Federal spending on major health care programs will jump by $104 billion, or 11.1%, this year, according to Congressional Budget Office estimates published on Monday.

Those figures include a $24 billion increase stemming from a shift in the timing of certain Medicare payments from 2017 into 2016. Today’s CBO figures are a detailed version of the broader estimates published last week.

The nonpartisan CBO projected in its 2016-2026 Budget and Economic Outlook that spending on federal health programs will make up 5.5% of the country’s gross domestic product this year, and reach 6.6% by the end of 2026.

After the passage of the Affordable Care Act, the federal government gave Oregon $300 million to build an online health insurance exchange. The state then hired Oracle, the world’s second-largest software company, with profits of nearly $10 billion last year, to build the website.

The website never worked. In May 2014, then-Gov. John Kitzhaber, who was running for re-election and getting a lot of heat for Cover Oregon’s failure—asked Attorney General Ellen Rosenblum to sue Oracle.

For nearly two years, Oracle has been in a bruising, $5.5 billion legal battle with the state of Oregon over who is at fault for Cover Oregon, the failed $300 million health insurance website.

Last week’s seven-candidate debate hosted by the Fox Business Network once again found much to discuss in terms of national security issues, immigration law enforcement, even a little economic policy, and, of course, the latest round of character attacks and counter-attacks. Still missing in action: at least the first subcutaneous probe of where the respective candidates stand on health policy issues.

Based on recent performance, it’s questionable whether health policy has attracted sufficient interest among the media and Republican primary voters to command more than a few seconds on the debate stage. But it’s not for lack of potential lines of inquiry.

Here are some questions to the candidates from Tom Miller of the American Enterprise Institute that still await new rounds of oversimplified, evasive, or (one might hope) thoughtful answers.

A Senate Committee on Homeland Security and Governmental Affairs chairman wants the federal government to disclose how much money taxpayers lost because of the rapid-fire financial collapse of 12 Obamacare health insurance co-ops, The Daily Caller News Foundation has learned.

Sen. Ron Johnson demanded in a Jan. 19 letter to the Centers for Medicare and Medicaid Services (CMS) that federal officials provide full accounting for the losses. A part of the Department of Health and Human Services, CMS oversees the experimental co-op program.

 

Sen. Sanders claims he can provide free health care for all Americans even while saving $6.3 trillion over the next 10 years. In truth, the actual cost of the Sanders health plan will be at least 40% more than he claims. In the worst case, it will be 49% higher.

Moreover, the increase in federal taxes required to fund his plan will not be the $13.8 trillion claimed by the economics professor who is advising Sanders, nor even the $28 billion estimated by fellow Forbes colleague Avik Roy: the new federal taxes required to fund the Sanders health plan will be $36.3 trillion!

In short, the Sanders health plan would require a 71% increase in federal spending over the next decade.

The decision states face of whether to expand Medicaid to non-disabled, working-age, childless adults—the Affordable Care Act primary expansion population—involves tradeoffs. These tradeoffs include higher taxes, reduced spending on items like education, transportation, or infrastructure, or reduced spending on other Medicaid populations such as the disabled, children, or the elderly. The ACA funding formula allows states to pass a much greater share of the costs of covering non-disabled childless adults to federal taxpayers, but the tradeoffs still exist.

On Sunday, January 17—hours before the Democratic presidential debate on NBC—Vermont Senator Bernie Sanders released details of his proposal to replace the entire U.S. health care system with a universal, government-run, single-payer one. In Sanders’ eight-page campaign white paper, entitled “Medicare for All,” the self-described “democratic socialist” outlines his plan’s core principles.

Warren Gunnels, Sanders’ policy director, retained Gerald Friedman, an economist at the University of Massachusetts at Amherst, to come up with a fiscal score of the Sanders plan. Friedman estimates that the plan would require $13.8 trillion in new government spending in the decade spanning 2017 through 2016. Avik Roy of the Manhattan Institute outlines why that estimate is far too low.

While Democrats are quite eager to point out that ObamaCare has reduced the number of uninsured by 17.6 million, they have conveniently failed to point out that in 2014, American taxpayers effectively paid about $6,000 for each person who became newly covered due to ObamaCare.

Is it really worth reducing worker wages by $1,200 apiece just to cover 2.3 million young adults? And leaving aside all the chaos created by millions of cancelled policies, premium increases paid by tens of millions who received no taxpayer subsidies whatsoever to soften the blow and similar market dislocations, are ObamaCare defenders really prepared to claim that it is worth paying $6,000 apiece to reduce the ranks of the uninsured?

President Obama is proposing to boost federal funding for states that choose to expand Medicaid under ObamaCare in a new effort to entice states to make the move.

Obama will propose in his 2017 budget to have the federal government pick up the entire cost of expansion for three years, no matter when a state decides to accept the expansion.

Under current law, states only got three years of full federal funding if they accepted the expansion in 2014. If nothing changes, states newly accepting the expansion would not get full federal funding after 2016 and instead would get payments that are somewhat less, eventually dialing back to 90% of costs.

The flurry of budget deals struck by congressional Republicans with President Obama in the final months of 2015 will increase the federal debt by hundreds of billions of dollars in the coming decade. They also make it clear that the true state of U.S. fiscal policy is far worse than shown in official projections — which are based on policies that are not going to survive over the long run.

James C. Capretta of the Ethics and Public Policy Center explains how the budget deals will affect the implementation of ObamaCare and ultimately the U.S. economy.