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in 2009 there is no bigger issue

The Impact of the 2009 Affordable Health Choices Act

EXECUTIVE SUMMARY

From the Senate Committee on Health, Education, Labor and Pensions 2009 Affordable Health Choices Act Independent Assessment by HSI Network LLC

For Public Dissemination (available at ehealth.org)

Summary

The plan lowers the uninsured significantly, to less than 1% of the population, but not without a cost of over four trillion dollars over 10 years.  (Note:  yes that is $4T)

There are no provisions in the legislation to offset this course.

Even if the most generous estimate of the employer sponsored tax exclusion ($300 billion per year, including collecting FICA contributions from employers) where used and combined with fraud estimates and block granting all of Medicaid (acute and long term care2), this would be a challenging proposal to finance with budget neutrality.

Finally, the public plans will be quite successful in recruiting large numbers of Americans. They will also likely crowd out at 79 million individual contracts with existing private insurers.

The underlying simulation model used is ARCOLATM, a proprietary version of a health reform coverage and cost assessment analytic engine. A peer-reviewed presentation of the core model structure is summarized in the journal Health Affairs1 and a longer version is available as a DHHS report at http://www.ehealthplan.org

(Note:  this org is doctor based and has done a lot of experiments and analyses on consumer spending on HC.  It generally favors HAS type of approach.)