Read this and get angry about Obamacare all over again. Remember how it had to receive a good report from the CBO in order to be passed? Well, here’s how the smoke and mirrors worked:
In sum, the scorekeeping baseline used to show a positive fiscal effect for the ACA reflects neither actual law nor historical practice. This hypothetical scenario, involving as it does perpetual overrides of Social Security and Medicare financing restrictions, would be untenably expensive. Yet it was only in comparison with this extreme and extra-legal scenario that the ACA was found to slightly reduce projected federal deficits. In comparison with actual prior law, the legislation greatly worsened the fiscal outlook…
The savings provisions of the ACA are insufficient to both finance an extension of Medicare solvency and to fund a massive new health entitlement. So even if the law’s savings provisions all worked as originally envisioned, the ACA would still add at least $340 billion to federal deficits over its first ten years. Even this outcome would require that lawmakers allow many of its provisions to inflict a steadily higher toll on taxpayers, providers, and beneficiaries over time. If instead Congress re-indexes these provisions in keeping with historical precedent, the deficit increase under this more pessimistic scenario would be over $500 billion in the first decade alone.
And then there’s the SCOTUS decision on the states and Medicare. In all the brouhaha about the individual mandate, the other portion of the SCOTUS decision didn’t get as much press, but it matters, and its effects are somewhat unknown at this point:
he CBO subsequently reassessed the ACA in light of the Supreme Court ruling. Previously CBO had assumed full state participation in the Medicaid expansion, increasing program enrollment by 17 million by 2022. After the Court’s decision, CBO lowered this estimate by roughly one-third, meaning that 6 million potentially eligible individuals would not be covered under Medicaid. CBO’s updated financial evaluation was better in some respects, worse in others:
—CBO projected that of the 6 million no longer expected to be covered under Medicaid, 3 million would remain uninsured altogether. This would reduce projected federal expenditures.
—CBO projected that the other 3 million would instead be insured under the ACA’s new health insurance exchanges. This would increase costs because the federal government is expected to pay more to cover these individuals under the exchanges than it would have through Medicaid.
There’s much, much more at the link.