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Costs More, Covers Less

The opinions expressed by columnists are their own and do not necessarily represent the views of

In the weeks since the Supreme Court upheld the constitutionality of the Patient Protection and Affordable Care Act, the evidence has continued to pile up that, constitutional or not, ObamaCare is bad news.

Yes, fans of the "reform" cheered this week's news reports suggesting that ObamaCare will be less expensive than originally feared. But those news reports were wrong.

The Congressional Budget Office did, in fact, report that two provisions, the expansion of Medicaid and subsidies to help middle-class families buy insurance, might cost $84 billion less over the next 10 years than previously projected. But that's a drop of less than 5 percent of the law's total cost over that period.

Plus, it's a "savings" only in the Washington sense that, instead of spending $1.76 trillion on those subsidies, now we're only going to spend $1.68 trillion.

ObamaCare will cost more and insure fewer people.

And the reason for this cost reduction isn't that Uncle Sam has found some new way to provide insurance less expensively — it's that the government is going to cover 3 million fewer people.

In particular, CBO notes that the Supreme Court made the law's Medicaid expansion optional for states, and at least seven governors have already announced that they'll pass. Some of the people who would've gotten Medicaid in those states may qualify for other federal subsidies instead, but not all. So the feds will spend less money providing coverage.

In other words, it'll cost less by covering fewer people. But that's not the end of the CBO report: It also showed that costs for the rest of the program, and for the law as a whole, are still rising.

For projected ObamaCare spending from 2012 to 2021, CBO estimates are now $81 billion higher than they were a year ago. (The big change: CBO now concludes that many of the law's expected savings in Medicare and elsewhere won't happen.)

So: We're going to cover fewer people — and pay more than we'd thought, anyway. That's nothing to cheer about.

Meanwhile, two new studies warn that, contrary to President Obama's repeated assurances, his law will cause many of us to lose our current insurance plan.

An article in the June issue of Health Affairs concludes that more than half of individual health plans won't meet ObamaCare's requirements for "essential coverage." The study dealt specifically with whether those plans could be sold on exchanges, but it's easy to see that the noncompliance would also apply to people who now have individual coverage.

The law won't immediately force people with those non-complying plans to change coverage, but many eventually will end up having to buy new, and likely more expensive, coverage.

At the same time, a new report from the benefits consulting firm Deloitte concludes that at least 10 percent of businesses are likely to drop their insurance over the next couple of years, and many more are thinking about doing so over time. Those workers would end up dumped into the new insurance exchanges, where they could face few choices and higher costs.

It may be even worse. An earlier report by Deloitte's rival, McKinsey & Co., found that as many as 30 percent of firms might drop their coverage. Any way you look at it, this is not good news for workers happy with their current coverage.

Finally, there are continued reports that ObamaCare may drive many doctors out of practice. One poll from the Doctor Patient Medical Association found that an astounding 83 percent of physicians are at least considering quitting or cutting back their practices because of the new law.

The actual number of physicians dropping out of medicine is likely to be far lower (there are reasons to question that survey's methodology), but numerous other polls confirm that many doctors, especially older ones, may quit.

So what have we learned this month? ObamaCare will cost more and insure fewer people. Many of us will lose our current insurance, and it's going to get harder to see the doctor of our choice.

As Chief Justice John Roberts noted, constitutional sure doesn't mean wise policy.

This article appeared on New York Post

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