We have no idea how much Obamacare costs
This article originally appeared on heartland.org.
Remember back when Obamacare was supposed to be reducing the deficit? Those were the days:
For Democratic lawmakers who were hesitant to sign onto the sweeping 2010 health care law, one of the most powerful selling points was that the Affordable Care Act would actually reduce the federal budget deficit, despite the additional costs of extending health insurance coverage to the uninsured.
Four years after enactment of what is widely viewed as President Barack Obama’s key legislative achievement, however, it’s unclear whether the health care law is still on track to reduce the deficit or whether it may actually end up adding to the federal debt. In fact, the answer to that question has become something of a mystery.
In its latest report on the law, the Congressional Budget Office said it is no longer possible to assess the overall fiscal impact of the law. That conclusion came as a surprise to some fiscal experts in Washington and is drawing concern. And without a clear picture of the law’s overall financing, it could make it politically easier to continue delaying pieces of it, including revenue raisers, because any resulting cost increases might be hidden.
Charles Blahous, a senior research fellow at George Mason University’s free market-oriented Mercatus Center, calls the CBO’s inability to estimate the net effect of the law “a real problem.” “The ACA’s financing provisions were assumed to be effective so as to get a favorable score out of CBO upon enactment, but no one is keeping track of whether they’re being enforced,” says Blahous, a public trustee for Social Security and Medicare. “We receive occasional updates on the gross costs of the law, but none on whether the previously projected savings provisions are producing what was originally projected.” As a result, Blahous says, “there’s no barrier to continually rolling back the financing mechanisms without the effect on the ACA’s finances ever being fully disclosed.”
Congressional budget scorekeepers said they can no longer measure the fiscal impact of many provisions of ObamaCare because the task is impossible.
In a little-noticed footnote from April, the Congressional Budget Office (CBO) said it will continue to assess the effects of the law’s exchange subsidies and the Medicaid expansion, while not tracking others.
“The provisions that expand insurance coverage established entirely new programs or components of programs that can be isolated and reassessed,” the office wrote.
“In contrast, other provisions of the Affordable Care Act significantly modified existing federal programs and made changes to the Internal Revenue Code.
“Isolating the incremental effects of those provisions on previously existing programs and revenues four years after enactment of the Affordable Care Act is not possible.”
Part of this lack of ability to predict the costs of Obamacare is due to the Supreme Court’s decision on the Medicaid expansion issue. With one in five Americans now on Medicaid, but with the surge in enrollment very uneven and the exchange experiences so inconsistent, it’s obvious now how incomplete the CBO predictions really were. And even without the uneven and ill-tracked nature of the expansion and relative eligibility, CBO is really going to be flying blind for the next few years on how much Obamacare is actually costing the taxpayers, or will cost them for the foreseeable future.