Harold Pollack does the math:
By 2019 when the reforms are fully implemented, the Senate bill would provide about $196 billion per year down the income scale in subsidies to low-income and working Americans.
Even policy wonks have trouble getting their heads around such a big number. With due allowance for the back-of-the-envelope nature of this calculation, $196 billion exceeds the combined total of federal spending on Food Stamps and other nutrition assistance programs, the Earned Income Tax Credit, Head Start, TANF cash payments to single mothers and their children, all the National Institutes of Health, and the Department of Housing and Urban Development. (I admit to some uncertainty about that last one. We may have to leave HUD behind…)
Some progressives have decided that they cannot support this imperfect bill. We have 196 billion reasons to disagree.
Gawker had the best take on this, headlining the post, "News of First Major Progressive Legislation in 30 Years Enrages Liberals." And make no mistake, this legislation is major, and as Pollack points out, quite a bit more so than people realize.
To avoid the psychologically scary $1 trillion price tag, the bill doesn't kick into action until 2014, the fifth year of the 10-year budget window. If the bill's price were actually being measured over 10 years, it would be well over a trillion (and still paid for, to be sure, just as the bill grows in the second 10 years, but continues cutting the deficit). In 2013, for instance, the subsidies are ... no dollars. In 2019, they're almost $200 billion. And because they grow each year alongside health costs, it's a safe bet they're above $2 trillion from 2020 to 2029.
That's why so many of the folks who focus on the subsidies are so scared of seeing this opportunity slip away. Democrats haven't been close to getting anything even comparable to this in decades, and there's no reason to think they'll have another chance anytime soon. I mean, we're about to pass a $900 billion bill to help low-income Americans afford health-care coverage, and that's wildly low-balling the true size of the subsidies!
December 22, 2009; 10:42 AM ET
Categories: Charts and Graphs , Health Reform
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