CMS accountant stirs up Medicare controversy

Sunday, March 14, 2004

March 15, 2004

WASHINGTON - Before Congress approved the Medicare legislation in November 2003, Richard Foster, the chief actuary for CMS, informed colleagues in an e-mail that he was told to withhold a series of Bush administration cost estimates for the legislation that could have "torpedoed" its passage, the Philadelphia Inquirer reported last week.
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 estimated by the Congressional Budget Office.
Thirteen conservative House Republicans had said that they would vote against the bill if its estimated cost was more than $400 billion, according to the Inquirer.
The fiscal year 2005 budget proposal President Bush released last month acknowledges the higher estimate. Analysts in CMS had "concluded repeatedly" that the Medicare legislation would cost "upwards of $100 billion" more than estimated by CBO, according to the Inquirer.
Five months before the House voted on the reconciled Medicare legislation in November, Foster estimated that the Senate's Medicare bill would cost $551 billion over 10 years, the Inquirer reports. Foster was concerned that he might lose his job if he revealed the higher figures.
In June, before the first congressional vote on the legislation, he wrote in an e-mail to colleagues, "I'm perhaps no longer in grave danger of being fired, but there remains a strong likelihood that I will have to resign in protest of the withholding of important technical information for key policy makers for political reasons."