How much will Obamacare -- call it the Patient Protection and Affordable Care Act if you like -- cost over the next 10 years?
More than you've been led to believe, reports Charles Blahous of George Mason University's Mercatus Center. To be specific, he projects it will add $1,160 billion to net federal spending over the next 10 years and at least $340 billion to federal budget deficits in that time.
Blahous was appointed by Barack Obama as one of two public trustees of the Social Security and Medicare programs. He worked on these issues in George W. Bush's administration and submitted his Mercatus paper for anonymous peer review.
Why does he say Obamacare will increase spending when the Obama administration, citing Congressional Budget Office numbers, promised it will save money?
One reason is that the CBO said Obamacare's "Class Act" provisions would save money, since the government would collect premiums immediately but not pay off policyholders until later.
But Health and Human Services Secretary Kathleen Sebelius has conceded that the Class Act is unworkable, and so Blahous zeroes out those phantom savings.
Another reason Obamacare was supposed to save money is that it raises the Medicare tax 0.9 percent for high earners. It then dedicates those resources both to Medicare and to general revenues, with the CBO counting the savings twice.
That's because under a 1985 internal ruling (not a full-fledged law passed by Congress), the CBO scores the costs of legislation against a hypothetical baseline rather than against current law.
But, as Sebelius conceded to Congress in March 2011, that's double counting. The government can't spend the same money twice. Medicare tax revenues dedicated to current Medicare spending can't be used to reduce the budget deficit. That's true "in practice," Medicare chief actuary Richard Foster wrote last year, despite the CBO's scoring procedure.
And, as Blahous points out, if the funds don't go to Medicare, then under current law, Medicare will go broke faster and be forced to reduce benefits. Since Congress is not likely to let that happen any sooner than it has to, the deficit reduction promised by the CBO score and claimed by the Obama administration simply ain't going to happen, no how, no way.
To all of which the Obama White House says only the CBO numbers should count and that Blahous worked in a Republican administration. This is about as intellectually serious a reply as, "Nyah, nyah, nyah nyah nyah, nyah."
Which is what we are coming to expect from the Obama White House. Consider the president's Supreme Court trash-talking earlier this month.
The supposed constitutional scholar didn't seem to know that the Supreme Court has been overturning laws since Marbury v. Madison in 1803. He suggested the Lochner case was an example of the Supreme Court striking down New Deal legislation. But Lochner was decided in 1905 and overturned a state, not a federal, law.
Similarly, Obama characterized House Budget Chairman Paul Ryan's budget as "social Darwinism" and falsely said it would require zeroing out spending for various wonderful programs. And he has heaped scorn on those who harbor any doubt that renewables will become major energy sources in the 21st century.
His experiences in university neighborhoods and Chicago politics have apparently left Obama ignorant that there are intellectually serious arguments against liberal policies. So when presented with such arguments by Ryan and others, he scowls, calls people names and does the intellectual equivalent of stamping his feet.
Someone needs to tell him that combining arrogant condescension with intellectual shoddiness is not a winning political tactic.
Or a winning governing strategy. Obamacare's architects also combined arrogant condescension with intellectual shoddiness. They shamelessly gamed the CBO scoring process to make Obamacare look like a money-saver. They threw in unworkable programs like the Class Act to make political points.
And so when Charles Blahous totes up the numbers and give us an idea of what Obamacare would really cost, they are left without an intellectually serious reply.
If Obama really knew constitutional law, he might remember that the Supreme Court unanimously overturned the National Recovery Act in 1935, after it became clear that, with its 700-plus industry groups setting wage and prices, it was unworkable and was becoming increasingly unpopular.
The legal arguments are not quite on point, but Obamacare is looking to be as unworkable as the NRA and even more unpopular. Plus, as Charles Blahous has established, hugely more expensive than advertised.