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Posted at 1:00 PM ET, 01/ 6/2011

What would it cost to repeal ObamaCare?

By Jennifer Rubin

Democrats and liberal pundits have made the argument that repealing ObamaCare would be a budget-buster. This is incorrect on two levels. First, Republicans would replace ObamaCare with something else; the decision is not ObamaCare vs. nothing, but, rather, ObamaCare vs. the Republican alternative.

The second problem with the argument is that it accepts at face value the phony accounting on which the Democrats based their legislation. As House Budget Chairman Paul Ryan (R-Wisc.) explained today in a written statement:

"The Democrats' health care law is a budget buster. Misleading claims on its deficit impact exclude the $115 billion needed to implement the law and over $500 billion in double-counting Social Security payroll taxes, CLASS Act premiums, and Medicare reductions. The law was written to measure 10 years of tax increases to offset 6 years of new spending. The Democrats stripped costly provisions that were included in initial score, and enacted them separately to add hundreds of billions of dollars to the deficit. Hiding spending does not reduce spending. There is no question that the creation of a trillion dollar open-ended entitlement is a fiscal train wreck.

Ryan has detailed at length why ObamaCare doesn't, in fact, save money:

The CBO score did not include the cost of setting up and administering the massive overhaul, including the cost of hiring new health-care bureaucrats to run the new spending programs, as well as thousands of IRS agents to enforce the new mandates.

Accounting for these discretionary appropriations would add $115 billion to the bill's ten-year cost, all but wiping out its alleged "savings."

The new law double-counts an estimated $521 billion in alleged offsets:

Social Security will receive an additional $53 billion in higher payroll tax revenue as a result of the new law. Instead of setting aside this revenue for promised Social Security benefits, the bill spends it on new subsidies.

Democrats claim they are extending solvency of Medicare by cutting $398 billion from the program, but they simultaneously claim that these savings will offset new subsidy programs. CBO has made clear these savings cannot be used twice.

The Democrats' bill created the CLASS program, a brand new long-term care entitlement. Over first ten years, program would take in $70 billion in premiums, but instead of setting money aside to pay for future benefits, the bill spends the premiums on new subsidies. Senate Budget Chairman Kent Conrad called the CLASS Act: "A Ponzi scheme [that] Bernie Madoff would have been proud of."

The Democrats' bill originally included the "doc fix" that CBO estimated would add $208 billion to the bill's score. Democrats removed this provision to lower the bill's CBO score, but promised doctors that they would enact the fix later, and did in fact pass a short-term prevention of cuts to physician payments last year, adding to the deficit.

Add it up - $115 billion in discretionary costs, plus $521 billion in double-counting, plus $208 billion for a long-term doc fix (minus the $143 billion of claimed savings) - and the law would add $701 billion to the deficit over the next ten years.

(Last year, Ryan addressed many of the same issues in a reply, via Facebook, to Ezra Klein. It is worth reading in full.)

Moreover, as The Post
reported
last week, costs may be even higher:

An early feature of the new health-care law that allows people who are already sick to get insurance to cover their medical costs isn't attracting as many customers as expected.

In the meantime, in at least a few states, claims for medical care covered by the "high-risk pools" are proving very costly, and it is an open question whether the $5 billion allotted by Congress to start up the plans will be sufficient.

And available data shows that, as conservatives fully anticipated, the costs are much higher than the Democrats calculated. More from The Post:

Montana is one of a few states in which the medical bills from those who have joined are huge. New Hampshire's plan has only about 80 members, but they already have spent nearly double the $650,000 the state was allotted in federal money to help run the program, said J. Michael Degnan, its director.

The spending, Degnan speculated, might slow down if it turns out that the early bills reflected a burst of pent-up need for care. HHS agreed to give New Hampshire more money, he added.

When the law was passed, proponents of the special health plans feared the $5 billion would run out before 2014.

And here is a further consideration: ObamaCare assumes that states will take the lead in setting up the health-care exchanges. But this is increasingly looking like a faulty assumption. Back in May, Indiana Gov. Mitch Daniels let it be known that he was not interested in expanding the state high-risk insurance pool and would force the federal government to do so. What if he said the same about the entire architecture of ObamaCare, namely the exchange that would be set up in his and the other 49 states? If that sentiment spreads to, say, 29 states headed by Republican governors, will HHS be able to manage 29 state exchanges and keep it all within the budget parameters of ObamaCare? It is highly unlikely.

But, listen, this is precisely the sort of issue on which Congress should hold extensive oversight hearings. Let's go through the numbers. Is Ezraright or are Ryan and conservative critics of ObamaCare right? Stay tuned.

By Jennifer Rubin  | January 6, 2011; 1:00 PM ET
Categories:  Obamacare  
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Comments


"A Democratic budget analysis, based on figures from the Joint Committee on Taxation and Congressional Budget Office, found that new GOP House rules would swell the deficit by $1.07 trillion. A CBO report out Thursday revealed that repealing the health care law would increase the deficit by $230 billion through 2021."
http://www.politico.com/news/stories/0111/47147.html#ixzz1AHQ5tMtw

"We get the Democracy that we deserve"
Conrad Black in NRO
LOL at what the new Republicans will accomplish.

Posted by: rcaruth | January 6, 2011 1:13 PM | Report abuse

What would it cost to repeal ObamaCare?

If it were done today,(and BTW,I hate OCare,I'm for Medicare for everyone),it would cost nothing to repeal because it has cost nothing to install as of today.
However,this discussion is a waste of time just as the "Repeal" process is a waste of time. For all the obvious reasons.

Posted by: rcaruth | January 6, 2011 1:59 PM | Report abuse

The Republicans are the blood-sucking spawn of pure evil. Which party would want to take away a sick person's right to get medical care? Republicans. Which party would like to take away your right to keep your children on your medical insurance until they're 26? The Republicans. Which party wants you to be denied medical coverage after your benefits reach a certain dollar point ? The Republicans. If the Republicans insist on repealing Obamacare then they will be KILLED in the 2012 election and Barack will simply veto the bill.. Even now they can't come up with a single Republican who is more popular than Barack Obama.Wake up Republicans: Obamacare is now as firmly entrenched as Social Security. Mark Montgomery NYC, NY boboberg@nyc.rr.com

Posted by: boboberg | January 6, 2011 2:16 PM | Report abuse

Republican healthcarealternative?
Oh please, there is NO SUCH THING!


Republicans NEVER ONCE had a health care plan. They simply don't care.

Fred Hiatt really got his moneys worth when he hired yet another insane neo-con hack like Ruben. She is as dumb as it gets, and it's hysterical to witness others dismantle her idiocy published here every day.

Oh, and scary Black Panthers, ms Rubin, scary angry black men with sticks! Oh noez!

Calling her a dishonest liar is kind.

Posted by: BirchMan | January 6, 2011 2:22 PM | Report abuse

"Obamacare vs. the Republican alternative". Would ONE Republican PLEASE tell us WHAT exactly that "alternative" is?!?!? We've heard time and time again about this so-called "alternative". In the entire time this bill was being written up in Congress, are you trying to tell us that there is NO written "hard-copy alternative" from Republicans?!?!?! Still???

Posted by: jyancy13 | January 6, 2011 2:22 PM | Report abuse

"Democrats and liberal pundits have made the argument that repealing ObamaCare would be a budget-buster. This is incorrect on two levels. First, Republicans would replace ObamaCare with something else; the decision is not ObamaCare vs. nothing, but, rather, ObamaCare vs. the Republican alternative"

Excuse me Ms. Rubin, inasmuch as I am a taxpayer and a voter, would you please explain what the GOP plans to replace "Obamacare" with? Did you intentionally leave out what the "Republican Alternative" is, because I havent heard a Republican explain what that alternative is, to date. Must the American people ask you jerks to explain this everyday from now on? This sounds like your tinkling on my leg and telling me it's raining. Typical GOP BS!

Posted by: ruthella10 | January 6, 2011 2:46 PM | Report abuse

What is the Republican plan you speak of, Jennifer?

Posted by: danw1 | January 6, 2011 3:12 PM | Report abuse

I'm not a fan of Obamacare; our family has already seen our health insurance premiums increase by 20% this year for an employer sponsored HD plan because of mandated changes in coverage. The cost predictions for Obamacare are grossly underestimated, as you've pointed out. But, I have to echo the comments above. What is the Republican alternative? In the absence of a constructive alternative healthcare proposal by the Republicans, public support for disbanding Obamacare will evaporate.

Posted by: Beagle1 | January 6, 2011 3:16 PM | Report abuse

The Republican Option is the system that existed before OCare with no changes.

Posted by: rcaruth | January 6, 2011 3:51 PM | Report abuse

For all of you liberal ostriches who keep repeating (as if that will somehow make it true) that the GOP never put forth their own health care plan, --> http://www.gop.gov/solutions/healthcare.

To that, I'll add a few more things that everyone can do, because - I know it's hard for the left to believe! - individuals can actually still bear some responsibility for their lives and the lives of their children without some government agency staring over their shoulder. Eat the right proportion of healthy foods, stay away from tobacco, alcohol and other drugs, and occasionally pull yourself away from your computers and TV sets and exercise!

Posted by: coffeetime | January 6, 2011 3:58 PM | Report abuse

Being opposed to Obamacare has been devastating to the Republicans so far, and I'm sure it will continue to be.

A return to the status quo ante would be preferable, but de-linking insurance from work, making it possible to buy insurance across state lines, getting the FDA focused solely on the safety, not the effectiveness of drugs so as to encourage innovation would be a good start towards something new. As always, it's a question of the government stepping down and allowing for more choices.

Posted by: adam62 | January 6, 2011 4:21 PM | Report abuse

"individuals can actually still bear some responsibility for their lives and the lives of their children"

"I pity the fool."
I guess begging on a street corner is the Republican solution to sick kids that are without insurance.

Posted by: rcaruth | January 6, 2011 4:44 PM | Report abuse

The Republican plan will be Something Else.

I see.

Posted by: Mannie_Davis | January 6, 2011 5:16 PM | Report abuse

You can demagogue with the best of them, Rex. Maybe you should consider running for Alan Grayson's former seat next time around.

Posted by: adam62 | January 6, 2011 6:12 PM | Report abuse

"The Republican plan will be Something Else."

I hope that the Republicans don't have a plan, since it's not the government's job to plan health care--health care should be the result of voluntary interactions among doctors, patients, hospitals, insurance companies, pharmaceutical companies, etc. The government should get out of the way and let that happen. If we need a subsidy or government program for the poorest of the poor, fine, but otherwise, health care is no different from food or housing--everyone needs to provide for themselves.

Posted by: adam62 | January 6, 2011 6:17 PM | Report abuse

The republicans argument boils down to this: Govt is the least efficient and effective entity to run most things, especially healthcare. There are better ways to make healthcare more affordable and get more people insured. The Dems argument (especially in these comments) is pretty muched summed up as: "You republicans are really really mean." I guess our education system is worse then I thought.

Posted by: belmontbob | January 6, 2011 8:29 PM | Report abuse

Ms. Rubin makes the bizarre argument that high-risk insurance pools for uninsured Americans with pre-existing conditions are costly failures. That may or may not be true. But such high-risk pools are the core Republican solution to the problem of insuring pre-existing conditions. If, as Ms. Rubin says, they don;t work, then the Republican alternative does not work, at least with respect to this vexing problem. (By the way, Ms. Rubin neglects to inform her readers that the high risk pools under the health reform law are stopgap measures that will last only until the law is fully implemented in 2014 and insurers are barred from engaging in such discrimination.

Posted by: hsny | January 6, 2011 9:43 PM | Report abuse

By the way - can someone explain to me why the "doc fix," which has nothing to do with the healthcare law, should be added to the cost?

Posted by: hsny | January 6, 2011 10:05 PM | Report abuse

The "doc fix" has nothing to do with the health care law? The doc fix is central to the whole medicare setup and medicare is smack in the middle of the system set up by the health care law. NOT looking at the whole thing inclusively enough to include the doc fix in the calculus is what has to count as the outlandish approach. It was only taken OUT of the provisions in order to perform a fiscal trick.

Posted by: Jeroboam | January 7, 2011 12:12 AM | Report abuse

The Doc fix is to a law implemented by Republicans. They did not think the idea through and the Dems should not have to be the ones taking the hit for Repub ineptitude. Under the Republican Healthcare system in the last decade my healthcare costs tripled. Those of you who complain their costs are just now going up must have been very sheltered or well off. My children are back on our health insurance and for this I am very happy and it will affect the way I vote in the future.

Posted by: Falmouth1 | January 7, 2011 6:06 AM | Report abuse

to "Jeroboam": the "doc fix" problem predated the health reform law by more than a decade. If health reform were repealed tomorrow and we were to return to the status quo ante, the cost of the "doc fix" would likely be exactly the same. Prescription drug costs are, as you would put it "central to the whole medicare setup." Shall we add the costs of the Bush prescription drug benefit to the estimate cost of President Obama's health reform law? So your logic does not work.
In any event, if enactment of healthcare reform must include the cost of the "doc fix," she we also add that cost to calculations of the total cost of Republican alternative proposals?

Posted by: hsny | January 7, 2011 8:58 AM | Report abuse

at the risk of violating some copyright law, I really can't improve on what Krugman just said about the absurd "doc fix" argument that Ms. Rubin and her fellow Republicans are making:

"If You Read This Blog Post, You Will Die
Eventually. Of course, if you don’t read it you’ll eventually die, too.

"So, would it make sense to consider the fact of your eventual mortality a cost of reading this blog post? Everyone who thinks so, raise your hands.

"And yet, Republicans are applying exactly the same logic to health care reform. They’re insisting that the cost of the “doc fix” — the routine increases in Medicare fees that are necessary to avoid making it impossible to get doctors to cover patients — should be counted as part of the cost of the Affordable Care Act. That’s even though the doc fix would have been equally necessary if the Act had never passed.

"And yes, we’ve been through this many times. Another day, another zombie lie attacks our brains."

http://krugman.blogs.nytimes.com/2011/01/07/if-you-read-this-blog-post-you-will-die/

Posted by: hsny | January 7, 2011 9:56 AM | Report abuse

at the risk of violating some copyright law, I really can't improve on what Krugman just said about the absurd "doc fix" argument that Ms. Rubin and her fellow Republicans are making:

"If You Read This Blog Post, You Will Die
Eventually. Of course, if you don’t read it you’ll eventually die, too.

"So, would it make sense to consider the fact of your eventual mortality a cost of reading this blog post? Everyone who thinks so, raise your hands.

"And yet, Republicans are applying exactly the same logic to health care reform. They’re insisting that the cost of the “doc fix” — the routine increases in Medicare fees that are necessary to avoid making it impossible to get doctors to cover patients — should be counted as part of the cost of the Affordable Care Act. That’s even though the doc fix would have been equally necessary if the Act had never passed.

"And yes, we’ve been through this many times. Another day, another zombie lie attacks our brains."

Posted by: hsny | January 7, 2011 10:12 AM | Report abuse

Are you that naive?... oh course there is pent up demand for care! Americans have NOT been able to afford health care for a decade or more - ever since the funny numbers projected from Washington during the G.W. Bush Administration hide America's demise, while at the same time the Republicans were looting the U.S.Treasury in the form of unpaid for tax cuts for the wealthy and TWO unpaid for wars removed from the budget, complete with NO-BID contracts for the wealthiest GOP campaign contributors.

...and the ridiculously gullible American people stand by passively playing with their cell phones and even more ridiculously attempting to drive a world economy (America), based on what color their friends like on Lady Gaga's pointed LED bra on FaceBook ! Facebook's $50 billion Wall Street misleading and simply greedy spin(100x actual value), for America's financial idiots perceived value based on this - is it NO wonder the greedy are laughing all the way to bank, while America dies in the ditch.

Is this NOT what is exactly happening right NOW in America?

Posted by: danglingwrangler | January 7, 2011 10:30 AM | Report abuse

Just a little heads up for you Republicans, who are obviously not the brightest, concerning policy making. If you really want people to take your side and vote to repeal the ObamaCare, you might want to start actually telling us what your "AMAZING" (insert sarcastic tone here) alternative is instead of bashing on the ObamaCare like little 10 year olds.
Just saying.

Posted by: Hatsahara | January 9, 2011 8:04 PM | Report abuse

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