Wednesday, January 12, 2011

Does The Health Care Bill Really Kill Jobs?

You might recall that, on January 6, 2011, I listed some of the reasons why I thought it would be a mistake to repeal the health care legislation passed in March of last year. The effort to repeal it has been officially named "The Repeal of The Job-Killing Health Care Law," by the Tea/GOP.

So, I thought I would try to find out more about the poor unfortunate souls, whose jobs were "killed" by this legislation. I mean, if millions of jobs have been or are going to be killed by this law, I might have to change my mind about it. We already have around 10% unemployment and lots of folks are really scared of losing what job(s) they have now. The Tea/GOP would not just be using their old tried and true fear and smear tactics again, would they?

I first looked at the report from the Congressional Budget office, who, by their own web cite admits that:

CBO's mandate is to provide the Congress with:
·        Objective, nonpartisan, and timely analyses to aid in economic and budgetary decisions on the wide array of programs covered by the federal budget and
·        The information and estimates required for the Congressional budget process.

OK. Non partisan, number crunchers. Right! I want the unvarnished truth about the affects of this legislation on jobs. This is a taste of what they said:

On March 20, 2010, CBO released its final cost estimate for the reconciliation act, which encompassed the effects of both pieces of legislation. Table 1 (on page 5) provides a broad summary and Table 2 offers a detailed breakdown of the budgetary effects of the two pieces of legislation. CBO and the staff of the Joint Committee on Taxation (JCT) estimate that enacting both pieces of legislation will produce a net reduction in federal deficits of $143 billion over the 2010-2019 period. About $124 billion of that savings stems from provisions dealing with health care and federal revenues; the other $19 billion results from the education provisions. Those figures do not include potential costs that would be funded through future appropriations (those are discussed on pages 10-11 of the cost estimate).[ Bold print provided by me].

CBO and JCT estimate that by 2019, the two pieces of legislation combined will reduce the number of nonelderly people who are uninsured by about 32 million, leaving about 23 million nonelderly residents uninsured. Those findings are presented in Table 4, along with the budgetary effects of the various provisions related to health insurance coverage. Table 5 shows the budgetary impact of the health care provisions that are not related to health insurance coverage (primarily involving the Medicare program). The impact of revenue provisions is reported separately by JCT.
CBO also analyzed the effects on health insurance premiums of an earlier version of the legislation. A November analysis examines the expected impact on average premiums for health insurance in different markets. Although CBO and JCT have not updated those estimates, the effects of the enacted legislation are expected to be quite similar.
Sounds good, right? But nothing at all about jobs. I wanted to know about jobs. The Tea/GOP want to repeal this law because they say it is killing jobs. So I went back to the CBO to see if they had anything to say about the effect of the proposed repeal of this law on JOBS, for crying out loud! This is what they had to say about that:

Impact on the Federal Budget in the First Decade

As a result of changes in direct spending and revenues, CBO expects that enacting H.R. 2 would probably increase federal budget deficits over the 2012–2019 period by a total of roughly $145 billion (on the basis of the original estimate), plus or minus the effects of technical and economic changes that CBO and JCT will include in the forthcoming estimate. Adding two more years (through 2021) brings the projected increase in deficits to something in the vicinity of $230 billion, plus or minus the effects of technical and economic changes.

Those projections do not include any potential savings in discretionary spending, which is governed by annual appropriation acts. By CBO’s estimates, repeal of the health care legislation would probably reduce the appropriations needed by the Internal Revenue Service by between $5 billion and $10 billion over 10 years. Similar savings would accrue to the Department of Health and Human Services.

There is no clear basis for projecting other effects of H.R. 2 on discretionary spending. PPACA contained a number of authorizations for future appropriations, which, if left in place, might or might not result in additional appropriations. For example, most of the authorizations were for activities that were already being carried out under current law or that were previously authorized and that PPACA authorized for future years. Thus, repeal of the PPACA authorizations might or might not result in discretionary savings associated with those authorizations.

Impact on the Federal Budget Beyond the First 10 Years

CBO estimates that enacting H.R. 2 would increase federal deficits in the decade after 2019 by an amount that is in a broad range around one-half percent of GDP, plus or minus the effects of technical and economic changes that CBO and JCT will include in the forthcoming estimate. For the decade beginning after 2021, the effect of H.R. 2 on federal deficits as a share of the economy would probably be somewhat larger.

As with all of CBO’s cost estimates, these estimates—both for the first 10 years and beyond—reflect an assumption that the provisions of current law would otherwise remain unchanged throughout the projection period and that the legislation being considered would be enacted and implemented in its current form. CBO’s responsibility to the Congress is to estimate the effects of proposals as written and not to forecast future legislation. However, current law now includes a number of policies that might be difficult to sustain over a long period of time. If those policies or other key aspects of the original legislation would have subsequently been modified or implemented incompletely, then the budgetary effects of repealing PPACA and the relevant provisions of the Reconciliation Act could be quite different—but CBO cannot forecast future changes in law or assume such changes in its estimates.

Effects on the Number of People with Health Insurance
Under H.R. 2, about 32 million fewer nonelderly people would have health insurance in 2019, leaving a total of about 54 million nonelderly people uninsured. The share of legal nonelderly residents with insurance coverage in 2019 would be about 83 percent, compared with a projected share of 94 percent under current law (and 83 percent currently).

Effects on Health Insurance Premiums

If H.R. 2 was enacted, premiums for health insurance in the individual market would be somewhat lower than under current law, mostly because the average insurance policy in this market would cover a smaller share of enrollees’ costs for health care and a slightly narrower range of benefits. Although premiums in the individual market would be lower, on average, under H.R. 2 than under current law, many people would end up paying more for health insurance—because under current law, the majority of enrollees purchasing coverage in that market would receive subsidies via the insurance exchanges, and H.R. 2 would eliminate those subsidies.

Premiums for employment-based coverage obtained through large employers would be slightly higher under H.R. 2 than under current law. Premiums for employment-based coverage obtained through small employers might be slightly higher or slightly lower (reflecting uncertainty about the impact of the enacted legislation on premiums in that market).

HOOWAH! All interesting stuff, but not a word about any jobs killed or un-killed by repealing the law. Granted, a good deal of their information is couched in econ-mumbo-jumbo, so the net gain or loss of jobs could be indirect as affected by general economic conditions. Could be the jobs answer was really there, but hidden behind the Keynesian kerfuffle and I'm just not smart enough to see it.

And what was the Tea/GOP reaction to the CBO reports? The new Speaker of the House, John Boehner, reacted this way:

“I do not believe that repealing the job- killing health care law will increase the deficit,” Boehner, R-Ohio, said about the CBO’s findings. “CBO can only provide a score based on the assumptions that are given to them. And if you go back and look at the health care bill and the assumptions that were given to them, you see all of the double-counting that went on, you see the fact that the doc fix wasn't even part of the bill.”

Then, just as I was about to sign off, I read this about the job-killing!

“The evidence is overwhelming that this health care law, by raising taxes, imposing new mandates and increasing uncertainty, is already destroying jobs in our country. It will continue to destroy jobs in America unless we do something about it,” Boehner said. “The [GOP] report shows how the law is making it harder to end the job-killing spending binge that threatens our children's future. And when you look at it dollar by dollar, you can tell that the numbers just don't add up.”

This “report” claimed to detail why the law killed jobs and with what they would replace it: 

“With 10 percent unemployment and massive debt, the American people want us to focus on cutting spending and growing our economy. That's what repealing the health care law is all about,” Boehner said. “I hope the House will act next week to repeal the job-killing health care law so we can get started on replacing it with commonsense reforms that will reduce the cost of health insurance in America.”

When I got to this part, I thought, wow! This report they have must contain  new intel that is not the same old regurgitation of nonsensical platitudes that they were spewing up during the debate last March. Sadly, but predictably:

 "The resolution sets out a dozen broad goals that align with long-standing GOP preferences for changes to the health-care system. Among them are "increased competition and choice" in insurance, changes to the medical liability system, and giving states more freedom over the shape of Medicaid. One item -- to "provide people with preexisting conditions access to aff

The president of the U.S. Chamber of Commerce spoke in lock-step with the Tea/GOP, when he stated:
"Think for a moment about the nation's job creators—the men and women who run our small and large businesses—as well as those who lead our universities, our health care facilities and the many other institutions that employ our workforce. If you were in their shoes today, would you jump quickly into new investments and hiring? Or would you wait for some clarity, and some common sense, to take hold first?
Most of these job creators would like nothing more than to keep their workers employed, create new jobs, and bring some hope and relief to families struggling without a paycheck. But when they look at what's going on in Washington, in the states, and around the world, what do they see?
They see massive tax increases on the horizon—not just the expiration of the tax cuts passed over the last decade, but also hundreds of billions of dollars in new taxes.
They see health care legislation that contains a burdensome mandate on employers and virtually no meaningful reforms to improve quality or control costs.
Congress and the administration also need to find more rational and affordable ways to address health care and climate change."
The Chamber supports a health care reform bill and we have offered many positive ideas to Congress, the administration, and the American people.
Unfortunately, the legislation emerging from the House and Senate is not reform. It's not reform when you undermine the private, employer-based system while doing nothing to rein in costs. It's a prescription for fiscal insolvency and an eventual government takeover of American health care."


I got the impression that this guy, in his speech on Tuesday, at chamber headquarters, was telling his business buddies all over the country, to NOT hire until health care legislation was repealed! If he is advocating holding job creation hostage, until he gets his way with health care, that certainly will affect jobs!

And I've heard all this before. What the Tea/GOP folks and their corporate sugar daddies are actually saying...again, is that this deficit-reducing law will actually increase the deficit and kill jobs. They are saying… again, that the tax breaks for small business employers, (so that they can give their employees health insurance for the first time) is actually a tax hike that will not create a healthier, more productive workforce, but will kill jobs. They are saying… again, that "increased competition and choice" will, this time, magically force the oligopolistic health insurance companies to provide insurance to people with preexisting conditions. They are saying… again, that limiting liability for doctors who are drunk, or who fall asleep, or who are just not competent and botch operations and kill people will stop the obscene yearly increases in health care costs and so health insurance will go down. It won’t and they know it. Costs have actually gone up, in states that have limited medical liability as part of general tort reform. And does the thought of giving doctors a free pass make anyone out there feel better about getting an operation?


I am so sorry that I could not give you better news. Does the Tea/GOP think that, if they say it over and over and over, ideas that haven't worked in the last thirty years will somehow attain new legitimacy? Shouting out great-sounding-yet empty platitudes have worked so well for them in the past, so they will attempt to repeal a “job killing” law that does not kill jobs. I don't know why I expected anything different.

Why are they doing this? That part’s simple. They’re just dancing with the date that brung em.

J. Brandeis Sperandeo 

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