“The Supreme Court’s decision on the 2010 healthcare law may result in what appears to be a fiscal windfall for the federal government. But it would be a grave mistake for lawmakers to react to illusory savings with real new spending. To illustrate this point, let’s look at a few of the possible Supreme Court rulings—and their projected fiscal consequences.”
“But it’s not supposed to provide more coverage for the same dollars. It’s supposed to provide it for fewer dollars. Remember all the talk about how ObamaCare would ‘bend the cost curve down’? No doubt many of ObamaCare’s backers would prefer that you forget. When the cost curve remains the same or, as will almost surely happen, bends upward, they’ll be taking cues from the backers of RomneyCare in Massachusetts.”
“IPAB’s unelected members will have effectively unfettered power to impose taxes and ration care for all Americans, whether the government pays their medical bills or not. In some circumstances, just one political party or even one individual would have full command of IPAB’s lawmaking powers. IPAB truly is independent, but in the worst sense of the word. It wields power independent of Congress, independent of the president, independent of the judiciary, and independent of the will of the people.”
“This year the biggest looming question has been whether fledging payment revisions in Obama’s law, also mirrored by private insurance plans, are succeeding in holding costs down. The rate of growth the past three years has hovered under 4 percent, historically low. That’s coincided with a shift to paying hospitals and doctors for better quality, not just their sheer volume of tests and procedures. Obama has argued that his overhaul would begin to ‘bend the cost curve’ to more affordable levels. The analysts remained skeptical.”
“Early this year, I was briefly involved with one of the Affordable Care Act’s bureaucracies called the Center for Medicare and Medicaid Innovation, or CMMI. Despite its lofty ideals, it is one more pork program and venue for political cronyism, as I learned firsthand.”
“Perhaps you thought that the Affordable Care Act is all about making insurance more affordable. Too bad no one told Americans that the law also turned the Health and Human Services Department into a giant venture capital investor for health care. This won’t turn out well. Awash in ObamaCare dollars, HHS has a growing investment portfolio that includes everything from new insurance companies to health-care start-ups to information technology.”
“There is bipartisan concern that the IPAB could harm Medicare and limit access to care for seniors. The IPAB is a panel of 15 unelected, unaccountable government bureaucrats empowered to ‘reduce the per capita rate of growth in Medicare spending.’ In the text of the healthcare law, it states that while the law prohibits ‘any recommendation to ration health care,’ it does not prohibit slashing payments to physicians and other medical providers.”
“A lot of people have been justly offended by the Solyndra scandal, in which the Obama administration squandered $535 million in a failed solar-energy company backed by one of Obama’s largest donors. But $535 mill in failed loans is chump change for this administration. Obamacare, according to the White House, will waste over $3 billion on faulty loans to state-sponsored health insurers called CO-OPs.”
On Monday, e21 sponsored a discussion, moderated by National Journal’s Major Garrett, between Charles Blahous and Jared Bernstein. The topic was Blahous’ recent paper entitled “The Fiscal Consequences of the Affordable Care Act” (published by the Mercatus Center of George Mason University). Click through for post-debate commentary from Jim Capretta, to watch the video, and read the presentations.
“The health reform law changes that: It raises Medicaid rates for primary care to match those of Medicare for 2013 and 2014. That, the Obama administration hopes, will lure doctors to accept Medicaid patients — and also prevent some costly emergency room visits down the line. But there’s a problem: The payment boost runs out at the end of 2014. While the federal government estimates that it will spend $11 billion raising provider rates for 2013 and 2014, no additional federal funds are appropriated beyond that. There’s already some thinking, among the health-care provider community, that a fierce lobbying battle could play out as doctors look to turn a short-term pay boost into a permanent one.”