Why It Matters That ObamaCare's Coverage Expansions Will Cost $2 Trillion Over a Decade


The Boston Globe editorial board says we shouldn't be concerned about the cost of ObamaCare and points to a recent Congressional Budget Office memo to prove it:

The latest attack on the Affordable Care Act, otherwise known as Obamacare, is the claim that its long-term cost has suddenly spiked from around $1 trillion to $1.7 trillion. Because the new figure is plucked from a March Congressional Budget Office estimate, opponents of the law contend that the agency's analysis shows it will be a budgetary disaster.

But as with so many assertions by critics of Obamacare, this one is misleading. Or as the CBO puts it: "Some of the commentary . . . has suggested that CBO and [the Joint Committee on Taxation] have changed their estimates of the effects of the ACA to a significant degree. That's not our perspective."

It's true that the Congressional Budget Office did not substantially change the way it estimated the effects of the health care overhaul. What it did do, however, was update its estimates to reflect nearly a full decade of implementation—which gives a better idea of the true cost of running the law over 10 years.

As I noted when the updated scores were released in March, the important thing to remember is that when the law was passed in 2010, CBO's scores looked at the cost of the law over the decade immediately following passage. But the major coverage expansions (health insurance subsidies and Medicaid)—and thus the bulk of the spending—are not scheduled to kick in until 2014.

What that means is that the initial score of slightly less than $1 trillion only reflected the cost of six years of expanded coverage. That number was important to getting the law passed, but it wasn't a great reflection of the true cost of a full decade of expanded coverage. Since we're now closer to the time when those coverage expansions are set to go live, CBO's revised scores give us a better idea of what a decade of expanded health insurance actually costs: The real price tag of the spending on coverage turns out to be closer to $2 trillion. 

This is not a dramatic shift in the CBO's view of the law, and doesn't give us a whole lot of new information, at least for those who were paying attention. We have better detail now, and official numbers, but estimates indicated that paying for the law's coverage expansions for a full decade would cost $1.8 trillion or more months before the law passed

The numbers have been updated since the following graphic was created in 2009, but it gives a pretty good idea of why the newer scores are so much higher.

NEXT: Katherine Mangu-Ward on Medical Marijuana

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  1. fsrit

        1. Ralph: What’s a battle?
          Skinner: Hahahaha, lets go.
          Chalmers: Did that boy say, “What’s a battle?”
          Skinner: No, he said, “What’s that rattle?” It’s about the heating duct.
          Chalmers: Hmm, it sounded like battle.
          Skinner: I’ve had a cold, so —
          Chalmers: Oh, so you hear r’s as b’s?
          Skinner: Yes.
          Chalmers: I understand.

      1. I can’t see what T wrote, and that makes me anxious.

        1. Don’t worry, once we immanentize the eschaton, it won’t matter.

          1. He must be broken so that he can be put back together properly.

        2. It’s a perfectly cromulent word.

  2. I still can’t get over this bandying about of the word “trillion.” It’s just too much.

    1. Would you prefer gazillion? Or would you like something even more abstract?

      1. But it’s not abstract. They actually are talking about real money that we don’t have.

        1. When someone says “billions” and “trillions”, if you can honestly envision that much cash (or whatever currency) as actually, truly tangible as oppoosed to ledgers and zeros, you’re a better man than I, Pro’L Dib.

          Just because I can grasp the concept of Avogadro’s number, doesn’t mean I can imagine that many discrete particles.

          1. I can envision billions, as that’s what I require to run my own personal space program.

              1. This one is good too.

                Yeah, that one is much better.

                I wonder how many Legos it would take to build all those structures?

            1. I think you really are Sir Richard Branson. I was too quick to accuse TAO as the limey. The mask slippeth.

              Come to think of it, it was you that accused me of being Canadian.

              I smell a false flag operation here.

              1. That’s nonsense. Utterly absurd. He’s focused on suborbital, which is for Limey losers.

              2. I have it on good authority that Pro D’Lib is Prince Phillip’s body double.

                1. Good SOD, the poor ugly bastard! You should just go and kill yourself, Pro’L Dib. That gene pool needs to be drained. You were discussing the merits of eugenics yesterday. no?

                  1. Yes, I was. Inbreeding is a mistake, and that’s all I’m going to say on the topic.

                    1. As you wish, but I’ll lay better than even odds you are a hemophiliac.

                    2. I may be an heir to the Scottish throne, I’ll grant that. But that goes back a ways.

            1. Oh, I get that. Really, I do. But to actually see a physical, big pile of money like that would really drive the point home.

        2. They actually are talking about real money that we don’t have.

          But we will have it. Ten years from now, when a basic man’s haircut will cost $100,000, we’ll be rolling in trillions.

      2. When I was a kid the only place you saw the word trillion was in astronomy class and sliderule errors.

        1. Sliderule? Should I get off your lawn, grandpa?

          1. Grandpas, I just realized, are the most egregious Gambol Lockdown offenders.

            1. Grandpas, I just realized, are the most egregious Gambol Lockdown offenders.

              Yes, we are! Stack’s reaction to my offer to let her use my land in BC put the lie to her claim of resenting her Gambol Lockdown. She wasn’t willing to try living like the Iron Age, much less the Stone Age.

          2. My high school physics teacher used to offer 5 extra points on exams if you used a sliderule.

            1. My high school physics teacher used to offer 5 extra points on exams if you used a sliderule.

              My father gave me a fine sliderule made of bamboo. I didn’t have an LED calculator until high school. It was quite expensive.

              1. I remember when my younger brother bought my dad a Bowmar Brain for Xmas one year. $100 for a four-function calculator. I went through HS and a year of college with a slide rule. I don’t think they even teach how to use one now.

                1. My people have been technical from way back. I have my grandfather’s old slide rule. He bought it go through UFlorida back in the late 20s (class of ’31, I believe). I theoretically know how to use it, but in practice I have to look it up every time. I’m way faster with my old HP using RPN.

                  1. +++ this.

                    I still use my HP-41CV. I can’t use non-RPN calculators anymore.

          3. Sliderule? Should I get off your lawn, grandpa?

            Nah, trample the dandelions all you want. They come right back.

        2. And on any show narrated by Carl Sagan.

          1. And on any show narrated by Carl Sagan.

            True. Still, astronomy. And I wasn’t a kid by the time he was doing Cosmos.

      1. Even billions are too much. I could do more real good with billions than the government could. Maybe they should just hand over all of that money to me.

        1. The world doesn’t need your vision of an all-Sulu Star Trek revival, PL.

          1. You know, I actually fall into the Shatner camp more than the Takei one. Despite Sulu Friday.

          2. LACIST!

          3. OH MY!

    2. it’s easier than “million squared”.

    3. I believe the technical distinction between billion and trillion is “more money than you can shake a stick at” and “more money than you can shake a stick at – plus the stick”.

      1. “more money than you can shake a stick at – plus the stick a mountain of the sticks”

  3. Does in anyone in Congress really care what a fiscal disaster this will be 10 years from now? I can’t think of a reason why any of them would.

    1. Because based on historical reelection rates, a majority of the current ignuts will still be there.

      1. so based on re-election rates, voters don’t care about the looming disaster any more than Congress does. And humans are the smart species.

        1. Makes you proud, don’t it?

    2. how many of them will still be alive in 10yrs?

  4. Another important aspect of this is the way costs grow every year. Even if what they claim is the cost of the first ten years was the actual cost, they can’t possibly say they think it will cost the same the next ten years. It’s just another growing entitlement. It’s like they want us to reach the tipping point faster. My guess is to create a crisis to assume more control.

    1. That graph indicates that they are predicting the cost will grow steadily year over year. Of course, we know, based on Medicare and such that their estimate of the growth rate is way too low. Way, WAY too low.

  5. “Cost” is an accounting opinion as in actual, average, weighted, etc.

    Yesterday the cost was $34 billion a year according to a GOP Medicare trustee.


    1. Which is, in itself, a refutation to the assertion that it would save us money.

      If you look at the actuals vs the projected of statist healthcare schemes, it’s more likely this will cost a trillion or more. Just what we need to get off the bullet train to insolvency and onto the rocket chair to insolvency.

      1. We get to ride a rocket chair?

        1. It’s not going to be that fun, but the brick wall will be every bit as painful.

          1. So… we’re going to be drugged during the ride and only come to a moment before impact? Sounds like my first relationship…

      2. I agree that the current statist health system is the worst of all worlds.

        High taxes support ridiculous expenses but only for the dying and elderly.

        1. So how do you keep all that tax money going to granny and gramps?

          Death panel?

          1. IPAB and smoothing the benefits curve.

            So yes. Richard Lamm was right.

            1. What’s the difference between the IPAB and a Death Panel?

              Are you saying that ditz Palin was right?

              1. in practice, of course she was right. Look at European systems and how many treatments are NOT provided to folks of a certain age. Cost/benefit analysis sounds much nicer, but the outcome is no different.

                1. Cost/benefit analysis sounds much nicer, but the outcome is no different.

                  Yeah, they wrap it in a lot of slimy, wonkish jargon, but when it comes down to it Granny and Gramps are fucked.

                  All in the name of compassion!

                  1. Yeah, they wrap it in a lot of slimy, wonkish jargon, but when it comes down to it Granny and Gramps are fucked.

                    Fitting, since they are the ones who started this mess.

              2. There are no death panels for dead people. That is where Snow Snooki erred.

                1. There are no death panels for dead people.

                  Brilliant observation. And for living people? I imagine you’re going to make it policy to deny them treatment, no?

                  Again, what’s the difference between the IPAB and a Death Panel?

                  1. I support death panels for the dying and near dead.

                    I am honest.

                    1. I support death panels for the dying and near dead.

                      I shouldn’t engage you, but this time I can’t help it.

                      Gabby Giffords. You are the attending ER physician.

                      Does she live or die?

                    2. I support death panels for the dying and near dead.

                      I do as well, it’s just that in my world, the death panel would be composed of the individual and family members, not some bureaucrats.

  6. but but it just cant be that health care costs will inflate over the same time period w/o ACA can it?! >so deduct that out my lil sliderule challenged libtoidz mmmkay

    1. The point isn’t that inflation won’t blow up healthcare costs, the point is that ACA won’t do a damn thing to stop it.

  7. So you repeal ObamaCare and the economy saves $1.7 Trillion. Is that what you’re saying?

    As of today, ObamaCare repeal would be a $1.7 Trillion ‘free lunch’ for the U.S. economy?

    $1.7 Trillion right back into our pockets?

    1. $1.7 Trillion right back into our pockets?
      of course…isn’t that where all money the govt “saves” goes?

      1. You can’t save money that doesn’t exist.

        1. clearly, there is no room in elected office for anyone with that type of thinking. Haven’t you been watching. Congress “saves” money all the time; simply spending 5% more instead of 10% more is saving. That either percentage has to be borrowed is irrelevant.

          1. I just hate the children

    2. Now you got it! That’s not just government math though – I was broke last month when I noticed driving by the Chevy dealer that I could save $5000 on a new Chevy truck so I went in and bought two of them. Going to buy two more next month, too. I was thinking of buying 20 next month but then I figured, nah, that’s just being fucking greedy.

  8. OT: (and for the lolz)

    Nickelback churns out big, dumb rock during pyro-laden Van Andel Arena show

    Just to show that Nickelback is emotionally diverse, Peake sat down at a piano for “Lullaby,” which was followed by the hokiest of we-must-stand-together rah-rah anthems, appropriately titled “When We Stand Together.” Kroeger said the latter was about “all of mankind uniting and making the world a better place,” which was funny, because mankind is clearly divided between those who love Nickelback and those who hate Nickelback, and is more likely to come together with the destruction of Nickelback.

    Towards the end of the show, Kroeger asked the crowd, “Would you like some half-cups of beer thrown at you?”, and then proceeded to “jam on some metal” with his bandmates as stagehands threw half-cups of beer into the crowd, hopefully to those aged 21 and older, not that any of the beer was consumable by the time it flew through the air and landed in your lap. The band then hammered away at frat-rocker “Burn it to the Ground,” which is about getting plowed and breaking stuff, as flamepots whooshed.

    1. Do you live in Grand Rapids? As far as I am concerned, Nickelback can stay in Michigan. They deserve each other.

      1. why yes I do. And no, I wasn’t at the concert.

      2. Is Nickelcreek, Nickleback’s retarded country cousins?

      3. I agree. If we can’t rid ourselves of the EPA, the lease it could do is place excessive regulations on Nickleback.

        In fact, I propose that it be its only function.

  9. Come on guys. It is not like all of the scaremongers who back when medicare and medicaid passed that they would bankrupt us were right or anything. Those programs stayed small programs to help the most deserving poor and elderly just exactly like their supporters said the would. Right?

    So there is no reason to believe the scaremongers now.

    1. my entire supply of Sarcasmometers, including the ones still in the box without batteries installed, just exploded.

  10. gotta love how the Globe piously calls someone pointing the truth an “attack”. It’s like the paper does not know what the CBO is or what it does.

    1. The truth is racist. Didn’t you know that?

      1. Facts have a strong liberal bias.

        That is why scientists shun the GOP with only 6% of all scientists are GOP.

        1. of course, 94% of “scientists” side with Dems. People dependent on govt funding tend to side with those willing to dole it out.

          1. Don’t feed it wareagle. Just walk away. The more attention you pay to it the more often it comes out of its hole.

        2. Most accountants and engineers are Republicans. Therefore, numbers, physics, and gravity all must have a conservative bias.

          Do you see how retarded that is, shrike?

          1. That is absurd. I can back my claim up and you cannot.

            Accounting is overweight with my Jewish pals – overwhelmingly liberal and anti-fascist.

            1. All those Jews. Let me guess all of your black friends are good basketball players.

              God your are pathetic Shreek.

              1. Jews don’t like fascists (Republicans) and that is a fact.

                1. Good thing Democrats don’t hate Israel or anything.

                  1. John, John, John….what were you telling me?

                    1. John, John, John….what were you telling me?

                      Do as John says, not as John does.

                      Besides, sometimes he actually has a troll-repellent effect.

            2. Shrike, there’s plenty of data on that. I didn’t see a cite for your “science” claim either.

              1. http://www.economist.com/blogs…..12/science

                One of the many reasons conservatives here hate me so much. I have facts and they don’t.

                1. so Repubs choose to not go into govt work. Stop the presses. If anything, you should be alarmed that scientists have allowed themselves to become an arm of the state, bought and paid for by politicians looking for specific outcomes. Can’t imagine why folks are skeptical of science.

                  1. Bullshit. Most scientists are privately employed.

                    Creationism and climate ignorance is harsh on the GOP.

                2. For fuck’s sake, I can tell you why scientists (barely) tend to be Democrats and are rarely Republicans (don’t forget about the 40% unaffiliated). It’s peer pressure. Most of them don’t want to be associated with the social conservatives and literal Biblical interpretations of history and science. The Republican Party carries that stigma, thanks to decades of unprincipled pandering to the socons on wedge issues.

                  1. Yes. I despise SoCons as well. That is my fondest wish – to rid Congress of the Jim DeMint assholes.

                3. One of the many reasons conservatives here hate me so much. I have facts and they don’t.

                  Sure, just like your claim that the deficit and the national debt have nothing to do with each other.

                4. One of the many reasons conservatives here hate me so much. I have facts and they don’t.

                  Mostly because you lie by omission. There are over 20 million scientist in the US. Less than 1% of them are members of the AAAS. The AAAS membership is overwhelmingly academics (government rent seekers). The survey by Pew that comes up with the 6% Republicans only applies to AAAS members.

                  The survey of scientist was conducted online with a random sample of 2,533 members of the American Association for the Advancement of Science (AAAS) ?.

                  It makes you “scientists shun the GOP with only 6% of all scientists are GOP” a lie.

          2. Do you see how retarded that is, shrike?

            Rest assured he doesn’t.

            Now let him get back to jerking off over his Warren Buffett poster.

            1. I would absolutely jerk off over $45 billion earned the capitalist way – with brains.

              1. $45 billion earned the capitalist way – with brains.

                I don’t think zombies HAVE $45billion, and even if they did, some of that would have to be spent on tattered clothing and dilapidated buildings for them to moan-around in.

                1. They are the 99%.

        3. I wonder, are those the same scientists who crank out bogus “research” by the scores? I seem to recall a recent article about a guy at Amgen who could only reproduce results from 36 of 43 high-profile experiments published in top journals.

          1. Yeah, I read that too. So much for all that government funded basic science.

        4. Re: Shrike,

          Facts have a strong liberal bias.

          And sunflower seeds have a nice personality.

          1. And sunflower seeds have a nice personality.

            I lol’d. Very artful construction of nonsense.

          2. OM, too bad you couldn’t cut it at Dope. The average IQ is about 50 points above H&R.

            1. Re: shriek,

              OM, too bad you couldn’t cut it at Dope.

              I left that forum a very long time ago when the economics-ignorant raised their ugly heads like so many weeds. After a guy asserted that his decisions were not economic, I just laughed and left.

        5. Facts have a strong liberal bias.

          For instance, check out this fascinating case of liberal academia at its finest:


      2. good things the Obamatrons save the race argument for the important things. Imagine if it was their default response. I bet those unemployed are racists, too; not getting jobs on purpose so POTUS looks bad.

  11. http://www.popsci.com/science/…..le-forever

    Lab grown humans are a step closer.

    1. Finally, the perfect food source

      1. C-A-R-N-I-V-O-R-E

      2. C-A-R-N-I-V-O-R-E

      3. Ambrosia

  12. But healthcare is a universal right so who cares how much it costs. After the basic right of a retirement and healthcare and the soon to be discovered right of a job, we won’t care about the cost of anything because we’ll all work for the g’ment.

    1. Medical care =/= health care.

    2. You know who else had a constitution that gave eveyone a right to a job?

      1. Ramses?

      2. Chuck Norris?

    3. Re: Number 7,

      But healthcare is a universal right

      Kodos for HHS secretary!

      we won’t care about the cost of anything because we’ll all work for the g’ment.

      “In Russia, Government works you!”

  13. Really, it doesn’t matter. A trillion here, a trillion there.
    We are so fucking doomed.

    1. From the richest civilization in history to the brokest civilization in history in just fifty short years.

      1. The Great Society won. We’ll all be equal now.

    2. …pretty soon you’re talking about real money

  14. Suderman is the anti-Obama. He posts a two picture article with only one alt-text!

    1. it means “that’s as far to the left as I can go in this term. But if I am re-elected….”

    2. You want alt-text on graphs, too?

      1. Alt-text everywhere.

  15. But we’ll make it up by selling all those rainbow colored unicorns that will appear in the Obamessiah’s second term.

    1. Sorry, they walked into the blades of the giant windmills.
      We’ll feed the meat to the orphans.

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