AS EXPECTED, ALL THE REPUBLICAN CANDIDATES came out against the the Supreme Court’s decision upholding subsidies for health insurance in every state for low-income American’s, some more vociferously than others, such as Mike Huckabee who said the ruling was an “act of judicial tyranny.”

Actually we don’t think Donald Trump has made a public comments on the ruling.

They all want to see the Affordable Care Act repealed.

So what do these Republican hopefuls think about the Congressional Budget Office (CBO) report issued on June 19, 2015 indicating that repealing the Affordable Care Act (ACA) will increase the deficit  from between $ 137 billion to $ 353 billion over the next ten years.

Using “dynamic scoring,” CBO concluded that repealing ACA would increase the federal budget by $ 137 billion.  Using “static” reporting, CBO said the deficit would increase by $ 353 billion.

Here is a link that defines the difference between dynamic and static reporting:

http://www.freedomworks.org/content/static-versus-dynamic-scoring

A Republican Senator, Mike Enzi (Wyoming) requested the report from COB.

The report was prepared under the direction of Keith Hall, who was selected in February by the House and Senate Republican majority.  Mr. Hall served on the Council of Economic Advisors under George W. Bush.

It was also prepared by the staff of the Joint Committee on Taxation (JCT).

The report is available at: http://www.cbo.gov/publication/50252

Then how, more specifically, will NOT REPEALING ACA NOT increase the deficit?

Because, according to the Centers for Medicare and Medicaid Services (CMS), it “includes a series of Medicare reforms that will generate billions of dollars in savings for Medicare and strengthen the care that Medicare benefits beneficiaries receive,” such as “eliminating incentives in existing payment structures that reward providers not for the volume of services delivered, but for the quality of those services.”

Here are key ACA Cost Containment Strategies:

IMPROVES THE QUALITY OF CARE

• Reduces the number of hospital readmissions
• Reduces hospital acquired conditions
• Bundling payments for ESRD (End Stage Renal Disease)
• Improves physician quality reporting

REFORMS OUR DELIVERY SYSTEM

• Promotes Accountable Care Organizations
• Establishes an Independent Payment Advisory Board

APPROPRIATELY PRICES SERVICES AND MODERNIZES FINANCING SYSTEMS

• Extends overpayments to Medicare Advantage Plans
• Makes improvements to productivity and market basket adjustments in most provider settings
• Modifies payments for advanced imaging services
• Further expands competitive bidding for Durable Medical Equipment

FIGHTS WASTE, FRAUD AND ABUSE

• The ACA includes a range of provisions to reduce waste, fraud and abuse such as expanding Recovery Audit Contractors (RAC’s); requiring face encounters with physicians before receiving certain services and requiring greater data matching capabilities.

Sources:

1) CMS Office of the Actuary, “Estimated Financial Effects of the ‘Patient Protection and Affordable Act,’ as Amended” (2010).

2) Centers for Medicare and Medicaid Services, 2010

3) Congressional Budget Office, “Estimate of direct spending and revenue effects for the amendment in the nature of a substitute released on March 18, 2010” (2010).