HHS Will Not Release Medicare Chief Actuary Foster’s Cost Estimates for Law
HHS Secretary Tommy Thompson will not release Medicare chief actuary Richard Foster's estimates for the cost of the new Medicare law, according to an HHS letter sent to Rep. Henry Waxman (D-Calif.) that the Associated Press obtained on Friday, the AP/Arizona Republic reports. The letter comes in response to Democrats' requests for Foster's estimates for the cost of the legislation -- including the new prescription drug benefit -- which Foster said ranged from "$500 billion to $600 billion all the way through the process" of the bill's passage. President Bush and Thompson repeatedly said the legislation would "cost no more than $400 billion over 10 years" at a time when "several conservative Republicans were wavering in support of the Medicare overhaul because of concerns about its price tag," the AP/Republic reports (Sherman, AP/Arizona Republic, 4/24). Foster has said former CMS Administrator Tom Scully told him not to reveal to Congress his estimates for the Medicare legislation. According to Office of Management and Budget estimates released after Congress passed the legislation, the Medicare law will cost $534 billion over the next 10 years -- $134 billion more than the Congressional Budget Office's estimate. Foster has said that the higher cost projection was known before the final House and Senate votes on the legislation in November but that Scully told him, "We can't let that get out." In an e-mail to colleagues at CMS, Foster indicated he believed he might lose his job if he revealed his cost estimates for the Medicare legislation. Scully has said that he did not threaten to fire Foster if the higher estimates were released. Scully also said that he "curbed Foster on only one specific request" made by Democrats at the time of the first House vote on the Medicare bill.
The HHS Office of Inspector General, the General Accounting Office and Department of Justice have been asked to look into the issue. Further, some Democrats on the House Ways and Means Committee have requested that Scully appear before them to respond to Foster's allegations, and Democrats on the Senate Finance Committee have sent committee Chair Chuck Grassley (R-Iowa) a letter requesting a hearing to discuss why Congress did not receive OMB's estimates. In addition, Sens. Hillary Rodham Clinton (D-N.Y.), Edward Kennedy (D-Mass.), Frank Lautenberg (D-N.J.) and Debbie Stabenow (D-Mich.) have sent Attorney General John Ashcroft a letter requesting a DOJ investigation into whether Bush administration officials violated two federal criminal laws prohibiting the withholding of certain information from Congress. GAO will conduct a joint investigation with HHS OIG, GAO spokesperson Jeff Nelligan said (California Healthline, 4/2). The HHS letter to Waxman, written by Dennis Smith, former acting CMS administrator, said Democrats "have no right" to review the estimates because Foster's analyses and estimates for various versions of the legislation are "exempt from disclosure," the AP/Republic reports. However, HHS did provide Waxman with four documents that had already been made public. Waxman said, "The response is completely inadequate. The administration is stonewalling our investigation," adding that Democrats are "evaluating our next steps," including a possible lawsuit to obtain the estimates (AP/Arizona Republic, 4/24).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.