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12 Days of Obamacare Surprises: An Optional Medicaid Expansion

Not all surprises are good. When it comes to Obamacare, the original projections are turning into unfortunately different realities. For the past 11 days, Heritage has highlighted one of the various changes in Obamacare projections (e.g., cost, enrollment, etc.) from when the law first passed until now. This Christmas morning will be the last day in this blog series and will highlight a positive Obamacare surprise.

In 2014, Obamacare expands Medicaid eligibility to able-bodied, childless adults earning up to 138 percent of the federal poverty level (FPL). If a state chose not to expand, the federal government would stop funding their existing Medicaid programs. The Congressional Budget Office (CBO) estimated that by 2016, Obamacare would drive an additional 17 million Americans into Medicaid.

Thankfully, the Supreme Court ruled that Obamacare’s Medicaid expansion was unconstitutionally coercive, ensuring state that chose not to expand would not lose existing federal assistance. Due to the Court’s ruling, the CBO now estimates that 6 million less Americans will be enrolled in the failing Medicaid program in 2022.

Surprise: While additional federal funding is available to those states that expand, the states will be burdened with the true cost. At least 20 states are planning to not expand or are unlikely to expand their Medicaid programs, according to Politico. The Supreme Court’s decision dealt a major blow to Obamacare and shifted a great deal of power to the states. This Christmas, in light of Obamacare’s many other mandates and requirements, this optional part of the law is certainly something to be thankful for.

12 Days of Obamacare Surprises:

11. Unlikely deficit reduction…

10. Unelected bureaucrats on IPAB…

9. Increased employer penalties…

8. More cuts to Medicare…

7. Loss of employer-sponsored insurance…

6. A 50/50 split on enrollment estimates…

5. More uninsured Americans…

4. Increased exchange subsidies…

3. Big tax increases…

2. The small business tax credit…

1. And the individual mandate.

Tags: federal funding, mandates, Medicaid, Obamacare surprise, requirements, States, true costs

12 Days of Obamacare Surprises: Deficit Reduction?

Not all surprises are good. When it comes to Obamacare, the original projections are turning into unfortunately different realities. For the next two days, Heritage is going to highlight one of the various changes in Obamacare projections (e.g., cost, enrollment, etc.) from when the law first passed until now.

Obamacare was passed into law under the guise that it would expand access to health coverage while simultaneously reducing the federal deficit.

In 2010, the Congressional Budget Office (CBO) estimated that Obamacare would result in deficit reduction totaling $143 billion from 2010–2019.

In 2012, the CBO estimated that Obamacare would result in deficit reduction totaling only $109 billion from 2013–2022, $34 billion less than in 2010. Among other updates, this is due to the rising costs of subsidies in the exchanges.

Surprise: The CBO lowered its deficit reduction projection by 24 percent, revealing that Obamacare will cost the American public far more than anticipated. Turns out, the best things don’t come in big, Obamacare-sized packages.

12 Days of Obamacare Surprises:

10. Unelected bureaucrats on IPAB…

9. Increased employer penalties…

8. More cuts to Medicare…

7. Loss of employer-sponsored insurance…

6. A 50/50 split on enrollment estimates…

5. More uninsured Americans…

4. Increased exchange subsidies…

3. Big tax increases…

2. The small business tax credit…

1. And the individual mandate.

Tags: "deficit reduction", CBO, Medicaid Expansion, Obamacare surprise, rising costs, subsidies

12 Days of Obamacare Surprises: The Independent Payment Advisory Board

Not all surprises are good. When it comes to Obamacare, the original projections are turning into unfortunately different realities. For the next three days, Heritage is going to highlight one of the various changes in Obamacare projections (e.g., cost, enrollment, etc.) from when the law first passed until now.

Obamacare created the Independent Payment Advisory Board (IPAB), which consists of 15 unelected bureaucrats who are tasked with finding savings within Medicare to meet a new, fixed target for spending growth in the program. The board’s recommendations will be implemented unless Congress enacts an alternative proposal that amounts to the same level of savings.

In 2010, the Congressional Budget Office (CBO) projected that IPAB would result in Medicare savings of $15.5 billion from 2010–2019.

In 2012, the CBO projected that the IPAB would result in zero savings for the years 2015–2019.  According to the CBO, “…the IPAB mechanism will not affect Medicare spending during the 2011-2022 period.” Later, in a letter regarding the repeal of Obamacare, CBO estimated that the IPAB could save $3.1 billion over the 2013–2022 period, but cautioned “That estimate is extremely uncertain because it is not clear whether the mechanism for spending reductions under the IPAB authority will be triggered under current law over the next 10 years.”

Surprise: The IPAB is yet another Obamacare plan that not only sounds like a bad idea, it is a bad idea. The IPAB is like a fruit cake—and it’s time to regift.

12 Days of Obamacare Surprises:

9. Increased employer penalties…

8. More cuts to Medicare…

7. Loss of employer-sponsored insurance…

6. A 50/50 split on enrollment estimates…

5. More uninsured Americans…

4. Increased exchange subsidies…

3. Big tax increases…

2. The small business tax credit…

1. And the individual mandate.

Tags: cost control, Independent Payment Advisory Board, IPAB, Medicare, Obamacare surprise

12 Days of Obamacare Surprises: Increased Employer Penalties

Not all surprises are good. When it comes to Obamacare, the original projections are turning into unfortunately different realities. For the next four days, Heritage is going to highlight one of the various changes in Obamacare projections (e.g., cost, enrollment, etc.) from when the law first passed until now.

In 2014, Obamacare requires all businesses with 50 or more full-time employees to provide government-approved health coverage for their workers or pay a $2,000 penalty for each employee after the first 30 workers.

In 2010, the Congressional Budget Office (CBO) estimated that total penalties paid by employers from 2010–2019 would equal $52 billion.

In 2012, the CBO updated its estimate for penalties paid by employers from 2013–2022 to total $106 billion.

Surprise: Employers are now estimated to pay more than twice the amount in penalties compared to the original estimate. Too bad employers won’t be able to re-gift Obamacare’s mandate.

12 Days of Obamacare Surprises:

8. More cuts to Medicare…

7. Loss of employer-sponsored insurance…

6. A 50/50 split on enrollment estimates…

5. More uninsured Americans…

4. Increased exchange subsidies…

3. Big tax increases…

2. The small business tax credit…

1. And the individual mandate.

Tags: CBO, employer mandate, Obamacare surprise, penalties

12 Days of Obamacare Surprises: More Medicare Cuts

Not all surprises are good. When it comes to Obamacare, the original projections are turning into unfortunately different realities. For the next five days, Heritage is going to highlight one of the various changes in Obamacare projections (e.g. cost, enrollment, etc.) from when the law first passed until now.

Obamacare makes across-the-board payment cuts to Medicare providers.

In 2010, the Congressional Budget Office (CBO) estimated that Obamacare would reduce Medicare spending by over $500 billion from 2010–2019.

In 2012, the CBO updated its estimate to total $716 billion in Medicare payment cuts from 2013–2022. The payment cuts will be made to Medicare Advantage, hospital services, home health services, nursing home services, and more.

Surprise: Medicare payment reductions are now estimated to be $200 billion more than they were in 2010. But the real surprise is that despite Medicare’s serious financing issues, these Medicare “savings” are used to pay for new spending in Obamacare, not to improve Medicare’s solvency.

12 Days of Obamacare Surprises:

7. Loss of employer-sponsored insurance…

6. A 50/50 split on enrollment estimates…

5. More uninsured Americans…

4. Increased exchange subsidies…

3. Big tax increases…

2. The small business tax credit…

1. And the individual mandate.

Donald Schneider is currently a member of the Young Leaders Program at The Heritage Foundation. For more information on interning at Heritage, please visit: http://www.heritage.org/about/departments/ylp.cfm.

Tags: across-the-board cuts, home health, hospital services, Medicare providers, nursing home, Obamacare surprise

12 Days of Obamacare Surprises: Loss of Employer-Sponsored Insurance

Not all surprises are good. When it comes to Obamacare, the original projections are turning into unfortunately different realities. For the next six days, Heritage is going to highlight one of the various changes in Obamacare projections (e.g., cost, enrollment, etc.) from when the law first passed until now.

Under Obamacare, most employers will either provide government-approved health coverage or drop coverage, pay a penalty, and send their employees to the new government-subsidized exchanges.

In 2010, the Congressional Budget Office (CBO) estimated that by 2019, three million fewer individuals would have employer-sponsored insurance (ESI) due to Obamacare’s impact.

In March 2012, the CBO updated its estimate to show that by 2016, six million fewer Americans would be enrolled in employer coverage.

In a separate report, the CBO projected the loss of ESI under different scenarios, one of which showed a loss of ESI coverage for 20 million Americans by 2019. The CBO reports show that businesses are less likely to offer coverage to employees under Obamacare.

Surprise: If you like your coverage, Obamacare might prevent you from keeping it. While estimates vary on exactly how many people will lose their coverage, it’s clear that it will be millions. Obamacare is the gift that keeps on giving—results that Americans don’t want.

12 Days of Obamacare Surprises:

6. A 50/50 split on enrollment estimates…

5. More uninsured Americans…

4. Increased exchange subsidies…

3. Big tax increases…

2. The small business tax credit…

1. And the individual mandate.

Tags: coverage, keeping it, Obamacare surprise