Some bad news: The cost curve is still bending in the wrong direction.
The study says: “Overall national health expenditures under this bill would increase by an estimated total of $222 billion (0.6 percent) during calendar years 2010-2019.”
The estimated effects of the bill on overall national health expenditures is that the share of GDP is projected to be 20.9 percent in 2019 compared to 20.8 under current law — “primarily as a net result of the substantial expansions in coverage.”
Also: the expansion of Medicaid to an additional 18 million people might be tough to achieve; “it is reasonable to expect that a significant portion of the increased demand for Medicaid would be difficult to meet, particularly over the first few years.”
And, “the additional demand for health services could be difficult to meet initially with existing health provider resources and could lead to price increases, cost-shifting, and/or changes in providers’ willingness to treat patients with low-reimbursement health coverage.”
Additionally, as was CBO, CMS is skeptical that there would be savings from Medicare.
To wit: “Reductions in payment updates to health care providers, based on economy-wide productivity gains, are unlikely to be sustainable on a permanent basis. If these reductions were to prove unworkable within the 10-year period 2010-2019 (as appears probable for significant numbers of hospitals, skilled nursing facilities, and home health agencies), then the actual Medicare savings from these provisions would be less than shown in then memorandum. Similarly, the further reductions in Medicare growth rates mandated for 2015 through 2019 through the Independent Payment Advisory Board may be difficult to achieve in practice.”
The “providers for whom Medicare constitutes a substantive portion of their business could find it difficult to remain profitable and, absent legislative intervention, might end their participation in the program (possibly jeopardizing access to care for beneficiaries).”
Should the bill(s) pass in its current form, I’m going to bookmark this article and add an entry to my calendar 5 and 10 years from today to see if we’re at all on track.