Impact of Health Care Reform

Obamacare in Pictures
Cenfer for HeaIfh PoIicy Sfudies -FaII 2010
Where will the
uninsured go?
The purpose of the
health care overhaul was
to provide coverage for
the uninsured. However,
even with Obamacare,
18 million Americans
will be uninsured in
2019. Those who do
gain coverage will do so
primarily through the
government-controlled
exchanges or through
Medicaid.
Source: Centers for Medicare and Medicaid Services.
* Estimate assumes 5 million
undocumented aliens.
Note: Figures have been
rounded.
heritage.org Obamacare in Pictures
Medicaid
18 million
Insurance
exchanges
16 million
23 million*
Uninsured
28%
32%
41%
Obamacare is
health care
redistribution
The health care law will
provide new coverage to
millions of Americans,
but one consequence will
be a major redistribution
of existing coverage.
Millions of Americans
will be moved out of
private health plans and
into government plans
and federally regulated
insurance “exchanges.”
Source: Centers for Medicare and Medicaid Services. heritage.org Obamacare in Pictures
Net Change in Health
Care Enrollment by 2019
Under Obamacare
Exchanges
+31.6
million
Medicaid/
SCHIP
+20.4
million
Employer-
Sponsored
Private
Insurance
–1.4
million
Other
Private
Insurance
–15.7
million
Uninsured
–33.8
million
Taxed enough
already?
Wait until
Obamacare
kicks in
To pay for generous
subsidies to purchase
health insurance, a huge
expansion of Medicaid,
and other new spending,
Obamacare raises taxes
and creates 17 new ones
that will affect all
Americans.
Source: Calculations based on data from the Joint Committee on Taxation. heritage.org Obamacare in Pictures
Annual Costs of Obamacare Taxes
Health
insurance
mandates
Hospital
insurance
tax
Revenue
from 15
other
taxes and
mandates
$0
$20
$40
2010 2015 2019
$60
$80
$100 billion
Total, 2010–2019
$502 billion
Obamacare’s bundle of budget gimmicks
Proponents
of the health
care law say it
will reduce the
budget deficit
from 2010 to
2019 by $124
billion...
... but after accounting for these
budget gimmicks, the new law
actually adds to the deficit.
Sources: Senate Budget Committee, Congressional Budget Office. heritage.org Obamacare in Pictures
Double-
counted
Medicare
cuts
Unpaid-for
“Doc Fix”
Discretionary
spending
Double-
counted
savings
from
CLASS
Program
Double-
counted
savings from
Social
Security
payroll taxes
–$124
billion
+$29
billion
+$70
billion
+$115
billion
+$283
billion
+$529
billion
A Medicaid Monster
Obamacare increases coverage by adding millions of Americans to the low-quality,
low-access Medicaid program, requiring billions of dollars from state budgets.
Sources: Centers for Medicare and Medicaid Services, statehealthfacts.org.
Increase in Medicaid
Population Under
Obamacare by 2014
32.3%
23.9%%% 2222
17.7%
22.8% 11.2%
40.7%
34.5%
56.7%
25.1%
28%
36.1% 3
21.8%
17.6%
49.5%
30.7%
24.7%
17.3%
65.6%
34.5%
42.8%
24.3%
36.1%
32.5%
36.8%
43.4%
36.3%
30.8%
21.1%
23.5%
12.1%%
30.9%
13.3%
8.7%
29.5%
31.4%
39.6%
25.7%%
24.7%
35.8%
22.3%
13.1%
U.S. total:
30.4%
41.1%
42.6%
18.1%
21.0%
44.2%
30%
36.4%
28.3%
34.3%
26.2%
WY
WV V
WI
WA VT
VA
UT
TX
TN
SD
SC
RI
PA
OR
OK
OH
NY
NV
NM
NJ
NH
NE
ND
NC
MT
MS
MO
MN
MI
ME
MD
DC
MA
LA
KY
KS
IN
IL
ID
IA
HI
GA
FL
DE
CT
CO
CA
AZ
AR
AK
AL
0% to 20%
20.1% to 30%
30.1% to 40%
40.1% to 70%
heritage.org Obamacare in Pictures
The Paperweight Bureaucracy
At 2,700 pages, the Patient Protection and Affordable Care Act is one of the
most bloated bills in congressional history.
Source: Library of Congress THOMAS, at http://thomas.loc.gov.
* Includes 150 pages from reconciliation bill.
heritage.org Obamacare in Pictures
Patient
Protection and
Affordable
Care Act (2010)
*
Senate
Finance
Committee
Bill (2009)
Bill Clinton’s
1994 health
care bill
America’s
Affordable
Health Choices
Act (2009)
Senate
HELP
Committee
Bill (2009)
2,700
pages
1,502
pages
1,342
pages
1,018
pages
839
pages
If you like
your health
care, can you
really keep it?
President Obama
promised health care
reform would not affect
those who already have
coverage. But one inde-
pendent study shows
more than 17 million
people will be forced out
of employer-sponsored
health care plans. That’s
more than one out of
every 10.
Source: The Lewin Group. heritage.org Obamacare in Pictures
Of the 17.2 million who no longer will have their
employer-sponsored health plans under Obamacare ...
1 million
will become
uninsured.
3.7 million
will end up in
Medicaid.
3.9 million
will end up in a
government
exchange
without subsidies.
8.6 million
will end up in a
government
exchange
with subsidies.
Obamacare
bends the
cost curve ...
in the wrong
direction
Health care reformers
touted Obamacare as a
way to reduce skyrocket-
ing health care spending.
However, in 2014, when
several key provisions
kick in, spending will
begin to rise even faster.
Source: Centers for Medicare and Medicaid Services. heritage.org Obamacare in Pictures
–$40
–$20
+$20
+$40
+$60
+$80 billion
Difference in National Health Expenditures Under
Obamacare Compared to Prior Law, in Billions
Obamacare
INCREASES
Spending
Obamacare
DECREASES
Spending
2010
2011 2012 2013
2014 2015 2016 2017 2018 2019
+$77
Net Change,
2010–2019
+$311
billion
Obamacare
accelerates
government
control over
health care
Government has been
taking greater control of
health care for decades.
But under Obamacare,
government will quickly
cross the “tipping point,”
controlling more than 50
percent of all health care
spending faster than
under prior law.
Source: Centers for Medicare and Medicaid Services.
* Excludes private spending on health plans in the exchanges.
heritage.org Obamacare in Pictures
2010 2011 2012 2013 2014 2015 2016 2017 2018
Percentage of National Health Expenditures
Under Government Control
“Tipping
Point”
53.0%
51.5%
47%
48%
49%
50%
51%
52%
53%
54%
50.9%
Under
Obamacare*
Before
Obamacare
49.9%
By 2020, Obamacare will ...
... increase the interest
on the national debt
by an average of $23.1
billion per year.
Sources: Calculations based on IHS Global Insight’s macroeconomic model. heritage.org Obamacare in Pictures
1 ... raise the national
debt by more than
$753 billion.
2 ... increase annual
budget deficits by an
average of $75 billion.
3
Change in Federal
Net Interest Payments
Change in Total Debt
Held by the Public
Change in Federal Budget
Surplus/Deficit
0
$10
$20
$30
$40
$50
$60
2010 2015 2020
$52.8 billion
billion
0
$200
$400
$600
$800
2010 2015 2020
$753.2 billion
billion
–$120
–$100
–$80
–$60
–$40
–$20
0
2010 2015 2020
–$106.3 billion
billion
States: Obamacare is unconstitutional
The Attorneys General of 21 states have filed suits to protect their citizens from
being forced by the federal government to purchase health insurance.
Source: American Legislative Exchange Council.
States filing suits
against Obamacare’s
“individual mandate”
WY
WV V
WI
WA
VT
VA
UT
TX
TN
SD
SC
RI
PA
OR
OK
OH
NY
NV
NM
NJ
NH
NE
ND
NC
MT
MS
MO
MN
MI
ME
MD
DC
MA
LA
KY
KS
IN
IL
ID
IA
HI
GA
FL
DE
CT
CO
CA
AZ
AR
AK
AL
heritage.org Obamacare in Pictures
About the Freedom of Choice in Health Care Act
The bill, filed by state legislators across the U.S., would protect patients’ rights to pay
directly for medical services and to choose not to carry health insurance.
Source: American Legislative Exchange Council.
Note: Arizona has
already passed legislation
and has another initiative
on the ballot.
Initiative on ballot
WY
WV
WI
WA
VT
VA
TN
SD
SC
RI
PA
OR
OK
OH
NY
NV
NM
NJ
NH
NE
ND
NC
MS
MO
MN
MI
ME
MD
DC
MA
LA
KY
KS
IN
IL
ID
IA
HI
GA
FL
DE
CT
CO
CA
AZ
AR
AK
AL
heritage.org Obamacare in Pictures
Announced intention
to file legislation
Filed legislation
Passed legislation
UT
TX
MT
Budget trick:
The CLASS
Program
Part of Obamacare, the
CLASS Program creates
an entitlement for long-
term care. Participants
pay premiums for five
years before receiving
benefits, creating the
illusion of deficit
reduction at the onset. In
reality, CLASS will add to
deficits by 2030.
Sources: Congressional Budget Office
and Centers for Medicare and
Medicaid Services. heritage.org Obamacare in Pictures
Projected Effects of the CLASS Program on the
Federal Budget
0
+$2
+$4
+$6
+$8
+$10
+$12 billion
2011 2015 2020 2025 2030
Congressional
Budget Office
Centers for
Medicare and
Medicaid Services
CMS and CBO
project CLASS
will generate
deficits by 2025
and 2030,
respectively
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