SCOTT SIMON, host:

The White House is denying accusations that the health overhaul bills moving through Congress now would actually increase health spending over the long haul. Congressional Budget Office Director Douglas Elmendorf touched off the dispute with this comment Thursday.

Mr. DOUGLAS ELMENDORF (Director, Congressional Budget Office): We do not see the sort of fundamental changes that would be necessary to reduce the trajectory of federal health spending by a significant amount.

SIMON: That's just about the last thing Democrats on Capitol Hill wanted to hear. So President Obama stepping in to try to make certain the effort stays on track.

NPR's Julie Rovner reports.

JULIE ROVNER: CBO Director Elmendorf's comments were widely interpreted to mean that the plans would increase the federal deficit over the next 10 years. That's not true. But what he was really saying was perhaps more disappointing to lawmakers crafting the bills, that the measures wouldn't slow the nation's total health spending in the long run and might in fact increase federal spending. And in any case, the political damage was done. President Obama hastily scheduled an appearance to reassure lawmakers that cost-cutting remained his top priority.

President BARACK OBAMA: Let me repeat, health insurance reform cannot add to our deficit over the next decade. And I mean it.

ROVNER: The administration also sent to Congress its own legislative proposal to aid in the cost-cutting goal, its first formal contribution to the health care effort. The idea is based on one that's already been floating around on Capitol Hill for the past several weeks. It would significantly beef up the power of an existing agency known as the Medicare Payment Advisory Commission, or MEDPAC.

Here's how the president described it.

President OBAMA: Every year there's a new report that details how much waste and inefficiency there is in Medicare, how best practices are not always used, and how many billions of dollars could be saved. Unfortunately this report ends up sitting on a shelf.

ROVNER: Under the president's plan, MEDPAC, or a new independent board just like it, would come up with a set of payment recommendations for health care providers, which the president and Congress could approve or reject but not amend. If the commission was ordered to find savings, the process would clearly bend the cost curve, as the phrase goes, on health spending.

But there's one big problem: Congress likes to decide Medicare payments itself. There are hospitals and doctors in every single congressional district, and adjusting payment levels is a popular form of congressional pork. So giving that payment power to outsiders hasn't sat well with people like Senate Republican moderate Olympia Snowe of Maine.

Representative OLYMPIA SNOWE (Republican, Maine): I think people ultimately expect Congress to weigh in and be accountable. We'll be held accountable, and just doing an up or down vote without ever having, you know, alternative proposals and modifications I think would be very difficult.

ROVNER: House Speaker Nancy Pelosi didn't seem too thrilled with the idea either at her news conference yesterday.

Representative NANCY PELOSI (Democrat, California): We've tasked the staff to figure out how we could come together so that we get the savings but the responsibility of Congress would be reflected in the criteria we put forth, and that the administration can have what they want.

ROVNER: In other words, it's always the same old story with Congress: spending money is easy, cutting spending is hard.

Julie Rovner, NPR News, Washington.

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