The Congressional Budget Office (CBO) and
Congress’s Joint Committee on Taxation have asserted they can no longer measure
the full fiscal effects of the Affordable Care Act (ACA), an announcement that has provoked widespread anger and disbelief on Capitol
Hill, especially among opponents of the law.
CBO’s conclusion was contained in a footnote
to a report—Updated Estimates of the Effects
of the Insurance Coverage Provisions of the Affordable Care Act—that the
office released on April 14, but this particular detail was not brought to widespread
light until recently.
In turn, Sen. Ron Johnson (R-WI) introduced
in Obamacare Reporting Act,” a bill that would
force the CBO to score the net impact of the law on the federal deficit. “CBO
undoubtedly faces considerable challenges in separating the impact of the law
from some of the other programs that interact with it, but it can and should be
able to estimate those costs and impacts so that Congress and the American
people understand the true scope of financial harm that Obamacare is
causing,” said Johnson.
When the ACA was enacted in 2010, the CBO’s initial
determination of the ACA’s budgetary impact
estimated a reduction in the deficit of more than $120 billion over a decade.
The CBO last
commented on the fiscal impact of the ACA two years ago, when it
noted that if the law were repealed, it would increase the deficit by $109
billion over a 10-year period.
Now, however, the April footnote
indicates that the CBO “can no longer determine
exactly how the provisions of the ACA that are not related to the expansion of
health insurance coverage have affected their projections of direct spending
and revenues.” The same footnote also stated that "[i]solating the
incremental effects of those provisions on previously existing programs and
revenues four years after enactment of the Affordable Care Act is not
possible." The CBO attributed these
difficulties to delays implementing several of the law’s provisions and
adjustments to other provisions of the law.
Some budget analysts have stressed
that the CBO’s footnote was not unusual and that after several years it is
often difficult, if not impossible, to determine the precise budgetary impact
of any bill because other factors are constantly shifting.