| 00:00:00 | MUCH. |
| 00:00:01 | II AM JIM CAPRETTA FELLOW AT THE ETHICS AND QUALITY CENTER. |
| 00:00:07 | I'M ALSO DIRECTOR OF OBAMACARE WATCH, SO WE ARE WATCHING THIS NEW HEALTH LAW VERY CAREFULLY, AND IT IS CENTRAL TO BOTH THE COST OF GOVERNMENT DAY THIS YEAR AS WELL AS THE COST OF GOVERNMENT DAY IN 2015 AND 2020 AND 25-- 20205. |
| 00:00:28 | THIS BILL HAS LOTS OF COSTS BUILT INTO IT THAT WILL MATERIALIZE WITHIN THE NEXT DECADE. |
| 00:00:34 | THE ADMINISTRATION IS FOND OF POINTING TO THE CONGRESSIONAL BUDGET OFFICE ESTIMATES OF THE NEW HEALTH LAW, AS AN ADVERTISEMENT THAT THEY SAY IS ACTUALLY A FISCALLY RESPONSIBLE BILL. |
| 00:00:46 | NOW, A CBO OF COURSE IS REQUIRED TO ASSESS LEGISLATION AS IT IS WRITTEN INCLUDING BUDGET GIMMICKS. |
| 00:00:53 | IF THEY ARE WRITTEN INTO LAW AND IMPLAUSIBLE ASSUMPTIONS THAT THEY ARE WRITTEN INTO LAW, ALL OF THAT HAS PUT IN THERE TO CREATE THE APPEARANCE OF BALANCE, BUT EVEN SO, IF YOU START WITH A CBO PROCESS AS A STARTING POINT FOR EXAMINING WHAT THIS BILL WILL DO YOU REVEAL AN AWFUL LOT SO LET'S DO THAT. |
| 00:01:14 | FIRST, YOU CAN TELL BY JUST THE VERY TOP TOPLINE NUMBERS THIS IS THE LARGEST EXPANSION OF GOVERNMENT OBLIGATIONS IN DECADES. |
| 00:01:21 | IN OTHER WORDS, AS ALL THE EVIDENCE THAT BENJAMIN WAS PUTTING FORWARD AND GROVER WAS TALKING ABOUT IN TERMS OF COST OF GOVERNMENT DAY GOING IN THE WRONG DIRECTION, WE ALREADY KNEW IT WAS GOING IN THE WRONG DIRECTION AND IN THIS PAST MARCH THEY PILED ON THE BIGGEST EXPANSION YOU ARE GOING TO EVER SEE PROBABLY IN OUR LIFETIME. |
| 00:01:42 | IT IS A VERY MASSIVE EXPANSION OF GOVERNMENT AND HERE COME A COUPLE OF THE REASONS WHY. |
| 00:01:48 | FIRST THE MEDICAID PROGRAM BY 2019, WILL HAVE 16 MILLION MORE PEOPLE ENROLLED IN IT, 16 MILLION PEOPLE JUST BY THE END OF THIS DECADE. |
| 00:01:58 | THERE IS ALSO A NEW ENTITLEMENT PROGRAM THAT WILL HAVE AN ADDITIONAL 19 MILLION PEOPLE IN IT. |
| 00:02:05 | THIS IS ACCORDING TO CBO, BY 2019 SO BETWEEN THESE TWO EXPANSIONS MEDICAID IN THIS NEW ENTITLEMENT PROGRAM, THAT IS AN ADDITIONAL 35 MILLION PEOPLE ON A NEW HEALTH ENTITLEMENT PROGRAM ACCORDING TO CBO. |
| 00:02:18 | BY THE END OF THIS DECADE. |
| 00:02:19 | THE COST OF THESE TO ENTITLEMENT EXPANSIONS WILL BE BY 2019 ACCORDING TO CBO, ABOUT $210 BILLION ANNUALLY AND IT IS EXPECTED TO RISE EVERY YEAR THEREAFTER AT A RATE OF AT LEAST 7%, ACTUALLY OF SOME OF THE GIMMICKS THAT WORD IN THE BILL IT WOULD PROBABLY BE RISING AT EIGHT OR 9% A YEAR SO WE HAVE CREATED ANOTHER ENTITLEMENT EXPANSION THAT IS GOING TO GROW ON THE FUTURE JUST AS FAST AS MEDICARE AND MEDICAID HAVE GROWN OR THE LAST 50 YEARS WHICH EVERYONE NOW KNOWS OF COURSES BURDENING THE CURRENT BUDGET IN ONE OF THE MAIN REASONS WHY THE COST OF GOVERNMENT DAY KEEPS INCHING BACK. |
| 00:02:57 | SO, BETWEEN THESE TWO EXPANSIONS, THEY HAVE PILED A VERY LARGE ENTITLEMENT EXPANSION ON TOP OF WHAT IS ALREADY AND THE BOOKS, AND LET'S FACE IT THIS IS VERY LIKELY TO BE A LOWBALL ESTIMATE, AND ONE OF THE MAIN REASONS WHY IS THAT CBO ASSUMES A VERY LOW DUMPING MIKE YOU THE RIGHT WORD OF EMPLOYER, EMPLOYERS DUMPING WORKERS INTO THE NEW SUBSIDIZED INSURANCE SYSTEM. |
| 00:03:24 | NOW THEY DO THAT FOR A NUMBER OF REASONS THAT I DON'T ACTUALLY AGREE WITH BUT THEY ASSUME A VERY FEW SINGLE-DIGIT MILLIONS OF PEOPLE END UP MIGRATING OUT OF JOB BASE PLANS TO GET THE COVERAGE THEY BEEN EXCHANGES. |
| 00:03:39 | HOLTZ-EAKIN FORMER DIRECTOR OF CBO A FEW YEARS AGO, DID ANOTHER STUDY. |
| 00:03:43 | HE LOOKED AT IT INDEPENDENTLY AND THROUGH HIS ANALYSIS HE IS ABLE TO INDICATE THAT THERE IS LIKELY TO BE AT LEAST 35 MILLION MORE PEOPLE WHO WILL BENEFIT FROM THE NEW SUBSIDIES BY GOING INTO THE GOVERNMENT-SUBSIDIZED SYSTEM. |
| 00:03:59 | 35 MILLION MORE PEOPLE. |
| 00:04:01 | SO INSTEAD OF HAVING BETWEEN MEDICAID IN THIS NEW COVERAGE EXPANSION 35 MILLION GOING AND WE ARE TALKING 70 MILLION MORE AMERICANS GOING INTO THIS NEW ENTITLEMENT ACCORDING TO DOUG'S ESTIMATE. |
| 00:04:11 | THAT WOULD ADD ANOTHER $500 BILLION JUST IN THE FIRST 10 YEARS TO THE COST OF THE BILL. |
| 00:04:19 | MANY MILLIONS MORE PEOPLE WILL BE TAKING ADVANTAGE OF THE SUBSIDIES. |
| 00:04:23 | ON AVERAGE BALLPARK, LET'S SAY IT IS ANOTHER $50 BILLION EACH YEAR SO INSTEAD OF $210 BILLION THAT CBO ESTIMATED WE ARE TALKING $260 BILLION EVEN THERE THAT IS LIKELY TO BE A LOWBALL ESTIMATE OF THE FISCAL CONSEQUENCES OF THIS BILL BECAUSE AS I INDICATED AT THE BEGINNING IT IS FILLED WITH GIMMICKS AND SLEIGHT-OF-HAND. |
| 00:04:43 | LET'S LOOK AT A COUPLE OF THEM. |
| 00:04:46 | FIRST THEY SUPPOSEDLY PAY FOR ALL OF THIS BY CUTTING MEDICARE PAYMENT RATES TO HOSPITALS AND OTHER INSTITUTIONAL PROVIDERS OF CARE. |
| 00:04:54 | THAT IS ONE OF THE MAIN WAYS THEY SAY THE BILL IS NEUTRAL. |
| 00:04:58 | BUT OF COURSE, IF YOU LOOK AT THE DETAILS, WHAT THEY HAVE DONE IS TAKE THE SOLO THAT THEY WERE ACTUALLY BELOW THE MEDICAID PROGRAM BY THE END OF THIS DECADE ACCORDING TO THE CHIEF ACTUARY OF THE MEDICARE PROGRAM WHO ACTUALLY WORKS FOR THE PRESIDENT OF THE UNITED STATES. |
| 00:05:12 | HE IS LOOKED AT THESE NUMBERS AND SAID IT IS COMPLETELY IMPLAUSIBLE THAT THE POLITICAL SYSTEM IS GOING TO ALLOW MEDICARE'S PAYMENT RATE TO GET ACCESS TO CARE TO GO BELOW THOSE OF MEDICAID. |
| 00:05:23 | MEDICAID RATES ARE SO LOW TODAY, THE NETWORK OF PROVIDERS WILLING TO SEE MEDICAID PATIENCE IS VERY VERY CONSTRAINED. |
| 00:05:30 | IT IS PROBABLY ALONG THE ORDER OF HALF OF THE POSITIONS THAT WILL ACTUALLY WILLINGLY SEE A LARGE NUMBER OF MEDICAID PATIENTS AND CERTAINLY THE HOSPITAL NETWORK. |
| 00:05:42 | YOU CAN IMAGINE OF MEDICARE RATES GO THAT LOW AND ALL THE MEDICARE BENEFICIARIES ARE ALSO FINDING IT DIFFICULT TO FIND PHYSICIANS WHO WILL SEE THEM, THE POLITICAL IS NOT GOING TO STAND FOR THAT SO PRICE-CUTTING IS NOT COST-CUTTING AND HEALTH CARE PER SE AND THAT IS WHAT THIS BILL DOES AND SUPPOSEDLY USES THAT TO MAKE THESE COSTS GO DOWN. |
| 00:06:02 | LASTLY, ON THE GIMMICKS SIDE I ALSO CAN'T NOT MENTION THE CLASS ACT. |
| 00:06:08 | THIS IS A LONG-TERM CARE INSURANCE PROGRAM PUT INTO THE BILL. |
| 00:06:12 | THIS IS A GIMMICK OF ALL GIMMICKS. |
| 00:06:13 | THE ONLY REASON THEY PUT IT IN THE BILL WAS THAT IT SUPPOSEDLY CREATED $70 BILLION IN ADDITIONAL REVENUE IN THE FIRST 10 YEARS OF THIS PROGRAM BUT OF COURSE THAT $70 BILLION IS NEEDED AFTER THE FIRST 10 YEARS TO ACTUALLY PAY CLAIMS ON LONG-TERM CARE INSURANCE WHEN THEY COME DO. |
| 00:06:30 | THEY HAVE DOUBLE COUNTED THESE PREMIUMS. |
| 00:06:32 | TAKE THAT OUT OF THE EQUATION, AGAIN THE BILL'S COST AND THE BURDENS GO OUT. |
| 00:06:37 | FINALLY, LET ME JUST MENTION QUICKLY THAT EVEN IF ONE WORKED -- WERE TO ASSUME THIS THIS IS NEUTRAL IT IS ALREADY CLEAR IT IS A MASSIVE TAX INCREASE ON THE AMERICAN PEOPLE. |
| 00:06:50 | I DON'T THINK PEOPLE FOCUS ENOUGH ON THIS. |
| 00:06:51 | THIS IS A 700 LIEN DOLLAR TAX INCREASE THAT JUST PASSED IN MARCH. |
| 00:06:59 | $700 BILLION IN NEW TAXES. |
| 00:07:02 | THERE IS A . |
| 00:07:03 | 9% MEDICARE INCREASE IN A 3. |
| 00:07:06 | 8% TAX ON INVESTMENT INCOME, AND A 40% TAX ON HIGH-COST INSURANCE PLANS, NEW TAXES ON INSURANCE PREMIUMS DRUG MANUFACTURERS A MEDICAL DEVICE COMPANIES ALLAH BUSH WILL BE PASSED ONTO CONSUMERS AND OF COURSE DON'T FORGET THE NEW MANDATE ON INDIVIDUALS THAT DON'T BUY INSURANCE AND EMPLOYERS THAT THEY DON'T PROVIDE QUALIFIED COVERAGE. |
| 00:07:26 | YOU PUT ALL THAT INTO THE PACKAGE AND THIS IS A GIGANTIC NEW BURDEN ON THE AMERICAN ECONOMY THAT WILL DESTROY JOBS. |
| 00:07:35 | FORTUNATELY, THE COST OF GOVERNMENT REPORT INDICATED MOST OF THIS DOESN'T HAPPEN UNTIL 2014 AND SO THERE WERE TWO NATIONAL ELECTION CYCLES BETWEEN NOW AND THEN. |
| 00:07:44 | THE FINAL WORD HERE HAS NOT BEEN UTTERED ON WHAT WAS PASSED IN THE SELF-LOVE. |
| 00:07:50 | THE AMERICAN PEOPLE WILL GET TO HAVE THAT AS THEY USUALLY DO. |
| 00:07:58 | THANK YOU. |
| 00:07:59 | >> THANK YOU JIM. |
| 00:08:00 | MOVING ON WE ARE GOING TO HAVE VERONIQUE DE RUGY TALK ABOUT REGULATIONS AND THE FINANCIAL REGULATORY |
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