NCPA - National Center for Policy Analysis


November 25, 2009

Just in time for Thanksgiving, Sen. Harry Reid has given us a giant turkey of a health care bill.  At 2,074 pages and more than 370,000 words, it's officially "scored" as costing $849 billion over 10 years -- $400 million per page, or $2.3 million per word.  But that doesn't come close to measuring its true cost, says Michael D. Tanner, a senior fellow at the Cato Institute.

The bill uses various accounting gimmicks to hide its true cost.  For example:

  • The bill doesn't include more than $200 billion needed to prevent a 21 percent cut in Medicare next year.
  • The Congressional Budget Office (CBO) "score" actually assumes Reid cuts Medicare 23 percent.
  • That cost has been spun off into a separate bill, even though the Senate voted down that approach last month.

Moreover (as Jeffrey H. Anderson notes), much of the spending is back-loaded:

  • The bill doesn't start spending until 2014, and only costs $9 billion that year.
  • But by 2019, the annual cost hits $196 billion.
  • The minority staff of the Senate Budget Committee reports that, if you factor out all the budget gimmicks and look at the 10 years of actual implementation, the cost is closer to $2.5 trillion.

And, while Reid brags that the bill will reduce the deficit by $127 billion over the next 10 years (which is about $50 billion less than the deficit the government ran last month alone), even that tiny savings depends on budget gimmicks and the willingness of future Congresses to make huge cuts in Medicare spending.  This will probably never happen, says Tanner, and even the Congressional Budget Office (CBO) warns that it will be "difficult" to achieve the predicted savings.

Perhaps more important, much of the cost has simply been shifted from the federal budget onto the backs of workers, businesses and state governments.  Judging by previous reforms, as much as 60 percent of the cost won't show up in government accounting, says Tanner.

To pay for all the new spending, Reid would enact at least 15 new or increased taxes totaling more than $493 billion, says Tanner.

If Reid gets the 60 votes he needs to pass this, U.S. taxpayers, businesses and patients can expect to pay a high price for this congressional feast, says Tanner.

Source: Michael Tanner, "Truly a Turkey," Cato Institute, November 20, 2009.

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