“It’s like monitoring a kindergarten class during arts and crafts,” said Zach Moller, the director of economic policy at the centrist think tank Third Way, and a former Senate Budget Committee aide. “All of the sudden, somebody spills the paste, and you’ve got to go clean that up. And while you turn your back, somebody is tugging someone else’s hair. It’s so much more complicated being the adult in the room with something like this.”
Budget office economists often must exercise judgment about questions that can be challenging to predict. Douglas Holtz-Eakin, who was the C.B.O. director from 2003 to 2005, recalled his efforts to calculate the expected costs of a terrorism insurance program in the aftermath of the 9/11 attacks. The work involved estimating the frequency and magnitude of terrorist attacks in coming years.
“You don’t want to know just how many times I just rolled dice on that one,” he said. But Mr. Holtz-Eakin, now the president of the American Action Forum, emphasized that the budget office would not serve Congress well if it cut corners or guessed about policies where it could conduct rigorous estimates.
Sometimes, the office works hard to understand the effects of a brand-new policy, and realizes later it has erred. During the debate over the Affordable Care Act, the office believed that the law’s individual mandate to obtain health insurance would have a major effect on the number of Americans who were covered under the law. In 2018, it acknowledged that years of experience had shown the provision’s impact had been substantially smaller.
Health care changes are often particularly slow to calculate. The budget office has constructed a computer model that evaluates the effects of public policy on health care insurance rates and spending. That model’s sophistication is valuable, but its heft means the program often takes a day to run, before analysts spend weeks assessing its output and interpreting the results, Mr. Hall said. He recalls explaining this process to frustrated Republican lawmakers during their efforts to repeal and replace the Affordable Care Act in 2017.
The final round of changes to the social spending package concerned price regulation for prescription drugs, a policy that could ripple through cost estimates for numerous related health programs.
When Republicans were trying to partly repeal the Affordable Care Act in 2017, the budget office faced criticisms for estimates that were politically damaging. But several C.B.O. directors said congressional angst is typically about the perceived slowness of the C.B.O. process, not the fairness of its estimates.