In his report, Charles Blahous revisits the Republican claim that the administration “double counted” Medicare savings when scoring the budgetary impact of the law. He argues that practice hides the real cost of the measure, even though it conforms with government accounting rules and has been used by both parties in the past.
“The enactment of the [Affordable Care Act] has seriously worsened a federal fiscal outlook that was already untenable over the long term,” Blahous wrote in a blog post about his study.
“Many of the cost-savings measures under the ACA were already required in some form under previous law, and thus their combination with a substantial expansion of federal health entitlements unambiguously worsens the nation’s fiscal predicament,” Blahous wrote.
The administration says the healthcare law reduces the deficit and extends the life of the Medicare trust fund.
The crux of the issue is whether the same Medicare savings can be used to pay for the health law’s subsidies and other benefits while simultaneously strengthening Medicare’s long-term fiscal outlook. According to the Medicare Office of the Actuary, the healthcare law extends Medicare’s hospital insurance trust fund from 2017 to 2029.
Critics such as Blahous say the act of counting the same pot of money as reducing the deficit and extending the life of Medicare is double-counting.
The administration does not accept the “double-counting” charge and says the deficit reduction from the law and the solvency of the trust fund are two separate things.