Does Obamacare add to or cut the deficit?

Writing in today’s New York Times, Christina Romer says in part:

Despite Republican claims that the law is a budget buster, the Congressional Budget Office, the nonpartisan, official scorekeeper on budget matters, estimated it would actually reduce the deficit over the next 10 years. Such fiscal responsibility is in stark contrast to the last major health care legislation, the Medicare prescription drug benefit passed in 2003, which was projected to add nearly $400 billion to the 10-year deficit.

She is right about that. However, she leaves out the part where CBO says such estimate is based on many assumptions and a myriad of pilot programs that are untried. It also says, those conclusions assume all aspects are implemented and effective and left as is by Congresses over the next ten years. Good luck with that. Before the ink was dry, one factor in those savings numbers, the budget maneuvering within the Class Act (long term care) portion of Obamacare was deemed unworkable and cancelled. Already the noble goal of reducing hospital re-admissions under Medicare is found to not be working.

And keep this in mind, even if there are savings actually generated, they are savings for the federal government, not for the millions of Americans with private coverage who will see their costs rise from a combination of new taxes, cost shifting, and benefit mandates. Obamacare relies on expensive premium subsidies, caps on insurance company loss ratios and insurance premium review and limitations to define “affordable” health care for the private sector focusing not on the problem, but the symptom.

As is true with so much coming from the thinkers in the Obama Administration (high interest rates on student loans, not tuition is the problem, make if financially difficult to outsource rather than helping companies be more competitive, push loan forgiveness or modification thereby undermining personal responsibility and more) dealing with health care avoids targeting the issues in favor of short term populist machinations.