The White House and its congressional allies are trying to suggest that the latest Congressional Budget Office (CBO) cost estimate proves that their health-care plan is fiscally responsible.
But, in fact, the latest CBO projections confirm — again — that the President’s health plan would pile more another unfinanced entitlement program on top of the unaffordable ones already on the federal books.
According to CBO, the new entitlement spending in the plan would cost $216 billion by 2019, and then increase by 8 percent every year thereafter. In other words, the President’s plan would stand up another health entitlement program that will grow much faster than the nation’s economy or revenue base. The changes the Democrats would make to the Senate-passed bill would make the entitlement program even more expensive.
Over a full ten years of implementation, the cost of the new entitlement spending would reach $2.5 trillion, at least, not $1 trillion as advertised by the White House.
The President and his congressional allies have suggested that the offsets they are pushing will more than cover this massive spending increase. But even a modest amount of scrutiny reveals these supposed offsets are nothing more than gimmicks and implausible assumptions.
For starters, the plan doesn’t count $371 billion in spending for physician fees under the Medicare program. The President and Congressional Democrats want to spend this money, for sure. They just don’t want it counted against the health bill. That’s because they want to reserve all of the Medicare cuts in the bill as offsets for another entitlement instead of using them to pay for the problem that everyone knows needs fixing. The President says he shouldn’t have to pay for the “doc fix.” But why not? Never before did congress move to add the cost of a permanent fix to the national debt. But that is exactly what the President now wants to do. When the cost of the “doc fix” is properly included in the accounting, all of the claimed deficit reduction from the President’s health plan vanishes.
Then there’s the “Cadillac” tax on high-cost insurance plans. Because of union pressure, the President pushed the tax back to 2018, well passed the point when he will have left office. But once in place, he now would allow the threshold used to determine “high-cost” to rise only with the CPI, beginning in 2020. That means a very large segment of the middle class would get hit with the tax as the years passed. The President has shown that he is unwilling to actually collect this tax. But he wants us to believe we can count on a huge revenue jump over the long-run because his successors will have more stomach for it than he does.
Similarly, to jury-rig “long-term deficit reduction,” the latest plan would first increase the premium assistance subsidies paid to low and moderate wage families above the levels in the Senate-passed bill, but then index their value to something below the growth in premiums to give the appearance of deficit reduction in the decade after 2019.
There’s no “bending of the cost-curve” here. It’s sleight of hand that, if actually implemented, would force millions of low-income families to pay ever higher premiums every year. The Democrats don’t want to talk about that. They just want to pretend they have been serious with fiscal discipline.
The other gimmicks remain in the plan as well. The double-counting of premiums for a long-term care insurance programs an offset for the health entitlement spending. The assumption that congress will allow Medicare reimbursement rates to fall so low that one in five hospitals and nursing homes might be forced to stop taking Medicare patients. And the expectation that somehow congress can hand out generous new subsidies to those getting insurance through the exchanges, even though many tens of millions of others with the same resources would get no additional help for their job-based coverage.
The bottom line here has been clear for months. The bill being pushed by the President would take what’s already a very bleak budget outlook and make it much, much worse.
Cross-posted at The Corner.
As Heritage analysts have noted time and again, spending from congressional liberals’ health care proposals would be in the trillions, growing the federal deficit. The President has proposed a modification of the Senate bill with provisions that would make it even more expensive. At last week’s Health Care Summit, hosted by the White House, Rep. Paul Ryan (R-WI) echoed these same concerns over the true cost of the President’s proposal for health care reform. Thus far, neither the President nor the leaders of Congress- not one- have responded to Ryan’s indictment:
- Budget Gimmicks Galore: “[W]hat has been placed in front of [CBO] is a bill that is full of gimmicks and smoke-and-mirrors…first off, the bill has 10 years of tax increases, about half a trillion dollars, with 10 years of Medicare cuts, about half a trillion dollars, to pay for six years of spending…Now, what’s the true 10-year cost of this bill in 10 years? That’s $2.3 trillion.”
- Double-Counted Savings: “It takes $52 billion in higher Social Security tax revenues and counts them as offsets. But that’s really reserved for Social Security. So either we’re double-counting them or we don’t intend on paying those Social Security benefits…It takes $72 billion and claims money from the CLASS Act. That’s the long-term care insurance program. It takes the money from premiums that are designed for that benefit and instead counts them as offsets.” Later, Rep. Ryan went on to point out, “You can’t say that you’re using this money to either extend Medicare solvency and also offset the cost of this new program. That’s double counting.”
- Medicare as a Piggy Bank: “Now, when you take a look at the Medicare cuts, what this bill essentially does — it treats Medicare like a piggy bank. It raids a half a trillion dollars out of Medicare, not to shore up Medicare solvency, but to spend on this new government program…Now, when you take a look at what this does…as much as 20 percent of Medicare’s providers will either go out of business or will have to stop seeing Medicare beneficiaries.”
- Ignoring the Doc Fix: “…[T]he doc fix, according to your numbers, costs $371 billion. It was in the first iteration of all of these bills, but because it was a big price tag and it made the score look bad, made it look like a deficit, that bill was — that provision was taken out, and it’s been going on in stand-alone legislation. But ignoring these costs does not remove them from the backs of taxpayers. Hiding spending does not reduce spending.”
Rep. Ryan’s arguments are reinforced by Heritage research regarding the true cost of the House and Senate health bills and other reliable sources. As an article in the Wall Street Journal points out, “No one in the political class has even tried to refute Mr. Ryan’s arguments, though he made them directly to the President and his allies, no doubt because they are irrefutable. If Democrats are willing to ignore overwhelming public opposition to Obamacare and pass it anyway, then what’s a trifling dispute over a couple of trillion dollars?”
The President and congressional Democrats have recently made quite a show of concern over the sustainability of current levels of federal spending. Ignoring the fiscal reality of their health proposals questions the seriousness of their intentions to control spending and reduce the federal deficit. The prosecution rests.