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POLITICO: In response to "Health Care Law Will Deepen Deficit"

September 16, 2011

Rep. Darrell Issa's opinion piece "Health Care Law Will Deepen Deficit" (POLITICO, Aug. 22) reminded me of the late great Sen. Daniel Patrick Moynihan's famous riposte: "You are entitled to your own opinions. You are not entitled to your own facts."

Despite Issa's claims, the Congressional Budget Office projects that the Patient Protection and Affordable Care Act will reduce the deficit by $132 billion between 2010 and 2019.

The CBO has stated repeatedly that its deficit-reduction projections are largely due to the ACA's reform of Medicare. Unlike in the past two decades, when Medicare spending averaged scorching annual growth rates between 8 percent and 9 percent, the ACA will slow growth to more sustainable levels.

It does so by making modest changes to provider reimbursements and introducing efficient preventive care practices. The most significant change equalizes payments to Medicare Advantage plans, a change that saves more than $135 billion over the next decade.

These changes are working. Both CMS and Standard & Poor's have reported declines in Medicare's growth since the health care act became law. The CBO's new projections suggest this decline in Medicare spending is larger than originally thought.

Between August 2010 and March 2011, the CBO lowered Medicare's projected annual growth rate from 5.8 percent to 5.4 percent. Given that Medicare will cost more than $7.4 trillion over the next decade, even a 0.4 percent reduction means $29.6 billion in savings.

Issa's claim that employers will drop employee health coverage to game new federal insurance credits is also misleading — and runs contrary to existing data. While the McKinsey survey predicts a significant departure of employer-sponsored coverage, other nonpartisan analyses disagree. Only 6 percent of firms with 500 or more employees and 3 percent of firms with more than 10,000 employees would likely terminate their health coverage, a Mercer survey found.

Another study by the Urban Institute determined that the law would have an even smaller effect on employer-sponsored coverage — a conclusion also reached by the CBO and demonstrated in Massachusetts after similar reforms.

Issa and I agree that Congress should reduce wasteful spending and regain our prime credit rating. Unfortunately for his argument, the CBO projected that legislation to repeal the ACA would actually increase the deficit by $119 billion.

Instead of repealing the law, perhaps we can learn from the countries that still have AAA credit ratings — all of which benefit from reforms akin to the Affordable Care Act.

Rep. Joe Courtney (D-Conn.)