President Obama's national health care law will cost $1.76 trillion over a decade, according to a new projection released today by the Congressional Budget Office, rather than the $940 billion forecast when it was signed into law.
Democrats employed many accounting tricks when they were pushing through the national health care legislation, the most egregious of which was to delay full implementation of the law until 2014, so it would appear cheaper under the CBO's standard ten-year budget window and, at least on paper, meet Obama's pledge that the legislation would cost "around $900 billion over 10 years." When the final CBO scorecame out before passage, critics noted that the true 10 year cost would be far higher than advertised once projections accounted for full implementation.
Today, 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. 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. Only next year will we get a true ten-year cost estimate, if the law isn't overturned by the Supreme Court or repealed by then. Given that in 2022, the last year available, the gross cost of the coverage expansions are $265 billion, we're likely looking at about $2 trillion over the first decade, or more than double what Obama advertised.
The big picture takeaway is that due mostly to weaker economic projections, the CBO now projects that more people will be obtaining insurance through Medicaid than it estimated a year ago at a greater cost to the government, but fewer people will be getting insurance through their employers or the health care law's new subsidized insurance exchanges. Overall spending will be higher than estimated a year ago, but increased revenue from penalties and taxes will more than offset this. Also interesting: CBO now expects two million fewer people to be covered as a result of the health care law than previously projected.
It's worth keeping in mind that what the CBO did today was update its forecasts for the cost of expanding insurance coverage under the health care law. That represents, by far, the bulk of the spending in the legislation, but it doesn't constitute a full rescoring of the law or a revised deficit estimate. That would have to include estimates for all the taxes, Medicare cuts and other spending in the law. Also, the $1.76 trillion cited above is for the years 2013 through 2022, but if we want to compare changes to last year's estimates, we have to use the comparable years of 2012 through 2021. (Estimates for 2022 only became available today.)
The CBO now projects that from 2012 through 2021 the federal government will spend $168 billion more on Medicaid than it expected last year, $97 billion less on subsidies for people to purchase insurance on government-run exchanges and $20 billion less on tax credits to small employers. That works out to a $51 billion increase in the gross cost of expanding coverage from what the CBO estimated a year ago. However, the CBO also expects the federal government to collect more revenue from penalties on individuals and employers, as well as other taxes. These revenue increases will more than offset the spending increases, according to the CBO, so it now expects the cost of Obamacare during those years to be $48 billion lower.
It's also worth noting that we were told time and again during the health care debate that the law didn't represent a government takeover of health care. But by 2022, according to the CBO, 3 million fewer people will have health insurance through their employer, while 17 million Americans will be added to Medicaid and 22 million will be getting coverage through government-run exchanges.