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New health care bill pros and cons: Will it cut costs?

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The expansion of coverage would cost the government an extra $172 billion in that year, the CBO says, or about $5,375 per person newly insured. Most of that spending is the result of a boost in eligibility for Medicaid or of subsidies to help families comply with a new mandate to buy insurance coverage if they don't have it.

Supporters say the expanded coverage is a bargain if you consider the reform's wider framework, including curbs on the growth of Medicare spending. In 2019, when the law's key provisions have taken full effect, the nation's overall spending on health care will be just $25 billion more than if no health care bill had been passed.

In effect, the plan would be covering many more people at about the same price: $4.7 trillion in that year. That estimate comes from Richard Foster, chief actuary for the Centers for Medicare and Medicaid Services.

President Obama and congressional Democrats planned their package to be "deficit neutral," with additional federal spending on health care offset by either tax hikes or the Medicare curbs.

So much for government costs. What about individuals and families?

The cost of a given amount of insurance coverage could fall by 10 to 30 percent due to the reforms, for people who don't have employer-sponsored coverage, the CBO estimated late last year. The agency, a nonpartisan scorekeeper for legislation, said premiums probably won't change much for people in employer-based plans.

Mr. Foster's analysis, meanwhile, saw no big change in the out-of-pocket costs that families pay on top of insurance premiums, compared with what they'd be paying without the law.

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