Three Years of Broken Promises
The president’s health-care law has done almost none of what he suggested it would.

HHS Secretary Kathleen Sebelius with President Obama


Michael Tanner

This legislation will also lower costs for . . . the federal government, reducing our deficit by over $1 trillion in the next two decades. It is paid for. It is fiscally responsible.

— President Obama, on signing the Affordable Care Act

One wonders how defenders of Obamacare can continue to make this and similar claims with a straight face. It has long been apparent that the bill’s costs were grossly understated, leaving out more than $115 billion in implementation costs, for example, double-counting Medicare savings, and relying on cost savings that even government actuaries suggest are unlikely.

Senator Jeff Sessions, in an analysis based on information provided earlier this month by the Government Accountability Office (GAO), has found that Obamacare would actually add $1.4 trillion to the national debt over the next ten years, and as much as $6.2 trillion over the next 75 years. It is true, as the GAO pointed out, that this is only one interpretation of the data (though one they call “reasonable”), but the scenario that Senator Sessions lays out reflects the concerns expressed by the Medicare trustees, the Congressional Budget Office, and the office of the chief actuary that the cost-containment mechanisms in the health law will not be sustained over time. Even if Senator Sessions’s analysis is off by, say, a couple hundred billion, it stretches credulity to call Obamacare “fiscally responsible.”

It’s about jobs. . . . In its life [health-care reform] will create 4 million jobs, [and] 400,000 jobs almost immediately

— Nancy Pelosi, February 25, 2010

Meanwhile, the evidence continues to mount that Obamacare is a job killer. For example, a new study from the National Federation of Independent Business predicts that Obamacare will result in a loss of 146,000 to 262,000 private-sector jobs by 2022, with 59 percent of the losses coming from small businesses. This is roughly 20,000 more lost jobs than NFIB had previously predicted, in 2011.

Another new study, by the International Franchise Association, warns that Obamacare puts as many as 3.2 million jobs at risk, particularly in industries such as chain restaurants. As many as one-third of all franchise-related jobs in every state could eventually be lost, with California, Florida, and Pennsylvania hardest hit.

Even more significant, the March edition of the Federal Reserve’s “beige book,” a compilation of regional economic surveys, reports that employers continue to cite Obamacare and uncertainty over the rising cost of health insurance as a reason they are not hiring in the wake of the recession. “Employers in several Districts,” the report says, “cited the unknown effects of the Affordable Care Act as reasons for planned layoffs and reluctance to hire more staff.”

It’s hard to imagine how Obamacare could ever create jobs, given the enormous burden it is placing on the private sector. According to a study released this week by the American Action Forum, the health-care law has already imposed more than 111 million hours of paperwork on American business, at a cost of more than $30 billion. That’s $30 billion that won’t go to create jobs.

Of course, this doesn’t begin to consider the broad effects of the roughly $1 trillion in new taxes that Obamacare imposes over the next ten years.

Quality, Affordable Health Care for All Americans

– Title 1 of the Patient Protection and Affordable Care Act

All Americans? Not even close. The latest CBO estimates suggest that, by 2023, there will still be more than 30 million uninsured Americans. For all the enormous cost and disruption caused by the Affordable Care Act, it will provide insurance for less than half the Americans currently without coverage. Further, only 25 million of them will actually receive proper insurance (and subsidized plans, at that). The remaining 12 million are merely dumped into Medicaid, hardly known for high-quality care. (Outcomes of Medicaid patients are actually, by some measures, worse than those of the uninsured.) According to the CBO, by the end of the decade almost 11 million fewer Americans will have private unsubsidized health insurance than do today.

Once upon a time we were told we needed to pass this law to find out what was in it. As Obamacare gets older, we are discovering the answer: broken promises.

— Michael Tanner is a senior fellow at the Cato Institute and author of Leviathan on the Right: How Big-Government Conservatism Brought Down the Republican Revolution.