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Surprise, Surprise, Surprise (Not Really) (2 comments)
Posted: Friday, May 14th, 2010By Dennis G. Smith
This past week, the Congressional Budget Office (CBO) announced that the “Patient Protection and Affordable Care Act” (PPACA) will cost at least $115 billion more than previously estimated and the Obama Department of Justice (DOJ) attorneys filed the government’s response to a lawsuit and defended the new law on the grounds of the power to tax. The immortal words of Gomer Pyle when he discovered the obvious are ringing in our ears—“surprise, surprise, surprise.”
Further, the extra $115 billion is generally based on the period 2010-2014 so we must assume the meter will be running beyond this timeframe. Once Congress starts funding these programs are we really to believe it will stop? Doubtful. Bear in mind none of these estimates include the Medicare “doc fix” which will cost at least $250 billion over the next 10 years.
The DOJ brief reads a bit like a comedy skit as its defense of Congress’ authority exposes the inconsistencies of the law itself. For example in defending the individual mandate, “… given the Act’s denial-of-coverage prohibitions directed at the insurance industry, more individuals might ‘make an economic and financial decision to forego health insurance coverage,’ … until their medical decision becomes dire. Such individual decisions multiplied by thousands – if not millions – of times, would result in a system in which only the sickest in our society tend to carry health insurance. Where the most expensive are in the insurance system, and the least expensive are outside it, insurance prices skyrocket and cost-shifting is magnified [emphasis in original].”
Well, that is exactly what will happen under the law. People will be able to wait until they get sick before they purchase coverage. Premiums for young, healthy people will skyrocket because Congress limits costs based on age.
The DOJ brief explains uncompensated care due to people’s low income and lack of ability to pay will cost $43 billion in 2008 (so why did Congress provide only $5 billion for high risk pools and why will we be spending in excess of $200 billion annually and still have 22 million uninsured?). The brief also points out that Congress has excluded millions of such individuals from the mandate to get coverage. So many of the individuals who are the source of uncompensated care don’t have to participate in this new scheme. That makes sense.
DOJ explains the plaintiffs might get lucky enough in the future to lose earnings that would exempt them from the tax. Conversely, millions of individuals who can afford to purchase coverage on their own will qualify for new government subsidies (families with income up to 400 percent of the federal poverty level … as much as $100,000 for a family of five will be eligible). Avoid the tax by collecting from your neighbor!! Defending the government’s authority does not require that the government’s policy to be rational.
The government’s defense of the law boils down to two fundamental arguments—doing nothing is commerce and the power to tax. The latter breaks President Obama’s pledge that taxes would not be raised on the middle class (President Obama had also previously opposed the individual mandate). Together, they argue that the authority of the federal government is limitless. All that is required is for Congress to determine when, where, and how it chooses to apply it. Maybe that is why Americans are upset.
1. http://www.cbo.gov/ftpdocs/114xx/doc11490/LewisLtr_HR3590.pdf
2. U.S. District Court for the Eastern District of Michigan, Thomas More Law Center v. U.S. Case No. 2:10-cv-11156, Defendants’ Response.
Very informative. You don’t see articles like this in the Washington Post. Mr Smith for President!
If the End Stage Renal Disease Program is an indication, this surprise will pale in comparison to reality in the future. Additionally, the burden of preventable chronic disease (and preventable injuries and violence)will rocket the costs skyward. None of this is really addressed in PPACA. An inconvenient oversight?