“Does the health-care act worsen the deficit? The answer, I think, is clearly that it does,” Blahous, a senior research fellow at George Mason University’s Mercatus Center, said in an interview. “If one asserts that this law extends the solvency of Medicare, then one is affirming that this law adds to the deficit. Because the expansion of the Medicare trust fund and the creation of the new subsidies together create more spending than existed under prior law.” [...]
Medicare is financed in part through a trust fund that receives revenue from payroll taxes. Before Obama’s health-care act passed, the trust fund was projected to be drained by 2017 (later updated to 2016). Absent the health-care law, Blahous writes, Medicare would have been forced to enact a sharp reduction in benefit payments in the middle of this decade, or “other Medicare savings would have had to be found.”
Enter the health-care law, which provides about $575 billion in Medicare savings — enough to automatically extend the life of the trust fund through 2029, according to estimates at the time, and avoid a sharp cut in benefits. But in cost estimates by the nonpartisan CBO, those savings also offset a dramatic expansion of Medicaid under the law, as well as new subsidies for uninsured people to purchase coverage.
– Getting to a Zero Deficit: This legislation is necessary despite continued improvement in the federal deficit. Without the federal policy changes contained in the reconciliation bill, the deficit under CBO’s most recent estimates (without the so-called fiscal dividend that balance will yield) would double to $139 billion by 2002. The deficit was $107 billion in FY 1996 and is currently projected to be $67 billion this year. However, without this legislation, it will not get to zero. The positive economic performance to date largely has been due to low inflation and business restructuring at home and the opening of new markets overseas that has resulted in higher-than-anticipated receipts.
– Medicare: The Balanced Budget Act of 1997 (BBA 97) makes the most significant changes to the Medicare program — the federal government’s health care program for all seniors — since its inception in the 1960s. It modernizes the program by granting new health care options for seniors — while maintaining and strengthening the traditional system. Further, it more equitably distributes federal managed care and new Medicare Choice payments between geographic regions. It also extends the life of the program’s funding mechanism, the Medicare trust fund (known as the HI or Part A trust fund).