“House Republicans attacked the 2010 healthcare law Wednesday for expanding a preventive care grant program that allegedly funded pet spaying and neutering in Tennessee. A statement from Energy and Commerce Committee Republicans also blasted grants they said paid for urban farming initiatives and the improvement of city bike lanes.”

“This year, the actuaries incorporated a more realistic ‘alternative scenario’ for future Medicare spending directly into the trustees’ report. The alternative scenario drops the unrealistic cuts from Obamacare and assumes a permanent ‘doc fix’ to prevent deep cuts in physician reimbursement rates. With these more realistic assumptions, Medicare spending is still headed through the roof. Indeed, in 2085, under the alternative scenario, Medicare spending would reach 10.5 percent of GDP, up from 3.7 percent today.”

“So how is Medicare, the nation’s biggest health care entitlement, doing now? Not so well. Two years after the passage of the Patient Protection Protection and Affordable Care Act, the program’s Trustees are reporting that the seniors’ health program is on a glide path to insolvency—perhaps by as soon as 2016. The technocratic reforms that were supposed to remake the program aren’t working nearly as well as hoped.”

“The nonpartisan Government Accountability Office said it’s not clear that the $8.3 billion Medicare Advantage bonus program will improve quality because most of the money is going to plans just rated average. The auditors did find, however, that the bonuses would temporarily ease the pain of unpopular cuts to insurance plans under President Barack Obama’s health care overhaul law.”

“The most oppressive aspects of the ObamaCare law don’t kick in until after the 2012 election, when the president will no longer be answerable to voters… But certain voters would surely notice one highly painful part of the law before then — namely, the way it guts the popular Medicare Advantage program… But the administration’s devised a way to postpone the pain one more year, getting Obama past his last election; it plans to spend $8 billion to temporarily restore Medicare Advantage funds so that seniors in key markets don’t lose their trusted insurance program in the middle of Obama’s re-election bid.”

“Last week the Mercatus Center published my study showing that the health care law of 2010 (the ACA) will add at least $340 billion to federal deficits over the next ten years, and more than $1.15 trillion to net federal spending. The study has received a great deal of attention, which has highlighted the need for wider public understanding of federal budget procedures. In this article I will explain some of those budget rules while further substantiating that my basic conclusion is correct.”

“But it is telling that this progressive champion of higher taxes, who delivers viral mini monologues about the greatness of giving back and paying one’s corporate fair share in exchange for valuable government services, can so easily transform her Senate campaign into a vehicle for obvious industry talking points. This is one of the reasons why the cost savings schemes in the 2010 health care overhaul probably won’t work. Those provisions generally save money by either taxing someone’s benefits (specifically the sort of expensive health plans held by many union members) or reducing someone’s payments (higher payments to Medicare advantage plans).”

“In March, the CBO released a new study on employee migration out of job-based plans and into Obamacare’s state exchanges. The effect of ObamaCare on employer-based insurance has been hotly debated ever since the law was enacted in March 2010. Several independent analysts predict that ‘dumping’ into the exchanges will occur at a much higher rate than CBO assumed in its original estimates of ObamaCare and argued that the result would be much higher federal costs than CBO estimated.”

“The ACA unambiguously worsens federal finances. As the accompanying graph shows, under a variety of possible assumptions (all based on the analyses of CBO and CMS), our annual deficits will be much larger because of the ACA than they would have been under prior law.”

“The health law’s backers relied on—and are still hiding behind—government budgeting conventions in order to argue that the law will result in lower overall deficits relative to expectations about the current fiscal trajectory. No matter how you run the numbers, the law can be expected to increase both total federal health spending and deficits.”