Back in May of 2010, just two months after the enactment of the Patient Protection and Affordable Care Act, the director of the Congressional Budget Office casually dismissed the argument that had been used by the law’s champions as the primary justification for its passage. In remarks before the Institute of Medicine, Douglas Elmendorf said that “rising health costs will put tremendous pressure on the federal budget during the next few decades and beyond.” And then he added, almost in passing, “In CBO’s judgment, the health legislation enacted earlier this year does not substantially diminish that pressure.”
In other words, the trusted referees at CBO expected that the law would fail to achieve the most essential task of health-care reform: to bring costs under control.
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