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How two little-known offices will shape healthcare reform

As efforts to pass healthcare reform progress, more responsibilities are being placed on the Congressional Budget Office and the Senate Parliamentarian's Office – two institutions famous for their devotion to fairness and attention to detail.

Senate parliamentarian Alan Frumin walks towards the Cannon House Office Building in Washington Tuesday. The Senate Parliamentarian's Office will be called upon to offer crucial counsel on Senate rules if the Senate uses reconciliation to pass fixes to its healthcare reform bill.

Lauren Victoria Burke/AP

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The complex, highly partisan closing push for healthcare reform is, in many ways, coming down to two Washington institutions whose devotion to nonpartisanship and a mastery of the arcane make them virtually inside-the-Beltway priesthoods: the Congressional Budget Office and the Senate Parliamentarian’s Office.

The CBO will score how much the House "fixes" will actually cost the federal government. With many conservative Democrats wavering in their support for the bill precisely because of deficit concerns, the CBO's score will likely determine what gets passed and when.

The rulings of the Senate Parliamentarian, meanwhile, will shape the course of those fixes when they come to votes in the Senate.

Despite the enormous responsibility now heaped on these two offices, however, there has been barely a peep from either side of the aisle accusing either of mismanagement or partisanship. Even in highly partisan times, both retain a reputation for independence and a mastery of highly specialized data without peer.

“There’s so much credibility in the CBO and parliamentarian’s office, based on decades being consummate professionals, and that’s going to serve everyone well,” says Ralph Neas, CEO of the National Coalition on Health Care, which is lobbying for reform.


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