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Repeal or "Fix"

The debate over Obamacare narrows.

10:35 AM, Oct 5, 2010 • By JEFFREY H. ANDERSON
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Less than a month before the midterm elections, candidates of both parties seem to have found something on which they can agree: There’s no sense in trying to defend Obamacare as it was passed by Congress and signed into law by the president. Instead, the debate over the federal health care overhaul has devolved into a contest between two opposing positions, staked out (for example) in one Senate race by candidates Rand Paul (R., Ky.) and Jack Conway (D., Ky.) and aptly characterized by Conway on Fox News Sunday: “I’d like to fix [Obamacare], and [Paul] wants to repeal it.”  

Repeal or "Fix"

The fact that we’ve gotten to this point is quite telling. When President Obama signed Obamacare into law on March 23, he wasn’t predicting that a debate over fixing versus repealing would characterize the lead-up to the November 2 midterm election.  Yet, just a few months after the law’s passage and more than three years before it would be implemented in any meaningful degree, even Obamacare’s supporters are granting that it’s broken.  (If not, why the need to “fix” it?)

The question, then, would seem to be whether Obamacare is really worth trying to fix, and a review of its effects in three key areas might help provide the answer.

Federal spending:  The widely publicized 10-year price-tag for Obamacare estimated by the Congressional Budget Office (CBO) was $938 billion. The CBO has since bumped up its estimate by $115 billion, bringing the tally to $1.053 trillion. However, this is only the CBO’s estimate for 2010 to 2019, while Obamacare wouldn’t go into effect in any meaningful way until 2014. According to the CBO, less than 2 percent of Obamacare’s publicized “10-year” costs would hit before its fifth year.

For Obamacare’s real first decade (2014 to 2023), the CBO projects that its costs would be $2.0 trillion, including nearly $300 billion in 2023 alone (meaning that, at the end of Obamacare's real first decade, costs would still very much be rising).

Moreover, the CBO never presented this $2.0 trillion estimate for Obamacare’s real first decade — or the more widely reported $938 billion estimate for what essentially amounts to Obamacare’s first six years — as the total cost of Obamacare.  Rather, this estimate was for the “gross cost of coverage provisions.”  The White House and Congressional Democrats highlighted this number, and (partly because the CBO doesn’t present the total number in anything like a clear fashion) the press ran with it.  But the CBO doesn’t present this as Obamacare’s total tab, which would be higher still.  

With America already facing a $13 trillion national debt, how would the Democrats pay for this (to the extent that they would)? According to the CBO, they would pay for it by siphoning $1.1 trillion (from 2014 to 2023) out of Medicare and other federal health care programs and spending it on Obamacare — and by raising taxes and fines on the American people by a cool $1.0 trillion (in addition to the tax increases that will result from their letting the Bush tax cuts expire).  

Health costs:  The CBO says that, in the individual market, the typical American family’s annual health care premiums by the end of this decade would be 10 to 13 percent higher under Obamacare than they would be without Obamacare — an increase of $2,100 per family, per year. Medicare’s chief actuary says that Obamacare would also raise overall nationwide health costs from 17 percent of the gross domestic product (GDP) today to 21 percent of GDP by the end of the decade — making costs $311 billion higher than they are projected to be without Obamacare.  

Even President Obama is now saying that Obamacare is “going to increase our costs,” and “we knew that” all along. But pre-passage, the president said nothing of the kind. Instead, he insisted that Obamacare would bend the cost-curve down. The Washington Post reported that he “flatly” told them that he would not “accept a bill that doesn't ‘bend the curve’ on rising health-care costs.”  Helpfully, senatorial candidate Conway now says, “We need to find some ways to control costs”—a curious statement in the wake of his party’s having just passed a mammoth, $2 trillion overhaul that would allegedly do just that.

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