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Most people have never heard of Douglas W. Elmendorf. But all of official Washington is waiting to hear what he has to say.

Elmendorf, a mild-mannered economist with a Harvard Ph.D., runs the Congressional Budget Office, the nonpartisan agency charged with assessing how legislation, like President Barack Obama’s proposed health overhaul, would affect the federal budget. His detailed analyses — “scores” in Washington argot — are highly educated guesswork but are more or less the final word, making him a combination oracle and judge on many of the biggest issues of the day.

Now Congress is awaiting Elmendorf’s judgment on a health bill that the Senate hopes to begin considering soon. He is in the thick of analyzing whether the bill, being drafted by Sen. Harry Reid, D-Nev., the majority leader, in close consultation with the White House, accomplishes what it promises at its advertised cost. In search of a favorable outcome, Reid has been submitting variations to Elmendorf for weeks.

A thumbs-up from Elmendorf could speed the process along, helping Obama fulfill his hope of signing a bill into law this year. A thumbs-down on any of the critical questions — how much the bill costs, how many people it covers, whether it reins in the runaway growth of health spending — could leave the White House and Democrats scrambling.

Democrats, who have been chafing at his calculations, sound nervous.

“He’s a good person, you know, but how they evaluate costs and benefits is very frustrating,” said Sen. Christopher J. Dodd, D-Conn. “They can tell you how much a treadmill costs, but they’re unwilling to calculate what the benefit is if somebody actually uses it, loses weight and therefore reduces premium costs. So you get a kind of one-dimensional view of budgeting.”

Elmendorf — bearded, bespectacled and cautious to a fault — shuns publicity and almost never appears on television, except for the occasional hearing shown on C-Span. He and his team of number crunchers occupy the cramped fourth floor of a government building that once housed FBI fingerprint files. His own office has a view of the freeway.

His work has earned him respect on both side of the aisle. Yet he also has critics who complain that he is making it harder for Democrats to pass health legislation by using methods that tend to exaggerate cost and underestimate savings.

Elmendorf said he is simply following the agency’s time-honored approach to producing “independent, objective analysis” and “letting the chips fall where they may.”

Yet for a quiet man who thinks carefully about everything — he courted his future wife by inviting her to a baseball game, after calculating that games offer precisely enough activity to fill in conversation lulls — Washington’s health care cauldron is an uncomfortable place to be. He is a Democrat who left partisan politics to join the budget office in January, and he is irking old friends.

“I get e-mail messages and read blog postings that think I’m a brilliant hero, and I also get blog postings and e-mail messages that think I’m a stupid traitor, and I’ve learned to let that roll off my back,” he said.