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Author Topic: How much will ObamaCare cost?
LetterRip
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JWatts,

quote:
First, if the person is still working full time, they are not collecting full social security. You lose benefits the higher your salary and the base line is minimum wage.
reread the link please. Ie even in your quote it mentions the retirement reduction is only if the person is 'younger than full retirement age'.

Also you seem to think the person who gets employed would only be getting unemployment benefits. I'm not sure that is a reasonable assumption. Why not food stamps, and other benefits?

Regarding Pyrs statement - drawing down and spending her pension actually could have a significant positive economic and tax impact - note that at the time of withdrawal that pension that was being contributed to tax free is now subject to taxation, so that could well offset any tax revenue decline from retiring.

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G2
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An update on the true cost of the BFD:
quote:
Federal payments required by President Barack Obama’s health care law are being understated by as much as $50 billion per year because official budget forecasts ignore the cost of insuring many employees’ spouses and children, according to a new analysis. The result could cost the U.S. Treasury hundreds of billions of dollars during the first ten years of the new health care law’s implementation.
For the public school grads, that comes out to $500 billion dollars over the next 10 years.

A half trillion dollar error? How did that happen? Easy:
quote:
“The Congressional Budget Office has never done a cost-estimate of this [because] they were expressly told to do their modeling on single [person] coverage,” said Richard Burkhauser in a telephone interview Monday.

<snip>

In May a congressional committee set the accounting rules that determine who will qualify for federal health care subsidies under the 2010 Patient Protection and Affordable Care Act. When the committee handed down the rules to the Congressional Budget Office, its formula excluded the health care costs of millions of workers’ spouses and children. The result was a final estimate for 2010 that hides those costs.

Of course, anyone with half brain knew the cost savings was a lie. Now the truth is coming out and it ain't pretty.
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Pyrtolin
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So the claim is that it would cost $500 billion less to have their families on Medicaid instead? Or that family insurance is more expensive than each person buying their insurance separately? Those are about the only two options for how such a conclusion could be reached given the two possibilities for where the other individuals in the family were then counted.
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Wayward Son
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Here's a link to the article G2 is referring to.

It sounds like the government is promising to subsidize health care for those who can't afford it. The estimates of how much this subsidy would cost was underestimated, because it only calculated the costs for individual insurance, not for family insurance, which is obviously higher. So more people pass the threshhold for assistance when the whole family is insured, which means the subsidy will cost more.

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Pyrtolin
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That's all well and good, but, if you have a family of four, calculating the cost for individual insurance vs family insurance would be the cost of insuring those four people as individuals vs insuring them as one family. So either family insurance costs more than 4x what individual insurance would, thus meriting a higher subsidy, or the other family members were calculated into Medicaid costs, because they weren't considered employed.

Most likely it's better than a wash in the favor of a surplus, because if people are being covered as a family instead of putting everyone else on Medicaid, the Medicaid numbers would drop significantly.

And even if the cost is higher, all that really does is reflect the net additional value created by providing those services to more people with more jobs created for doctors and other medical personnel in the process.

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G2
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quote:
Originally posted by Pyrtolin:
Most likely it's better than a wash in the favor of a surplus, because if people are being covered as a family instead of putting everyone else on Medicaid, the Medicaid numbers would drop significantly.

No, it's not. Read the article, it's $50 billion more per year. Not a wash and no matter how many times you repeat it, it won't become one.

quote:
Originally posted by Pyrtolin:
And even if the cost is higher, all that really does is reflect the net additional value created by providing those services to more people with more jobs created for doctors and other medical personnel in the process.

WTF? So even if you're totally wrong, it's still good! Nice, no matter what this works perfectly in the land of Oswald Bates. Your grasp of what's really happening is obscured by the ideological theory you cling to. [Roll Eyes]

[ August 10, 2011, 10:40 AM: Message edited by: G2 ]

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Pyrtolin
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quote:
So even if you're totally wrong, it's still good!
No, actually, if I'm wrong, it's better, because it means they under estimated the amount of employment and financial benefit to the public that would be created by the bill, and it meas that we'd actually producing that much more money to work toward getting our economy back on track.
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G2
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quote:
If employers dump many of their workers onto the exchanges, as numerous independent analyses suggest is likely, taxpayers may need to spend as much as $200 billion a year extra on these exchange subsidies. Well, it turns out that the Obama Administration agrees that initial spending estimates are too low. The White House’s fiscal year 2013 budget adds $111 billion in exchange spending between 2014 and 2021, with even more spending to come in future years.

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AI Wessex
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From the author's full article:
quote:
Administration officials say the big increase from last year’s estimates is no cause for alarm and that the administration is not forecasting an erosion of employer coverage or higher insurance costs.

About two-thirds of the increase is due to effects of newly signed legislation that raises costs for one part of the health care law, but still saves the government money overall. The rest is due to technical changes in Treasury assumptions about such matters as the distribution of income in America.

“The estimates do not assume changes in what exchanges look like, the cost of insurance, or the number of Americans who will get their insurance in this new marketplace,” Treasury spokeswoman Sabrina Siddiqui said in a statement Friday.


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JWatts
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"About two-thirds of the increase is due to effects of newly signed legislation that raises costs for one part of the health care law, but still saves the government money overall. The rest is due to technical changes in Treasury assumptions about such matters as the distribution of income in America."

That still translates to the law will be billions more costly than advertised. And I suspect an extra $66 billion between 2014 to 2021 to be unlikely.

The CBO is updating it's estimates on Obamacare projected costs this month.

For reference from the original CBO estimate:
quote:
CBO and JCT estimate that, on balance, the direct spending and revenue effects of
enacting the Patient Protection and Affordable Care Act would yield a net reduction in
federal deficits of $130 billion over the 2010-2019 period

CBO

[ March 12, 2012, 05:41 PM: Message edited by: JWatts ]

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Greg Davidson
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"Researchers writing in the New England Journal of Medicine believe that the growth in per patient Medicare costs has slowed, contra earlier projections that spending would soar at an unsustainable rate"
Slower Growth in Medicare Spending

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AI Wessex
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JWatts, if you think the original numbers are incorrect (they have to be since they are based on population, medical cost and income assumptions), why do you think the numbers you have just become aware of are accurate? You know that assumptions have to be adjusted over time. I want to learn more about what the Administration's explanation means, but it's a good thing that they make those explanations publicly. I haven't seen very many adjustments to claims on the other side of the discussion, since that might weaken their arguments.
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JWatts
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quote:
Originally posted by AI Wessex:
JWatts, if you think the original numbers are incorrect (they have to be since they are based on population, medical cost and income assumptions), why do you think the numbers you have just become aware of are accurate?

Obamacare was carefully designed to provide a misleading estimate of costs. The 10 year projection window of the CBO was gamed along with the 4 year election cycle, by making the taxes and costs kick into full gear in the 2013 to 2014 time frame.

And I don't think the current numbers are particularly accurate, I expect them to go up further.

quote:
Originally posted by AI Wessex:
You know that assumptions have to be adjusted over time.

This isn't a simple adjustment. The 10 year CBO window was gamed to make costs appear a lot cheaper than they were. It's an open secret. Anyone looking at the numbers realizes it was intentional. It's not like the full costs kicking in after the next election is a secret or anything.


quote:
Originally posted by AI Wessex:
I want to learn more about what the Administration's explanation means, but it's a good thing that they make those explanations publicly.

The Administration hasn't revealed anything. The CBO is revising the estimates based upon current conditions and the shifting 10 year window. The CBO is non-partisan and the Obama administration can't prevent them from publishing the numbers when requested. The costs were heavily back loaded at the time of the bills initiation to claim artificially low numbers.

quote:
Originally posted by AI Wessex:
I haven't seen very many adjustments to claims on the other side of the discussion, since that might weaken their arguments.

I don't even know what you mean here. The opposition has consistently claimed the Obama administration low balled the numbers and that they would escalate drastically as the expensive features of the bill started kicking in. That's exactly what is happening. To claim this weakens the oppositions argument is incomprehensible.
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JWatts
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And here are the new CBO projections which are in. And they aren't even close to Obama's original claim that Obamacare would reduce spending.


quote:
CBO and JCT now estimate that the insurance coverage provisions of the ACA will have a net cost of just under $1.1 trillion over the 2012–2021 period—about $50 billion less than the agencies’ March 2011 estimate for that 10-year period

The net costs reflect:
* Gross additional costs of $1.5 trillion for Medicaid, the Children’s Health Insurance Program (CHIP), tax credits and other subsidies for the purchase of health insurance through the newly established exchanges and related costs, and tax credits for small employers,

* Offset in part by about $0.4 trillion in receipts from penalty payments, the new excise tax on high-premium insurance plans, and other budgetary effects (mostly increases in tax revenues).

So the Federal government is going to incur additional costs of $1.5 Trillion and offset $400 billion through additional taxes.
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G2
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quote:
Originally posted by JWatts:
And here are the new CBO projections which are in. And they aren't even close to Obama's original claim that Obamacare would reduce spending.


If only someone had seen this coming! Oh ... wait ...

quote:
Originally posted by G2 on March 19, 2010 11:33 AM:
Add it all up, we get the 10 year rough estimate coming in around 1.5 trillion.

That is the low number. Having never seen the estimate for a government scheme do anything but exceed estimates, it's pretty fair to say we'll go well above that number over the next 10 years.

And here's the CBO:
quote:
oday, the CBO released new projections from 2013 extending through 2022, and the results are as critics expected: the ten-year cost of the law's core provisions to expand health insurance coverage has now ballooned to $1.76 trillion.
What!?!? Why did this happen!?!?
quote:
That's because we now have estimates for Obamacare's first nine years of full implementation, rather than the mere six when it was signed into law.
If only, IF ONLY, someone had known. Oh ... wait ...

quote:
Originally posted by G2 on March 19, 2010 11:33 AM:
See how the costs are scored in the first 4 years? That's because this really doesn't kick in until 2014 - another part of the shell game to make this seem cheaper than it is.


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cherrypoptart
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With all of this talk about costs, I'm still genuinely curious about something. Does this cover dental?
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Pyrtolin
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quote:
The costs were heavily back loaded at the time of the bills initiation to claim artificially low numbers.
That would only make sense if the long term projections were worse, not better than the short term numbers. The timeline was shifted to meet the magic number for the total initial 10 year outlays; moving up implementation would have improved it's long term outlook, but increased the overall outlays over the initial 10 years above the arbitrary 900 billion goal.

quote:
And they aren't even close to Obama's original claim that Obamacare would reduce spending.
No, the claim is that it would reduce the deficit, not spending.

quote:
So the Federal government is going to incur additional costs of $1.5 Trillion and offset $400 billion through additional taxes.
"Additional" means the costs of those specific programs compared to their baseline, not as compared to the entire budget.

The figures above don't count already priced in savings like cutting Medicare Advantage, more aggressive pursuit of Medicare/Medicaid fraud, and other program changes that part of the bill but not among the factors specifically listed above.

And, if those costs are being estimated based on previous projections of the anticipated growth of overall healthcare costs, they're already an overestimation given that the provision that have already been enacted have already started to push down the overall growth curve and shifted providers toward finding more cost effective way to provide services (such as reducing re-admissions and hospital acquired infections) rather than investing in flashy technology that provides a low overall increase in quality, and blithely passing the costs along. (Similarly, the requirements to move to digital record keeping have created a strong enough market push to move the price of acquiring such a system from ~$3000+ about 3-4 years ago, to being able to having nominally free, support based offerings on the market today)

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velcro
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quote:
oday, the CBO released new projections from 2013 extending through 2022, and the results are as critics expected: the ten-year cost of the law's core provisions to expand health insurance coverage has now ballooned to $1.76 trillion.
Misleading. The ten year cost of 2011-2020 is lower. The ten year cost of 2013-2022 is higher, exactly as predicted originally. No ballooning, just the increasing costs over time, exactly as advertised. Oh, and the income from the act? That's increasing too, but your sources (unidentified) won't mention it.
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G2
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quote:
Originally posted by velcro:
quote:
oday, the CBO released new projections from 2013 extending through 2022, and the results are as critics expected: the ten-year cost of the law's core provisions to expand health insurance coverage has now ballooned to $1.76 trillion.
Misleading. The ten year cost of 2011-2020 is lower. The ten year cost of 2013-2022 is higher, exactly as predicted originally. No ballooning, just the increasing costs over time, exactly as advertised. Oh, and the income from the act? That's increasing too, but your sources (unidentified) won't mention it.
Really? Who predicted $1.76 trillion originally? Pelosi? Reid? Obama? Look back through the thread(s) on this. Who was talking about total cost approaching $2 trillion over 10 years? What was the cost they claimed?

Oh, and income from the act? You claim an increase, but you list no source for that. What do you call income to a government by the way?

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KidTokyo
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At the risk of making a drive-by here, I feel a need to point out that, regardless of whatever health care solution we have, we are essentially doomed if no serious effort is made -- I mean a really serious effort -- to address the fact that Americans are systematically killing themselves with poor eating and health habits. Other countries spend less on health care not just because they have more efficient systems, but because they are not larding up their arteries and making themselves ill.

Our costs are huge because there is so much sickness here. Some serious regulation of big agro and food in general would probably save far more money than any new health care system.

It baffles me that in the land of "personal freedom" so many have lost sight of the fact that "personal liberty" to eat badly and smoke a lot can create a burden on others. I'm much happier paying taxes for roads and bridges and police that everyone needs than higher medical bills which subsidize people who have spent their lives treating their bodies like a wastebasket and who need extensive treatment down the road. I'm sorry if this sounds cruel, but I've seen it so many times here and it makes me angry.

I knew someone whose daily afternoon snack was two Dove bars. He's not doing well these days. Dude...cut it out!

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G2
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quote:
Originally posted by KidTokyo:
At the risk of making a drive-by here, I feel a need to point out that, regardless of whatever health care solution we have, we are essentially doomed if no serious effort is made -- I mean a really serious effort -- to address the fact that Americans are systematically killing themselves with poor eating and health habits. Other countries spend less on health care not just because they have more efficient systems, but because they are not larding up their arteries and making themselves ill.

This is a relevant point. The obesity epidemic is only growing and costing more. The direct medical cost of obesity was $61 billion in 2000 and is projected to rise to about $344 billion in by 2018 [new info:these costs totaled about $147 billion in 2008]. Contrast that with smoking, one of the big "evils" of our time, which causes a little more than $196 billion each year in health-related costs.


quote:
Originally posted by G2 on April 01, 2010:
Let's pull together some numbers and recent studies and see what the long run actually looks like:
quote:

A new study led by researchers from the Harvard School of Public Health (HSPH) in collaboration with researchers from the Institute for Health Metrics and Evaluation at the University of Washington estimates that smoking, high blood pressure, elevated blood glucose and overweight and obesity currently reduce life expectancy in the U.S. by 4.9 years in men and 4.1 years in women. It is the first study to look at the effects of those four preventable risk factors on life expectancy in the whole nation.

Below is the number of years that would be gained in life expectancy in the U.S. if each individual risk factor was reduced to its optimal level:
  • Blood pressure: 1.5 years (men), 1.6 years (women)
  • Obesity (measured by body mass index): 1.3 years (men), 1.3 years (women)
  • Blood glucose: 0.5 years (men), 0.3 years (women)
  • Smoking: 2.5 years (men), 1.8 years (women)

Assuming the obese are fat for the majority of their life, about a 1 year reduction in life expectancy for obesity after, what, maybe 40 or 50 years as obese and all the medical costs that drives? The CDC says 34% of U.S. adults 20 years of age and older — over 72 million people — are obese and that in 2000, the total cost of obesity in the United States was estimated to be $117 billion. A little basic arithmetic here and we find it costs about $1625 a year to medically treat a fat person.

The CDC also tells us that the US life expectancy is 77.7 years. That means we can expect the average fat person to die around 76.4 years of age saving us a whopping $2112. That means that, in the long run, we will spend $91,650 per person to care and treat obesity related issues. Fat people are eating way more than their fair share of the healthcare pie ( [LOL] sorry, couldn't help it) and it will need to be addressed by a "fat tax" or fines for those that exceed the state mandated BMI for a healthy person.

As for smoking, the CDC did the math: For each of the approximately 46.5 million adult smokers in 1999, these costs represent $1,760 in lost productivity and $1,623 in excess medical expenditures. Since it only cuts a couple of years off your life, in the long run we're really not saving any money with smokers either.

quote:
Originally posted by KidTokyo:
I'm sorry if this sounds cruel, but I've seen it so many times here and it makes me angry

Don't be sorry, you're 100% justified in being angry or frustrated with this since you, and all of us, are now being asked to bear the cost of it. It is mind boggling that we are seriously looking at paying as much or more for overweight and smoking related health issues than we are for national defense.
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AI Wessex
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You've pointed to some real problems. What do you suggest to fix them if the government can't help? Do you know of a solution that solves the problem without raising costs as opposed to just lowering costs without solving the problem? Can the private sector take this on proactively? Would you "educate" people out of their bad habits, tax them for indulging themselves?

We know there are lots of problems, we're short on solutions.

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KidTokyo
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My solution would irritate both ends of the political spectrum. I'd end subsidies to big aggro and put warning labels on anything which still has hf corn syrup in it. A box of fruit loops is like a pack of cigarrettes in my book. I'd also mandate calorie counts on every restaurant menu, everywhere. Beyond that, our culture needs to move away from tolerating self indulgence. It's not so much that McDonald's is evil....I go there more than I care to admit....but people eat too much of it. Stop eating fries with that burger and you cut the calories in half. Your life could change. we should popularize the 2,000 calorie a day diet more than we do. Apologies for typos here, iPad butter fingers.
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G2
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quote:
Originally posted by KidTokyo:
My solution would irritate both ends of the political spectrum.

Then you're probably on the right track. [Razz] [Cool]
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Wayward Son
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And finally PoliFactCheck chimes in:

quote:
In 2010, the CBO analyzed cost projections, which go up over time as more provisions of the law are implemented. In that report, the gross cost to the government for coverage was projected at $938 billion. That figure -- again, the gross cost -- didn’t take into account revenue offsets, such as new taxes on the wealthy and penalties paid by individuals and employers who don’t opt into insurance. Those payments bring down the law’s net cost.

The CBO’s latest report updates those figures, but it looks at different years. The new gross estimate is $1.762 trillion -- the figure cited in Cruz’s tweet. But it looks at costs over 11 years -- 2012-2022 -- whereas the earlier report’s figure was for 10 years. And it’s important to note that the timespan of 2012 through 2022 covers nine years when the law is fully implemented (and thus its costs are greater).

So, when we compare the years encompassed in both reports (2012 through 2019), here’s how that apples-to-apples comparison shakes out.

In the CBO’s first estimate, the gross figure is $931 billion.

In the new estimate, the figure is $1.01 trillion.

That’s an increase of 8.6 percent...

Ezra Klein pointed out in the Washington Post’s Wonkblog that the cost went up "because the recession has made people poorer, and so the health-care law is going to have to spend more to help them get health insurance."

Finally, when comparing net figures from the CBO -- which certainly provide a more true-to-life picture of the law’s cost than gross numbers -- the projection for those eight years is actually less. The CBO estimated it at $784 billion in 2010 and revised that to $768 billion in 2012.


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G2
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Refining it to a full 10 years of implementation:
quote:
Now let's take a closer look at the numbers and how Obamacare became law before we decide who is being dishonest here.

First, lets get rid of the 11-year window the CBO uses in their most recent report, and make a new ten-year window so we can have a apples-to-apples ten-year comparison. Full Obamacare implementation doesn't start until 2014, so the CBO still hasn't procured an estimate of what a full 10-years of Obamacare spending looks like. But let's be generous to Obamacare's defenders and assume that the spending in 2023 is the same as 2022. That would make the true, 2014-2023, 10-year cost of full Obamacare implementation around $2.02 trillion.

$2.02 trillion.
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TCB
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There's nothing actually new here. Critics routinely noted during the health care debate that the ACA front-loaded benefits (or, alternatively, back-loaded costs). The assumptions of the 10-year cost projections were transparent to anyone who did a little research.
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JWatts
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quote:
Originally posted by TCB:
There's nothing actually new here. Critics routinely noted during the health care debate that the ACA front-loaded benefits (or, alternatively, back-loaded costs). The assumptions of the 10-year cost projections were transparent to anyone who did a little research.

Yes, but there were plenty of people denying the obvious fact that the bill was back-loaded with costs.


2009 CBO estimate of Net cost for 10 year window: $130 billion in savings over 10 year window

Reid Letter

Remember this figure was widely touted by Democrats as the cost of the bill.

2012 CBO estimate of Net cost for 10 year window: $1,100 billion in costs over 10 year window.

CBO estimate

So we've gone from -130 to +1,100 over a 10 year projected window in less than 3 years. The numbers will most likely get worse.

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MattP
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The CBO also estimates that if the mandate is scrubbed then the number of insured will increase by 16M, 4M people will lose their employer-provided insurance, and private insurance premiums will increase by 15%.

http://www.ahipcoverage.com/2012/03/23/the-link-the-impact-of-aca-market-reforms-without-a-mandate/

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TCB
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JWatts, I still think your claim is misleading for two reasons.

First, a cost projection from 2012-2021 can't contradict a cost projection from 2010-2019. It's an apples-to-oranges comparison.

Second, the $1.1B figure you cited ignores Medicare cuts (among other things) that the government claims will save money, offsetting the costs. If I were to guess, I'd say you're skeptical that the savings will actually materialize [Smile] , but nothing in the data bears that out yet.

It's probably true that the Democrats worked hard to keep the initial 10 year projection under $1T to help sell the bill, and, yes, that was misleading in a way. But, as I said, the assumptions of that projection were clear at the time.

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JWatts
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quote:
Originally posted by TCB:
JWatts, I still think your claim is misleading for two reasons.

First, a cost projection from 2012-2021 can't contradict a cost projection from 2010-2019. It's an apples-to-oranges comparison.

Supporters claimed Obamacare would save money. Detractors, such as myself, said No, the numbers were gamed to take advantage of the 10 year CBO budget window. I fail how to understand how this claim is misleading?


quote:
Originally posted by TCB:
Second, the $1.1B figure you cited ignores Medicare cuts (among other things) that the government claims will save money, offsetting the costs. If I were to guess, I'd say you're skeptical that the savings will actually materialize [Smile] , but nothing in the data bears that out yet.

[LOL] No data bears it out. Really? This is heavily dependent in the Medicare Doc fix of a 25% cut to doctor reimbursement rates. This has been continuously postponed since 2002. It's been postponed six times since Obamacare was passed. It's misleading to claim that there is no data that the Medicare cuts won't be as much as predicted. The cuts have been postponed six times in the last two years.


quote:
Originally posted by TCB:
It's probably true that the Democrats worked hard to keep the initial 10 year projection under $1T to help sell the bill, and, yes, that was misleading in a way. But, as I said, the assumptions of that projection were clear at the time.

And I'm holding their feet to the fire.
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Pyrtolin
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quote:
Supporters claimed Obamacare would save money. Detractors, such as myself, said No, the numbers were gamed to take advantage of the 10 year CBO budget window. I fail how to understand how this claim is misleading?
Because it saves more after the window than within it. The window was gamed to keep the total 10 year outlays down to the arbitrary $900ish range. Had the moved up the time table, the overall outlays would have been higher, but the revenues would have been higher as well, moving the portion of the plan that results in net deficit reduction forward. (Of course those projections do not account for the corresponding income and overall economic contractions that deficit reduction causes)

quote:
This is heavily dependent in the Medicare Doc fix of a 25% cut to doctor reimbursement rates.
No it's not. The doc fix is part of the baseline that the ACA is being compared to, so while it does have an absolute effect on the overall budget, it doesn't have a relative effect on the ACA numbers. Extending the doc fix shifts the entire budget baseline meaning that the ACA reductions would still exist compared to that new baseline.
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Pyrtolin
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quote:
2009 CBO estimate of Net cost for 10 year window: $130 billion in savings over 10 year window

Reid Letter

Remember this figure was widely touted by Democrats as the cost of the bill.

2012 CBO estimate of Net cost for 10 year window: $1,100 billion in costs over 10 year window.

Apples and oranges- you're comparing the total cost of the _entire bill_ in the first case, which includes revenues and program cuts to the net expenditures of just the portion of the bill that provides insurance payments and subsidies in the second, excluding program cuts and revenues. So the proper number to compare to would be the $900+ billion in total outlays from the original window that included 4 years without the full Medicaid expansion and subsidies to the equivalent $1.1Billion now that there are only 2 years left without the full program in effect.

And in that you can already see some of the downward pressure as $900B/6years (to be generous and lowball the cost) = $160B/year while the next two years ring in at only $100B/year.

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JWatts
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quote:
Originally posted by Pyrtolin:
Had the moved up the time table, the overall outlays would have been higher, but the revenues would have been higher as well, moving the portion of the plan that results in net deficit reduction forward.

Your statement seems to be completely contradictory to the CBO estimates. The CBO has estimated that Net costs have grown substantially.

Perhaps you are just much smarter than the CBO or know something they don't. Care to share?

quote:
Originally posted by Pyrtolin:
quote:
This is heavily dependent in the Medicare Doc fix of a 25% cut to doctor reimbursement rates.
No it's not. The doc fix is part of the baseline that the ACA is being compared to...
The PPACA's (aka Obamacare) cost projects assume that the Doc fix is enacted! If it is not enacted then costs will go up. Revenues will stay the same. So Net costs for Obamacare will rise.
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Pyrtolin
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quote:
Originally posted by JWatts:
Your statement seems to be completely contradictory to the CBO estimates. The CBO has estimated that Net costs have grown substantially.

Perhaps you are just much smarter than the CBO or know something they don't. Care to share?


No, I can just read what they said. They specifically said that these were the costs of "the insurance coverage provisions of the ACA" not the net cost of the bill, just the costs of one section that is entirely outlays.

quote:
quote:
No it's not. The doc fix is part of the baseline that the ACA is being compared to...
The PPACA's (aka Obamacare) cost projects assume that the Doc fix is enacted! If it is not enacted then costs will go up. Revenues will stay the same. So Net costs for Obamacare will rise.
The doc fix was not in the ACA, it was pat of the CBO's baseline. Nothing changes for the ACA itself if the doc fix is renewed; the entire baseline shifts, but that doesn't affect the net costs of the ACA, because it was removed from the ACA months before it passed and evaluated as a separate policy item.

[ March 29, 2012, 12:20 PM: Message edited by: Pyrtolin ]

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quote:
Originally posted by TCB:
There's nothing actually new here. Critics routinely noted during the health care debate that the ACA front-loaded benefits (or, alternatively, back-loaded costs). The assumptions of the 10-year cost projections were transparent to anyone who did a little research.

I refer you back to the first page in this thread.
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TCB
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JWatts said:
quote:
Your statement seems to be completely contradictory to the CBO estimates. The CBO has estimated that Net costs have grown substantially.
As Pyrtolin was saying, I believe this is refuted in the CBO document you cited:
quote:
Those amounts do not encompass all of the budgetary impacts of the ACA because that legislation has many other provisions, including some that will cause significant reductions in Medicare spending and others that will generate added tax revenues, relative to what would have occurred under prior law. CBO and JCT have previously estimated that the ACA will, on net, reduce budget deficits over the 2012–2021 period; that estimate of the overall budgetary impact of the ACA has not been updated.

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JWatts
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quote:
Originally posted by TCB:
Those amounts do not encompass all of the budgetary impacts of the ACA because that legislation has many other provisions, including some that will cause significant reductions in Medicare spending and others that will generate added tax revenues, relative to what would have occurred under prior law. CBO and JCT have previously estimated that the ACA will, on net, reduce budget deficits over the 2012–2021 period; that estimate of the overall budgetary impact of the ACA has not been updated.

I think you are misreading the quote. Has not been updated does not mean that the numbers have not changed.

quote:

"As of the bill's passage into law, the Congressional Budget Office (CBO) estimated the legislation would reduce the deficit by $143 billion over the first decade, but half of that was due to expected premiums for the C.L.A.S.S. Act, which has since been abandoned.

Wiki
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TCB
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Agreed, the repeal of CLASS Act hurt the deficit numbers in the near-term projections (although, as your quote says, it still projects that the ACA will reduce the deficit). Interestingly, that provision was somewhat egregious in terms of front-loading savings and back-loading costs, so while killing it hurt the near-term projections, it may actually help longer-term projections.

Anyway, my purpose in quoting the CBO document is showing that $1.1B isn't a net figure.

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JWatts
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quote:
Originally posted by TCB:
Anyway, my purpose in quoting the CBO document is showing that $1.1B isn't a net figure.

Ok, that's valid. The $1.1B is the net figure for the insurance portion. It's not the net figure for everything in the bill, particularly not the Medicare portion. But most likely the PPACA is not (and really never was) going to actually reduce the deficit. It's all dependent on reducing projected Medicare reimbursement by $500 billion over the next 10 years and raising an additional $600 billion through taxes and penalties.
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