Health care reform

Paper Tries to Debunk Claims About ObamaCare's Effect on the Deficit Without Mentioning Arguments About Why ObamaCare Will Increase the Deficit


When attempting to debunk a common argument, I tend to think it's usually helpful to understand what that argument is. The nameless editorial writers at the Tampa Bay Times, on the other hand, don't seem to think that's necessary.

In an unsigned editorial this weekend, the paper claims to "debunk" arguments about ObamaCare's effect on the deficit. Here's how it starts.

One of the chief Republican objections to health care reform is that it will add too much to the deficit and the nation can't afford it. The problem with this claim is that it's wrong. The Congressional Budget Office has consistently maintained that the Affordable Care Act reduces the deficit by tens of billions of dollars even as it extends health coverage to millions of Americans. 

It then goes on to summarize the most recent CBO assessment of the health law's projected coverage and budgetary effects, as if that were all the evidence one needed to declare with absolute confidence that the law will reduce the deficit. 

It's a remarkable exercise in missing the point: ObamaCare's critics contend that the CBO's projections are quite likely to be wrong, and have put forth a number of arguments about why. The TBT editorial doesn't mention, much less attempt to respond to, a single one of those arguments. The closest it comes is a brief mention of Rep. Tom Price's (R-Georgia) statement that the law is projected to require $1.7 trillion in spending over the next decade, which is not really an argument about the budget gap at all but a instead statement of the law's total projected spending without regard to its effect on the budget deficit. Otherwise, it reads as if the editorial's author does not even know that those arguments exist. 

Happily, that can be remedied. The basic problem with the CBO's method of scoring the health law is that it is required to assume two things: that current law will continue precisely in its current form and that no further changes will be made, and that laws will be implemented exactly as called for by the relevant legislative text. It's a useful budgetary exercise, but it's rarely an accurate representation of how legislation works (or doesn't) over time. 

For example, in order for ObamaCare to reduce the deficit, ObamaCare will have to generate substantial savings over the preexisting budget baseline for Medicare. As a matter of convention, CBO scores those Medicare savings as if they will happen exactly as the law's authors envision. But Medicare savings schemes have historically proved difficult to maintain. And ObamaCare's proposed Medicare savings, which hinge in large part on provider productivity improvements, do not seem particularly promising: Medicare's own chief actuary has warned that "there is a strong likelihood" that changes called for by ObamaCare "will not be viable in the long run." 

Even the CBO, the source of the TBT editorial's deficit numbers, seems to agree that, at the very least, this is a possibility worth considering. In its alternative budget baseline following the law's passage, the budget office included the assumption that the Medicare savings called for by the law would not be sustainable after the end of this decade, going out of its way to highlight "the important implications of those health care policies for the federal budget." Hint, hint, wink, wink. 

What if the law's Medicare savings do pay off? Is the budget in the clear? Sorry, but no. The problem here is that long-held budgetary scoring conventions allow the savings to be "spent twice," once on expanded health coverage, and again on shoring up Medicare. It's all part of the way Medicare's trust fund accounting works: A dollar becomes available and it is marked as being present in the "trust fund." In the meantime, that dollar is spent on something else, but it is still recorded as being in the trust fund, despite having already been spent. Which means that eventually the governemnt will need to raise taxes, borrow, or cut some other spending in order to make up for that dollar that's recorded as being present in the trust fund but isn't. 

Again, the CBO agrees with this assessment: In December 2009, director Douglas Elmendorf explained that "to describe the full amount of [Medicare] HI trust fund savings as both improving the government's ability to pay future Medicare benefits and financing new spending outside of Medicare would essentially double-count a large share of those savings and thus overstate the improvement in the government's fiscal position."

That has serious consequences. When Charles Blahous, one of Medicare's public trustees, ran the numbers earlier this year, he found that in every single scenario, even those in which all of the law's savings come to fruition as hoped for, the law still increases the deficit thanks to this double counting. 

You wouldn't know any of this from reading the TBT editorial. Who could possibly believe that there was any remotely plausible alternative to the single, decade-long projection offered by the CBO? I mean, besides the CBO, which warned lawmakers in prepared testimony that although it had put great care into its estimates, "the actual outcomes will surely differ from those estimates" in part because ObamaCare "will put into effect a number of policies that might be difficult to sustain over a long period of time."

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  1. I like the cutesy sign in front of his lectern. When I run for President, my sign will say PUPPIES AND KITTENS.

    1. Puppies and kittens killed my Aunt Mildred.

      1. She deserved it. You gotta admit.

      2. Your aunt Mildred was a fucking whore.

        1. So you knew her, too

        2. BE THAT AS IT MAY… And I don’t have to admit anything. I don’t know how those puppies and kittens got into the house of someone so highly allergic, but her will clearly stated who the beneficiary was to be and anyway the case is considered closed.

          1. …but her will clearly stated who the beneficiary was to be and anyway the case is considered closed.

            Congratulations on your new found success.

            1. If you’ve got an windfall, you didn’t inherit that. Somebody else made that happen.

    2. Mine says Hookers and Blow

      Almanian – 2012
      I Can Handle The Truth


      1. That’s what I have tattooed on my forehead.

        1. I thought it said POOR CONTINENCE CONTROL.

          1. No, it says WARNING: PRONE TO ANAL PROLAPSE.

            1. No, no no. This is me.

              1. No, no no. This is me.

                Warty is a 404 error. Whoa.

                1. Warty is a 404 error. Whoa.

                  Close enough. Curse you, broken preview.

              2. Funny I’ve always pictured Warty as the Orange hair man in Johnny English.

                1. http://moviescreenshots.blogsp…..-2003.html

                  The best I could find scroll about halfway down.

            2. No, you moron. I’ve seen the surveillance photos. That’s his tramp stamp.

              Maybe people who don’t know anything about the science shouldn’t venture stupid opinions.

              1. Fuck you, the science is settled, and his tramp stamp says “DELIVERIES IN REAR”.

    4. And Pink Ponies.

    5. Mine will say “Free Ponies for All”.

  2. The Tampa Bay Times can either flack for Obama or check facts. They made their choice… why can’t you just be happy for them?

    1. Why do you always have to criticize the TBT’s boyfriends? They aren’t smart enough, they aren’t good enough, they are scum bag lying politicians?

  3. Also the CBO estimates about Obamacare and the deficit rest solely on all aspects of the law being implemented and working. Politically, this is not going to happen. States are going to opt out of the Medicaid expansion and some more ballsy states will decline to set up the insurance exchange.

  4. Is that the same picture they ran with the editorial?

  5. Wait – you mean this might not turn out the way they SAID it would?

    What the HELL??!!

  6. Come on Suderman, remember when unemployment dropped below 8% after the stimulus?

  7. Who knows what the hell the real deficit is anymore these days, now that the Treasury Department is playing games and fudging the debt and deficit numbers to an extent that it has never approached before in our history.

    1. You know who else fudged the numbers?

      1. You know who else fudged the numbers?

        The Keebler Elves? They put fudge on everything.

        1. That’s not fudge…

  8. Your aunt Mildred was a fucking whore.

    Someone is technically not a “whore” if they give away pussy for free to anyone who asks for it.

    Posting here since threaded comments won’t post for me.

  9. The Tampa Bay Times was formerly the St. Petersburg Times and claimed that they changed the name to better reflect the region they serve, but actually change their name to disassociated themselves with their reputation as a liberal mouth piece that was losing readership at record pace. Of course the real reason that they continue to lose subscribers is because of the horribly unconvincing crap they print.

    1. Yes and no. They also changed their name so people would confuse them with the Tampa Tribune.

      1. They’re probably jealous because the Tribune has a better comics section.

      2. They should be merged into The Tampa Tribtime Tampa Baybune.

        1. I still wouldn’t read it.

    2. They should rename themselves The Tampa Baywatch.

  10. If you question the relevance/accuracy of the CBO score in any way, the liberals just retort that it’s “bipartisan” so it must be right and you’re just being partisan.

    1. The thing is, it is right, except when it’s not.

      1. I’m so glad that they were right about Medicare and it turned out so cheap.

        1. You aren’t supposed to bring up those past massive miscalculations.

          That’s supposed to be lost down the memory hole.

        2. Every government program winds up cheaper and better-run than expected. When you think of thrifty and efficient, doesn’t “federal government” come immediately to mind?

    2. Yes the liberals are well versed in circular logic.

      The CBO score was predicated on liberal democrat’s fairly tale assumptions.

      And the same CBO score is then used as “proof” that the legislation is fiscally sound.

      Kind of like the way the Keynseseans point to economic models built on the assumption that Keynesean economic theory is valid as “proof” that the “stimulus” package worked.

  11. current law will continue precisely in its current form and that no further changes will be made, and that laws will be implemented exactly as called for by the relevant legislative text.

    I’m wondering if that includes budgeting for

    (a) no tax bennies/premium support for people in states without a state exchange, and

    (b) no penaltaxes on businesses in states without a state exchange.

    Because that’s the way its written.

    I understand that they would have to guesstimate how many, and maybe even which, states won’t have exchanges, but hey, if Top Men can’t guesstimate their way through budgets, then the universe has no meaning.

    1. Whoa, there slick. Top Men don’t need budgets. Top Men use continuing resolutions.

      1. Not just any dumb old hayseeds can go three years without a budget; only the most educated people in the country can pull off those kinds of wealth-creating feats.

    2. The penalties on businesses aren’t taxes, since businesses actively affect interstate commerce and thus the penalties count as regulation under that clause.

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