“Since passage of the Affordable Care Act (ACA), the American Action Forum (AAF) has tracked the state of its regulatory implementation. To date, the ACA has imposed a total of $27.6 billion in new regulations – at least $20.4 billion in lifetime costs on private entities and $7.2 billion in increased burdens on state budgets. In this paper AAF examines how this $27.6 billion in new costs break down on a state-by-state level. The data show that five states will endure at least $1 billion in ACA regulatory costs.”

“At first glance, it would seem that this graph vindicates the ACA – come 2021, the difference in growth rates between NHE pre-and-post ACA have fallen to less than a percentage point. What they gloss over, however, is the massive spike in growth rates starting in 2014, when the ACA’s coverage provisions go into effect. This adds to the absolute cost of the ACA over time, even though the growth rate slows down eventually, based on projections.”

“Unless Obamacare is repealed, it will add $1.7 trillion in new spending. That much is certain. Any offsetting reductions are dubious, at best. Budgetary analysis and historical experience point to the same conclusion: If fully implemented, Obamacare will drive up health costs for all Americans and widen the river of government spending and debt.”

“But although Romer is right about the severity of the problem, she is dead wrong about ObamaCare’s role in addressing it. ObamaCare did not lay the foundation for sensible cost control, and did not partially ease budgetary pressures, as she asserts. Quite the contrary, ObamaCare will pour an ocean of gasoline on the health entitlement fire, and the supposed cost-control mechanisms are a mirage.”

“It turns out that, even when you compare the years that are common to each CBO report, a clear trend emerges. Today, the CBO believes that Obamacare will spend more money, raise more tax revenue, and reduce the deficit less than the agency thought in 2010. And things could get worse.”

“The Congressional Budget Office (CBO) has just published, in two reports, its updated score of the 2010 health care law. The new score is bad news from almost any vantage point. CBO’s fiscal evaluation of the law is worse than before, even though the number of people receiving health insurance coverage is now projected to be fewer.”

“Much attention has been given to the argument that without the individual purchase mandate, other parts of the health care law would become unworkable. Much less attention has been given to the fact that without the states forced to be on board with the Medicaid expansion, the law’s health exchange subsidies might be fiscally unworkable. The Supreme Court may have just set in motion of chain of events that could lead to the law’s being found as busting the budget, even under the highly favorable scoring methods used last time.”

“Reconciliation allows a bill to pass the Senate in a limited time period, with limited amendments, and with only 51 votes; filibusters are not permitted. In 2010, Democrats split their health-policy changes into two bills, one of which they enacted through this fast-track process. In 2013, a Republican majority could use the same reconciliation process to repeal those changes.”

“For states, this is a clear winner – covering more individuals and saving budget dollars at the same time. For the taxpayer this is a nightmare. The taxpayer would save some money on the Medicaid expansions that would not take place (where the feds pay 90 percent of the cost) but they will pick up the full cost of the additional and generous insurance, bearing an additional $500 billion over ten years.”

“The following are just four of the worst features of Obamacare; there are many other aspects of the law that would be damaging. And all of these features could remain threats to the strength of the economy and quality of American health care if the Court upholds the law or severs the unconstitutional provisions from the rest of the legislation. That is why Congress must stand ready to repeal the rest of Obamacare in the event that the Court does not invalidate the entire thing.”