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How To Make The CBO Your Tool of Disinformation

It Wasn?t The Costs It Was The Phasing

Phillip Klein of The Washington Examiner is shocked. Phillip Klein is appalled. He’s shocked and appalled. It seems that he was the last individual in Washington, DC to get the message that The Affordable Care Act of 2009 (AKA ObamaCare) was going to take a wee tad more out of the national wallet than we were previously led to believe after the CBO estimated it’s ten year impact in March of 2010. Klein hyperventilated below.

President Obama’s national health care law will cost $1.76 trillion over a decade, according to a new projection released today by the Congressional Budget Office, rather than the $940 billion forecast when it was signed into law. Democrats employed many accounting tricks when they were pushing through the national health care legislation, the most egregious of which was to delay full implementation of the law until 2014, so it would appear cheaper under the CBO’s standard ten-year budget window and, at least on paper, meet Obama’s pledge that the legislation would cost “around $900 billion over 10 years.”

(The Washington Examiner)

Yep, that’s right Mr. Klein, the law was foisted off four years into the future in order to game the CBO ground rules for budgetary impact. A simple examination of the original CBO ACA budgetary impact estimate in Mar 2010 versus the mandatory annual update in Mar 2012 tells us just how badly the system just got yinced. All numbers below are in $Bn.

The First CBO Estimate of The ACA

The March 2010 estimate covers the impact window of 2010 to 2019 and gets us to a figure that is solidly under the $900 Bn per decade that our President flashed around town as an argument in favor of how frugal and cheap this new entitlement would be. It purports to show a law that only adds $79Bn/year to the Federal Budget.

It performs this feat of financial prestidigitation by counting four years of set-up costs as if they were actual full-on coverage. The law essentially doesn’t go full-metal Khrushchev until 2014. Thus, the time period 2010 to 2013 imposes only $31Bn or less than 5% of the 2010 to 2019 budgetary impacts.

The next chart shows the time period of 2012 to 2022. It shows a net budgetary impact of $1,252 Bn over 11 years. This gives us an annual cost of slightly more than $113Bn. This occurs because the time-phasing of the new 11 year estimate includes 9 operational years of ACA expenses and only 2 set-up years. The set-up years in the new estimate are set to cost $8bn total or less than 1% of the total budgetary impacts.

The Updated Cost of The ACA (11 Year Phasing Vs 10 in Original)

The final chart combines the two estimates over the entire time-phase 2010 to 2022 to demonstrate what costs were sunk, what costs were common to both estimates and what costs were concealed in the initial CBO estimate. The sunk costs column shows that an estimates $11Bn worth of set-up fees have been expended in 2010 and 2011. The common cost window of the two estimates (2010-2019) shows that the original estimate called for $783Bn ($794Bn – $11Bn sunk) to be expended in the original estimate. This compares to an estimated $772Bn to be expended in the new estimate.

...And Here's Where They Hid $481Bn

We perceive the true mendacity of passing a law in 2010 and phasing its actual operation to start in 2014 when we compare the costs for each estimate from 2020 to 2022. The original estimate has no such costs; the new estimate has $481Bn. Yep, that’s almost ½ Trillion that got laundered via the ground rules and assumptions relevant to how the CBO estimates costs. It kind of makes me wonder how Congress got the high approval rating of 11%.

In conclusion, the CBO didn’t lie to Phillip Klein or to Ma and Pa Middleton. They played a game by a circumscribed set of rules. The legislators that designed the Affordable Care Act knew these rules and gamed them in a disingenuous fashion to make the CBO estimate appear to say something that was obviously not the actual truth. Figures don’t lie, but liars can and do figure. Therefore, the CBO can, is and will be turned into a tool of disinformation by the dishonest leeches America keeps sending to Congress with depressing regularity.

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COMMENTS

  • hungarianfalcon

    Numerous entities (almost exclusively conservative) pointed out this slight of hand. It’s actually pretty disgusting that:

    1. We have a press that refuses even to look at this deceit with any sort of energy.

    2. We have a subset of clowns from point #1 that are proceeding in getting all righteous about it.

    HF

  • trueconservative2012

    Does this report deal with revenues/offsets or just the costs of the health care legislation ? How do i deal with my left leaning colleagues who say that, yes, the ACA will cost 1.5 trillion (or whatever) over 10 years, but it will be more than offset by reductions in health care costs and revenue increases? The CBO even admits that in the report. Help a brother out here.
    thanks!

    • cynicalindependant

      As I understand it the ACA only “costs” money if the individual mandate is overturned.

      For the longest time the conservative position included a mandate because it makes the bottom line work.

      Obviously times change and a lot of us don’t care whose idea a mandate was, we just want to be rid of it.

      If I’m misunderstanding this I would appreciate links for sure.

      • Repair_Man_Jack

        It makes up about 2/3 of my taxes and penalties column in each estimate. Check the CBO report links under each table if you want to see it specifically broken out.

        • trueconservative2012

          again, though– that’s assumed by the CBO report–which is where you get the increased cost of the program.. Yet, they say that they continue to believe it will reduce deficits on the whole. So in other words, your chart needs another column— one that has proposed offsets/tax increases, etc that add up to more than the cost of the program.. then we can assail that data if possible..

          • Repair_Man_Jack

            Judging from what happened to insurance plan premiums from 2009 to present, I don’t see that evidence. Even with the IM, I don’t see why the insurance companies should reduce their fees. They’ve been given a monopoly. If someone is legally bound to buy your product, why price fairly at all?

          • Repair_Man_Jack

            http://www.whitehousedossier.com/2012/03/14/million-covered-work-obamacare/

            Ask your liberal friend whether they’ve priced in the cost of the additional 4 million people who will not be getting employer-based coverage by 2016. That’s the sort of thing any true conservative would want to see accounted for in an estimate.

          • trueconservative2012

            Thanks for your response! I just asked the guy (an office mate)– and here’s his response: how does 4M people without employer-based coverage add to the cost of the ACA? Those people will either have to go without and pay the penalty, find a new job, or else buy their own care from a private company.

            i didn’t know what to say so i thought i’d ask…

          • lineholder

            It depends on where they end up. Depending on their income level and/or age, they get pushed into Medicaid/Medicare, both federally funded programs.

            If the mandate stands, they have to either purchase insurance or pay the penalty. If they purchase via the public health insurance exchange (once again depending on income) then it is possible they will receive a subsidy to help pay for their insurance purchase. Subsidies would be available to people with incomes up to 99K per year (depending on family size). Basic cost for a Silver insurance policy via the exchange is projected to be $7,200 per year. The subsidies being allowed range from $0 to $6800 each.

            Those subsidy costs increase in the costs of operation.

          • trueconservative2012

            Good info– thanks! i guess it’s all contingent on who those 4M people are who lose employer based insurance. I hadn’t seen that figure, so I’m not sure where it comes from..

          • Repair_Man_Jack

            They have an entire new enforcement infrastructure to hire, train and maintain as a SEPM cost over the lifetime of the bureaucracy. Things like this are why Medicare is 19 times more expensive per year than what the CBO originally estimated.

          • lineholder

            for people to administer this ridiculous law, on top of what we already have with Medicare, Medicaid, and SCHIP.

          • lineholder

            Given the lack of emphasis placed on potential employer dumping in the CBO ACA report, I’m gathering that they are projecting this 4 million increase in loss of employer-sponsored insurance to be due to higher unemployment, along with factors such as the loss of grandfather clause provisions and the medical loss ratio ruling.

            Is that your take on it as well?

          • Repair_Man_Jack

            Allthough, I’m not sure if anyone’s calculated a good cost indifference curve to estimate future employer dumping. It sounds like a fun OR project :)

          • lineholder

            I can visualize in my mind’s eye how much of a difference this could potentially make in the cost of the system, but I’d love to see it in a visual form…charts, graphs, anything you can think of.

          • lineholder

            You might want to consider the post-tax implications of employer-dumping.

            Our current system is that an employee purchases their health insurance via their employer and the premiums they pay are pre-tax, correct?

            If an employer “dumps” and provides the employee with monetary compensation to make up the difference in loss of health insurance benefits, then it all becomes taxable income. Both the 25% that the employee is currently paying for benefits and the 75% that the employer is currently paying that may/may not be compensated to the employee.

            I’d love to see what this translates into in regards to any increase or decrease in expendable income for the individual employee. I think it’s misleading in a way, because the employee might be technically seeing an increase in wages, but it’s taxed, then they are required to buy health insurance coverage. But I’ve not seen that put into any chart/graph form either.

          • lineholder

            Even a person opts to pay the penalties, they can still receive provision of services through the EMTALA legislation. In other words, they can always go the ER and get treated. This doesn’t drive up costs of ACA per se, but it does play into trends for health care costs across the system as a whole.

            In addition, the current CBO ACA report doesn’t address speculation about a phenomenon that might occur called “employer dumping”. Because of the way ACA is structured, it can actually be cheaper for an employer to stop offering insurance to certain employees, pay the penalty, and offer the employee a suitable monetary compensation to cover the difference rather than continuing to carry the current 75% rate of cost health insurance coverage that they pay for at the present time.

            The McKinsey survey indicated that the phenomenon of “employer dumping’ could be much higher than the Dems had estimated that it would be when the legislation was being developed. If “employer dumping” is high, then subsidy costs could conceivably go through the roof. (This factor isn’t even included in the current CBO projections)

        • cynicalindependant

          Thanks!

  • trueconservative2012

    I thought that too– but from the report –linked below (PDF), it says that the mandate (0.4 trillion offset) is already included in the revised figures–the 1.2 -1.5 trillion costs of the health care plan. So there is an additional 1.5 to 2 trillion in savings and offsets that supposedly make the ACA a deficit reducer. I’m hoping to find someone that can attack that part of the equation. Because, yes, everyone knows ACA will cost money– but if we can’t prove it’s not offset, we’ll lose that argument.

    http://cbo.gov/sites/default/files/cbofiles/attachments/03-13-Coverage%20Estimates.pdf

    • cynicalindependant

      Thanks for the link!

    • Repair_Man_Jack

      Ask to see them quantified and phased. To use the line from Jerry McGuire “Show me the money!”

    • lineholder

      Just a suggestion, but look at both the ACA report and the General Budget report. Open them in two separate windows and compare them.

      When you read through the ACA report, do you remember the comments about “wages and salaries remaining stagnant”, “unemployment remaining higher than it was reported to be in 2011″? Under normal circumstances, this would point to decreasing levels of revenues coming in to the federal government. But the General Budget report shows revenue increases, primarily from individual income taxes, Social insurance taxes, corporate taxes, and off-budget Social Security taxes.

      From what I can tell, and RMJ is probably in a better position to determine this than I am, they are utilizing a few provisions in the law to (1) reduce the number of people ACA will actually cover by 3 million (2) increase the number of people who will be without employer-sponsored health insurance by 3 million (3) shift more people into the Medicaid category rather than obtaining insurance via the public health insurance exchange (4) projecting increase in revenues due to increased collection of penalties coming from people who aren’t covered by any type of health insurance.

      They’ve incorporated a few gimmicks into this report to make it sound less costly than it truly will be, just like they did in 2010 when the law was originally passed. And they haven’t incorporated any impact of potential employer dumping into the scenario at all, which could dramatically drive up costs.

      Plus, the “cost savings” from Medicare and Medicaid that Liberals claim will save this monstrosity stem primarily from a supposed increase in coverage, comes from elimination of DSH conversions for the payment formulas for both Medicare and Medicaid. Except that if individual mandate falls through via SCOTUS, then the coverage won’t exist and the cost savings won’t happen.

  • johnt

    Da guvmint gets it’s hands on this lalapalozza it’s bye bye solvency
    Which we are steamrolling towards even without this suicide pact.
    Of course there’s always higher taxes, followed by higher taxes,etc.
    Just another way for Obama , Democrats, and a gleeful media to cause pain and collapse. The little devils have to have their fun.
    About 90 years ago Von Mises called the leftists, the Destructionists, and he couldn’t even have guessed at this crowd of lowlifes.

    • johnt

      for the first ten years.

  • lineholder

    I was hoping someone on the front page at RS would bring up this topic. The truth about the costs of O-care are finally being revealed! I’m very glad to see it. It’s coming at an interesting point in time during the election season.

    Just curious, but have you seen any comments coming from moderate to left websites indicating any blowback against Obama and the Dems for this?

    It will also be interesting to note what polling responses to this might be. O-care isn’t exactly popular by any means, but this could increase opposition to it even more.

    Now, if we can just get Reubs to take the info and run with it!!

    • trueconservative2012

      the left will say that the old report said that Obamacare would cost ~1 trillion out to 2019. This new report, also by the CBO, says that Obamacare will cost $400B more out to 2022. I think they are happy to assume both– because they’re still relying on the “smoke and mirrors” to show that this reduces the deficit by $2T over a 20 year span.
      and i dont have a lot of facts to rebut that. the only estimates of that were from the CBO and they agreed with Obamacare. Heritage and the Ryan budget both assume a lot of the same savings as well– so it’s hard for them to argue against those projections.

      • Repair_Man_Jack

        Until they can provide dispositive sources of info to back the $2Tr, the $2tr might as well not really exist.

        • lineholder

          It was all speculation to begin with, and it was rose-colored to the point of being delusional.

          They just wanted enough “cover” to allow them to present this as a
          good thing” to the American people.