Prof Gruber at MIT says today in NEJM:
In summary, analysis by both the Congressional Budget Office and the CMS actuary show that the ACA will substantially reduce the federal deficit, only slightly increase national medical spending (despite an enormous expansion in insurance coverage), begin to reduce the growth rate of medical spending, and introduce various new initiatives that may lead to more fundamental reductions in the long-term rate of health care cost growth. The ACA will not solve our health care cost problems, but it is a historic and cost-effective step in the right direction.
At the same time the CBO states:
CBO estimates that total authorized costs in the first two categories probably exceed $115 billion over the 2010-2019 period, as detailed below.1 We do not have an estimate of the potential costs of authorizations in the third category.
The administrative and other costs for federal agencies to implement the act’s provisions will be funded through the appropriations process; sufficient discretionary funding will be essential to implement this legislation in the time frame called for. Major costs for such implementation activities will include:
1. Costs to the Internal Revenue Service (IRS) of implementing the eligibility determination, documentation, and verification processes for premium and costsharing credits. CBO expects that those costs will probably total between $5 billion and $10 billion over 10 years.
2. Costs to HHS, especially the Centers for Medicare and Medicaid Services, and the Office of Personnel Management for implementing the changes in Medicare, Medicaid, and the Children’s Health Insurance Program, as well as certain reforms to the private insurance market. CBO expects that those costs will probably total at least $5 billion to $10 billion over 10 years.
The CBO further states:
CBO estimates that the amounts authorized for these items exceed $86 billion over the 10-year period (out of the roughly $105 billion total shown in the table that was provided along with the May 11 letter). Thus, CBO’s discretionary baseline, which assumes that 2010 appropriations are extended with adjustments for anticipated inflation, already accounts for much of the potential discretionary spending under PPACA.
In addition, there are a number of other items that could overlap some or even by a considerable amount with current law activities assumed in CBO’s baseline. Title V of PPACA includes many of those items. For example, section 5210 and sections 5301-5303 of PPACA replace provisions of prior law with new provisions offering a great deal more detail. The May 11 letter addresses these potential sources of overlap. The last paragraph on page 3 of that letter states: “Although Tables 1 and 2 provide more information about the discretionary costs associated with PPACA, they do not represent all of the potential budgetary implications of changes to existing discretionary programs—including both potential increases and decreases relative to recent appropriations…”
That is the savings that Gruber lauds have been wiped out and more so by the CBO. This is the same Gruber who allegedly was being paid as the mouth piece for the White House without allegedly fairly and openly disclosing as such.
I never stop wondering about those Economics and Business types!
In summary, analysis by both the Congressional Budget Office and the CMS actuary show that the ACA will substantially reduce the federal deficit, only slightly increase national medical spending (despite an enormous expansion in insurance coverage), begin to reduce the growth rate of medical spending, and introduce various new initiatives that may lead to more fundamental reductions in the long-term rate of health care cost growth. The ACA will not solve our health care cost problems, but it is a historic and cost-effective step in the right direction.
At the same time the CBO states:
CBO estimates that total authorized costs in the first two categories probably exceed $115 billion over the 2010-2019 period, as detailed below.1 We do not have an estimate of the potential costs of authorizations in the third category.
The administrative and other costs for federal agencies to implement the act’s provisions will be funded through the appropriations process; sufficient discretionary funding will be essential to implement this legislation in the time frame called for. Major costs for such implementation activities will include:
1. Costs to the Internal Revenue Service (IRS) of implementing the eligibility determination, documentation, and verification processes for premium and costsharing credits. CBO expects that those costs will probably total between $5 billion and $10 billion over 10 years.
2. Costs to HHS, especially the Centers for Medicare and Medicaid Services, and the Office of Personnel Management for implementing the changes in Medicare, Medicaid, and the Children’s Health Insurance Program, as well as certain reforms to the private insurance market. CBO expects that those costs will probably total at least $5 billion to $10 billion over 10 years.
The CBO further states:
CBO estimates that the amounts authorized for these items exceed $86 billion over the 10-year period (out of the roughly $105 billion total shown in the table that was provided along with the May 11 letter). Thus, CBO’s discretionary baseline, which assumes that 2010 appropriations are extended with adjustments for anticipated inflation, already accounts for much of the potential discretionary spending under PPACA.
In addition, there are a number of other items that could overlap some or even by a considerable amount with current law activities assumed in CBO’s baseline. Title V of PPACA includes many of those items. For example, section 5210 and sections 5301-5303 of PPACA replace provisions of prior law with new provisions offering a great deal more detail. The May 11 letter addresses these potential sources of overlap. The last paragraph on page 3 of that letter states: “Although Tables 1 and 2 provide more information about the discretionary costs associated with PPACA, they do not represent all of the potential budgetary implications of changes to existing discretionary programs—including both potential increases and decreases relative to recent appropriations…”
That is the savings that Gruber lauds have been wiped out and more so by the CBO. This is the same Gruber who allegedly was being paid as the mouth piece for the White House without allegedly fairly and openly disclosing as such.
I never stop wondering about those Economics and Business types!
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