As Congressional leaders continue to search for ways to pass the Senate health bill in the House later this week, Americans continue to be subjected to dubious rhetoric surrounding the bill’s provisions. The Senate bill’s supporters claim that their legislation must be made law, no matter the cost, in order to achieve universal coverage in the United States. However, even if the Senate bill does pass, this will not be the case. Despite the fact that the proposed legislation is exorbitantly expensive, it would still fail to achieve universal health coverage.
According to the Congressional Budget Office (CBO), by 2019, the legislation would cost (PDF) $196 billion annually and still leave 24 million Americans uninsured.
The fact that 24 million people remain would uninsured with enactment of the Senate health bill is remarkable. Under current law, there would be 55 million uninsured Americans in 2019. That means that over 43 percent of the projected uninsured would be unaffected by the legislation, continuing to go without coverage ten years from now. Yet according to research by Heritage expert James Capretta, the bill would cost well over $1 trillion over the next ten years. Capretta shows that the true ten year cost of the plan is more likely to be close to $1.2 trillion, but even this estimate significantly underestimates the true long term cost of the plan. Capretta further points out that this estimate includes ten years of new revenues, but only 6 or 7 years of new spending, skewing the Congressional Budget Office’s ten-year cost analysis to make the bill appear less expensive than it really is. He says that a true ten year estimate would put the price tag closer to $2.3 trillion.
Congressional leaders claim that the cost is justified because the bill extends health care coverage to 31 million uninsured Americans. It depends on what one means by “coverage”. Much of the increased coverage would come in the form of Medicaid expansion, as well as exchange subsidies. But Medicaid is characterized by low-quality care and it often fails to meet the health needs of its beneficiaries. According to recent analysis by Heritage Health Policy Fellow Brian Blase, Medicaid expansion in Tennessee actually decreased the quality of care relative to surrounding states that did not expand their own Medicaid programs. In the four years after expanding Medicaid, Tennessee’s improvements in general mortality were more than 50 percent lower than its neighbors. In many states, Medicaid beneficiaries end up in the hospital emergency rooms because they can’t find a doctor who’ll take artificially low Medicaid payment rates. Clearly, Medicaid is not a vehicle for improving the quality of care for millions of Americans. And coverage without efficient access to medical services is probably not what ordinary Americans have in mind when it comes to health care reform.
If the highly unpopular health care legislation is going to cost taxpayers over $196 billion annually ten years from now, while leaving an estimated 24 million Americans without coverage, perhaps that is yet another reason why Congress ought to pause, come to its senses, and press the re-set button. Americans expect and deserve better.
Rick Sherwood currently is a member of the Young Leaders Program at the Heritage Foundation. For more information on interning at Heritage, please visit:http://www.heritage.org/about/departments/ylp.cfm
