The New York Times
Sunday editorial is generally held for the weightiest of weighty issues, and this Sunday was no different, when the editorial board opined on the damage that could be done
if the Supreme Court decides to end Obamacare subsidies in more than 30 states. The potential impending damage was underscored Monday by news from the Congressional Budget Office about how well the law is actually working.
State economies would suffer, insurance markets would be disrupted, millions of people would lose coverage, hospitals and insurance plans that have counted on revenues from newly insured people would be left high and dry, and people who continue to hold policies would pay a lot more for them. The health care markets in which individuals and families buy their own policies—on the exchanges and outside them—would fall into chaos.
With subsidies no longer available, the younger, healthier and less costly people to insure would decide to go without insurance, and insurers would be forced to jack up their premiums for the remaining people, likely sicker and requiring more health care. That would trigger a so-called death spiral that would cause more people to drop out and rates to rise even higher, making things worse than they were before the reform law was enacted.
Those who can pay for insurance would face much higher premiums, as high as 47 percent more on average, according to a RAND Corporation analysis, and would most likely have a smaller choice of plans and networks of doctors and hospitals.
Meanwhile, according to the CBO
[pdf], the nation will be spending 20 percent less on those subsidies (if the Supreme Court doesn't dismantle them) than the agency predicted last year, and less even than they predicted just in January.
But here's the amazing part.
The government is now spending less on health care than CBO had projected back in January 2010—a projection made before the Affordable Care Act, and its costly coverage provisions, came into law.
So even adding all the spending in Obamacare, the CBO is projecting the federal government will spend $600 billion less on health care than the agency expected in 2010, when it wasn't counting even a dollar of the spending in Obamacare.
Even with all the Obamacare spending on subsidies and Medicaid, the CBO says the government is going to spend substantially less
on health care than they expected without
taking Obamacare into account.
The law is working. Maybe not optimally in all states, but in aggregate it's helping to dramatically slow down the rate of healthcare spending increases, and the CBO sees that happening for the next decade. That is, if the Supreme Court doesn't throw a monkey wrench into the works. There's a great deal at stake here, from the nation's economy down the the health of millions of individuals; down, in fact, to life and death for many.