Last week, Bradley Herring of Johns Hopkins University and Erin Trish of University of Southern California released a study confirming that the health-spending slowdown that continued in 2010–13 “can likely be explained by longstanding patterns” over more than two decades, rather than the passage of the Affordable Care Act as the administration likes to claim.

The paper predicts the health care law will produce a “likely increase in health care spending.” Over at e21, my colleague Charles Blahous explains the findings:

Experts have also long understood that insurance coverage tends to fuel additional health service utilization, driving up spending. This has long been evident from academic studies and has been incorporated into many models for projecting health spending. The Medicare trustees’ projections reflect this understanding of insurance effects; essentially, the more that insurance coverage reduces out-of-pocket costs, the more health spending there will be (all other things being equal). This is good when it means more people can afford health services they need; it’s bad when it prompts the purchase of services people don’t need and wouldn’t choose to buy unless so incented. Good or bad, it’s a reality; more insurance generally means more spending. …
Moreover, not only has the ACA not contributed meaningfully to the recent cost slowdown, but it will likely put upward pressure on health spending going forward. Herring-Trish find that the law’s Medicaid expansion will by itself increase total national health spending roughly 1% by 2019. A 1% increase may sound small, but remember we already spend over $3 trillion a year on health care, and faced unsustainable cost growth trends before the ACA’s coverage expansion added to them.
In fairness it should be acknowledged there are other provisions of the ACA that its advocates hoped would counteract the coverage expansion’s effect of adding to total health costs. However, many of those measures, from the Cadillac plan tax to the Independent Payment Advisory Board (IPAB), have not produced their desired savings because they have not taken effect and it’s uncertain that they ever will. Our best information remains that the ACA, by expanding Medicaid as well as other subsidized insurance, didn’t merely shift more of the burden of funding existing health care costs to taxpayers– it actually increased those costs. Sooner or later, lawmakers will need to fix that problem

Blahous’s piece is here, and here is the Herring-Trish paper.

Now, if the goal was to make our debt problems worse than they already were without improving the health outcomes then Hillary Clinton is right when she said that that the Affordable Care Act “is one of the greatest accomplishments of President Obama, of the Democratic party, and of our country.”