The Supreme Court just made three million more uninsured people, and Republican's repeal plans would cost $109 billion over the next decade. Those are the conclusions of The Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) in
new estimates following the Supreme Court's ruling last month on the Affordable Care Act. The Court ruled that states could opt out of Medicaid expansion, and while it's not clear yet whether or how many states will actually decide not to expand the program, it will result in more people without insurance.
It will also, however, save the federal government an additional $84 billion. In March 2012, CBO estimated that the insurance provisions of the law—exchanges and Medicaid expansion—would have a net cost of $1,168 billion in the next ten years. They've revised the costs down to $1,252 billion. That's at the expense of the three million people who will not have enough income to participate on the exchanges, but will have too much to qualify for the existing Medicaid programs in the states. About one third of the population they previously estimated to be eligible for the expanded Medicaid could qualify to go on the newly created insurance exchanges, but about two-thirds of it will not.
That, again, is speculative, assuming that the state who have said they will refuse to expand Medicaid follow through and don't do it. What isn't speculative is that the Republicans' latest repeal bill, H.R. 6079, would be very expensive for the country, and leave far, far more than three million uninsured.
Assuming that H.R. 6079 is enacted near the beginning of fiscal year 2013, CBO and JCT estimate that, on balance, the direct spending and revenue effects of enacting that legislation would cause a net increase in federal budget deficits of $109 billion over the 2013–2022 period. Specifically, we estimate that H.R. 6079 would reduce direct spending by $890 billion and reduce revenues by $1 trillion between 2013 and 2022, thus adding $109 billion to federal budget deficits over that period.
That's after they figure in savings to the various agencies that wouldn't have to administer the law. So shrinking government, one their arguments, end up costing us more. But, you know, it's all about smaller government and the deficit for Republicans. That's what they'll tell you.