The CBO confirms what they’ve already said in the past. However, the SCOTUS ruling has the potential to hurt folks in the red and purple states.

This from The New Republic:

The Congressional Budget Office just published a newly updated estimate of the Affordable Care Act and its impact on the budget. The estimate largely tells us what we already knew: The law, when fully implemented, will dramatically reduce the number of Americans without health insurance. It will also reduce the deficit. […]

But this latest CBO estimate comes with an asterisk previous ones lacked. Thanks to the Supreme Court, states are more likely to opt out of the law’s expansion of Medicaid. The non-participation of some states won’t worsen the budget picture: If anything, the federal deficit should come down even more if some states keep their Medicaid programs as they exist today, with more limited enrollment. But if states don’t participate in the expansion, more Americans will end without health insurance.

So yeah, there it is. You can’t have one thing without the other. So while the SCOTUS decision was a big win for Obama, it might end up being a loss for those in states with legislatures that simply won’t implement the changes. I’m sure Missouri won’t implement them, or Kansas for that matter. But, for me, that won’t matter because my employer provides health insurance, so there will be no change for me.

More as it develops…

  • mw

    We can argue the CBO assumptions, but down that road lies madness. CBO estimates are always seriously flawed, but nevertheless the best non-partisan numbers we are likely to get. Best to just accept it and go on from there.

    Of course, when the left talks about deficits they are almost always promoting tax hikes ( or revenue enhancement or whatever euphemism is popular today). When the right talks about deficits they are almost always promoting spending cuts (except defense).

    Case in point: In this post where Justin is talking about Obamacare and deficit reduction, we are in fact talking talking about a staggering large tax hike. It’s actually pretty easy to distill down to the basics. To whit:

    If ObamaCare costs $1 trillion dollars to provide promised new benefits (it does), and it does not really control costs (it doesn’t), and it really is deficit neutral or a deficit reduction (as the CBO asserts), then simple arithmetic tells us it must also raise $1 trillion dollars of new revenue (which the SCOTUS ruling informs us must be a tax for the legislation to be constitutional). And that pretty much makes it the biggest nominal dollar tax increase in our history. QED.

  • Tully

    Now now, mw, don’t go confusing Justin with pesky details of reality. He still believes one can legislate resources into existence, and that CBO estimates are based on real-world numbers, rather than on rigged assumptions even Barney Frank knows are as likely as the country being fiscally saved by a horde of flying unicorns farting platinum nuggets out of their arses in a sparkly nation-wide rainbow.

    Of course Justin also vehemently believed that the GM bailout would break even for the taxpayers before the end of 2010, and still maintains it was a good deal (well, for the unions it was) despite being tens of billions in the hole and sinking deeper. (Issue stock price, $33. Breakeven stock price for taxpayers, $53/share. Current stock price, $18.80.)

    Yes, it’s the largest tax increase in history. No, the cost-side assumptions are not at all realistic. Yes, it will increase the deficit in the real world. And the possibility that it will actually increase the uninsured in areas is the DIRECT result of rushing through a ginormous piece of flawed legislation without hammering out the details before rushing it over the transom. There was an opportunity to do a good job of it, but the admin and the Dems abandoned that silly idea to cram it full of crap and pass it ASAP instead.

  • Eugene McCain

    And so even the CBO is not accepted by conservatives if it doesn’t give them the answers they want to believe. The reality that conservatives refuse to acknowledge is that the current system, where we have 30 million or so uninsured….the cost of their uninsured care is picked up, at the highest cost possible, by all the rest of us. While bringing all these millions into mandated insurance coverage has a cost…not doing so has a much greater cost. That is the reality. Also, all the talk of the mandate being a tax is just silly. The only “tax” identified by SCOTUS was the “penalty” for refusing to participate in the insurance program. This penalty on the 1% or so that might try to avoid participating…. is enforced thru the vested power of taxation. That is all…and it seems smart to me. But for all those that are paying for their insurance…this is Insurance…not Tax. Very simple…but threatening to conservative views…who think the “government” is something other than “us”.

  • I love that MW thinks that an article from Reason Magazine can prove anything. And Tully, who accused me in another thread of being too emotional and ignoring the facts thinks that taking longer would have produced something useful for the uninsured as the GOP was working as hard as possible to avoid that possibility.

  • mw

    Ah… Jimmy Jimmy Jimmy

    I love how you always focus on the article source as opposed to the actual content. Always. 100% of the time. As predictable as death and taxes. Well – at least taxes.

    My comment is not dependent on the Reason article link.

    My comment is dependent on one thing – simple arithmetic.

    Solve for X in this equation:

    $X (revenue) -$1T (new spending) = $0 (CBO deficit estimate)

    Take as long as you like.

  • Tully

    CBO analysts will be the first to tell you that they work under assumption rules that are not realistic in the real world, and have zero discretion to deviate from them.

    Yep, it’s the darned math that doesn’t work out, regardless of source. There’s also the pesky little problem that insurance ≠ access, any more than handing out bus passes to everyone puts more buses on the routes. The utterly predictable result of increasing demand without increasing actual supply to match is that either prices go up or rationing is implemented/increased, or both. And it physically impossible for us to increase supply to match demand in the timeframe of the implementation, even assuming rush training and expanded training programs for doctors, physician’s assistants and nurse practicioners. So there will be shortages, price problems, and quality will assuredly suffer.

    On the bright side, at least a few states have figured out that they have to expand their basic-care infrastructure, which has long been the weakest link in our system. And with or without the legislation, the system was already heavily transitioning away from the independent-practice model and towards the salaried-institutional model. In 2008, 35% of doctors worked on salary. As of last year, that was up to 65%.

  • Angela

    I need to see some numbers. Of the uninsureds, how much of their health care bill is picked up by the government? By mandating health insurance coverage, how much do we save? Will Obamacare increase competition in the health insurance industry? Will it increase competition in the delivery of health care? It seems to me that all this bill really does is ask citizens to get coverage who currently do not have coverage, or who currently do not qualify for government assistance. I really don’t see that there are expanded costs to the government since those who qualify for assistance already receive it.

  • Angela

    Also, just wanted to point out that people are running to the doctor for the simplest ailments because they know they;’re covered. That drives up costs too. There should be a yearly limit on number of doctor visits or it comes out of your own pocket after that. People would be wiser about what they go to the doctor for. Unless of course you’ve been diagnosed with a legitimate illness that requires more care. I mean honestly, going to the doctor for sniffles or a stubbed toe. Get real!