use to measure the effects of proposed changes to spending and taxes. So for that reason and others, actual budgetary outcomes are almost certain to differ from CBO's baseline projections. For a related discussion, see Chapter 1 of CBO's Budget and Economic Outlook; see also The Uncertainty of Budget Projections: A Discussion of Data and Methods for supplemental information.

CBO is required to develop a cost estimate for virtually every bill reported by Congressional committees to show how it would affect spending or revenues over the next five years or more. For most tax legislation, CBO uses estimates provided by the Joint Committee on Taxation, a separate Congressional analytic group that works closely with the two tax-writing committees. CBO also prepares cost estimates for use in drafting bills (especially in the early stages), formulating floor amendments, and working out the final form of legislation in conference committees. To the extent that its resources permit, CBO estimates the cost of bills at the request of individual Members.

Keep in mind that each CBO estimate provided here is for a bill or resolution at a particular stage of the legislative process and that the bill--and its estimated budgetary effects--may have changed since the estimate was prepared. To check on the current legislative status of a particular bill or to find the text of a bill and other related information, visit the Library of Congress's Thomas: Legislative Information page.

Keep in mind also that the estimates provided here reflect effects of legislation on the federal budget and not on health care costs in general.  Whatever the effects of health care reform on the federal deficit are, those effects may or may not represent equivalent changes in the cost of healthcare.


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