How Obamacare — And Big Hospitals — Will Raise Health Costs

The New York Times published a column highlighting one way Obamacare will raise health costs: by promoting hospital industry consolidation that will force prices higher.

The Times highlighted the case of two Chicago-area hospital systems whose merger was investigated by the Federal Trade Commission in 2000. The article notes that one hospital CEO “had told his board that the deal would ‘increase our leverage, limited as it might be,’ the investigation found, and ‘help our negotiating posture’ with managed care organizations.”

The other hospital’s CEO said that “it would be real tough for any of the Fortune 40 companies in this area…to walk from [the merged hospital group] and 1,700 of their doctors.” The end result of the merger:

It was a great deal for the hospitals. The fees they charged to insurers soared. One insurer, UniCare, said it had to accept a jump of 7 to 30 percent for its health maintenance organizations and 80 percent for its preferred provider organizations.

Aetna said it swallowed price increases of 45 to 47 percent over a three-year period. “There probably would have been a walkaway point with the two independently,” testified Robert Mendonsa, an Aetna general manager for sales and network contracting. “But with the two together, that was a different conversation.”

And who was left holding the bag? Not the shareholders of UniCare or Aetna. It was the people who bought their policies, who either paid higher premiums directly or whose wages grew more slowly to compensate for the rising cost of their company health plans.

Industry mergers give hospitals more market clout to raise prices—and those higher, “take it or leave it” prices are passed on to all Americans in the form of higher insurance premiums.

What has Obamacare done to solve this problem? It’s made it worse. The Times quotes Martin Gaynor, an expert on industry consolidation, about this “potentially troubling” aspect of the law:

Professor Gaynor, for instance, worries that accountable care organizations may prove anticompetitive. Merger activity has jumped in anticipation of the law’s coming fully into effect.

“Hospitals want to maintain their revenue streams and enhance their bargaining leverage,” said Professor Gaynor. “This [i.e., Obamacare] is a way to do so.”

Obamacare as a way for hospitals to “enhance their bargaining leverage”? No wonder they endorsed the law. However, the American people will be paying the price—quite literally—for years to come.

This post was originally published at The Daily Signal.

The Chart All State Legislators Should See

On Monday, the Government Accountability Office released their annual update on the fiscal outlook for state and local governments.  According to the GAO report, state and local government budgets will come into balance…NEVER.

There are other relevant facts included in the GAO study — the near-doubling of health spending as a percentage of GDP, for instance, or GAO’s conclusion that “as a percentage of gross domestic product, our model estimates that total tax revenues…will remain below the 2007 historical high through 2060, due to the projected modest growth in receipts.”  But when it comes to whether or not states should expand their Medicaid programs under Obamacare, the basic calculus should be the determining one: If under current projections state and local government budgets will NEVER balance, why should any state increase spending by expanding Medicaid?

Why States Should Fear the Latest Obama Budget

Press reports surrounding yesterday’s release of the White House budget made news of the fact that the President’s new proposal for states to expand their pre-school programs, funded by a proposed increase in tobacco taxes.  What most stories surrounding the budget did NOT mention, however, is the inherent logic that when you tax an activity, you get less of it.  The numbers buried deep in the budget make that clear: Table S-9 demonstrates that revenue from the higher tobacco tax would decrease almost immediately after its implementation, and fall every year thereafter.  As the chart below shows, revenue would drop from nearly $10 billion in 2015 to just over $6 billion in 2023.  The only reason the pre-school proposal is anywhere near balanced is that the tax increases would begin immediately, while the new programs would take years to get implemented.  But over the long run, the program would be a budget-buster — the White House budget shows revenues falling short of expenses by more than $5 billion per year after 2020.

Besides the obvious fact that this second increase of tobacco taxes in four years would represent another instance of President Obama violating his “firm pledge” not to raise middle-class taxes, the entire program is funded by yet another budget gimmick.  Most importantly, the irresponsible nature of this funding proposal should represent a cautionary tale to state legislators considering Obamacare’s Medicaid expansion.  Either the pre-school proposal will pass its unsustainable costs on to states — creating yet another unfunded mandate — or it will increase the deficit over the long-term — which will force Washington to take steps like cutting the federal Medicaid match rate to close the yawning budget gap.  In either event, it’s another indication of how the federal government’s unsustainable spending will eventually get passed right on to the back of states.

Year Spending Taxes Difference
2014 $130 $7,725 $7,595
2015 $1,385 $9,844 $8,459
2016 $3,360 $9,264 $5,904
2017 $6,081 $8,718 $2,637
2018 $8,260 $8,205 -$55
2019 $9,923 $7,723 -$2,200
2020 $11,237 $7,268 -$3,969
2021 $12,460 $6,842 -$5,618
2022 $12,350 $6,440 -$5,910
2023 $11,581 $6,062 -$5,519

 

White House Budget Summary: Obama’s “One Percent” Solution

According to the Congressional Budget Office’s most recent baselines, the federal government will spend a total of $6.87 trillion on Medicare and $4.36 trillion on Medicaid over the next ten years – that’s $11.2 trillion total, not even counting additional state spending on Medicaid.  Yet President Obama’s budget, released today, contains net deficit savings of only $152 billion from health care programs.  That’s a total savings of only 1.35 percent of the trillions the federal government will spend on health care in the coming decade.  Sadly, it’s another sign the President isn’t serious about real budget and deficit reform.

Overall, the budget:

  • Proposes a total of $401 billion in savings, yet calls for $249 billion in unpaid-for spending due to the Medicare physician reimbursement “doc fix” – thus resulting in only $152 billion in net deficit savings. (The $249 billion presumes a ten year freeze of Medicare physician payments; however, the budget does NOT propose ways to pay for this new spending.)
  • Proposes few structural reforms to Medicare; those that are included – weak as they are – are not scheduled to take effect until 2017, well after President Obama leaves office.  If the proposals are so sound, why the delay?
  • Requests a more than 50% increase – totaling $1.4 billion – for program management at the Centers for Medicare and Medicaid Services, of which the vast majority would be used to implement Obamacare.
  • Includes mandatory proposals in the budget that largely track last year’s budget and the President’s September 2011 deficit proposal to Congress, with a few exceptions.  The largest difference between this year’s budget and the prior submissions is a massive increase in savings from reductions to nursing and rehabilitation facilities – $79 billion, compared to a $32.5 billion estimated impact in September 2011.

A full summary follows below.  We will have further information on the budget in the coming days.

Discretionary Spending

When compared to Fiscal Year 2013 appropriated amounts, the budget calls for the following changes in discretionary spending by major HHS divisions (tabulated by budget authority):

  • $37 million (1.5%) increase for the Food and Drug Administration (not including $770 million in increased user fees);
  • $435 million (4.9%) increase for the Health Services and Resources Administration;
  • $97 million (2.2%) increase for the Indian Health Service;
  • $344 million (5.7%) increase for the Centers for Disease Control;
  • $274 million (0.9%) increase for the National Institutes of Health; and
  • $1.4 billion (52.9%) increase for the discretionary portion of the Centers for Medicare and Medicaid Services program management account.

With regard to the above numbers for CDC and HRSA, note that these are discretionary numbers only.  The Administration’s budget also would allocate an additional $1 billion mandatory spending from the Prevention and Public Health “slush fund” created in Obamacare, further increasing spending levels.  For instance, CDC spending would be increased by an additional $755 million.

Obamacare Implementation Funding and Personnel:  As previously noted, the budget includes more than $1.4 billion in discretionary spending increases for the Centers for Medicare and Medicaid Services, which the HHS Budget in Brief claims would be used to “continue implementing key provisions of [Obamacare].”  This funding would finance 712 new bureaucrats within CMS when compared to last fiscal year – a massive increase when compared to a request of 256 new FTEs in last year’s budget proposal.  Overall, the HHS budget proposes an increase of 1,311 full-time equivalent positions within the bureaucracy compared to projections for the current fiscal cycle, and an increase of 3,327 bureaucrats compared to last fiscal year.

The budget includes specific requests related to Obamacare totaling over $2 billion, including:

  • $803.5 million for “CMS activities to support [Exchanges] in FY 2014,” including funding for the federally-funded Exchange, for which the health law itself did not appropriate funding;
  • $837 million for “beneficiary education and outreach activities through the National Medicare Education program and consumer support…including $554 million for the [Exchanges];”
  • $519 million for “general IT systems and other support,” including funding for the federal Exchange;
  • $3.8 million for updates to healthcare.gov;
  • $18.4 million to oversee the medical loss ratio regulations; and
  • $24 million for administrative activities in Medicaid related to “implement[ing] new responsibilities” under Obamacare.

Exchange Funding:  The budget envisions HHS spending $1.5 billion on Exchange grants in 2013.  That’s an increase of over $300 million compared to last year’s estimate of fiscal year 2013 spending – despite the fact that most states have chosen not to create their own Exchanges.  The budget anticipates a further $2.1 billion in spending on Exchange grants in fiscal year 2014.  The health care law provides the Secretary with an unlimited amount of budget authority to fund state Exchange grants through 2015.  However, other reports have noted that the Secretary does NOT have authority to use these funds to construct a federal Exchange.

Abstinence Education Funding:  The budget proposes eliminating the abstinence education funding program, and converting those funds into a new pregnancy prevention program.

Medicare Proposals (Total savings of $359.9 Billion, including interactions)

Bad Debts:  Reduces bad debt payments to providers – for unpaid cost-sharing owed by beneficiaries – from 65 percent down to 25 percent over three years, beginning in 2014.  The Simpson-Bowles Commission made similar recommendations in its final report.  Saves $25.5 billion.

Medical Education Payments:  Reduces the Indirect Medical Education adjustment paid to teaching hospitals beginning in 2014, saving $11 billion.  Previous studies by the Medicare Payment Advisory Committee (MedPAC) have indicated that IME payments to teaching hospitals may be greater than the actual costs the hospitals incur.

Rural Payments:  Reduces critical access hospital payments from 101% of costs to 100% of costs, saving $1.4 billion, and prohibits hospitals fewer than 10 miles away from the nearest hospital from receiving a critical access hospital designation, saving $700 million.

Anti-Fraud Provisions:  Assumes $400 million in savings from various anti-fraud provisions, including limiting the discharge of debt in bankruptcy proceedings associated with fraudulent activities.

Imaging:  Reduces imaging payments by assuming a higher level of utilization for certain types of equipment, saving $400 million.  Imposes prior authorization requirements for advanced imaging; no savings are assumed, a change from the September 2011 deficit proposal, which said prior authorization would save $900 million.

Pharmaceutical Price Controls:  Expands Medicaid price controls to dual eligible and low-income subsidy beneficiaries participating in Part D, saving $123.2 billion according to OMB.  Some have expressed concerns that further expanding government-imposed price controls to prescription drugs could harm innovation and the release of new therapies that could help cure diseases.

Medicare Drug Discounts:  Proposes accelerating the “doughnut hole” drug discount plan included in PPACA, filling in the “doughnut hole” completely by 2015.  While the budget claims this proposal will save $11.2 billion over ten years, some may be concerned that – by raising drug spending, and eliminating incentives for seniors to choose generic pharmaceuticals over brand name drugs, this provision will actually INCREASE Medicare spending, consistent with prior CBO estimates at the time of PPACA’s passage.

Post-Acute Care:  Reduces various acute-care payment updates (details not specified) and equalizes payment rates between skilled nursing facilities and inpatient rehabilitation facilities, saving $79 billion – a significant increase compared to the $56.7 billion in last year’s budget and the $32.5 billion in proposed savings under the President’s September 2011 deficit proposal.  Equalizes payments between IRFs and SNFs for certain conditions, saving $2 billion.  Adjusts payments to inpatient rehabilitation facilities and skilled nursing facilities to account for unnecessary hospital readmissions and encourage appropriate care, saving a total of $4.7 billion.  Restructures post-acute care reimbursements through the use of bundled payments, saving $8.2 billion.

Physician Payment:  Includes language extending accountability standards to physicians who self-refer for radiation therapy, therapy services, and advanced imaging services, saving $6.1 billion.  Makes adjustments to clinical laboratory payments, designed to align Medicare with private payment rates, saving $9.5 billion.  Expands availability of Medicare data for performance and quality improvement; no savings assumed.

Medicare Drugs:  Reduces payment of physician administered drugs from 106 percent of average sales price to 103 percent of average sales price.  Some may note reports that similar payment reductions, implemented as part of the sequester, have caused some cancer clinics to limit their Medicare patient load.  By including a similar proposal in his budget, President Obama has effectively endorsed these policies.  Saves $4.5 billion.

Medicare Advantage:  Resurrects a prior-year proposal to increase Medicare Advantage coding intensity adjustments; this provision would have the effect of reducing MA plan payments, based on an assumption that MA enrollees are healthier on average than those in government-run Medicare.  Saves $15.3 billion over ten years.  Also proposes $4.1 billion in additional savings by aligning employer group waiver plan payments with average MA plan bids.

Additional Means Testing:  Increases means tested premiums under Parts B and D by five percentage points, beginning in 2017.  Freezes the income thresholds at which means testing applies until 25 percent of beneficiaries are subject to such premiums.  Saves $50 billion over ten years, and presumably more thereafter, as additional seniors would hit the means testing threshold, subjecting them to higher premiums.

Medicare Deductible Increase:  Increases Medicare Part B deductible by $25 in 2017, 2019, and 2021 – but for new beneficiaries only; “current beneficiaries or near retirees [not defined] would not be subject to the revised deductible.”  Saves $3.3 billion.

Home Health Co-Payment:  Beginning in 2017, introduces a home health co-payment of $100 per episode for new beneficiaries only, in cases where an episode lasts five or more visits and is NOT proceeded by a hospital stay.  MedPAC has previously recommended introducing home health co-payments as a way to ensure appropriate utilization.  Saves $730 million.

Medigap Surcharge:  Imposes a Part B premium surcharge equal to about 15 percent of the average Medigap premium – or about 30 percent of the Part B premium – for seniors with Medigap supplemental insurance that provides first dollar coverage.  Applies beginning in 2017 to new beneficiaries only.  A study commissioned by MedPAC previously concluded that first dollar Medigap coverage induces beneficiaries to consume more medical services, thus increasing costs for the Medicare program and federal taxpayers.  Saves $2.9 billion.

Generic Drug Incentives:  Proposes increasing co-payments for certain brand-name drugs for beneficiaries receiving the Part D low-income subsidy, while reducing co-payments for relevant generic drugs by 15 percent, in an attempt to increase generic usage among low-income seniors currently insulated from much of the financial impact of their purchasing decisions.  Saves $6.7 billion, according to OMB.

Lower Caps on Medicare Spending:  Section 3403 of the health care law established an Independent Payment Advisory Board tasked with limiting Medicare spending to the growth of the economy plus one percentage point (GDP+1) in 2018 and succeeding years.  The White House proposal would reduce this target to GDP+0.5 percent.  The Medicare actuary has previously written that the spending adjustments contemplated by IPAB and the health care law “are unlikely to be sustainable on a permanent annual basis” and “very challenging” – problems that would be exacerbated by utilizing a slower target rate for Medicare spending growth.  According to the budget, this proposal would save $4.1 billion, mainly in 2023.

Medicaid and Other Health Proposals (Total savings of $41.1 Billion)

Limit Durable Medical Equipment Reimbursement:  Caps Medicaid reimbursements for durable medical equipment (DME) at Medicare rates, beginning in 2014.  The health care law extended and expanded a previous Medicare competitive bidding demonstration project included in the Medicare Modernization Act, resulting in savings to the Medicare program.  This proposal, by capping Medicaid reimbursements for DME at Medicare levels, would attempt to extend those savings to the Medicaid program.  Saves $4.5 billion over ten years.

Rebase Medicaid Disproportionate Share Hospital Payments:  Proposes beginning DSH payment reductions in 2015 instead of 2014, and “to determine future state DSH allotments based on states’ actual DSH allotments as reduced” by PPACA.  Saves $3.6 billion, all in fiscal 2023.

Medicaid Anti-Fraud Savings:  Assumes $3.7 billion in savings from a variety of Medicaid anti-fraud provisions.  Included in this amount are proposals that would remove exceptions to the requirement that Medicaid must reject payments when another party is liable for a medical claim.  A separate proposal related to the tracking of pharmaceutical price controls would save $8.8 billion.

Transitional Medical Assistance/QI Program:  Provides for temporary extensions of the Transitional Medical Assistance program, which provides Medicaid benefits for low-income families transitioning from welfare to work, along with the Qualifying Individual program, which provides assistance to low-income seniors in paying Medicare premiums.  The extensions cost $1.1 billion and $590 million, respectively.

“Pay-for-Delay:”  Prohibits brand-name pharmaceutical manufacturers from entering into arrangements that would delay the availability of new generic drugs. Some Members have previously expressed concerns that these provisions would harm innovation, and actually impede the incentives to generic manufacturers to bring cost-saving generic drugs on the market.  OMB scores this proposal as saving $11 billion.

Follow-on Biologics:  Reduces to seven years the period of exclusivity for follow-on biologics.  Current law provides for a twelve-year period of exclusivity, based upon an amendment to the health care law that was adopted on a bipartisan basis in both the House and Senate (one of the few substantive bipartisan amendments adopted).  Some Members have expressed concern that reducing the period of exclusivity would harm innovation and discourage companies from developing life-saving treatments.  OMB scores this proposal as saving $3.3 billion.

State Waivers:  Accelerates from 2017 to 2014 the date under which states can submit request for waivers of SOME of the health care law’s requirements to HHS.  While supposedly designed to increase flexibility, even liberal commentators have agreed that under the law’s state waiver programcritics of Obama’s proposal have a point: It wouldn’t allow to enact the sorts of health care reforms they would prefer” and thatconservatives can’t do any better – at least not under these rules.”  No cost is assumed; however, in its re-estimate of the President’s budget last year, CBO scored this proposal as costing $4.5 billion.

Implementation “Slush Fund:”  Proposes $400 million in new spending for HHS to implement the proposals listed above.

FEHB Contracting:  Similar to last year’s budget, proposes streamlining pharmacy benefit contracting within the Federal Employee Health Benefits program, by centralizing pharmaceutical benefit contracting within the Office of Personnel Management (OPM), saving $1.6 billion.  However, this year’s budget goes further in restructuring FEHBP – OPM would also be empowered to modernize benefit designs (savings of $264 million); create a “self-plus-one” benefit option for federal employees and extend benefits to domestic partners (total savings of $5.2 billion, despite the costs inherent in the latter option); and adjust premium levels based on tobacco usage and/or participation in wellness programs (savings of $1.3 billion).  Some individuals, noting that OPM is also empowered to create “multi-state plans” as part of the health care overhaul, may be concerned that these provisions could be part of a larger plan to make OPM the head of a de facto government-run health plan.

Other Health Care Proposal of Note

Tax Credit:  The Treasury Green Book proposes expanding the small business health insurance tax credit included in the health care law.   Specifically, the budget would expand the number of employers eligible for the credit to include all employers with up to 50 full-time workers; firms with under 20 workers would be eligible for the full credit.  (Currently those levels are 25 and 10 full-time employees, respectively.)  The budget also changes the coordination of the two phase-outs based on a firm’s average wage and number of employees, with the changes designed to make more companies eligible for a larger credit.  The changes would begin in the current calendar and tax year (i.e., 2013).  According to OMB, these changes would cost $10.4 billion over ten years – down from last year’s estimate of $14 billion over ten years.  Many may view this proposal as a tacit admission that the credit included in the law was a failure, because its limited reach and complicated nature – firms must fill out seven worksheets to determine their eligibility – have deterred American job creators from receiving this subsidy.  Moreover, the reduced score in this year’s budget compared to last year’s implies that even this expansion of the credit will have a less robust impact than originally anticipated.

Fact Check: Obamacare’s $6,400 Voucher Question

President Obama again just cited the old saw that premium support will cost seniors $6,400 per year.  Those claims have been widely debunked elsewhere.  But it’s worth highlighting the $6,400 voucher question included in Obamacare itself…

As we previously noted, if President Obama thinks that premium support is a “voucher” program, then that means Obamacare is a voucher program as well.  The Congressional Budget Office has estimated that 20 million people will get vouchers to buy health insurance under Obamacare.  But that’s not all the Congressional Budget Office has said.  Back in June, CBO noted that beginning in 2019, the amount of the Obamacare voucher would not keep up with inflation:

The shares of income that enrollees have to pay will increase more rapidly than in the preceding years, and the shares of the premiums that the [vouchers] cover will decline….A smaller percentage of people will be eligible for [vouchers] over time because incomes are projected to increase more quickly than the eligibility thresholds, and federal [vouchers] will cover a declining share of the premiums over time…

A May 2011 CBO analysis gives one hypothetical example.  Under Obamacare, beginning in 2019, premium costs for individuals could rise by 10-12 percent every year – while the amount of the voucher could rise by less than three percent.  According to CBO, if Obamacare is not repealed or amended, virtually all Americans will be forced to buy health insurance – but fewer and fewer individuals will qualify for vouchers over time, and those vouchers will pay a smaller and smaller share of overall insurance premiums.

So while President Obama levels false accusations about the higher costs seniors will pay under premium support proposals due to inadequate “vouchers,” the truth is there’s only one proposal that guarantees Americans will have inadequate vouchers to pay for health insurance.  That proposal is Obamacare itself.

Even Supporters Fear Obamacare’s Impact on States

An eye-opening article in yesterday’s Los Angeles Times shows the dilemma states are facing as they begin to make crucial policy and budgetary choices surrounding Obamacare.  The article notes that the law “takes states into uncharted territory” as they attempt to estimate the fiscal impact of Obamacare’s massive Medicaid expansion:

California, which plans to expand coverage to hundreds of thousands of people when the law takes effect in 2014, faces myriad unknowns.  The Brown administration will try to estimate the cost of vastly more health coverage in the budget plan it unveils next month, but experts warn that its numbers could be way off.  Officials don’t know exactly how many Californians will sign up for Medi-Cal, the public health insurance program for the poor.  Computing the cost of care for each of them is also guesswork.  And California is waiting for key rulings from federal regulators that could have a major effect on the final price tag, perhaps in the hundreds of millions of dollars….

Unanticipated costs associated with the healthcare changes could undermine California’s efforts to improve its standing on Wall Street and keep the economy moving.  They could force fresh cuts in services if they consume much more of the state budget than Brown is able to approximate….

Gov. Jerry Brown expressed a new concern in an interview last week.  He said recent signs from Washington suggest the federal government may not pay as much of the costs associated with the new law as originally promised, sticking states with a larger share of the bill.  “As the guardian of the public purse here, I have to watch very closely what may come out of Washington,” the governor said.  “So we’re going to move carefully.  We want to make sure the federal government is on board.”

These statements of caution and concern come from a major supporter of the law.  And little wonder: Over the past two fiscal years, states had to close a combined $146.3 billion in budget gaps – yet Obamacare is about to impose new unfunded mandates on states of at least $118 billion.  Both the numbers, and the diffident attitude from the governor of the largest state in the union, should serve as a cautionary tale for states contemplating the massive fiscal hit Obamacare will impose on their budgets.

Obamacare’s Christmas Present: Higher Premiums

Even as Americans gather to celebrate the Christmas holiday, they will soon face an unwelcome surprise come the new year: premium increases sparked by Obamacare.  Earlier this month, the Los Angeles Times reported on a 20% increase sought by California Blue Shield – and what was one of the reasons given for the jump?  You guessed it:

The company also expects higher costs from an influx of new customers under the federal healthcare law in 2014. “It’s a once-in-a-lifetime change in the healthcare market that will bring a lot of volatility, and we need higher reserves for that,” [a spokesman] said.

If Obamacare results in only a 20% premium increase, customers may be lucky.  Recently, Aetna CEO Mark Bertolini told an investor conference that premiums could double as a result of Obamacare:

While subsidies in the law will shield some people, other consumers who make too much for assistance are in for “premium rate shock,” Mark Bertolini, who runs the third-biggest U.S. health-insurance company, told analysts yesterday at a conference in New York….“We’ve shared it all with the people in Washington and I think it’s a big concern,” the CEO said.  “We’re going to see some markets go up as much as 100 percent.”

Candidate Obama promised repeatedly that his health plan would CUT premiums by an average of $2,500 per family within his first term.  But premiums have already risen by $3,065 since Barack Obama was elected President.  And the recent news suggests premiums will only skyrocket further in the coming months and years.  In other words, Obamacare is shaping up to be a perpetual lump of coal in Americans’ Christmas stockings.

They Said It…

The New York Times has an interesting story today on market research taken by groups attempting to build support for Obamacare, and encourage Americans to sign up for insurance plans in the law’s Exchanges.  Among the more interesting passages were the following two paragraphs:

Lake Research Partners recommended that Enroll America not cite specific dollar amounts at all when they talk to the uninsured about new coverage options. “Talking about ‘free or low cost’ plans may be more motivating,” the survey authors wrote in a report.

Another finding: respondents generally did not like hearing that the law would require most Americans to buy health insurance or pay a fine starting in 2014.  “The data show warning signs for messaging around the mandate,” the survey authors wrote.

One of the many problems with this messaging is its inaccuracy.  As a major Bloomberg article noted last month, most Americans will be required to pay thousands of dollars per year for health insurance under Obamacare – at least in part because the law’s mandated benefits will raise individual health insurance premiums by $2,100 per family.  And those who can’t afford insurance will pay a tax, not a fine, the President’s claims notwithstanding.

Just as important, the fact that liberal supporters of the law are trying to hype its “free” benefits tells you everything about Obamacare you need to know.

Another Problem Obamacare Made Worse

In the Wall Street Journal this morning, Laura Meckler has a must-read article outlining the nation’s skyrocketing spending on health care:

All together, nearly one in four federal dollars is devoured by health-care spending.  That is more than double the 10% of the budget it consumed in 1960, before Medicare and Medicaid were created.  The Congressional Budget Office projects that in just a decade, health care will consume nearly one in three federal dollars, pressuring government spending in other areas, such as infrastructure and the military.  Any deal to avert the fiscal cliff likely would do little to alter this trajectory, meaning pressure from health-care costs likely will continue to weigh on Washington and spur yet more budget wrangling.

As we have previously noted, demographic changes prompted by the impending retirement of the Baby Boom generation, coupled with continually rising health costs, will put a squeeze on the federal fisc for decades to come.  Yet, as the Journal article notes, any supposed “grand bargain” reached in the coming days and weeks “likely would do little to alter” the unsustainable nature of federal health spending, which will “continue to weigh on Washington” – and subsume other important budgetary priorities – for the foreseeable future.

Recall that nearly four years ago, the Obama Administration and its liberal media allies boldly pledged that “health care reform is entitlement reform.”  Those fanciful claims have long since been obliterated, by a law that took over half a trillion dollars from Medicare to fund yet more spending on health care entitlements.  This morning’s article makes plain this Administration’s failed fiscal record – one of skyrocketing spending and mountains of debt, exactly the types of “reform” we don’t need.

On Raising Premiums — And Raising the Retirement Age

Earlier this week, the Center for American Progress released a report about the potential effects of raising the retirement age.  Among the reasons cited in the report to oppose an increase in the retirement age was the following:

Since 65- and 66-year-olds would be older and on average less healthy than the nonelderly population in the exchanges, shifting these individuals to the exchange pools would increase premiums for all enrollees in the exchange by an average of about 3 percent.  Premium increases in the exchanges would be highest for the youngest exchange beneficiaries, as those younger than age 30 would see an increase of 8 percent and those between the ages of 30 and 34 would see an increase of 5 percent.  Such substantial increases in premium costs for young and relatively healthy individuals could result in these individuals choosing not to purchase health insurance—a process known as adverse selection—which would increase costs for the less healthy individuals remaining in exchanges.  This scenario could threaten the viability of the exchanges.

These claims are particularly interesting for CAP to make, because there’s one law that guarantees skyrocketing premiums for young Americans – and it’s called Obamacare.  An Associated Press study, and story, the week after the law passed noted the impact:

Under the health care overhaul, young adults who buy their own insurance will carry a heavier burden of the medical costs of older Americans — a shift expected to raise insurance premiums for young people when the plan takes full effect. Beginning in 2014, most Americans will be required to buy insurance or pay a tax penalty.  That’s when premiums for young adults seeking coverage on the individual market would likely climb by 17 percent on average, or roughly $42 a month, according to an analysis of the plan conducted for The Associated Press….The higher costs will pinch many people in their 20s and early 30s who are struggling to start or advance their careers with the highest unemployment rate in 26 years.

So if the Center for American Progress really wants to lower premiums for younger Americans – as opposed to attempting to defend America’s unsustainable status quo on entitlements – it should whole-heartedly endorse a repeal of Obamacare, and its onerous new regulations that will jack up premiums for millions of 20-somethings nationwide.