You decide which possibilities seem the most likely based on the available evidence, and you form my opinions around those. Opinions are not facts.
How much has Obamacare saved the American people?
- Thread starter Oneuli
- Start date
You decide which possibilities seem the most likely based on the available evidence, and you form my opinions around those. Opinions are not facts.
Yes, as you know.
It slowed the rate of growth and that saved money relative to what would have spent without the change. Obviously.
Think!
Althea
Althea told me...........
Only because they were incorrect about the number of people who would obtain Medicaid.
Yes. And deep down you know it's true.
Nothing to offer except a trite exercise in "possible world" semantics?
Think so?
It rose briefly and then fell dramatically. By comparison, it's now rising rapidly with no sign there will be any reversal.
"Obviously?"
You're using that word wrong. Try harder.
Yes, and so do you.
Am I?
Is that right?
Who told you that?
Althea
Althea told me...........
Actually, House Teabaggers de funded key aspects of the law beginning in '14
A primary argument made for passing the Affordable Care Act (ACA, or so-called “Obamacare”) was that only such an expansion of the federal role in healthcare could successfully slow the growth of national health costs and thereby avert fiscal disaster. During the first few years after the law’s enactment, many of its supporters contended it was already accomplishing this, which other analysts strongly disputed. But more recently a quiet consensus has overtaken the former controversy: thus far the ACA’s cost-containment mechanisms are failing, and the net effect of the law has been to make our national healthcare affordability problem worse than it was.
The ACA was complex legislation containing on the one hand several elements expected to increase healthcare spending, and on the other hand several it was hoped would reduce costs. On the cost-increasing side, the law significantly expanded federally-subsidized health insurance coverage, lowering millions of Americans’ out-of-pocket contributions to their own healthcare purchases. It is well documented that the greater the share of individuals’ healthcare financed by insurance, the more services they tend to use. The ACA’s coverage expansion, direct benefits, premium assistance and cost-sharing subsidies thus all increased healthcare demand, utilization and costs.[1]
At the same time, the ACA contained various provisions designed to slow healthcare spending growth. It established a new excise tax on high-premium employer-sponsored plans, the so-called “Cadillac plan tax,” intended to counter the cost-driving effects of the longstanding federal tax preference for employer-sponsored health insurance. The ACA also constrained Medicare provider payment growth, which it was hoped would have “spillover” effects of forcing efficiencies and generally lowering costs. The law also created a new Independent Payment Advisory Board (IPAB) with powerful authority to further constrain Medicare spending growth, while limiting lawmakers’ opportunities to override IPAB’s decisions. Also included in the ACA were various provisions designed to limit hospital readmissions, promote bundled payments, and move to value-based provider reimbursements.
Importantly, these provisions taken together were not projected to lower spending as much as the ACA’s subsidized coverage expansion would increase it. Specifically, the Centers for Medicare & Medicaid Services actuaries estimated the ACA would increase total health spending while assuming each of its cost-saving provisions would be fully implemented.
Unfortunately from a fiscal perspective, the ACA’s cost-increasing provisions took effect while many of its cost-saving provisions did not. The Cadillac plan tax was immediately postponed until 2018 in the reconciliation law amending the original ACA, and was more recently postponed to 2022 in the latest omnibus appropriations act. Some previously-planned Medicare Advantage cuts were scaled back, while the vast majority of the ACA’s scheduled Medicare payment reductions are only beginning to be implemented. IPAB was also repealed earlier this year. These events conformed to previous warnings that the proceeds of the ACA’s various savings provisions could not be safely spent until they had actually accrued.
National healthcare spending growth slowed significantly in the years leading up to and after the ACA was passed, tempting some to assert that the ACA itself was holding down cost growth. This was never a fully credible claim, not least because the spending slowdown was an international phenomenon and preceded the ACA’s 2010 enactment, but also because it long preceded 2014 when the ACA’s main coverage expansion provisions took effect. Subsequent evidence is that the ACA’s net effect has been to push healthcare spending higher.
Figure 1 shows historical and projected growth in National Health Expenditures (NHE) per capita. The graph suggests a trend. Annual percentage growth in NHE per capita was declining substantially before the ACA was enacted in 2010. In 2014, however, the ACA’s coverage expansion kicked in, and its effect of increasing national health spending was immediate. For the past few years NHE growth per capita has been elevated, a trend projected to continue in the near future.
Note that these raw per capita growth figures only tell part of the story, because NHE growth tends to rise and fall with broader economic growth. Figure 2 shows how historical and projected per capita GDP growth looks over the same time period. The trend in Figure 2 is partially, but not wholly, parallel with Figure 1; it shows faster growth after the ACA was enacted than before. With respect to GDP growth, this reflects the enactment of the ACA just after the Great Recession.
Figure 2 thus provides context for Figure 1, but neither figure tells the whole story. To reveal the healthcare spending growth trend, the critical factor to isolate is the difference between the two figures – that is, the difference between per capita NHE growth and per capita GDP growth, or in other words, “excess” NHE growth. Figure 3 shows the evolution of excess NHE growth.
Figure 3 shows that excess NHE growth spiked during the Great Recession: basically, the economy contracted but NHE did not, causing a substantial differential. During 2010-13 excess NHE growth effectively disappeared, as the economy recovered while health spending moderated. But then in 2014 the ACA’s coverage expansion began, which meant that despite our continuing economic recovery, the problem of excess NHE growth re-emerged.
While health economics is too complex for us to blame the ACA alone for the recent adverse trend, the evidence on balance points to the ACA increasing rather than decreasing health spending.
https://economics21.org/html/obamacare-failing-contain-healthcare-costs-3108.html
The ACA was complex legislation containing on the one hand several elements expected to increase healthcare spending, and on the other hand several it was hoped would reduce costs. On the cost-increasing side, the law significantly expanded federally-subsidized health insurance coverage, lowering millions of Americans’ out-of-pocket contributions to their own healthcare purchases. It is well documented that the greater the share of individuals’ healthcare financed by insurance, the more services they tend to use. The ACA’s coverage expansion, direct benefits, premium assistance and cost-sharing subsidies thus all increased healthcare demand, utilization and costs.[1]
At the same time, the ACA contained various provisions designed to slow healthcare spending growth. It established a new excise tax on high-premium employer-sponsored plans, the so-called “Cadillac plan tax,” intended to counter the cost-driving effects of the longstanding federal tax preference for employer-sponsored health insurance. The ACA also constrained Medicare provider payment growth, which it was hoped would have “spillover” effects of forcing efficiencies and generally lowering costs. The law also created a new Independent Payment Advisory Board (IPAB) with powerful authority to further constrain Medicare spending growth, while limiting lawmakers’ opportunities to override IPAB’s decisions. Also included in the ACA were various provisions designed to limit hospital readmissions, promote bundled payments, and move to value-based provider reimbursements.
Importantly, these provisions taken together were not projected to lower spending as much as the ACA’s subsidized coverage expansion would increase it. Specifically, the Centers for Medicare & Medicaid Services actuaries estimated the ACA would increase total health spending while assuming each of its cost-saving provisions would be fully implemented.
Unfortunately from a fiscal perspective, the ACA’s cost-increasing provisions took effect while many of its cost-saving provisions did not. The Cadillac plan tax was immediately postponed until 2018 in the reconciliation law amending the original ACA, and was more recently postponed to 2022 in the latest omnibus appropriations act. Some previously-planned Medicare Advantage cuts were scaled back, while the vast majority of the ACA’s scheduled Medicare payment reductions are only beginning to be implemented. IPAB was also repealed earlier this year. These events conformed to previous warnings that the proceeds of the ACA’s various savings provisions could not be safely spent until they had actually accrued.
National healthcare spending growth slowed significantly in the years leading up to and after the ACA was passed, tempting some to assert that the ACA itself was holding down cost growth. This was never a fully credible claim, not least because the spending slowdown was an international phenomenon and preceded the ACA’s 2010 enactment, but also because it long preceded 2014 when the ACA’s main coverage expansion provisions took effect. Subsequent evidence is that the ACA’s net effect has been to push healthcare spending higher.
Figure 1 shows historical and projected growth in National Health Expenditures (NHE) per capita. The graph suggests a trend. Annual percentage growth in NHE per capita was declining substantially before the ACA was enacted in 2010. In 2014, however, the ACA’s coverage expansion kicked in, and its effect of increasing national health spending was immediate. For the past few years NHE growth per capita has been elevated, a trend projected to continue in the near future.
Note that these raw per capita growth figures only tell part of the story, because NHE growth tends to rise and fall with broader economic growth. Figure 2 shows how historical and projected per capita GDP growth looks over the same time period. The trend in Figure 2 is partially, but not wholly, parallel with Figure 1; it shows faster growth after the ACA was enacted than before. With respect to GDP growth, this reflects the enactment of the ACA just after the Great Recession.
Figure 2 thus provides context for Figure 1, but neither figure tells the whole story. To reveal the healthcare spending growth trend, the critical factor to isolate is the difference between the two figures – that is, the difference between per capita NHE growth and per capita GDP growth, or in other words, “excess” NHE growth. Figure 3 shows the evolution of excess NHE growth.
Figure 3 shows that excess NHE growth spiked during the Great Recession: basically, the economy contracted but NHE did not, causing a substantial differential. During 2010-13 excess NHE growth effectively disappeared, as the economy recovered while health spending moderated. But then in 2014 the ACA’s coverage expansion began, which meant that despite our continuing economic recovery, the problem of excess NHE growth re-emerged.
While health economics is too complex for us to blame the ACA alone for the recent adverse trend, the evidence on balance points to the ACA increasing rather than decreasing health spending.
https://economics21.org/html/obamacare-failing-contain-healthcare-costs-3108.html
Althea
Althea told me...........
In most cases, that wasn't the metric. It was more a question of whether your college grad kids would have ANY insurance, instead of not having any protection. Kids almost never think about health insurance.
Until they break a leg skiing.
Democrats dominated the Congress for 30 plus years. Republicans took over in 1995. After that, the Government experienced the first ever surplus. Deficits dropped significantly until they began seeing a surplus in 1998 as a result of the Contract with America, until after 9-11 and our subsequent invasions into Iraq and Afghanistan. Stop being a dishonest dumbfuck and pretending that there wasn't a reason the deficits began again. Find a single war that was ever fought with a surplus.
Deficits went up and down for thirty plus years dishonest dumbass. They didn't become a surplus until Republicans took over the Congress. Congress holds the purse strings.
Where BillyBob Clinton gets credit is that unlike the Obama moron, he saw the American people's will and signed onto Newt Gingrich's agenda. Pretending it was a result of Clinton makes you look ignorant, dishonest and a partisan hack.
The deficit fell in 73 and 74, then increased again. The deficit fell in 79, then increased again. The deficit fell in 84, then increased again. The deficit fell in 87, then increased again. What does that say about your moronic hypothesis?
The Republican controlled Congress in the 90's had the first surplus since 1969. What does that do to your hypothesis. STFU, seriously. You look like a moron.
Yes, partisan hacks like you are quite full of excuses, moronic hypothesis and a lot of "IFs". Dunce.
You have it ass backwards. When Democrats took back control of the Congress for a very short four year term with Nancy Pelosi at the helm of the purse strings, deficits shot up to $1.4 trillion and we ended up with a massive and costly healthcare plan that never worked. Dunce.
You never had a track on it snowflake. Try re-thinking and this time use what little brain you have.
Blah, blah, blah, whine, Blah, blah, blah, whine, Blah, blah, blah, whine. STFU, seriously.
Spending rose so little that we ended up with $10 trillion in additional debt. A record no other President will ever supersede. You really are too stupid for words, seriously.
