What the Affordable Care Act does is reduce some spending, while creating a whole bunch of new, untried subsidies for the middle class. But interestingly enough, the mainstream press has simply taken for granted the ‘fact’ that the ACA reduces deficits. At least that’s what NPR told me this morning on the way to work. Every discussion I’ve read or heard so far about the incoming Republican House mentions that their intentions to repeal Obamacare are actually fiscally irresponsible since it reduces the deficit. Full stop. Here’s Washington Post resident wonk, Ezra Klein, making just that case. I’m not sure why Democrats are so insistent here. The ACA is first and foremost a coverage bill. Cost-containment can come later.
Kevin D. Williamson, of National Review, disagrees with Klein, noting that much of the supposed cost-savings in the law are little more than elaborate gambles. Will Medicare spending really go down under the new bill? Will we actually raise the revenue we hope to raise? Will the subsidies stay at the amounts they are written at now, or will they increase under voter pressure? What about the notorious doc fix? What about the unchanged structural problems facing our healthcare system? Lipstick on a pig and all that jazz. He notes this passage from CBO chief, Doug Elmendorf:
