I've written before about some of the problems with the way the Congressional Budget Office scores medium- and long-term savings--something that became glaring when it concluded that the administration's proposal for an independent agency to make cost-saving recommendations for Medicare would save a mere $2 billion over 10 years.* (The idea is that Congress could vote the recommendations up or down in their entirety, but couldn't mess around with the details, a process that generally results in the cost-saving measures being gutted.)

Well, now it looks like the White House is escalating a bit in its standoff with the CBO--guerilla-style. On his blog, OMB director Peter Orszag just posted a letter signed by nine of the 20 health care experts who advise CBO on how to score health care legislation, which argues that "a properly structured Independent Medicare Advisory Council (IMAC), with a congressional mandate and authority to do so, can reduce the rate of growth of health expenditures substantially." I'm not sure how the letter came about, but it strikes me as a pretty shrewd way to suggest CBO's original estimate may have lowballed the savings. At the very least, it gives the administration something credible to point to when it makes that point. ("CBOs own health care advisers say...").

*In fairness to CBO, even the White House concedes that most of the savings from an IMAC-type agency would come after the first ten years. But, if nothing else, CBO's $2 billion forecast over 10 years created the perception that it was pretty weak beer, which was both unhelpful and probably inaccurate, even if the narrower point about 10-year savings wasn't way off the mark.  

Update: Speaking of scoring issues between OMB and CBO, I'm told OMB recently defeated CBO on the softball field for the first time in years. Make of that what you will...

Update II: More critical details on that softball game: Apparently it wasn't even close. According to OMB, the final margin was 26-17--though we know what CBO thinks of OMB's scoring. (Okay, I think we're set on softball for the moment...)

--Noam Scheiber