The fallout over the report reveals the kind of political pitfalls that Pence is increasingly facing as he emerges as one of the most important figures in the administration. The vice president must deal with the baggage from the administration's actions and President Trump's statements.
Over the past few weeks, Pence has been playing a number of important roles inside the administration. The most important is that he has become a bridge to the conservatives on Capitol Hill, trying to calm nerves over bills like the health care reform.
In this role, Pence is facing some of the challenge that then-Vice President Walter Mondale confronted when he had to sell President Jimmy Carter's more controversial ideas, like energy conservation and fiscal austerity, to a Democratic Congress that was hoping for another Great Society, not some kind of middle way.
Mondale, previously a senator from Minnesota who had impeccable liberal credentials with his former colleagues in Congress, worked hard to persuade Democrats that Carter, despite his unorthodox ways, still was on the same political page. His efforts were only of middling success as Carter ultimately proved to be unpopular with Democrats despite Mondale's efforts.
Pence has a better chance of succeeding since, generally, Trump is not doing much to depart from the party agenda, unlike the way that Carter did with the Democrats. This is a debate over how conservative to be in going after the Affordable Care Act, not whether to stick to the political middle.
Now with the CBO report, Pence will be needed more than ever. Not only does he need to sell the conservatives that this not "Obamacare Lite" but a serious move in the right direction toward market-based health care. He also needs to persuade moderates that this bill is still worth the political risks that could result from rolling back health care coverage for millions of people.
If Pence can pull this off he will emerge from this battle as a real power player within the White House. The only thing that has insulated President Trump thus far from the ongoing attacks by Democrats, the relentless investigations from the news media, and the growing scrutiny of the courts is the Republican Congress.
President Trump, the divider, is depending on the fact that partisanship will hold and that in the end the Republican Congress will not abandon him or, even worse, turn against him. Until that happens it will be very difficult for any Democrat to make headway against this White House. So, if the vice president can get them through this challenging moment with an actual piece of legislation and without an open right-wing revolt, the President will keep turning to him as his point man on the Hill.
Pence has also become an important voice on foreign policy, The president sent him to Europe to help ease concerns among U.S. allies about Trump's commitment to NATO. Pence is taking a lead role in deliberations with Japan.
The vice president is also being used as the "clean-up man in chief." After many of the President's more controversial statements and decisions, Pence has stepped in to try to smooth things over.
When Trump attacked the "so-called" judge who halted his first executive order on immigrations, Pence took to the airwaves to justify the attack. Pence tweeted out that the administration joined the "Jewish people" on Holocaust Remembrance Day after the White House came under fire for having rejected the State Department draft of a statement that mentioned Jews.
Pence has also been important in the appointment process. A number of people who Pence considered allies are now in the administration, including former Indiana Sen. Dan Coats, who the Senate confirmed as director of national intelligence, and Marc Short, one of Pence's former aides who has been named legislative affairs director for the President.
Pence is clearly looking to solidify his credentials not just to have greater standing in this White House but also to keep making the case that he is one of the most promising prospects as a Republican presidential candidate for future elections.
His commitment to the right is already well-established. What being vice president offers Pence is the ability to show that he can govern and that he can be a conservative leader with polish.
The biggest threat for Pence is that the bigger his role becomes the more he will suffer from the baggage of the current administration. Besides the tensions over health care there are the scandals. With the Russiagate investigation looming large over the White House, as steady drips of information keep raising questions about what happened in the 2016 election, Pence has to beware the possibility of becoming part of a historic political scandal.
If things go south for Trump through scandal, failed legislation, or diminishing approval ratings among Republicans, Pence will be seen as part of the problem as well. He would do well to remember the fate suffered by Walter Mondale, who could never overcome Carter's shadow when he ran in 1984.
Clearly, Pence is willing to take this risk as was evident when he first signed up for this job last summer. In the coming days, he will have to show that he can live up to this difficult challenge as he tries to shore up the president's support amid the furor over health care.