The increase is due mainly to the fact that the original CBO score of the Patient Protection and Affordable Care Act did not factor in the cost of actually having the government implement the reform via discretionary spending, and the law provided for a significant number of grants which did not have a specific dollar value.
I suspect at least some of the decisions about how to structure the new law’s grants and discretionary spending requirements were to help keep the CBO score low. Democrats became bizarrely and dysfunctionally obsessed with the CBO score about which most Americans are completely misinformed if they know anything at all.
The extremely long, completely unnecessary, four-year phased implementation was the most egregious gimmick to keep the CBO score below some arbitrary number. If you believe the new law will actually provide significant help to Americans in need, the multi-year delay by Congressional Democrats, simply to get a prettier CBO score, should cause moral outrage.
In the end, how much the law will actually cost is anyone’s guess. The CBO tries their best, but their projections require some huge assumptions that could easily be wrong, and their previous track record on predicting the costs of health care legislation is poor. What we do know is that the new law lacks true cost control and will not bring our outsized and escalating health care expenditures in line with the rest of the industrialized world. It will not come close to solving that problem, regardless of what this revised analysis by the CBO says.
We don’t have a deficit crisis in this country, we have a health care spending problem (and a military spending problem, but that is another article). We pay nearly twice as much as most countries, and our health care cost problem is, at its core, almost exclusively a political corruption and corporate influence crisis. We know by looking at examples from other countries how to reduce health care costs for consumers, and we know how bringing down those costs can reduce our federal deficit. Many of the ideas, like drug re-importation, even have broad popular support. The only obstacle is Washington politicians completely beholden to the powerful health care lobbies that make huge donations to their campaigns. Our elected representatives have and continue to actively shape legislation to help large health care corporations charge us way more than necessary, and way more than should be allowed.
This year’s health care reform was written, supported, and sold to Americans by PhRMA and the for-profit hospitals. Until Congress is actually willing to take on these groups directly, we regular Americans will continue to get ripped off. . . and our deficit will continue to increase.