The Congressional Budget Office earlier this week released a new spending estimate for the health overhaul law that has been noted by a number of commentators. Conservatives have been decrying the increased cost, while administration officials and liberal bloggers say the law doesn’t guarantee new spending.
Today, CBO Director Douglas Elmendorf adds more detail on his blog that is likely to fan the debate: “The potential discretionary costs identified two days ago include many items whose funding would be a continuation of recent funding levels for health-related programs or that were previously authorized and that [the health law] would authorize for future years. (For example, those potential costs include $39 billion authorized for Indian health services that already receive appropriations every year.) CBO estimates that the amounts authorized for those items exceed $86 billion over the 10-year period (out of the roughly $105 billion total shown in the table provided yesterday).”
His clarification came after Peter Orszag, the director of the Office of Management and Budget, on his blog Wednesday said the new CBO estimate of the cost of discretionary authorizations caused some people to draw the wrong conclusions. “The letter simply updates CBO’s calculation of the size of discretionary authorizations included in the legislation. CBO’s tally, which is not included in its estimate of the cost of the law, has led some to erroneously conclude that the law includes more spending and less deficit reduction than CBO has previously reported.” And, because President Barack Obama has pledged to freezing discretionary spending, he said, “any actual new funding would have to fit within this freeze and so would have to be offset by budget cuts elsewhere.”
Ezra Klein was among the first bloggers to note the new information.
Conn Carroll of the Heritage Foundation’ The Foundry yesterday termed it the nation’s continuing “post-passage Obamacare education” when the CBO “confirmed that the federal government will have to spend an additional $115 billion implementing the law, bringing the total estimated cost to over $1 trillion. … This is by far not the only nasty little surprise that has come back to bite Obamacare after passage. Shortly after it became law, U.S. employers began reporting hundreds of millions if dollars in losses thanks to tax changes in the bill.”
Cato’s Michael Cannon looks at another hot topic, the nomination of Elena Kagan to the Supreme Court and says senators should check her ties to the new health law. “Senate Judiciary Committee members should be sure to ask Solicitor General and Supreme Court nominee Elena Kagan, during her upcoming confirmation hearings, whether she or her office played any part in crafting ObamaCare or the administration’s defense to the lawsuits challenging that law. If Kagan helped to craft either, that would present a conflict of interest: when those lawsuits reach the Supreme Court, she would be sitting in judgment over a case in which she had already taken sides.”
Another Obama nominee, Donald Berwick, who is slated to head the office that oversees Medicare, is also coming in for some rough criticism among bloggers. Pundit and Pundett points to a critical story by Philip Klein at the American Spectator and says, “Here’s hoping that he’ll meet with some serious resistance, and that America will learn more about government-run healthcare and rationing in the process.”
Ben Domenech at Red State.com says, “President Obama’s nomination of Donald Berwick as the head of the Centers for Medicare and Medicaid Services (CMS) is a gathering far less attention than a certain other nominee — but it will be getting more attention in the weeks to come, given his particularly radical agenda when it comes to health policy.” He also links to a speech Berwick gave several years ago on the British health system.
In other health postings, Wonk Room’s Igor Volsky says, “The National Association of Insurance Commissioners (NAIC) — the insurance industry funded group tasked with making recommendations to HHS about the medical-loss ratio standards in the new health care law — released a new draft report Monday, suggesting that the Secretary should exempt plans in the individual health insurance market from spending 80% of premium dollars on actual medical expenses. … The draft NAIC warns that the rules may be ‘too strict for some individual policies,’ leading some customers to lose coverage.”
Timothy Jost on the Health Affairs blog explores the new regulations for insuring young adults on their parents’ plans. ” Although this age group is on the whole quite healthy, it is far from invincible. One study found that injury-related emergency room visits were more common for young adults than for either children or older adults, with nearly one-quarter of 18 to 29 year-olds having had an emergency room visit in the preceding year.” He also notes that pregnancies are not uncommon among people this age.
Katherine Nix at the Foundry writes about the effect of the new health law on doctors.