Isn’t it strange that the Affordable Care Act was advertised as “shrinking the deficit” back in 2010 because its fiscal outlays were so efficient, but now proponents are complaining that it’s not their fault the bill doesn’t have enough funds for implementation? How can you launch a project under the banner of cost efficiency and neglect an entire component of its cost structure? Imagine an ad touting a sports car with the world’s cheapest, most powerful engine, neglecting to mention that it’s a gas guzzler.
Meanwhile, the cost of the bill, initially estimated to be around $898 billion, has doubled, to about $1.85 trillion. A minority report from the Senate Budget Committee has the figure at $2.7 trillion. All kinds of regulatory deadlines in the bill have been missed. Confusion reigns among plans, patients, and administrators alike.
… As the Affordable Care Act continues to come apart at nearly every seam, Republicans will probably hold firm on their principles and refuse to bail Democrats out of the fix they have put themselves into, until and unless the Democrats are willing to make real and substantive reforms. These reforms should include, at a minimum, reducing insurance subsidies, empowering Health Savings Accounts, repealing the anti-innovation medical-device tax, loosening up the rules regarding insurer participation in exchanges, and giving states more flexibility in the design of their exchanges.