The Gross Reservoir in Boulder where the melted ice represents provisions in the ACA that have been implemented.
This column is long overdue with good reason since this writer has been mobile meeting with a diverse group of friends, colleagues and new acquaintances over the past several weeks. My travels took me from my hometown, Omaha, to three “major” league cities in the Heartland. This was a terrific opportunity for field research, and I had ample time to speak with numerous people about their perceptions of the health reform legislation, and how it may impact them personally, as well as professionally, once the implementation kicks into high gear in 2013.
Each city had improved since the last time I had been there. New health care facilities had been built including a brand new facility on the east side of Milwaukee. Denver impressed me with the active nature of its citizens. I was not surprised to find that Colorado has one of the lowest obesity rates in the country. Statistics like this are important because obesity costs all of us collectively over $200 billion annually. Diabetes costs us even more, and both can be prevented. Perhaps it’s time for our leaders in Washington to talk about big picture issues like chronic disease management and getting spending under control, instead of naming post offices or whatever fights are on the agenda for the week.
The health reform legislation, aka Obamacare, is back in the headlines this month. And for good reason, as the implementation process has produced its fair share of political fireworks with the contraception rule and others. The Supreme Court of the United States (SCOTUS) is dedicating more time to hear arguments on the constitutionality of this law than it has any other case in the last forty years. The President’s re-election effort centers on this law, which is his biggest domestic policy achievement. So get used to hearing about it because it is not going away.
While the above reasons make for terrific headlines in the media, the true drama in my humble opinion will be the cost of this legislation over the next decade and beyond. The Congressional Budget Office (CBO) released their analysis of the Affordable Care Act and how much it will cost taxpayers over the next ten years. The findings contradict the President (click to see video timed 2:18-2:30), and members of his party in Congress, who argued fervently that the health reform legislation would not add to the deficit, and that it might actually save money over time. This, of course, was based on the assumption that millions of uninsured would have new insurance coverage, thus lowering costs for everyone.
The CBO analysis says on the second page “…the ACA’s provisions related to insurance coverage are now projected to have a net cost of $1,252 billion or ($1.252 Trillion) over the 2012–2022 period. That amount represents a gross cost to the federal government of $1,762 billion or ($1.762 Trillion), offset in part by $510 billion in receipts and other budgetary effects (primarily revenues from penalties and other sources).” This translates to a law costing a lot more than expected. Somebody is going have to pay for it. The ACA will add to the deficit, and be partially paid for through tax increases initially, once existing tax policy expires in 2013.
The cost is higher than originally estimated because the CBO anticipates more people will be added to Medicaid and CHIP (government programs) instead of seeking coverage through insurance exchanges. This, of course, brings up long term budgetary concerns as entitlement programs already make up the largest portion of federal spending. What happens when you expand an already expensive program without working on lowering costs? Questions like this and others will be explored in upcoming weeks.
While the trip was much needed, it feels good to be home, and there are plenty of comments and emails to catch up on. Stay tuned for more content on this subject as well as the introduction of multimedia in the upcoming weeks as yours truly will be hosting a weekly radio show on health reform beginning in April. Please continue to make healthreformexplained.com your one stop shop for information on this topic, and if you find yourself in Chicago, hit up Dante’s for some of the best pizza ever. Believe the hype. Thanks to everyone for the hospitality.
Finally, before I sign out, a quick shout out to my alma-mater, Marquette University, for making their second straight trip to the sweet sixteen. Keep up the good work, and if all goes according to plan, the next city to visit may just have to be New Orleans!