Obamacare's Unknowable Price Tag

This much we know: There is no way of figuring out what (or by how much) the Affordable Care Act is going to do to the federal budget compared to the estimates used to push the program through Congress. Back in 2009, it was really important to President Obama that people understand he "not sign a plan that adds one dime to our deficits—either now or in the future. Period." He sold the plan as costing about $938 billion in its first decade of operation.

Nowadays, the Congressional Budget Office (CBO), the agency originally charged with tallying up Obamacare's costs and revenues, says it's no longer able to estimate the law's effects on the deficit. There have been too many delays, postponements, modifications, you name it, to the original bill. "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," the CBO concludes

Yet if past experience with massive government-run health care programs is any indicator, the odds are high that Obamacare will end up costing way more than it was supposed to. Here are three examples to think about as the health care reform law gears up for its second year of sign-ups (for more information, go here).

1. Massachusetts Commonwealth Care. This is the plan supported by Gov. Mitt Romney that provided the very model for Obamacare. It guaranteed universal coverage and subsidized insurance premiums for low-income residents. Initial cost estimates came in at $472 million while actual costs were closer to $628 million for an error ratio of 1.2:1.

Masscare EstimateReason Infographic 

2. Medicare. In 1967, Congress estimated that the nation's single-payer system for the elderly, Medicare, would cost $12 billion in 1990. The actual price tag was $110 billion, for an error ratio on 9.17:1.

Medicare EstimateReason Infographic

3. Medicaid DSH program. Medicaid pays for health insurance for the poor (its expansion represents the main way Obamacare in enrolling new beneficiaries). The "disproportionate share hospital program" (DSH) gives money to facilities that serve a large number of poor patients. In 1987, Congress figured DSH payments would be less than $1 billion in 1991. Instead, they totaled $17 billion, creating an error ratio of 17:1.

Medicaid DSH EstimateReason Infographic

Read more about phony-baloney health care accounting here and here. And check out Reason's special collection of new stories about "The Sad Story of Obamacare."

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  • ||

    Best gifs ever!!!

  • Scruffy Nerfherder||

    Those things are obviously racist

  • ||

    How can Reason be so cruel as to force the blood people to carry around death crushing amounts of cash?!?!

  • Fist of Etiquette||

    What is this? Buzzfeed? All those animated gifs.

  • Mr. Soul||

    prices are irrelevant if you don't bear the costs.

  • scareduck||

    Well, we do know that the Medicare fee-for-service reimbursement cuts never happened. And since that was the largest single line item in the alleged savings due to Obamacare, we can pretty much rule out any actual savings.

  • Sudden||

    we can pretty much rule out any actual savings.

    Except for all the lives we save. We'll be saving the lives of eleventy trillion low income elderly chilrunz with pre-existing conditions every day. So it is written, so shall be done.

  • wagnert in atlanta||

    And if there aren't eleventy trillion sick kids to save, we'll make some of the well ones sick! Compulsory compassion, that's our cry!

  • ImanAzol||

    Send the bill to someone who cares.

    Literally. Find a sick person, find a liberal, tell them to pay the bills. See how fast they backpedal.

  • Rasilio||

    No we know the cost, it cost us our freedom.

  • GILMORE||

    Do we really need to 'liquify' the poor stick figures?

    I mean, it seems like an extra-dimension of anthropomorphic dramatization has been thrown in here to ensure we're clear that the poor laborers have not simply been crushed, but their bodies (which were apparently just stick-shaped blood-bags) have been completely pulverized, with their live-essences shooting out of them with swatted-mosquito-like speed. No chance for even a scream? A brief cry of terror before their lives are mercilessly snuffed out by the....giant piles of money they're carrying? Is the context here that they'd thought they'd hit it rich? They'd stumbled across giant-sized money, and thought they were going to live the remainder of their stick-figure lives in stick-figure luxury?...only to be undone by their own cupidity, crushed to death by excess wealth...

    Also: they're brown. You goddamn racist.

  • Sudden||

    Clearly, the gifs should be structured in such a way as the formerly obese Americans, filled to the brim with cash that they use to buy evil Gaea killing meat, have just enough cash removed from their pockets to slim them down to fitness levels unrivaled by even the world's greatest athletes.

    And they'll still have enough money left over to get a degree in (insert culture of preference) studies, a Prius, and solar panels for their new home in an up and coming hipster area.

  • ||

    Has Ted seen all the gifs? He's gonna plotz!

  • Fist of Etiquette||

    I can't stop looking at them.

  • GILMORE||

    "You and I... we're not really so different from one another, you know...I too feel as though I am being repeatedly, endlessly crushed while trying to escape a box with giant-sized, cartoon money... "

    As you stare at the stick figure, so also does the stick figure gaze into you.

  • GILMORE||

    Now this post has been taken off of H&R?...

    Is this so that the wanton slaughter of GIF-Men can continue unabated without provoking further public outcry?!

    The body count by this point has also become 'unknowable'. Who will build the monument to the Unknown Gif-Dead?

  • ||

    Said monument will almost certainly be my next endeavor.

  • Christophe||

    I was wondering why everyone was complaining about GIFs on the site. Now I can't unsee it.

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