Nobody likes the referee.

Just ask Congressional Budget Office Director Douglas Elmendorf, who has been taking heat from all sides in recent weeks for his agency’s handling of health care reform.

It goes with the territory. The CBO probably isn’t doing its job as independent arbiter if it isn’t ruffling a few feathers, and its budget scores are sometimes treated as holy writ and can make or break bills, although they are merely an educated guess.

“Everybody hates them,— said one House Democratic aide, half tongue-in-cheek. “It’s important to have an independent analysis of legislation, but there’s clearly been a lot of frustration with the CBO from both sides of the aisle.—

Democrats have been annoyed at the CBO for deciding not to consider as savings the money spent on preventive health care measures. And both parties have voiced frustration with the CBO’s pace, saying it’s taking far too long for the agency to deliver essential cost estimates on their health care plans.

Elmendorf notes that this year has been chock full of big issues, and his agency is working overtime to keep up.

“We’re facing overwhelming demand on health care, climate change and many other issues, and we are working flat out,— Elmendorf said in an interview, adding that the CBO is trying to meet as much of the demand “from House and Senate and Democrats and Republicans as [it] can.—

That includes having to turn around comprehensive analysis of thousands of pages of incredibly complex legislation in mere days.

Elmendorf also is prepared to strongly defend the wisdom of the 250-employee-strong CBO. “The Congress is paying us to evaluate the evidence and form an independent, objective view of the effects of policies, and they are paying us to stand firm and defend these views, even when they are unpopular with certain Members of Congress,— he said.

Senate Democrats last week were bristling at a CBO directive to not talk about the details of the health care reform bill that Senate Majority Leader Harry Reid (D-Nev.) sent along.

Democrats said that even members of the Senate Democratic Conference remain in the dark about many proposals Reid is exploring. That’s because the CBO has vowed to release everything Reid has asked the agency to score if Democrats talk publicly about them.

Reid doesn’t want all elements of the bill he sent to the CBO released because he does not anticipate including every scored provision in the final product. Instead, Reid has asked the CBO to score several different versions of various policy options so that he can pick and choose which ones fit best in the bill, Democratic sources said. Releasing cost estimates of portions that do not make it into the legislation could still be used as a rhetorical weapon by its critics, Democrats argue.

Elmendorf addressed the issue of public CBO scores versus private scores in an Oct. 21 blog post.

Elmendorf said on his blog that the CBO has a long-standing policy of only honoring requests for confidentiality on proposals that have not been made public.

Sen. Jeff Merkley (D-Ore.), a former CBO defense policy analyst, said it’s not unusual for the agency to require tight lips in return for confidentiality.

“I don’t know the details of [Reid’s] interaction with CBO on this issue, but what they’re seeking to do is be consistent,— Merkley said. “If they are providing a confidential score to be used for internal insights, then they can keep it confidential. But if it’s to be used for public debate, then the full — it can’t be cherry-picked — then the full scope of the details need to be in the public realm so everyone can debate it fairly.—

Some House Republicans have also complained that they have had a hard time getting answers from the CBO.

Rep. Dave Camp (R-Mich.), ranking member of the Ways and Means Committee, “has been prepping a bill all year in case the [leadership] needed one and experienced many delays and frustrations with the pace of CBO,— a GOP aide complained.

Back-bencher Rep. Louie Gohmert (R-Texas) also ripped the agency as “lapdogs— on the House floor last week for refusing to score Republican health care plans. But the CBO generally has scored bills only when they are put forward by leadership or ranking members, and Republican leaders have yet to produce a health care bill in either chamber.

House Minority Leader John Boehner (R-Ohio), however, said Monday he has finally delivered his party’s health alternative to the CBO and said he expects to get it back in plenty of time for a final vote.

Elmendorf has also sparred with Senate leadership, generating the ire of Reid when he suggested at a hearing in July that a way to cut health care costs would be to adopt a politically unpopular tax on health insurance benefits. Asked about Elmendorf’s comments at the time, Reid quipped, “What he should do is maybe run for Congress.—

Elmendorf also locked horns with a visibly annoyed Senate Finance Chairman Max Baucus (D-Mont.) in September as Baucus was attempting to push his health care package through his committee in time to have a measure on the floor in early October.

Elmendorf told the Finance panel that it would “take some time— to complete a score of the amended bill, and Baucus pushed back.

“We want the CBO to be relevant on the most important issues facing us. And certainly a preliminary score and some of the most important amendments will make CBO relevant,— Baucus told Elmendorf. “I can’t overemphasize how important this point is.—

But Elmendorf held his ground, arguing that CBO analysts can only move so fast.

“We have turned around a vast amount of material for you. But there are limits,— Elmendorf said.

He added later, “I think a very important part of my judgment as director, Mr. Chairman, is what that maximum safe speed is. And — and what — we’re not sitting around obsessing over the fine decimal places, if that’s your concern. But we — but to get the analysis right, we need to think about what is proposed in the amendments, the effects it would have.—

In the end, the “maximum safe speed— ended up being about six days. But Baucus had promised Senators the ability to review the cost estimate before voting, which meant 12 days ultimately elapsed between the end of the bill’s markup and the final vote.

At a press conference in September, Elmendorf also addressed concerns that the CBO is not properly scoring the cost savings many Democrats assume will come from wellness programs in their health care reform bills.

“We do try to look ahead a little bit, but it is hard to be specific in quantifying effects,— Elmendorf told reporters Sept. 24.

He also noted, “Not everything that’s good for health is good for the budget.—