Affordable Care Act
FEATURED RESEARCH, TESTIMONIES AND ANALYSIS:
The American Action Forum filed an amicus brief in the Supreme Court for the case on the constitutionality of the Patient Protection and Affordable Care Act. The brief, signed by 101 economists, including two Nobel laureates and multiple former senior government officials, argues that the Medicaid expansion provision of the PPACA unconstitutionally coerces states to act. The amicus brief analyzes public data from governmental sources to quantify the effect of losing federal Medicaid funds and tests whether states could realistically choose to decline Congress' offer.
As millions of Americans file their 2011 income taxes this week, they should start a rainy day fund because the pending onslaught of tax increases stemming from President Obama’s “Affordable Care Act (ACA)” will dramatically impact their standard of living.
In a failed attempt to pay for the ACA, President Obama is set to increase taxes by $2.4 trillion between now and 2030. This massive tax increase targets individual health plans, employers, and medical innovators. Its effects will be felt by every American in the form of a less innovative, more costly healthcare system that chokes economic growth and stands in the way of job creators.
The American Action Forum’s three Supreme Court amicus briefs led by Forum President Douglas Holtz-Eakin and including Nobel Laureates and hundreds of health experts proved pivotal to the oral arguments held this week on the individual mandate, severability, and the Medicaid expansion. No other outside organization on the left or right was cited more frequently or at greater length. The Forum amicus briefs prompted questions and commentary from counselors on both sides of the case as well as five Supreme Court Justices: Chief Justice Roberts, Justice Kennedy, Justice Alito, Justice Scalia, and Justice Sotomayor.
On Monday the American Action Forum and the Blue Dog Research Forum released a poll of Supreme Court experts, including former Supreme Court clerks and lawyers who have argued before the Court, to ascertain the likelihood of potential outcomes for the Patient Protection and Affordable Care Act (PPACA) case. Of particular interest in the survey were the outcomes predicted by specialists in regard to PPACA’s most controversial element, the individual mandate, which forces all Americans to have health insurance meeting certain minimum coverage requirements or pay a financial penalty for choosing to forgo insurance. Concerns exist on both the mandate’s constitutionality and whether the mandate, which data shows to be hugely intertwined with the other PPACA reforms, is severable from the law.
The American Action Forum and the Blue Dog Research Forum today announced the results from a poll on the Affordable Care Act taken among former clerks of the Supreme Court and attorneys who have argued before the Court. It was executed by Purple Insights and was designed to gain expert insight into the probable outcomes of the Affordable Care Act case heard before the Supreme Court this week.
In response to numerous reports of poor public opinion regarding the Affordable Care Act (ACA), the Obama Administration is attempting to publicize any and all good news about the health reform law. This week it was a report from the Assistant Secretary for Planning and Evaluation (ASPE) on the 105 million people benefitting from the lift of lifetime limits in health plans. A lifetime limit is a max dollar amount that a health insurance plan will pay out in benefits for any single beneficiary.
President Obama campaigned on the commitment of having the most open and transparent administration in history. Unfortunately, like President Obama’s campaign promise to lower health insurance premiums by $2,500 per family, this commitment quickly fell victim to the Patient Protection and Affordable Care Act (PPACA).
In an attempt to track PPACA implementation costs and paperwork burdens, the Forum has produced a database of formal rulemakings published in the Federal Register since passage in March 2010. In a separate document, the Forum has produced a “Calendar” of pending PPACA rulemakings with estimated costs and links to the Unified Agenda. This document summarizes our PPACA database of published rulemakings; some of the regulations are still in the proposed rule stage. All of the figures cited are from the Federal Register entries or separate Regulatory Impact Analysis documents.
American Action Forum President Doug Holtz-Eakin expressed five major points in his testimony. First, at a time when sound policy requires low taxes and reductions in present and future transfer spending, the ACA moves dramatically in the wrong direction. Second, the mandates and tax provisions in the ACA will have detrimental impacts on employment growth, wages, and economic growth. Third, the impact of the ACA will be more expensive health insurance putting employers in the position of either reduced wage rates, fewer employees, or dropping insurance coverage. Fourth, the ACA has strong incentives to drop health insurance coverage, and to the extent that employers pursue these incentives, taxpayers face tremendous upside risk to the cost of the ACA. Fifth, even without unexpectedly large numbers of employers dropping coverage, the ACA will exacerbate an already-dangerous fiscal outlook.
American Action Forum President Douglas Holtz-Eakin delivered congressional testimony that emphasized three lessons learned during the first year of the Affordable Care Act. First, health care reform remains a missed opportunity for Medicare reform. Medicare is in deep financial distress that cannot be disguised by gimmicky trust fund accounting, will unlikely be successfully absorbed by the planned provider cuts in the ACA, and that lacks a real fix to the broken Sustainable Growth Rate (SGR) mechanism. Second, Medicaid will be deeply stressed by the ACA, as states lack the flexibility to balance the mandates and coverage expansions as beneficiaries continue to have difficulty in achieving access to providers. Third, it has become obvious that the ACA is not a route to more jobs in America. Instead, its toxic mix of mandates, higher taxes, explosive spending, and deficits are a drag on the already-weak economic recovery.
In this testimony, Doug Holtz-Eakin makes four major points. First, the mandates and tax provisions in the PPACA will have detrimental impacts on employment growth, wages, and economic growth. Second, the impact of PPACA will be more expensive health insurance, putting employers in the position of reduced wage rates, fewer employees, or dropping insurance coverage. Third, the PPACA has strong incentives to drop health insurance coverage, and to the extent that employers pursue these incentives, taxpayers
A close examination of CBO's work and other evidence undercuts this budget-busting argument about repeal and leads to the exact opposite conclusion, which is that repeal is the logical first step toward restoring fiscal sanity. The history of federal entitlements is one of inexorable growth. Once erected, more and more people get added to the programs. The ACA will be no different. Spending will soar, and the tax hikes and spending "offsets" that were cobbled together to get the bill passed will either wither away or vanish altogether. Repeal isn't a budget buster; keeping the ACA is. Assertions to the contrary are, well, audacious.
The American Action Forum released a letter signed by 200 economists and other experts from across the country supporting full repeal of the new health care law. To promote job growth and help to restore the federal government to fiscal balance, we, the undersigned, feel that it would be beneficial to repeal and replace the Patient Protection and Affordable Care Act (P.L. 111-148). Too many Americans remain unemployed and the United States faces a daunting budgetary outlook. We believe the Patient Protection and Affordable Care Act is a threat to U.S. businesses and will place a crushing debt burden on future generations of Americans.
The Affordable Care Act (ACA) is an impediment to economic growth and federal fiscal balance, threatening nearly 700,000 jobs and increasing the deficit by nearly $300 billion in the near term. At a time when too many Americans remain unemployed and the country faces a daunting budgetary outlook, alternative approaches to health care reform would be preferable.
Targeting discretionary programs needed to implement the healthcare reform law will be central to any defunding strategy. Operation Healthcare Choice has analyzed the healthcare reform law and identified potential programs that may serve as a starting point for defunding it in the 112th Congress.
The healthcare reform law flunks the test of real healthcare reform and fails to help restore fiscal balance to the nation's budget. Operation Healthcare Choice recommends five legislative objectives for the 112th Congress to replace the healthcare reform law.
Oversight hearings should begin immediately as the Obama Administration has abused the traditional rulemaking process to limit public comments from key stakeholders and the American people. Operation Healthcare Choice recommends five immediate areas for oversight hearings in the 112th Congress.
Advocates of the new reform law have made several related claims: Once people know what is in it, it will be more popular, it is front-loaded with good news, and it will control costs and reduce the budget deficits in the future. The experience of the first six months says something very different. The implementation has been plagued with delays and a lack of transparency that make it very difficult for people, large companies, and small businesses to understand the new law. And it is not, as a result, more popular. Instead, polling done at the American Action Forum suggests that it has become a litmus test for whether America is on the wrong track. Our polls indicate that roughly 65 percent of respondents think that the country is on the wrong track. Of those respondents, just under 95 percent oppose the PPACA.
The new health care law is a threat to the health of small businesses. Its heavy dosage of mandates and penalties will be a financial burden, and the law is riddled with hidden barriers to job growth. In what might be the greatest irony of all, the healthcare law is a threat to U.S. medicine. That’s because the most common business form among healthcare providers is the sole practitioner.
The Federal government faces a daunting fiscal outlook, which makes the budgetary impact of the PPACA even more important. The official Congressional Budget Office (CBO) analysis indicates modest deficit reduction over the next ten years and beyond. Douglas Holtz-Eakin and Michael Ramlet examine the underpinnings of the CBO’s projection and conclude that it is built on a shaky foundation of omitted costs, premiums shifted from other entitlements, and politically dubious spending cuts and revenue increases. A more comprehensive and realistic projection suggests that the new reform law will raise the deficit by more than $500 billion during the first ten years and by nearly $1.5 trillion in the following decade.
The PPACA will have profound implications for U.S. labor markets. The PPACA is fiscally dangerous, raising the risk of higher labor (and other) taxes at a time when the job market is struggling. It provides strong incentives for employers – with the agreement of their employees – to drop employer-sponsored health insurance for as many as 35 million Americans, perhaps leading to widespread turmoil in labor compensation and employee insurance coverage – and raising the gross taxpayer cost of the subsidies to roughly $1.4 trillion in the first 10 years.
The answer, unfortunately, is that the budget office is required to take written legislation at face value and not second-guess the plausibility of what it is handed. So fantasy in, fantasy out. In reality, if you strip out all the gimmicks and budgetary games and rework the calculus, a wholly different picture emerges: The health care reform legislation would raise, not lower, federal deficits, by $562 billion.