CBO estimates cost of Obamacare even lower than before

shira

Diamond Member
Jan 12, 2005
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More good news about Obamacare. Estimates on its cost continue to go down, and the 2015-to-2019 projected cost is now more than $200 billion less than the original 2010 estimate.

Do you remember all those confident predictions that employers would abandon their employees to the exchanges? It's not happening. And the growth in the cost of health care is continuing to be quite modest (just 1.8% / year for the eight years ending 2013).

But of course Obamacare is a "disaster," a "train wreck," a . . . well, I'm sure righties have a new term. And if they get their way and the SCOTUS kills it, we can all go back to the way health insurance used to be, the way God intended health insurance to be.

The cost of President Obama's signature health care law is continuing to fall.

The Congressional Budget Office announced on Monday that the Affordable Care Act will cost $142 billion, or 11 percent less, over the next 10 years, compared to what the agency had projected in January.

The nonpartisan agency said the Affordable Care Act will cost less for two essential reasons: health insurance premiums are rising more slowly, and fewer people are now expected to sign up for Medicaid and for subsidized insurance under the law's marketplaces.

More people aren't signing up for the law because , the agency added, fewer employers than anticipated are canceling coverage and more people than earlier estimated had private coverage. By 2025, the CBO estimates "the total number of people who will be uninsured ... is now expected to be smaller than previously projected."

All around, it's positive news for Obama's law, which has been accused of killing jobs and draining federal coffees. To be sure, the law is still expensive -- expected to cost $1.2 trillion over 10 years -- but the price has been falling since the law was passed in 2010 and went fully into force last year.

In March 2010, the CBO predicted that the law would cost $710 billion during the period from 2015 to 2019, without trying to come up with projections beyond that. After several revisions, the law is now expected to cost $506 billion – 29 percent less -- during those same five years, as shown in the chart.

CBO issued its new estimates less than a week after the Supreme Court heard a case challenging a crucial provision of the law. It’s unclear how the justices will rule, and a decision against the Obama administration could make these estimates irrelevant.

In revising their estimates, the agencies noted two trends.

The first is the relatively modest increase in how much private insurance companies spend on their policyholders' health care. Between 1998 and 2005, spending on health care increased by an average of 5 percent per year, adjusting for inflation and demographics. That figure fell to 1.8 percent per year for the period from 2006 to 2013, the latest year for which data are available.

The administration has said that this decline in spending on medical care is at least partly a result of cost-saving measures in the Affordable Care Act. Critics have argued on the contrary that the decline was due to the recession, and that health care costs could begin to rise again. Independent experts have suggested that much of the effect is due to the weak economy, but not all of it.

The CBO had previously expected that the pace of increasing spending would rise fast again, but now they predict that "such a bounce back seems less likely in light of the further slowing of spending growth observed in the most recent data."

The agencies also revised their estimates in response to new data on who was insured and how before the law took effect.

They concluded that fewer people were employed by firms that might stop offering coverage as a result of the law's passage, since their employees are now able to buy coverage individually through the exchanges. And they realized that fewer people were uninsured to begin with than they had thought.

As a result, fewer people will need to purchase insurance through the exchanges or need federal help to do so.

The agencies also concluded that the number of people who rely on Medicaid is smaller than they had anticipated, which is another source of savings.

These revisions mean that while fewer people will gain coverage as a result of Obamacare, the number of people who will still lack insurance despite the law's passage is also lower than previously anticipated.
 

glenn1

Lifer
Sep 6, 2000
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So what exactly is the causal mechanism for the decline in healthcare costs that can be attributed to Obamacare? If it's mainly because of the $700B in Medicare cuts and trimming reimbursement rates, that doesn't mean that savings are being realized by the individual consumer. That's not a criticism per se, but the nature of the cost savings and where they occur are important factors, just as I want to lose weight but not by the means of chopping off one of my limbs.
 

monkeydelmagico

Diamond Member
Nov 16, 2011
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Charity care costs for safety net hospitals are down too. This project is starting to post up some impressive numbers but the states that did not choose to expand are doing equally well.
 
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cabri

Diamond Member
Nov 3, 2012
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10 years projections == BS in numbers

Then CBO processes numbers that are handed to it by others.

The effect of the ACA has not even hit employers yet with the exception of the Cadillac tax; how can they say that "fewer employers than anticipated are canceling coverage"
 

fskimospy

Elite Member
Mar 10, 2006
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10 years projections == BS in numbers

Then CBO processes numbers that are handed to it by others.

The effect of the ACA has not even hit employers yet with the exception of the Cadillac tax; how can they say that "fewer employers than anticipated are canceling coverage"

What gave you the idea that the ACA hasn't hit employers yet? There are no remaining provisions of the ACA that haven't been enacted that would credibly cause employers to cancel coverage for their employees.

I see this sort of thing come out often, that the ACA 'hasn't hit employers'. It's a fantasy. At what point do people just accept that the ACA isn't this crazy disaster that they were told it was going to be?
 
Nov 30, 2006
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Good news...but I thought the CBO wasn't going to track ACA costs anymore? I don't know how I got that idea....must have misread something. Didn't the CBO used to say that ACA would actually cut the deficit?

EDIT: It appears that some parts will no longer be tracked like Employer mandate costs. Also, it's interesting to see how the CBO attempted to sweep the "projected surpluses" issue under the carpet. Good interview for those so interested.

http://kaiserhealthnews.org/news/hoth-cbo-will-not-evaluate-some-health-law-money-after-changes/
 
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fskimospy

Elite Member
Mar 10, 2006
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Good news...but I thought the CBO wasn't going to track ACA costs anymore? I don't know how I got that idea....must have misread something. Didn't the CBO used to say that ACA would actually cut the deficit?

Yes, they said that they won't be estimating the overall deficit impact anymore because of all the changing and tweaking went on, however. They are still measuring the costs of things that have already been implemented though.

Considering the costs listed here are lower than previously expected, it is likely that this means the ACA will cut the deficit by even more than previously thought.
 

Jhhnn

IN MEMORIAM
Nov 11, 1999
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So what exactly is the causal mechanism for the decline in healthcare costs that can be attributed to Obamacare? If it's mainly because of the $700B in Medicare cuts and trimming reimbursement rates, that doesn't mean that savings are being realized by the individual consumer. That's not a criticism per se, but the nature of the cost savings and where they occur are important factors, just as I want to lose weight but not by the means of chopping off one of my limbs.

Oh, please. The important part is that the predictions of Doom! have not materialized, nor likely will they ever. Well, unless Repubs find some way to fuck it up, something that's apparently one of their top priorities.
 

First

Lifer
Jun 3, 2002
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As the 2013 and 2014 data on premiums and overall health care costs becomes clearer, it becomes more and more unlikely that the recession was as big a driver of reduced healthcare cost and more and more likely that the ACA contributed significantly.

Amazing how much Obamacare has exceeded initial expectations (and particularly predictions from Repubs/conservatives) for government coffers and the quality of life for Americans generally. Particularly the uninsured. Meanwhile, one party continues to want to repeal it...with lip service to replacing it with something vague that hasn't even gotten through Congressional committee, let alone a floor vote. History will not be kind to these poorly informed anti-ACA malcontents.
 

realibrad

Lifer
Oct 18, 2013
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Went from a horrible system, or a slightly less horrible system that looks to cost a little less.
 
Nov 30, 2006
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Yes, they said that they won't be estimating the overall deficit impact anymore because of all the changing and tweaking went on, however. They are still measuring the costs of things that have already been implemented though.

Considering the costs listed here are lower than previously expected, it is likely that this means the ACA will cut the deficit by even more than previously thought.
The interview I linked and the CBO report seems to say otherwise.

http://kaiserhealthnews.org/news/hoth-cbo-will-not-evaluate-some-health-law-money-after- changes/

I think you’re right, I think the CBO consistently in recent years has projected that overall it would have a positive impact on the deficit, maybe bring it down by $120 billion over ten years or so. And when Republicans made a big push to try to repeal Obamacare, the CBO warned that it could add $210 billion to the deficit, so that was the flip side. But very interestingly in April, very quietly in a footnote to a very complicated report, the CBO signaled for the first time that while it could point to areas or programs in the Affordable Care Act that would bring down the deficit long term they couldn’t make a blanket assertion that the law taken together with all of its component parts would have that impact. They backed away. In a sense, they backed down, from that earlier projection.
 
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bshole

Diamond Member
Mar 12, 2013
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This is why it is IMPERATIVE that we get another Democrat into the Presidency. That is our next step towards the end goal of completely susidized medicine. The nutjob Republican candidates are talking about REPEALING it. I can't even imagine the economic damage of such a bone-headed move.
 

Jhhnn

IN MEMORIAM
Nov 11, 1999
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The interview I linked and the CBO report seems to say otherwise.

http://kaiserhealthnews.org/news/hoth-cbo-will-not-evaluate-some-health-law-money-after- changes/

"Otherwise" as meaning they can't track parts of the program, not that what they can track isn't consistent w/ the OP's contention, correct?
 

fskimospy

Elite Member
Mar 10, 2006
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This is incorrect, if anything your interview backs up what I said. Did you read your own link?

The first line:
The Congressional Budget Office will no longer evaluate the fiscal implications of some parts of the Affordable Care Act, partly because of all the changes made during implementation.

If you're looking for what the CBO said on the issue I will direct you here:
https://www.cbo.gov/publication/45447

What the CBO said specifically:

Based on revisions to the estimated budgetary effects of aspects of the ACA that CBO and JCT have analyzed, the agencies have no reason to think that their initial assessment that the ACA would reduce budget deficits was incorrect.

However, the incremental budgetary effects of many provisions of the ACA are embedded in CBO’s baseline projections for preexisting programs and tax revenues, and they cannot be separately identified using the agencies’ normal estimating procedures—which are generally based on data that reflect all of the provisions of current law, including the ACA.

A retrospective analysis of the effects of a current law is very different from a cost estimate for proposed legislation, particularly because it requires formulation of a counterfactual benchmark representing what would have happened if the law had not been enacted—a challenging undertaking that is beyond the scope of CBO’s usual analyses.

Therefore, CBO and JCT cannot readily provide a retrospective analysis of the ACA that is analogous to the cost estimate provided by the agencies in 2010. That problem is not unique to the ACA but is common to most legislation that affects preexisting federal programs.

It appears that you were concerned that this news meant the CBO no longer believed the ACA would reduce deficits. Presumably now you're much happier as you know that's not the case, correct?
 

Londo_Jowo

Lifer
Jan 31, 2010
17,303
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londojowo.hypermart.net
10 years projections == BS in numbers

Then CBO processes numbers that are handed to it by others.

The effect of the ACA has not even hit employers yet with the exception of the Cadillac tax; how can they say that "fewer employers than anticipated are canceling coverage"

If I'm not mistaken the Cadillac tax doesn't begin until 2018.

http://obamacarefacts.com/obamacare-taxes/

• 40% Excise Tax “Cadillac” on high-end Premium Health Insurance Plans 2018
 
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WHAMPOM

Diamond Member
Feb 28, 2006
7,628
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In the beginning of the last century the Bull Moose Party had universal healthcare as part of their election platform. Just think how efficient healthcare would be now after a hundred years of tweaking if Teddy would have got a third term.
 

First

Lifer
Jun 3, 2002
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^ I think putting "taxes" in quotes was a good idea, considering there are none on the poor or middle class. Certainly I don't see any in my bi-weekly payroll check, my S-Corp or my annual return to the IRS.

There are some small ones on capital gains on the rich, so you've got that I guess.
 

fskimospy

Elite Member
Mar 10, 2006
87,964
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Hahaha.
1. DSF tries to concern troll about how the ACA was supposed to reduce the deficit.
2. Told he's wrong and that's still the case.
3. DSF tries to falsely claim the CBO said otherwise.
4. When corrected about what the CBO said, DSF links to an op-ed from ultra right wing think tank which tries to argue that the CBO is wrong about its own reporting by uncritically accepting altered CBO models generated by staffers for Senate Republicans.

Just stop digging.
 
Nov 30, 2006
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^ I think putting "taxes" in quotes was a good idea, considering there are none on the poor or middle class. Certainly I don't see any in my bi-weekly payroll check, my S-Corp or my annual return to the IRS.

There are some small ones on capital gains on the rich, so you've got that I guess.
I was talking about the mandates. The SCOTUS called these taxes which is the reason I quoted the word.

ACA_Tax_Constant_Dollars1.png
 

glenn1

Lifer
Sep 6, 2000
25,383
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Oh, please. The important part is that the predictions of Doom! have not materialized, nor likely will they ever. Well, unless Repubs find some way to fuck it up, something that's apparently one of their top priorities.

So as long as it didn't blow up on the launchpad and give the GOP the ability to criticize, you have no interest in analyzing it further? And have no cares about what is helping contain costs in Obamacare in order to sustain the positive drivers (e.g. improved primary care = less emergency room costs) and reducing the "bad" ones (e.g. healthcare costs are going down because less people are seeking medical assistance)?

I think ACA recast the healthcare system using an extremely ass-backwards premise and methods but I'd still like to know what worked and how. I'd still prefer my approach of universal catastrophic care for all, etc. but I also realize there's more than one way to skin a healthcare cat.
 

First

Lifer
Jun 3, 2002
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I was talking about the mandates. The SCOTUS called these taxes which is the reason I quoted the word.

ACA_Tax_Constant_Dollars1.png

SCOTUS used Congress' power to tax as a reason to uphold ACA; it said nothing of the existence of middle class taxes, or for that matter taxes on the poor.

So yes, there are taxes that predominantly hit the rich. As there should be given their historically small tax bill as of right now. Do you have a problem with those specific ACA taxes, and why?