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The Future of Healthcare Reform In the United States$
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Anup Malani and Michael H. Schill

Print publication date: 2015

Print ISBN-13: 9780226254951

Published to Chicago Scholarship Online: May 2016

DOI: 10.7208/chicago/9780226255002.001.0001

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PRINTED FROM CHICAGO SCHOLARSHIP ONLINE (www.chicago.universitypressscholarship.com). (c) Copyright University of Chicago Press, 2021. All Rights Reserved. An individual user may print out a PDF of a single chapter of a monograph in CHSO for personal use.date: 01 August 2021

The Fiscal Consequences of the Affordable Care Act

The Fiscal Consequences of the Affordable Care Act

(p.109) Chapter Five The Fiscal Consequences of the Affordable Care Act
The Future of Healthcare Reform In the United States

Charles Blahous

University of Chicago Press

This chapter discusses the enactment of the Affordable Care Act (ACA) in 2010 and how it worsened the federal fiscal outlook relative to previous law. Incomplete appreciation of the scorekeeping methods under which the Congressional Budget Office operates causes incomplete public understanding. The ACA would only reduce federal deficits relative to a scenario in which Medicare makes full scheduled benefit payments irrespective of limitations upon its financial resources and statutory authority. Overall, the new spending authorized by the ACA well exceeds the savings generated by its other provisions, so on balance it adds substantially to federal deficits. Unchanged, the ACA will add roughly $340 billion to federal deficits over the next ten years and approximately $1.2 trillion to net federal spending. Roughly two-thirds of federal subsidies for participation in the health exchanges would need to be eliminated to meet a minimum standard for fiscal improvement.

Keywords:   scorekeeping, Medicare, Affordable Care Act, federal deficit, health care reform

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