ObamaCare Will Push 2 Million Out of Work! And That’s a Good Thing!

A CBO report on the Affordable Care Act is getting a polarized reading.

health-costs-money-stethoscope

Memeorandum today is leading with a John Podhoretz piece in the New York Post headlined “Congressional Budget Office sends death blow to ObamaCare.”

The Affordable Care Act, a k a ObamaCare, became law almost four years ago. It became operational last Oct. 1. Yesterday, Feb. 4, 2014, the ACA may well have been dealt its death blow.

The Congressional Budget Office released a major study of the government’s budget and its effect on the overall economy over the next 10 years. In dull bureaucratic language, it delivers a devastating analysis of the inefficiencies, ineffectualities and problematic social costs of ObamaCare.

The one-two punch: Virtually as many Americans will lack health coverage in 10 years as before the law was passed — but 2 million fewer will be working than if the law hadn’t passed.

One killer detail comes on Page 111, where the report projects: “As a result of the ACA, between 6 million and 7 million fewer people will have employment-based insurance coverage each year from 2016 through 2024 than would be the case in the absence of the ACA.”

ObamaCare’s key selling point was that it would give coverage to a significant number of the 30-plus million Americans who lack it. Now the CBO is telling the American people that a decade from now, 6 million-plus of their countrymen won’t get health care through their employers who otherwise would have.

Wall Street Journal piles on with “The Jobless Care Act.”

On Tuesday no less than the Congressional Budget Office reported that the health law is causing Americans to work less or not at all, in a remarkable intellectual turnabout for the budget shop that Democrats cited repeatedly when selling ObamaCare. Now CBO—full of liberal-leaning economists—says the economy will lose the equivalent of two million full-time workers by 2017 and 2.5 million over the next decade, a threefold increase over its prior estimate.

CBO’s analysis is rooted in ObamaCare’s complex design that includes new subsidies, taxes and mandates. For low-wage, lower-skilled or discouraged workers in particular, ObamaCare offers incentives that can force them to trade jobs for entitlement benefits.

BO’s conclusion is that ObamaCare will encourage people to supply less labor by deciding not to take a job or by working fewer hours. The law’s insurance subsidies are gradually taken away as income rises, “creating an implicit tax on additional earnings,” the CBO observes. These effective marginal tax rates reduce the rewards for work—whether it be overtime, accepting a promotion, or training in the hope of higher future earnings. CBO doesn’t note, though we will, that simply extending “free” coverage skews job search decisions by offering an in-kind bonus for unemployment.

CBO’s job-loss prediction is all the more remarkable because it doesn’t include the impact of ObamaCare’s employer mandate, which requires businesses with 50 or more full-time employees to offer insurance or pay a $2,000 penalty for each worker beyond 30 employees. CBO more or less punts on the issue because the White House delayed the mandate for a year and the changes would be hard to model. But this means CBO is probably still underestimating job losses because common sense says that labor mandates raise hiring costs and induce businesses to hire less, or pay lower wages, or slash hours, or all three.

‘But the flip side of this is pretty compelling. The editorial board of the New York Times proclaims ObamaCare is “Freeing Workers From the Insurance Trap.”

The Congressional Budget Office estimated on Tuesday that the Affordable Care Act will reduce the number of full-time workers by 2.5 million over the next decade. That is mostly a good thing, a liberating result of the law. Of course, Republicans immediately tried to brand the findings as “devastating” and stark evidence of President Obama’s health care reform as a failure and a job killer. It is no such thing.

The report estimated that — thanks to an increase in insurance coverage under the act and the availability of subsidies to help pay the premiums — many workers who felt obliged to stay in a job that provided health benefits would now be able to leave those jobs or choose to work fewer hours than they otherwise would have. In other words, the report is about the choices workers can make when they are no longer tethered to an employer because of health benefits. The cumulative effect on the labor supply is the equivalent of 2.5 million fewer full-time workers by 2024.

Some workers may have had a pre-existing condition and will now be able to leave work because insurers must accept all applicants without regard to health status and charge premiums unrelated to health status. Some may have felt they needed to keep working to pay for health insurance, but now new government subsidies will help pay premiums, making it more possible for them to leave their jobs.

The report clearly stated that health reform would not produce an increase in unemployment (workers unable to find jobs) or underemployment (part-time workers who would prefer to work more hours per week). It also found “no compelling evidence” that, as of now, part-time employment has increased as a result of the reform law, a frequent claim of critics. Whether that will hold up after a mandate that requires employers to provide coverage, which was delayed until 2015, kicks in is uncertain.

Michael Hiltzik of the LA Times agrees, weighing on on “Why the new CBO report on Obamacare is good news.”

The Congressional Budget Office is out with its latest report on the Affordable Care Act, and here are a few bottom lines:

 

— The ACA is cheaper than it expected.

— It will “markedly increase” the number of Americans with health insurance.

— The risk-adjustment provisions, which Congressional Republicans want to overturn as a “bailout” of the insurance industry, will actually turn a profit to the U.S. Treasury.

Given all this, why are the first news headlines on the CBO report depicting it as calling Obamacare a job killer?

You can chalk up some of that to the crudity of headline-writing, and some to basic innumeracy in the press. But it’s important to examine what the CBO actually says about the ACA’s impact on the labor market. (You can find it at pages 117-127, excerpted here.)

The CBO projects that the act will reduce the supply of labor, not the availability of jobs. There’s a big difference. In fact, it suggests that aggregate demand for labor (that is, the number of jobs) will increase, not decrease; but that many workers or would-be workers will be prompted by the ACA to leave the labor force, many of them voluntarily.

As economist Dean Baker points out, this is, in fact, a beneficial effect of the law, and a sign that it will achieve an important goal. It helps “older workers with serious health conditions who are working now because this is the only way to get health insurance. And (one for the family-values crowd) many young mothers who return to work earlier than they would like because they need health insurance. This is a huge plus.”

The ACA will reduce the total hours worked by about 1.5% to 2% in 2017 to 2024, the CBO forecasts, “almost entirely because workers will choose to supply less labor — given the new taxes and other incentives they will face and the financial benefits some will receive.”  That translates into about 2.5 million full-time equivalents by 2024 — not the number of workers, because some will reduce their number of hours worked rather than leaving the workforce entirely.

The overall impact on the community will be muted, moreover, because most of that effect will be seen at the lowest levels of the wage-earning scale. The effect will be “small or negligible for most categories of workers,” the CBO says, because there will be almost no impact on workers who get their insurance from their employers or who earn more than 400% of the federal poverty line (for a family of three, that’s $78,120), the point at which eligibility for federal premium disappears.

As for labor demand, the CBO estimates that on balance, the ACA will increase aggregate demand for goods and services, in part by relieving lower-income people of the burden of health insurance or healthcare expenses, so they can increase their spending on other things. In turn, that will “boost demand for labor,” especially in the near term, while the economy remains slack.

For those who haven’t been reading for the past several years, I opposed the passage of ObamaCare and still think that, on balance, it’s a Band Aid on a broken system that further distorts the insurance market and diminishes personal freedom without fixing the underlying problem of out-of-control healthcare costs. But my preferred alternative, a base single payer system for all supplemented with private insurance for the well off, was and remains politically unviable. (As a side note, I think parts of the system, notably the exchanges, were essentially designed as a back door way of  breaking the link between employment and healthcare, thus opening the door for single payer.)

As for yesterday’s CBO report, though, the NYT/Hiltzik view is surely correct. Regardless of one’s views on the Obama administration or of the best way to address the shortfalls of the American healthcare delivery system, it’s hard to construct an argument as to why people who can otherwise afford to retire should be forced to stay in their job solely because they have no alternative means of obtaining health insurance. Or, for that matter, why people who would otherwise prefer to move from one company to another to take  job they would otherwise find more suitable should feel forced to stay put in order to keep their health coverage. Surely, we can agree those are bad outcomes even if were disagree on whether the government ought be able to force insurance companies to cover pre-existing conditions, create healthcare exchanges, or mandate that individuals obtain insurance.

FILED UNDER: *FEATURED, Health, , , , , , , , , , , , , ,
James Joyner
About James Joyner
James Joyner is Professor and Department Head of Security Studies at Marine Corps University's Command and Staff College. He's a former Army officer and Desert Storm veteran. Views expressed here are his own. Follow James on Twitter @DrJJoyner.

Comments

  1. JoshB says:

    It doesn’t matter what the CBO actually says – the dishonest articles are already being written. Expect to see a lot of “GOP says Obamacare costs 2 millions jobs – Democrats disagree!”

  2. michael reynolds says:

    So we’re able to predict the state of the economy and the consequences of one of its moving parts in such great detail that we can see the employment picture in ten years? Right. That’s why back in 1997 they so accurately predicted the recession of 2007.

    Economists can’t predict the sunrise. This is bullsh!t pseudo-science, whichever interpretation you like.

  3. rudderpedals says:

    I for one welcome our 2 million new entrepreneurs.

  4. James Joyner says:

    @michael reynolds: You’re right that we suck at complex predictions about the medium-term future. I’m not sure that it follows that we shouldn’t try to get the best predictions possible, though, for crafting public policy.

  5. C. Clavin says:

    Based on the GOP reaction…it appears that Republicans in general have a difficult time with reading comprehension.

    Another benefit is that Obamacare empowers entrepreneurs…allowing them to leave a job and chase their dream while still being insured at a reasonable rate.
    You would think Republicans would be all for that…but instead they lie about the benefits of the law…as Cathy McMorris Rogers did in her response to the SOTU.

    I tend to agree with you, James…a fundamental overall would be ideal…but that’s a radical change…Obamacare is the Conservative approach.

    Good on Paul Ryan for being the rare Republican legislator honest about this.
    http://talkingpointsmemo.com/livewire/paul-ryan-gop-job-losses

  6. Tyrell says:

    My idea years ago was to bring these people into health care through medicare. There would have been no need for a totally new website, people could have applied through the medicare site, options could have been offered similar to the prescription plans, and it would have gone a lot smoother. The people who have been signing up for the AHA are mainly those with pre-conditions, those who have lost their jobs, and those who are older. The younger people who have good jobs and are healthy are not signing up. Many of them are not interested. Many of them do not have good jobs and aren’t about to pay their hard earned money for ObamaCare. Many of them are paying for college debt. There are no incentives that appeal to them. If they got a free PS3 with “Black Ops”, “Ghost Recon” or “Assassins Creed” they might pay attention to that sort of offer, with some pizza coupons thrown in.
    The option of the health clinics which offer free or reduced treatment should be considered.

  7. PD Shaw says:

    it’s hard to construct an argument as to why people who can otherwise afford to retire should be forced to stay in their job solely because they have no alternative means of obtaining health insurance.

    Not hard at all; its facetious comparison. From the CBO report:

    Under the ACA, employers with 50 or more full-time-equivalent employees will face a penalty . . . [under certain circumstances]. Originally scheduled to take effect in 2014, that penalty is now scheduled to be enforced beginning in 2015. In CBO’s judgment, the costs of the penalty eventually will be borne primarily by workers in the form of reductions in wages or other compensation – just as the costs of a payroll tax levied on employers will generally be passed along to employees. Because the supply of labor is responsive to changes in compensation , the employer penalty will ultimately induce some workers to supply less labor.

    In the next few years, however, when wages probably will not adjust fully, those penalties will tend to reduce the demand for labor more than the supply. In the longer run, some businesses also may decide to reduce their hiring or shift their demand toward part-time hiring – either to stay below the threshold of 50 full-time-equivalent workers or to limit the number of full-time workers that generate penalty payments.

    The employer penalty will reduce the number of full-time jobs and compensation for those below the 400% household poverty. Many will find the compensation unattractive and become permanently entrenched in poverty or the underground economy. For those of us with higher skills, things are looking great though.

  8. rudderpedals says:

    @Tyrell:

    The option of the health clinics which offer free or reduced treatment should be considered.

    It has been, but you’d be surprised at the results. An executive order came down from the Governor in my state directing each of the county health departments to stop providing low and no cost clinical services to the public. Humane, existing alternatives are drawing the wrong kinds of attention.

  9. C. Clavin says:

    @Tyrell:
    Medicare for all is politically impossible.
    However if you start voting Democratic..instead of against your own interests…we might get there.

  10. C. Clavin says:

    @PD Shaw:
    In other words you can be like Orin Hatch…who is either too stupid to read, or is lying…you choose.

    “Obamacare, the President’s signature domestic policy achievement, will lead to more than 2 million fewer jobs and hurt much-needed economic growth,” he said. “A direct threat to the long-term health and prosperity of our nation, this law must be repealed.”

  11. Grewgills says:

    Interesting that neither of the articles critical of the ACA link to the actual CBO report and both of the articles with a positive read on it do link to the CBO report. I wonder why.

  12. Woody says:

    @C. Clavin:

    Based on the GOP reaction…it appears that Republicans in general have a difficult time with reading comprehension.

    Considering how many degree-holding media people – Murdoch or not – are promoting the GOP framing, I’d say Republicans understand “comprehension” very well.

    Democrats running for re-election could run testimonials from entrepreneurs now able to take a chance / maligned or mistreated employees able to find better jobs / working poor now able to get treatment, but as media professionals are personally well-covered and only speak to others similarly circumstanced, we’ll see if that gets any play.

  13. sam says:

    @PD Shaw:

    PD, how is any of that responsive to JJ’s claim? He is talking about people who can afford to retire but elect not to do so because of the necessity of having insurance, now being supplied by the employer. If they can get insurance elsewhere, they can go ahead and retire. I fail to see how you are successful in rebutting him. If you mean to say that the number of people who would be able to retire will be reduced because of penalty horribles, please do note that that is a different issue.

  14. Gavrilo says:

    it’s hard to construct an argument as to why people who can otherwise afford to retire should be forced to stay in their job solely because they have no alternative means of obtaining health insurance.

    This is a fantastic argument that should be extended beyond health insurance. I could afford to retire right now if only I had alternative means of obtaining food, shelter, clothing and the rest of life’s necessities. They should pass a law to provide those things. I’m writing my Congressman!

  15. Moosebreath says:

    @Tyrell:

    “My idea years ago was to bring these people into health care through medicare. ”

    In other words, you like James’s solution, “my preferred alternative, a base single payer system for all supplemented with private insurance for the well off, was and remains politically unviable.”

    So do I. It’s a pity that our politics won’t permit it, as raising the taxes needed to pay for it would never pass the best Congress money can buy.

  16. James Joyner says:

    @Gavrilo: ObamaCare doesn’t provide free health coverage.

    Under the old system, workers could be tied to a specific employer because that’s where they got their health insurance and be unable to take another job or retire because they’d be unable to obtain comparable coverage elsewhere because of pre-existing conditions. I don’t like the way it does it but ObamaCare attempts to fix that.

    People still have to work to get money to buy things, including health coverage. That’s a completely separate issue.

  17. C. Clavin says:

    @Gavrilo:
    In other words you believe that no one should be treated at an emergency room unless they can prove they have the means to pay…just as I cannot get food or clothing at a store unless i provide a means of payment…or shelter if I cannot pay my rent or mortgage.
    I wish Republicans had the balls to stand up and admit that like you just did. Because that is the very basis of the discussion…the fundamental right of access to basic health care.
    Now…I can grow my own food, build my own shelter, and sew my own clothes. Certainly pioneers and settlers did that. However they all died prematurely due to a lack of access to health care.
    If that is the world you believe in…terrific.
    Scream it from the hilltops.
    Don’t hide behind specious arguments about mandates etc.
    If only all Republicans were as honest as you are.

  18. mantis says:

    Republicans on healthcare:
    Ready to retire but can’t afford health insurance? Go f*ck yourself.
    Want to quit your job and start a company but need health insurance? Go f*ck yourself.
    Want to get a job with a startup that doesn’t offer insurance yet? Go f*ck yourself.

    These are the circumstances that the lying GOP is now calling “lost” jobs. They are the enemies of retirement and entrepreneurship.

    Stay where you are and work til you die. Vote Republican.

  19. mantis says:

    @Gavrilo:

    This is a fantastic argument that should be extended beyond health insurance. I could afford to retire right now if only I had alternative means of obtaining food, shelter, clothing and the rest of life’s necessities.

    That would make some sense if your food, shelter, clothing, etc. cost 20 times as much if you don’t have a job. But unlike health insurance, it doesn’t, so it’s just another moronic argument from you.

  20. David M says:

    @Gavrilo:

    This is a fantastic argument that should be extended beyond health insurance. I could afford to retire right now if only I had alternative means of obtaining food, shelter, clothing and the rest of life’s necessities. They should pass a law to provide those things.

    I’ll treat this nonsense semi-seriously and point out that we already have Social Security, Disability, Medicare and Medicaid to do exactly that.

  21. Scott says:

    The ability to leave your job and go do something else is an increase in freedom, just the opposite of what the opponents of the ACA proclaim. The removal of 2M people from the workforce (mostly people near the end of their working lives) will free up positions for hiring and promotion enabling younger employees to move up and improve themselves. The lessening of labor supply will allow wages to climb and employment rate to decline. All of these things are good.

  22. OzarkHillbilly says:

    @mantis: Indentured servitude? Good.
    Freedom? Bad.

  23. C. Clavin says:

    On topic…but off topic:
    http://www.nytimes.com/2014/02/05/business/wellpoint-a-onetime-critic-of-health-law-may-yet-profit.html?ref=business&_r=1
    Once you stop huffing an puffing and stamping your feet…the ACA makes some sense. Perfect? Far from it. Better than what we had…oh yeah.
    Off course it may take decades for Republicans to figure it out…because change is scary for those unable to open their minds.

  24. OzarkHillbilly says:

    @Scott: Not if you are a corporate honcho.

  25. PD Shaw says:

    @sam: Because Joyner, whom I assume read something from someone who read the CBO report, is participating in burying the bad news by exaggerating one paragraph in the entire report about retirement. The CBO says that the ACA is destroying jobs roughly in the middle of the economy.

  26. walt moffett says:

    @rudderpedals:

    Also look up Neighborhood Health Center at DHHS. We’ve had federally funded clinics that “… that serve populations with limited access to health care. ” for some time.

  27. C. Clavin says:

    @PD Shaw:
    You need to provide the quote to explain that…because from what I read in the report there is little evidence the health-care law is affecting employment and that businesses are not expected to significantly reduce head count or hours as a result of the law.

  28. mantis says:

    @PD Shaw:

    The CBO says that the ACA is destroying jobs roughly in the middle of the economy.

    No, it doesn’t.

  29. David M says:

    @PD Shaw:

    And you’re cherry picking to try and show the report said something it did not. At least Joyner tried to point out something the report actually said.

  30. Gavrilo says:

    @James Joyner:

    ObamaCare doesn’t provide free health coverage.

    Of course it does. It’s called the Medicaid expansion. If you were paying attention, you’d know that it represents a very large percentage of the people who have enrolled since Oct. 1. Further, if you were paying attention, you’d know that it’s evidence of Obamacare’s enormous success. At least according to most of the regular readers of your blog.

    Why is it the federal government’s (i.e. taxpayer’s) responsibility to subsidize early retirement for anyone?

  31. anjin-san says:

    @ Gavrilo

    Why is it the federal government’s (i.e. taxpayer’s) responsibility to subsidize early retirement for anyone?

    RIght. Let’s stick to corporate welfare and welfare for the rich.

  32. PD Shaw says:

    @David M: “And you’re cherry picking to try and show the report said something it did not. At least Joyner tried to point out something the report actually said.”

    I quoted the report, and how would you quantify whether I am cherry picking or Joyner has?

    How many times does the CBO report use these words:

    “Retire” or “Retirement” = three times
    “Employer Penalty” = nine times
    “Penalty” = thirty-seven times

  33. TheoNott says:

    Another point: Those 2 million workers leaving the workforce may well act to raise wages and lower unemployment. With fewer workers looking for work, more unemployed workers will find it and employers will need to offer more attractive compensation.

  34. David M says:

    @PD Shaw:

    The CBO says that the ACA is destroying jobs roughly in the middle of the economy.

    This is not true, regardless of how well you can count.

  35. C. Clavin says:

    @Gavrilo:
    Medicaid subsidizes early retirement?
    Look…if you don’t know what you are talking about…then find out something about the topic and then form your own opinion…instead of parroting the opinions of others who know as little as you.

  36. David M says:

    @C. Clavin:

    Medicaid subsidizes all kinds of people, but even if Gavrilo is correct that some are early retirees with very little income, so what? That’s certainly not worth worrying about.

  37. al-Ameda says:

    What is remarkable to me is that from the mid-1990s until 3 years ago, health insurance premium costs were increasing annually by over 3 to 4 times the rate of inflation, and no one was talking about the loss of jobs due to those increased costs to employers.

    At 3 different organizations I was charged with pricing out and negotiating our benefit contracts and I can tell you that, annually, for about 13 years we’d get notification that our health insurance premiums were increasing by 9% to 17%. At one financially stressed organization we had to structurally change our health insurance benefit offering to an HSA based plan otherwise we were faced with laying off 10% of our employees – and this was prior to ACA.

    I guess no one asked anyone to assess the effect of THAT.

  38. john personna says:

    @michael reynolds:

    Heh, I wish I could give that both a +1 and a -1. The reminder of the limits to prediction is great, but that isn’t quite the same as we have no clue.

  39. john personna says:

    @James Joyner:

    Sure, without modeling where would we set SS withholding? With dice?

  40. David M says:

    It’s either amusing or pathetic that the GOP is complaining about this, when it’s a feature of health care reform not an unexpected consequence. Not only that, but it’s their feature. The GOP are the ones constantly pushing for means-testing and to end the favorable tax treatment of employer health insurance, two policies that will cause the exact same reduction in workers. (Not jobs)

  41. john personna says:

    I was very surprised to see that jobs “lost” were voluntary.

    I think it is more than semantic to ask in what sense “lost?”

    In the sense that your kid won’t step up to take that same job?

  42. steve says:

    PD- They also say the ACA will create more demand for products and services, increasing employment. I read over most of the report and near as i can tell they make specific predictions about people leaving the labor market (the 2 million workers being cited so often), but are not making specific predictions about the competing effects that might either reduce or increase job creation.

    Steve

  43. grumpy realist says:

    I thought the Japanese health care system had problems. Then I had to start dealing with the US health care system…..

    I want to go back to Japan. Even with the aftereffects of Fukushima, I’m liable to live longer there than I am here.

  44. JohnMcC says:

    @Gavrilo: OK, I ran my little personal story into the ground in earlier threads on this topic but just for the record I’ll saddle it up again: Two years ago I was prepared to retire at age 66. Medicare coverage (check), Social Security (check), part time status on my job — a job I really love BTW — cleared with my employer (check), my wife (a contract employee) who’d enjoyed a lifetime of good health shopping for a personal health plan (check).

    Then she found the breast cancer.

    Two plus years have gone, now, and (thanks be) she’s doing great because of treatment paid for by my employer-based health insurance. But with the recent cancer, the only way she’d ever have health insurance is because of the ACA. No questions about medical history. No exceptions for pre-existing conditions. An open market with subsidies if we needed them (which thankfully, we don’t).

    And at age 68 I can retire. If the ACA had been repealed, she’d have needed my employer-provided insurance until she received Medicare at age 65. That would have put me at 73 yrs of age. With my prosthetic hip (and soon a prosthetic knee), cardiac stent, purple heart, cataracts and all.

    That is what you are calling a federal give-away so I can have an ‘early retirement’.

    You are amazing ignorant of what you speak, sir.

  45. David M says:

    @john personna:

    I was very surprised to see that jobs “lost” were voluntary.

    I think it is more than semantic to ask in what sense “lost?”

    **People on Medicaid may not want to work a little more if it means they are no longer eligible

    **People who don’t necessarily need the money may stop working full time simply to get health insurance

    **People may not want to work more if it means they lose their health insurance subsidy

    This reduction in hours is better thought of as a much larger number of people making small changes to how much they need to work, rather than 2 million people not working at all instead of working full time.

  46. Gavrilo says:

    @C. Clavin:

    It might help with your comprehension if you mouthed the words as you read them.

  47. Jeremy R says:

    That CBO report actually refutes a number of recent GOP ACA talking points, though that’s getting little attention:

    http://www.politico.com/story/2014/02/obamacare-first-year-enrollment-numbers-103098.html?hp=f1

    And in a significant victory for the Obama administration, the budget office now says the law’s “risk corridors” program — the part Republicans are calling a “bailout for insurers” — would actually save $8 billion over the long term.

    The reason: The program is supposed to pay health insurers that have higher-than-expected costs, but the money flows both ways. So if insurers’ costs are lower than expected, they’re supposed to pay the government.

    As a result, the CBO now projects that the program will collect more payments from insurers than it gives them, saving the government money between 2015 and 2017. The program is a temporary one that only lasts for three years.

    http://www.mediaite.com/online/cbo-report-obamacare-will-reduce-fulltime-employment-by-2-5-million/

    The CBO also projected that an aggregate of the ACA’s policies “will reduce federal budget deficits by $206 billion over the 2015-2024 period,” and estimated that insurance premiums in 2014 would be lowered by about 15% from the agency’s initial projections.

    http://www.washingtonpost.com/blogs/fact-checker/wp/2014/02/04/no-cbo-did-not-say-obamacare-will-kill-2-million-jobs/

    The CBO did look at the effect on demand for labor (i.e., jobs) but said the effects are mostly on the margins or are not measurable. In fact, in contrast to a common GOP talking point, the CBO declares that “there is no compelling evidence that part-time employment has increased as a result of the ACA,” though it notes the data may be murky because the employer mandate was delayed until 2015.

    And finally, from today’s Senate testimony:
    CBO director: Obamacare will reduce unemployment

  48. stonetools says:

    Good article, James.

    But my preferred alternative, a base single payer system for all supplemented with private insurance for the well off, was and remains politically unviable.

    Do you know which political party has made it politically unviable?

  49. Gavrilo says:

    @JohnMcC:

    Quite honestly, I don’t care about your personal circumstances. Just like you don’t care about mine. Congratulations for working a couple of extra years so your wife could have health insurance while she had cancer. You’re an American hero.

  50. stonetools says:

    Republicans on CBO:

    CBO: The stimulus worked by forestalling Great Depression era unemployment and creating millions of jobs.

    Republicans: “The CBO is wrong. The stimulus failed!”

    CBO: The ACA will reduce the deficit in the long run
    Republicans: No! The ACA will blow up the deficit!

    CBO: The ACA might reduce the supply of labor next decade.
    Republicans: All hail the CBO! Believe it!

    I expect that shortly the Republicans will go back to disbelieving the CBO-possibly as soon as today’s Senate testimony.

  51. David M says:

    @Gavrilo:

    Are you saying that we should end Medicare, Medicaid and all of the Obamacare insurance subsidies?

  52. C. Clavin says:

    @Gavrilo:
    Yeah…I’m sure the problem is me.

  53. Woody says:

    @stonetools:

    Excellent synopsis of Ken Ham’s debate tactics last night . . . oh, wait.

  54. C. Clavin says:

    Here’s an article explaining how Republicans loved the idea of people being able to de-couple from employers…just the thing they are ranting about now.
    http://talkingpointsmemo.com/dc/republicans-obamacare-cbo-report-insurance-employment
    Funny how electing a black man can suddenly change peoples point of view.

  55. Tyrell says:

    @C. Clavin: I have been a loyal member of the Southern Wing of the Democratic Party since the late ’60’s. I voted Republican once – for Richard Nixon in 1972.They tell me there hasn’t been a Republican elected around here (5 city council members, mayor, and police chief) since the Reconstruction Era. I can’t remember the last time a Republican even ran. Some day a Southern Democrat will return to the White House.

  56. grumpy realist says:

    I wish that those who want to get rid of health insurance, taxes, and all of the stuff required to live in the community of Mankind simply pull up their stakes and move to Somalia. No taxes, no nasty requirements on health insurance, no gun control…..

    I also point out you’re not going to live as long as you would in the US, but I guess that in your mind that’s a small price to pay for FREEDUMB.

    Go on, quityerbitchin and show what you really stand for. Move.

  57. michael reynolds says:

    @James Joyner:

    You’re right that we suck at complex predictions about the medium-term future. I’m not sure that it follows that we shouldn’t try to get the best predictions possible, though, for crafting public policy.

    I think that’s reasonable, but I’m not sure it’s true. The myth that we have some ability to predict our economy stops us from investigating approaches that might actually work. Or if no better approach exists, then let’s at least treat predictive economics like astrology – with which it shares a record of accuracy – rather than pretending it’s science. Bad information is not always better than no information.

  58. john personna says:

    @Gavrilo:

    That is really bad dude. First for the insensitivity, but second because someone else wants that job too. Old age retirement really does expand job opportunities for the young.

    What, you want John to keep working, and some slacker to stay in his mom’s basement?

  59. john personna says:

    @michael reynolds:

    Do you have the math for that? Can you disprove Bob Schiller’s study of last earnings and future returns?

    If not who actually is playing astrology?

    Throwing up hands and saying “it’s all rot” is not actually a scientific argument.

  60. anjin-san says:

    @ JohnMcC

    Just want to go on the record that I do care about your personal circumstances and am glad that Obmacare has made a difficult situation a bit better. I know what it’s like to have a family member who is seriously ill.

  61. michael reynolds says:

    @john personna:

    John, it’s pretty simple. If your friendly neighborhood doctor keeps telling you you’re at death’s doorstep and you live another 50 years, do you trust that doctor? If your horse racing tout gives you 10 tips and in every case the horse comes in out of the money, do you trust your tout? If your weather man misses entire hurricanes and massive snow storms and floods, do you listen to your weather man?

    If your friendly, neighborhood economist misses every prediction, why should we listen? We are making trillion dollar bets on the strength of predictions that are always wrong.

    I was alive in 1997 and reasonably alert and yet I don’t recall that economists were predicting that ten years out we’d be on the edge of a second Great Depression.

    There are certain events which clarify the state of our knowledge. Failing to predict global economic meltdown not just ten years out, not even just one year out, but six months out, three months out, a week out, clarifies the state of economic understanding. Can you find a single economist who got it right? No doubt, since economists taken as a group manage to predict every possible outcome and thus somebody’s got to be right, but of what use is that? Of what predictive use is a “science” that claims the ability to predict, and then fails to predict the biggest damned thing to happen in the economy since the 20’s?

    Pretending to know can be every bit as bad, and is often worse, than just admitting that we do not know. We do not know what effect Obamacare will have. We just don’t. We cannot see the future. Never have been able to, still can’t.

    And we never will be able to. Because “the economy” is a system of everything. It includes all of human activity, and that is too many variables, too much randomness, too much free will (much of it in response to predictions) to allow accurate and thus useful prediction.

  62. rudderpedals says:

    @walt moffett: I see the Neighborhood Health Center concept as a start. The pdf at your link has 48 of them in my state, 48 that I regret to say are pining for the fjords as the order terminating no/low cost clinics at the 48 county health departments came after the pdf’s Feb 2013 update.

  63. C. Clavin says:

    @Tyrell:
    At the risk of generalization, Southern Democrats are todays Republicans.
    I can only judge by your comments which are, outside of wanting single payer, typically right of center.

  64. john personna says:

    @michael reynolds:

    You retreated from math, and science, to loosely connected metaphor.

    Noted.

  65. john personna says:

    It does actually require some study and discernment to divide the various relms of economic modeling, statistics, and prediction by type.

    It’s not just “like this guy I know …”

  66. michael reynolds says:

    @john personna:

    You’re making the argument that was made by generations of medieval and renaissance doctors: how can you possibly understand the subtlety of the bodily humors and the efficacy of horse dung as a medication, you non-doctor?

    To which the non-doctor replies: all your patients die.

  67. john personna says:

    BTW, I was asking specifically about Shiller’s CAPE. Now that I’m on a real computer I can share a reference:

    New global research on Graham / Shiller Cyclically Adjusted Price Earnings (CAPE) ratio

  68. john personna says:

    @michael reynolds:

    Of course I am not, you on the other hand are making the argument that there is no difference between an island witch doctor and a Harvard MD.

    It’s all witchcraft to you.

  69. michael reynolds says:

    @john personna:

    Predictions are either correct or not. Don’t tell me I need to be able to chart a horoscope and a retrograde moon and unless I can do so I can have no position on the accuracy of astrology.

  70. john personna says:

    @michael reynolds:

    The really sad thing is that the economists you would respect never make the kind of predictions you despise.

    But of course you can never get to know them … because you have your broad brush, your prejudice.

  71. john personna says:

    @michael reynolds:

    Secondly, “predictions” which are true or false have no place in science.

    Science can only talk about probabilities and uncertainties. That’s why NASA never says that this or that comet will hit true or false. They state their odds.

  72. michael reynolds says:

    @john personna:

    A prejudice? Dude, they failed. They were wrong. They missed it. They didn’t overlook some small, peripheral event, they failed to predict the biggest economic event that any of them are likely to see.

    If accurate prediction is impossible, fine. I don’t fault anyone for failing to do the impossible. But pretending to predict when you have no ability to do so is fraud. It’s a con game.

    Probability? Okay, did economists predict, let’s say, a 75% chance of a global economic meltdown ten years before 2007? A 50% chance? And again, if they cannot predict an event of massive, earth-shaking importance, an event that is precisely in their wheelhouse, one is only being reasonable to suspect that they don’t know what the hell they’re talking about.

    Just how much wrong has to occur, how much failure, before you’re prepared to apply a bit of skepticism?

  73. C. Clavin says:

    @michael reynolds:
    But isn’t your argument that no one can predict the future so we should frankstein-walk our way into the future? You have opinions about the economy. Those opinions are based on the work of economists. They aren’t completely independent/original thoughts.

  74. bill says:

    maybe my reading comprehension is bad but did they say that the aca is discouraging people from working more and being successful? i could see those who are at retirement age, but younger people shouldn’t have that kind of worry.

  75. john personna says:

    @michael reynolds:

    It is pretty clear that you are trying to argue against economics without understanding what economics is.

    A prejudice? Dude, they failed. They were wrong. They missed it. They didn’t overlook some small, peripheral event, they failed to predict the biggest economic event that any of them are likely to see.

    That works for any field, right? Apollos burned, shuttles crashed, and so NASA knows NOTHTING, NOTHING I TELL YOU!

    Probability? Okay, did economists predict, let’s say, a 75% chance of a global economic meltdown ten years before 2007?

    Smart economists, and there are many, stayed mum.

    Your problem is that you judge the field buy the dumb guys, with foolish “predictions.”

    Note the responses to Fooled by Randomness and The Black Swan. They split. Stupid people said “no way!” but smart economists didn’t like the books either. Why? “Nothing new here,” they said.

    Hell, no less a mathematician than Benoit Mandelbrot explained precisely why the kind of predictions you hate can’t be made .. but hate on him, he was doing economics.

  76. john personna says:

    @michael reynolds:

    BTW, my man Bob Shiller did in fact call both the dot-com crash and the housing crash before they happened. He’s a smart guy who will occasionally go out on a limb, and in those cases he was right.

    Of course, he phrases things with “coulds” and “mights,” because he knows all about the fractal uncertainty.

  77. michael reynolds says:

    @john personna:

    If smart economists don’t do predictions it rather proves my initial point that economic predictions are unreliable, doesn’t it? If only the dumb ones predict, why are we listening to economic predictions?

  78. john personna says:

    @michael reynolds:

    No, it shows that your black-white argument is of no practical value.

    Because you would exclude the good kind of data-driven study and correlation with the bad kind of seat of the pants, thumb in the wind, guess.

    These guys are economists:

    On the use of evidence-based policy

    Very interesting group. Behavioral economists given fairly free reign in the British government.

  79. superdestroyer says:

    @rudderpedals:

    I suspect that more of the 2 million will be self-described authors, playwrights, artists, and performers. I have always suspect that virtually everything pushed by progressives is to make it easier to be a freelance writer in Burlington, Vt.

  80. C. Clavin says:

    @superdestroyer:
    So why shouldn’t we make it easier to be a freelance writer in VT and a painter in Telluride and a marine biologist in Miami and a chef in Memphis?
    Why should we only make it easier for the 1%?

  81. anjin-san says:

    @ bill

    younger people shouldn’t have that kind of worry.

    It sucks that younger people have to worry about insurance companies not being able to deny them insurance because of pre-existing conditions and having their employer not having the power to deprive them of their income AND their health insurance in one fell swoop.

    It’s so damn unfair.

  82. Grewgills says:

    @michael reynolds:
    To be fair, they were being fed bad data on new products that most people, including the people getting rich of them, didn’t understand. That said, there were still economists that were saying that the housing bubble was a bubble and that the economy was not on a sustainable path.

    We do have a rather large country that has rather large commitments going forward. We have to make predictions to plan for those commitments (Social Security, Medicare, etc). That those predictions will always be imperfect is understood by everyone, but without any predictions how do we budget for future needs?

  83. humanoid.panda says:

    @bill: If there is a young person out there who is wealthy enough to consider early retirement whose only hang up is a pre-existing condition, then he is rather successful, innit?

    On a more serious note, like all income-tested programs the ACA is mildly discouraging of work on the margins, as it means that someone just on the cusp of moving away from subsidies might find that extra income means fewer post-insurance dollars in his bank account. This is not a huge problem, as subsidies close to 400% of poverty line are not huge, but its something that Congress might have looked at if it was not full of trolls.
    Another problem that should be looked at is the fact that a lot of people near the Medicaid line tend to have unstable income, and might be bouncing between Medicaid and exchanges, which is not a healthy condition, but again, fixing the problem would require acknowledging that the law works in general, but the particulars need some fidgeting with. Not going to happen until 2016 at the earliest.
    Really, in many ways the ACA is health-reform 1.0. We need to get to Health Reform 1.3, en route to Health Reform 2.0, but see above for trolls in government.

  84. Just 'nutha' ig'rant cracker says:

    @Grewgills: Reynolds doesn’t need to budget for future needs. He’s (by his own admission) one of the 1% (although probably near the bottom of that cohort) .

    And like others of his group, any information that doesn’t meet his needs is useless, useless, useless.

  85. humanoid.panda says:

    @michael reynolds: Michael, you are one of the smartest commenters here, but I think you are wrong on this one. I presume that you support deficit spending during recessions. Why would you take such a counter-intuitive position if it were not for the fact that economists designed theories that predict that deficit spending during recessions is useful in fighting them. Aren’t those theories a form of prediction (if you do A, B will happen)?

  86. humanoid.panda says:

    @superdestroyer: If someone can support themselves being a writer in Burlington, VT, and the only thing stopping them is the fact that insurance is vastly more expensive on the individual market, what the hell is wrong with fixing that problem?
    Also, as someone originally from a country that has a very vibrant enterpreunarial culture and a universal healthcare system, I can relate from personal experience that the latter really helps the former. Basically, the story is that the Israeli version of the NSA is manned by 18-25 year old soldiers. The unit can only recruit people who are unfit for service in frontline units (basically, something like 60% of its workforce has asthma).These people, when they leave their unit, tend to form tiny start ups, the kind of outfits that would never could offer good insurance to an unhealthy population. These startups are responsible to a huge segment of the Israeli tech market, which is per capita muh bigger than anything anywhere else in the world. I have had a rather lengthy exposure to this culture, and I can guarantee that guaranteed health insurance is a necessary (not sufficient of course) condition for the existence of those start-ups.

  87. John425 says:

    “As for yesterday’s CBO report, though, the NYT/Hiltzik view is surely correct.”

    Of course, since it supports the Obama administration’s POV. Hardly a surprise on this board.

  88. David M says:

    @John425:

    And yet you’re unable to provide evidence to contradict that view.

  89. Stan says:

    Back on the subject of JJ’s post, the Congressional Budget Office has concluded 1) that the Affordable Care Act imposes a high marginal tax on employment for a certain class of workers, and 2) that this tax encourages them to quit working and live on their savings and retirement income. Whether this is good or bad ethically is above my pay grade. Whether it’s good or bad for the country depends on our situation. During World War II we faced a severe labor shortage and it was of vital importance for the war effort to draw as many civilians as possible — women, the able bodied elderly, underemployed African-Americans and Hispanics, for example — into the work force. We’re not in this situation now, and if Larry Summers and others are right about the way the economy is moving our problem now is an oversupply of potential workers. In these circumstances, the decision of a million or so people to leave the work force is not in any sense a disaster for the economy. As I suggested earlier, the ethical implications are more problematic.

  90. Neo says:

    The distinction to this argument today is that ObamaDoesn’tCare in fact doesn’t force employers to not employ these 2 to 2.5 million people but that these people will see that it is to their advantage not to work additional hours and will cut themselves off.

    Wow! The government has create a incentive to not work, to be less productive, to remain in your station, to create more “income inequality.”

    And, tell me again .. which Party will be campaigning against “income inequality” this year ?

  91. Mikey says:

    @michael reynolds: @john personna: This seems relevant, from Scientific American magazine:

    Why Economic Models are Always Wrong

    But what if there were a way to come up with simpler models that perfectly reflected reality? And what if we had perfect financial data to plug into them?

    Incredibly, even under those utterly unrealizable conditions, we’d still get bad predictions from models.

    The reason is that current methods used to “calibrate” models often render them inaccurate.

  92. bill says:

    @anjin-san: well, creating another massive piece of bureaucracy doesn’t seem to be the answer. kids can stay on their parents plan til their 27 but the aca is relying heavily on them to buy in?! riddle me that one!
    long run, it’s a massive tax- call it what it is. and the benefit doesn’t actually seem to benefit many aside from ins. co’s.

  93. Tyrell says:

    @humanoid.panda: I think that those numbers of the CBO are high. A few thousand or so, maybe. Most older people who are working are using their money to pay for food, utility bills, property taxes, and other items, most of which keep going up yearly. Many are helping out their children and grandchildren. And more than a few work because they want to stay active and do something. Health researchers are telling people to stay active. The idea of people retiring to a life on a golf course, beach, or yacht is a thing of the past and was probably rare.

  94. C. Clavin says:

    @Neo:
    A Fox news viewer, no doubt. These Republican parrots are always babbling about disincentive work.
    How about the retirement age guy that has to keep working so his wife can get cancer care?
    How about the next Steve jobs who can’t get away from his employer because he can’t afford insurance?
    How about the mother that would like to take care of her kids but has to work because they can’t afford insurance?
    Republicans used to love this very same idea…but then a black President implemented it. And now it’s making their heads spin.

  95. C. Clavin says:

    @bill:
    A massive tax?
    Link please.

  96. C. Clavin says:

    @bill:
    85% of Americas are not be affected tax-wise at all.

    The new tax related provisions in the Affordable Care Act (Obamacare) include tax hikes, limits to deductions, tax credits, tax breaks, and other changes. While a few of the changes directly affect the average American, tax increases primarily affect high earners (those making over $200,000 as an individual or $250,000 as a family), large businesses (those making over $250,000), and the health care industry, while tax credits primarily affect low-to-middle income Americans and small businesses.

    As time goes on the Republican lies and mis-information become more and more apparent. Desperation is setting in. They were wrong. (As they are about damn near everything.) And it’s going to be real hard to get around that going forward.

  97. grumpy realist says:

    @bill: Actually, if you looked at how much paper-shuffling gets done, a national health service would probably have the LEAST bureaucracy attached.

    It was extremely easy in Japan. I would go to a doctor, show my NHS card, and pay the small amount (often as low as $7) required. Nothing else. They didn’t even bother to take down the card number most of the time.

    Here in the US, every single time I go to my gynecologist I end up having to argue back and forth with the idiots at the testing lab because they have YET AGAIN failed to input the correct health insurance information when submitting the claim and gee, it got bounced again.

  98. john personna says:

    @Mikey:

    Heh, you are making me wake up and read carefully …

  99. rudderpedals says:

    @superdestroyer: Where’s the beef? Freelancers able to strike out on their own is pure good.

  100. john personna says:

    @Mikey:

    OK, I said above:

    Note the responses to Fooled by Randomness and The Black Swan. They split. Stupid people said “no way!” but smart economists didn’t like the books either. Why? “Nothing new here,” they said.

    This one is more like “The Black Swan!” whocouldaknowed!

    They specifically discus “risk models” which fundamentally look at a history, a time series, and tell you what you can expect, if things go the same way. Modern economic thinking is that such models are useful, if you treat them warily, and remember that they are only a look back.

    The great foolishnesses of LTCM (my favorite example) and etc. were in that they didn’t treat the models with any suspicion at all. They took it as given that if X was out of bounds in the past, it would be out of bounds in the future, by the same margin. That’s how they got those “could never happen in 10,000 years” claims.

  101. C. Clavin says:

    One day after multiple media outlets
    misinterpreted a CBO report on Obamacare, Elmendorf clarified the CBO’s position during the hearing. The federal agency, Elmendorf said, had found Obamacare “spurs employment and would reduce unemployment over the next few years.”

    “When you boost demand for labor in this kind of economy, you actually reduce the unemployment rate, because those people who are looking for work can find more work,” Rep. Chris Van Hollen (D-Md.) asked Elmendorf.

    “Yes, that’s right,” Elmendorf responded.

    Of course it wasn’t just the media that was dead wrong…it was also the majority of the Republican Party and it’s cult members.

  102. Tyrell says:

    Related issue – cost of prescription went up from $4 a month to $17. What is going on with that? The pharmacist doesn’t know why. That may not sound like much, but over the year will amount to $156!! That would pay for two theme park season passes, six trips to a movie, two pairs of tennis shoes, a Blackhawks jersey, Halloween decorations, two NASCAR tickets, or a bicycle.
    Is anyone else experiencing these kinds of unexcusable increases? (400% ) I am going to talk to the doctor and see what he thinks.

  103. Gromitt Gunn says:

    @Tyrell: If your plan operates on a calendar year basis, your deductible may have reset on Jan. 1.

  104. Pharoah Narim says:

    @Gavrilo: And why are employers involved in health care? Maybe they should be splitting my car, home, and boat insurance too…

  105. C. Clavin says:

    @Pharoah Narim:
    Pointless.
    Gavrillo thinks the pre-Obamacare system was absolutely perfect.
    Best system in the world.

  106. Pharoah Narim says:

    @Gavrilo: Golly, you write the best Republican bumper stickers! This is a classic!

  107. Scott says:

    The buzz is talking about the disincentive to work. It really is about the freedom to work at the employer of your choice. Therefore, let me add one more positive aspect to the freedom to leave your employer. Given the job satisfaction stats out there, perhaps employers will work harder to positively incentivize their employees to stay.

  108. wr says:

    @Tyrell: Instead of talking to your doctor, why don’t you call your insurance company? They’re the ones charging you the copay. Find out what the story is.

  109. Rob in CT says:

    @Stan:

    A reasonable, even-handed post. I just wanted to point that out, so it doesn’t go completely unnoticed as the flamewars rage.

  110. wr says:

    @Scott: What’s really crazy about this whole moralistic tut-tutting about “disincentivizing” people to work is that for as long as I can remember Republicans have been screaming that the way forward for America was for all the citizens to become entrepeneurs and start their own businesses. And what has kept countless numbers of people from doing that? Their need for their employer’s health insurance.

    So now we’re free — and you have morons whining about freelance writers.

  111. Tyrell says:

    @Gromitt Gunn: @wr: I will look into that and as Gromitt pointed out it might have something to do with a deductible.
    Thanks.

  112. al-Ameda says:

    @grumpy realist:

    Here in the US, every single time I go to my gynecologist I end up having to argue back and forth with the idiots at the testing lab because they have YET AGAIN failed to input the correct health insurance information when submitting the claim and gee, it got bounced again.

    Ah yes… the magic of the private sector market place.

    I’d love to see America adopt a system similar to that used in Switzerland – every one pays a tax that funds the legislated basic national health plan which they get through a private insurance company, and if you desire additional coverage, or catastrophic coverage you purchase that on the market. The basic plan is mandated and the price/profit to insurance companies is restricted by law. We’re not rational enough to do this – it will not happen in my lifetime.

  113. Mikey says:

    @al-Ameda: That’s Germany, too–a universal, multi-payer system. The legislated national health plan (Gesetzliche Krankenkasse) is funded by a tax and run by private companies–in fact there are many from which to choose. Those at higher incomes can opt out of the public system and get wholly private insurance, but even then, most who can do so still choose to stay in the public system. Many people purchase supplemental private insurance and dental insurance (the latter not being provided through the public system).

    It’s not perfect, but their costs per capita and as a percentage of GDP are half of ours and they get excellent coverage and care.

  114. humanoid.panda says:

    @Mikey: Same system exactly in Israel. Not perfect, but about 10 million light years ahead of the US, in a much poorer country.

  115. Grewgills says:

    @bill:

    kids can stay on their parents plan til their 27 but the aca is relying heavily on them to buy in?! riddle me that one!

    You do understand that if they are on their parents plan that they have insurance and thus have bought in.

  116. jd says:

    Every night I’ll see an economist on TV telling me why the market went up or down 5 points that day. They never seem to have anything to say on the matter the night before.

  117. john personna says:

    @jd:

    Very few of them are economists, or even past econ majors. Jim Cramer, for instance, graduated (magna cum laude) from Harvard College with a A.B. in government.

    But yes, most day-to-day economic news is random and not “caused” by anything. Exceptions are obvious, as when an embargo changes oil prices, or a blizzard kills an orange crop.

  118. Blue Galangal says:

    @C. Clavin: If I recall correctly, that was one of Rush Limbaugh’s talking points against the ACA. He had a somewhat memorable rant on paying hippies to braid hair in Key West and why should “we” have to pay for that !!eleventyone1!!11!

  119. Andre Kenji says:

    Everytime that I see people complaining about the National Healthcare System of Brazil I point out that many Americans would give up a finger to have access to that.

  120. JohnMcC says:

    Thought I’d run a few numbers about the cost of the ACA subsidies vs the cost of uninsured people using the healthcare system without being able to pay their bills.

    Before the healthcare reform went into effect according to an HHS study reported in the USToday of 5/10/11, only 12% of uninsured people paid their healthcare bills leaving $49 Billion in debt to be shifted to the taxpayer or to the insured patient.

    About 6 million users of the ‘exchanges’ are expected to be receiving the tax subsidies under ACA (Huffpo of 11/5/13) for an average amount of $2,672 (Slate Moneybox of 8/14/13). Multiplication yields a total amount in Obamacare subsidies of $16 Billion.

    Thought that would be interesting in the present discussion.

  121. grewgills says:

    @Gromitt Gunn:
    Mine did. Dr visits went from $12 to 15 and prescriptions went up about the same. I think last year I would have paid $6 instead of 8 for the last Rx I picked up. Thankfully the premiums at least stayed the same.

  122. Mikey says:

    @grewgills:

    Thankfully the premiums at least stayed the same.

    Lucky you. My premiums have more than doubled the last three years, the deductible increased from $2.5K to $3K, the company’s contribution to my HSA went from $1500 to $1000 AND we have to “earn” half of that by participating in various “wellness” programs and such. Oh, and the percentage covered after deductible went from 95% down to 90% which means everything costs twice as much.

    There are many aspects of my job that I enjoy, and I’m paid very well, but I despise our health care plan.

  123. al-Ameda says:

    Mine did. Dr visits went from $12 to 15 and prescriptions went up about the same. I think last year I would have paid $6 instead of 8 for the last Rx I picked up. Thankfully the premiums at least stayed the same.

    I’ve negotiated benefit contracts in three organizations and It still amazes me how much complaining employees will make concerning increases in co-payments – I suspect it is because they don’t usually pay the premium costs, in many cases the employer pays most of the premium cost.

  124. Grewgills says:

    @al-Ameda:
    I’m not complaining. As far as medical costs go, we had our baby for less than $100, all of the well baby check ups are free and the clinic is close enough that we can walk if the weather cooperates. Yearly physicals are free and with how rarely I go to the Dr the hike in co pay will be negligible for me. $400/month to have wife and baby on my plan isn’t too big a hit all things considered. Looking at the exchanges here with the help we could get from ACA and state sources I could probably do a bit better than that, but we’ve liked Kaiser and it’s easier to keep us all on one plan.

  125. Grewgills says:

    @al-Ameda:
    In HI premium costs for employees are capped at a low percentage of income (1.5% if memory serves) for a basic plan, so premiums can only go up so much. I was mainly thankful that the premium cost for my family has been stable for the past 3 years.

  126. Frank says:

    @michael reynolds: Somehow I am sure, however, that in your mind Global Warming predictions are settled science.