Tag Archives: congressional budget office

Health Alerts

CBO: Obamacare’s Uninsured Up 5 Million, Medicaid Dependents Up 16 Million Since Initial Estimate

half full or half empty?

(A version of this Health Alert was published by Forbes.)

Last week’s Congressional Budget Office’s Updated Budget Projections: 2016 to 2026 significantly reduced estimates of Obamacare’s benefits, relative to CBO’s estimates published in 2010, when the law was signed:

  • In 2010, CBO estimated Obamacare would leave 22 million uninsured in 2016 through 2019. This month, CBO estimates Obamacare will leave 27 million uninsured through 2019 – an increase of almost one quarter.
  • In 2010, CBO estimated Obamacare would leave 163 million with employer-based health benefits in 2016 and 159 million in 2019. This month, CBO estimates Obamacare will leave only 155 million with employer-based plans. The number will decrease to 152 million in 2019.
  • In 2010, CBO estimated Obamacare exchanges would enroll 21 million people in 2016, increasing to 24 million in 2019. This month, CBO estimates Obamacare’s exchanges will enroll only 13 million people this year, and 20 million in 2019.
  • In 2010, CBO estimated Obamacare would result in 52 million Americans remaining or falling into dependency on Medicaid or the Children’s Health Insurance Program, the welfare programs jointly funded by state and federal governments that subsidizes low-income households’ health care, in 2016. CBO estimated that figure would drop slightly to 51 million in 2019. This month, CBO estimates 68 million will be dependent on the program this year through 2019 – an increase of almost one third in the welfare caseload.

Continue reading CBO: Obamacare’s Uninsured Up 5 Million, Medicaid Dependents Up 16 Million Since Initial Estimate →

Health Alerts

Congressional GOP’s Budget Hits Reality Hard

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iStock_000007047153XSmall(A version of this Health Alert was published by Real Clear Policy.)

The Congressional Budget Office’s recent budget update revealed a dramatic deterioration in the federal government’s finances. The cumulative deficit over the next ten years, through 2025, is now estimated to add up to $8.5 trillion. Just last August, the number was $7 trillion.

The CBO itself notes that “about half of the $1.5 trillion increase stems from the effects of laws enacted since August.” In other words, this is the work of the 114th Congress, in which Republicans hold the majority in both chambers for the first time in the Obama presidency.

Republican apologists assert that Congress’ powers to shrink the government are limited as long as President Obama is in office. This is true. So, let’s see where Congress can go from here. Continue reading Congressional GOP’s Budget Hits Reality Hard →

Health Alerts

Health Care and the Budget Deal: Three Steps Forward, One Step Back

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debt

(A version of this Health Alert was published by Forbes.)

Yesterday, the White House and Congressional leaders announced a last-minute budget agreement that avoids a so-called government shut-down for now. The deal has four health-related items, and is expected to reduce net federal health spending by about $4.5 billion over five years, and $15.5 billion over ten years. Overall, it is not a bad deal with respect to health care. However, some of its budget savings are fragile and it largely avoids reforms that will actually reduce the growth of health spending. Continue reading Health Care and the Budget Deal: Three Steps Forward, One Step Back →

Health Alerts

Bipartisan Medicare Reform: Debt and Deficits, All the Way Down

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The extremely flawed so-called Medicare “doc fix” has passed. Its direct consequences include increasing federal government control of the practice of medicine and increasing deficits by at least $141 billion through 2025. However, it also has implications far beyond Medicare’s physician fee schedule, to post-Obamacare reform and general governance. Let’s tackle the fee schedule first. This “doc fix” was promoted as solving the problem that Congress has to increase Medicare’s physician fees at least once a year beyond the rate of growth originally legislated in 1997. If this did not happen, physicians’ fees would drop by about 20 percent, and they would reduce Medicare beneficiaries’ access. This “doc fix” abolishes the 1997 formula in favor of fixed, nominal rates of growth. As a consequence, the fee schedule is not “fixed” in the sense that it is “solved”. It is “fixed” in the sense that Congress has dictated the total amount that will be paid to physicians in future years. It will go up 0.5 percent per year from 2016 through 2019. Then, the amount freezes, and doctors enter a war of all against all, competing against each other for shares of an amount that will inexorably shrink in inflation-adjusted terms. It gets even more bureaucratized after 2025, but there is no point thinking about that because the whole thing is almost certain to unravel before then. Continue reading Bipartisan Medicare Reform: Debt and Deficits, All the Way Down →

Medicare

Congress is About to Create a New Ponzi Scheme

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Known as the Community Living Assistance Services and Supports Act, or Class Act, this entitlement is in both the House and Senate bills:

The program will hand over its revenues to the feds, who will promptly spend it. In return, the program’s administrators would receive federal IOUs, just as Medicare and Social Security do. But these are nothing more than liabilities that have to be repaid, either by taxes or borrowing. …

[According to the Congressional Budget Office,] “the program would add to budget deficits in the third decade — and in succeeding decades — by amounts on the order of tens of billions of dollars for each 10-year period.” These long-term demands on the Treasury would coincide with shortfalls in Medicare and Social Security projected to be in the hundreds of billions of dollars.

Full op-ed by Scott Harrington in The Wall Street Journal.

Health Insurance

CBO: Insurance Proposal Would Effectively Nationalize Private Insurance

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A Medical Loss Ratio (MLR) is the percentage of premium dollars an insurer spends on claims as opposed to administrative costs and other expenses. According to news reports, a proposal from Senator Rockefeller and others would limit MLRs to 90%. The Reid bill already requires insurers to issue rebates to enrollees on a pro rata basis if its medical loss ratio falls below 80% or lower for the individual and small-group markets or 85% or lower for the large-group market. 

However, the Congressional Budget Office (CBO) says that a 90% MLR would expand “the federal government’s regulatory role in the health insurance market so much that it would make such insurance an essentially governmental program, so that all transactions related to health insurance policies (even those with private companies) should be recorded as cash flows in the federal budget.”  A similar ruling helped kill Hillary Clinton’s health reform proposal 15 years ago.

Donald Marron, former Acting Director of CBO, explains the issue at his blog.

New Health Care Law

Whose Study of ObamaCare Premium Increases is More Reliable?

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The Blue Cross study is in fact more precise than CBO’s because it is based on real market data, rather than modeling assumptions. The association mined the actuarial data from its six million individual or small-business policies, nearly one-eighth of those sold in the U.S.

Full report in The Wall Street Journal.

Our report on other estimates here, here and here.