$2 Trillion For a Decade of Expanded Health Coverage Under ObamaCare?


Early in the process of drafting the recent health care overhaul legislation, Democrats realized that they had a spending ceiling: Somehow, they would have to coax the official price tag of the final legislation down below the trillion dollar mark. So they started bailing. They threw out a proposed update to Medicare's physician's reimbursement system and fiddled with the numbers until the headline figures were in an acceptable range. In a major speech, President Obama promised the law would cost "around $900 billion over 10 years," and the final tally was close enough: According to the Congressional Budget Office, the gross cost of the law's health coverage provisions came in at $938 billion for the first decade.

But what Democrats didn't highlight was that the first decade as scored by the CBO was not actually the first decade in which the law was fully operational. The major coverage provisions do not kick in until 2014, and neither do the associated costs. Yet the CBO started the clock on its cost estimate in 2010, meaning that the initial estimate really only looked at the cost of six years of coverage (2014 through 2019). As I pointed out several months before the law passed, the true cost of paying for the law's coverage expansions over a full decade was more like $1.8 trillion—well above either the unofficial ceiling in Congress or the president's public estimate.

Now that we're closer to 2014, those costs are plain to see. Indeed, the cost of a full decade could hit $2 trillion. The Congressional Budget Office released updated estimates for the health law yesterday and reported that the gross cost of the coverage provisions between 2012 and 2022 is expected to come in around $1.76 trillion. That's an 11 year estimate, but it still only looks at nine years of fully expanded coverage; 2012 and 2013 add just $9 billion to the tab. But coverage in 2022 alone clocks in at $265 billion, a little more than the $250 billion cost projected for 2021. Add another year like that to the tally and the total skips past the $2 trillion mark.

All this is separate from whether the law reduces projected federal budget deficits. The law also includes a variety of tax mechanisms intended to raise revenue and Medicare payment tweaks designed to reduce spending by a little more than the cost of the expanded coverage provisions. The CBO sticks by its assessment that the law will reduce the deficit on net. But there are good reasons to be skeptical of those projections as well, especially now that we now have evidence that President Obama signed off on health reform budget gimmicks.

Read Philip Klein, who makes a similar point at The Washington Examiner.

Here's a great song about big numbers:

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  1. Brrrrr! Stick ’em! Hahaha! Stick ’em!

    Brrrrr! Stick ’em! Hahaha! Stick ’em!

  2. Brrrrr! Stick ’em! Hahaha! Stick ’em!

  3. Plus, I’m pretty sure they’ve scaled back, pretty far, their estimates of how many uninsured people will actually become insured under OCare.

    1. yep. coverage through employer and exchange market down, enrollment in Medicaid and CHIP up, and total number of remaining uninsured up.

  4. Brrrrr! Stick ’em! Hahaha! Stick ’em!

    1. Rock the beat with tha fresh funky rhythm…

  5. Health reform budget gimmick link is fubared.

  6. Wait, a bill passed with completely imaginary numbers turns out to cost more than initially anticipated?

    Say it ain’t so!

    1. Yep….government plan costs twice as much as initially estimated….what a surprise.

      The money cost is negligible in contrast to the loss of liberty involved with Obamacare.

      1. The money cost is negligible in contrast to the loss of liberty involved

        Property and liberty aren’t mutually exclusive. But yeah.

      2. But don’t worry: it’s going to reduce the deficit! Ahahahahahaha!

      3. The surprise is that it will only cost twice as much as estimated. Let me know when we hit the 5x mark and I’ll be impressed.

  7. Wonder how much more Romneycare would cost us.

  8. They’re just continuing the proud tradition of every federal health care program ever passed. Surely you’re not agaisnt tradition, right?

  9. Rush just talked about this. Saved some reading.

    1. Why do you think that anyone cares what Rush talked about?

      Anyway, there is only one entity that should be identified by the single name “Rush” and that is a Canadian prog-rock trio.

      1. Still not into you, even if you are a label in my blog.

        1. That’s OK Suki, I listen to Limbaugh from time to time, and I’ve been a Reason subscriber since the 1980s. I also listen to NPR occasionally.

          1. I listen to NPR sometimes. Watch PBS between obnoxious fundraisers too.

            1. Traitor!!!!11! 🙂

              1. If I already paid for it, I need to keep tabs on it.

      2. It’s YYZed! (sadly) And no, I can’t play it. Neil Peart stands alone.

        1. I CAN play YYZ. But I’m a bass player, not a drummer so….little different degree of difficulty.

          Also, Neil Peart SUCKS as a lyricist, and his drumming’s WAY overdone. But he is technically incredible.

          1. Does playing it on Guitar Hero count?

            1. Why not?

          2. Best lyrics ever in a rock band. It’s like Ayn Rand had triplets.

  10. Just two trillion dollars?

    That is less than the Iraq War will cost us according to a Nobel winner in economics (Stiglitz).

    Seriously, Medicare/caid costs $800 billion per year.

    1. To you people, everybody else’s money is small change. Right comrade?

      1. GOP = the party of big Government. You can’t scrape that Bush Shit off your shoes and you know it.

        1. Who the fuck said anything about the GOP?

          Goddamn Shriek, you’re an idiot. Libertariandoesn’t mean GOP.

          1. Suki did. The self-admitted Limbaugh dittlehead.

            1. Looking through the entire thread, Suki hasn’t mentioned the GOP once yet.

              Seriously, grow the fuck up and stop being TEAM BLUE’s bitch.

              1. I guess she/he was referring to Rush the band then.

                1. Neither one is the equivalent of the GOP.

              2. I rarely mention that party at all anyway. Applying the little commie troll’s logic, Reason is GOP because they said the same thing as Rush. Actually, troll thinks anything not Progressive/Commie/Democrat is GOP.

            2. Suki did. The self-admitted Limbaugh dittlehead.

              I listen to NPR and watch Bill Maher. Does that make me a Democrat?

              1. Only if you recite them as canon.

              2. They are not mouthpieces for a political party.

                Letterman is a liberal but not a mouthpiece for Democrats.

                Rush = mouthpiece for the GOP.

                1. Prove it – with unequivocal and absolute definitiveness.

                2. Rush = mouthpiece for the GOP.

                  And yet, somehow, he rarely manages to get his preferred candidates nominated…

                  1. He won’t endorse anyone. Never does. Remind us who he endorsed this cycle if I am wrong.

                    He just flaks for Team Red.

                    1. shrike|3.14.12 @ 3:00PM|#
                      “He just flaks for Team Red.”

                      So his cheerleading costume is from the team opposite yours.

                    2. He won’t endorse anyone, but you can tell he doesn’t want Romney or Paul.

        2. Not to beat a dead horse, but you do realize that their is no discernible difference between the parties right?


          1. One could make that argument.

            Actually I like a Dem president and a GOP House. The GOP becomes a drag coefficient when they don’t have the White House.

            1. No, you like the NSDAP and the KPD swapping off.

            2. That’s what I’m voting for.

    2. Maybe it is worth it. The point is that they lied and deceived and knew exactly what they were doing so that they could get this piece of shit passed. Government should not operate by sneaking stuff by people hoping that they don’t notice what is really happening.
      Wasn’t heath care reform supposed to save money? And these numbers don’t even count the huge cost of compliance put onto businesses and individuals.

      1. Yes, there was subterfuge involved in it.

        I can’t find evidence of compliance cost for any critical businesses. Someone like Google or Apple already complies.

        Our $7700 per person cost vs $3800 in Europe puts us at a competitive disadvantage as well as a tax disadvantage.

        That is the real cost. Medicare is the primary driver of that cost too.

        1. Our $7700 per person cost vs $3800 in Europe puts us at a competitive disadvantage as well as a tax disadvantage.


          Cause our GDP is still effectively the same as THE ENTIRETY of Europe, with roughly 1/3rd of their tax rate (averaged).

          I’d say we have the better end of that deal.

        2. I was wondering which place do you consider more capitalist ? Sweden, France or USA ?

          1. All three are capitalist.

            The US is more capitalist but I cannot prove it. I just see the effect.

        3. I can’t find evidence of compliance cost for any critical businesses. Someone like Google or Apple already complies.

          Well, not really. Once their plan loses its grandfathered status (and if it hasn’t already, it will), they have to suck up all the requirements, so they can’t “comply” without, at a minimum, changing their plans to include the extra benefits.

    3. Spending $2 trillion is only ok when we do it!

      1. And, of course, Obamacare is intended to last forever. The wars in Afghanistan and Iraq won’t.

        1. The wars in Afghanistan and Iraq won’t.

          So, you’re an optimist?

        2. “The wars in Afghanistan and Iraq won’t.”

          If Obama doesn’t get crowned.

    4. Not enough christfag.

      1. Hey, that’s my line!

    5. You know who else was a Nobel winner in economics…

      1. The little sign painting Keynesian won a Nobel Prize? I thought he only got onto the cover of Time a few times as he laid the intellectual path for the shrikes of today to follow.

        1. No. Sorry, I broke the mold; was referring to Krugnuts, just to take a swing at Shriek’s “Stiglitz” reference.

          1. Krugman is the new Goebbels and Zimmerman rolled into one.

    6. There is no such thing as Nobel winner in economics.

      Alfred Nobel didn’t establish a prize for economics.

      1. Thus proving he was smarter than we suspected. If only he hadn’t gotten a guilt complex about militarily useful exsplosives, we’d be spared the Outstanding Achievements in Killing Brown People Prize*, too.

        *Misnamed the Peace Prize.

        1. Identify yourself or stop jacking my best lines.

        2. Also, you don’t pluralize “achievement.” It’s singular, in reference to the body of work itself.

      2. There is no such thing as Nobel winner in economics.

        Sorta’ true, but misleading.
        The “Sveriges Riksbank Prize in Economic Sciences in Memory of Alfred Nobel” is commonly referred to as the “Nobel Prize in Economic Sciences.”

        1. And those who do so are the one’s being misleading.

    7. Sez the “free marketer, pro-choice” Shriek.

    8. Wasn’t Stiglitz the guy in “Inglourious Basterds” who killed all his own officers, and came over to join Lt. Aldo Raines and TEAM JEW-SA – FUCK YEAH!?

      So, a good guy…

  11. so, the U.S. is supposed to have the highest expenditures – for a industrialized nation – will Obamacare actually cut costs to get us to er, European levels? Or will it just be a big money suck?

    1. Or will it just be a big money suck?

      Even though I know it’s a rhetorical question, the act of asking seemed too obvious to bother.

  12. Based on the Canadian experience, you haven’t even begun to see how much this will cost you.

    Or the budget fights that will go on once it really gets rolling.

    < snark >
    But, don’t worry! I’m sure that the US Congress and the POTUS at the time will take the necessary action to deal with the issue completely.
    < /snark >

    1. That recent John Stossell video told us where to get quick healthcare in Canada.

    2. Laugh it up, canuckistani. I know you’re smart enough to realize that when we go down, y’all are coming along for the ride whether you want to or not.

      1. If I didn’t realize that, do you think I’d give a flying F**K about whether you spend yourselves into oblivion?

  13. I have to question the characterization of that song as “great.”

  14. Dr. Evil is good for this story, but this is a clear case where the Thelma and Louise pic should have been used.

    1. For the thievery metaphor, or the jumping off a cliff metaphor?

  15. The CBO sticks by its assessment that the law will reduce the deficit on net.

    It’s all fine! CBO SAYS SO.

    Duh! What’s everyone freaking out about? For a magazine called “Reason”…

  16. The CBO sticks by its assessment that the law will reduce the deficit on net.

    Even though its costs have already doubled!

    Something tells me that assessment relies on things like ACOs and so forth working miracles on the cost curve. As far as ACOs go, that projection is already in the shitter.

    1. Read my lips, RC:

      The. CBO. Says. It’s. Gone. Be. OK!

      So it’s all good in the hood, bruthaman – ain’t got nuttin’ to worry ’bout nuttin’. Smoother ‘n Silky’s pitch to wimmins, shonuff.

      Solid. Right on….j’a be coo….

      *hand slap*

    2. The CBO has to make their assessments based upon what the laws say will happen. So if the law says that every dollar spent by the government on health care will magically cause a gold coin to drop out of the air and land in the treasury, that’s how the CBO has to calculate it.

      1. Gold coins dropping out of the air! Why didn’t I think of that! GENIUS!

  17. How can they say this when the doc fix has not been implemented like the law specified? Are they still scoring costs as if the new doc fixes had never been passed, or are they now scoring based on the assumption that the last doc fix was the last that will happen? I would really like know their methods now.


  19. $2 trillion? Screw that. We all know it’s going to cost ever more.

    Why not be honest and, when anybody ask how much it costs, you laugh, throw up your hands and yell “$11ty skidillion”

  20. The left doesn’t give a damn how much this costs. They just don’t.

  21. BTW, Peter, the last link in the third to the last paragraph is broken (“evidence that President Obama signed off on health reform budget gimmicks”).

  22. Our $7700 per person cost vs $3800 in Europe puts us at a competitive disadvantage as well as a tax disadvantage.

    If you put the kinds of cost controls, rationing and waiting times* of the European systems in place here the Al Sharptons and David Dukes would be on them in a flash contending that their victimized group was getting the worst of the deal. If you think we have a litigious victim culture now, wait till there’s a real Euro style welfare state in place.

    *combined with the some of the shitty facilities that prevail there. But that’s mostly in England, which varies from excellent to positively 19th century in quality depending on the hospital trust managing things. And, in fairness, almost no one is advocating an English-style system.

  23. In my opinion, Obama?s administration did two major mistakes. It bailed out the banking sector (to which prof. Stiglitz refers as Privatizing Profits, Socializing Losses) and also started the health care reform. The money needed for the fading industry and service sector were pumped to something, that would not function under such conditions. I hope that next president will be a Republican, who will actually do something about the current unpleasant situation.

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