"The basic budgetary facts are not in dispute.
When Obamacare was enacted, the official cost estimate was roughly $900 billion over the period from 2010 through 2019. However, the health law’s cumulative costs have since roughly doubled as more of its provisions come online.
The simple difference in the time period, plus the increase in massive new entitlement spending, has started to bring the law’s true costs into sharper focus. For 2015 through 2024, CBO now estimates that the insurance subsidies and the big Medicaid expansions will cost $1.89 trillion. President Obama initially promised that he would not sign a bill that added “one dime” to the federal deficits.
And the ACA did indeed include various measures to offset its costs, particularly steep Medicare payment reductions and some big tax hikes.
But in both cases, the pay cuts and richer revenues will generate intense political opposition.
In its 2010 assessment of the law, the CBO formally expressed doubtas to whether the Medicare payment policies could be sustained. Curiously, during his questioning with Gruber at the House hearing, Rep. Stephen Lynch (D-Mass.) complained of the law’s 40 percent excise tax on high-cost, union-negotiated plans. Organized labor, as Lynch indicated, hates that tax. Other Obamacare taxes are almost universally unpopular, such as the medical device tax that hits a lot of biotechnology firms in some very liberal states.
It’s only 2014, and the health law’s big spending provisions, such as the exchange subsidies and the Medicaid expansion, are just up and running. Assuming it continues in its current form, Obamacare’s big spending spree is certain to soar, and may turn out to be even higher than the CBO’s projections."
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