Obamacare in Pictures

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Where will the
uninsured go?
The purpose of the
health care overhaul was
41% Uninsured
23 million*
to provide coverage for
the uninsured. However,
even with Obamacare,
18 million Americans
will be uninsured in
Medicaid
2019. Those who do
gain coverage will do so
32% 18 million
primarily through the
government-controlled
exchanges or through
Insurance
Medicaid.
Note: Figures have been
28% exchanges
rounded. 16 million
* Estimate assumes 5 million
undocumented aliens.

Source: Centers for Medicare and Medicaid Services. Obamacare in Pictures heritage.org
Obamacare is Exchanges
+31.6
health care million Medicaid/
SCHIP
redistribution +20.4 Net Change in Health
million Care Enrollment by 2019
The health care law will
provide new coverage to Under Obamacare
millions of Americans,
but one consequence will
be a major redistribution
of existing coverage.
Millions of Americans
–1.4
million
will be moved out of Employer-
private health plans and Sponsored
into government plans Private –15.7
Insurance million
and federally regulated Other
insurance “exchanges.” Private
Insurance
–33.8
million
Uninsured
Source: Centers for Medicare and Medicaid Services. Obamacare in Pictures heritage.org
Taxed enough Annual Costs of Obamacare Taxes
already? $100 billion Health
Wait until Total, 2010–2019
insurance
mandates
Obamacare $80 $502 billion
kicks in Hospital
insurance
To pay for generous tax
$60
subsidies to purchase
health insurance, a huge
expansion of Medicaid,
$40
and other new spending,
Obamacare raises taxes
and creates 17 new ones Revenue
from 15
that will affect all $20
other
Americans. taxes and
mandates
$0
2010 2015 2019

Source: Calculations based on data from the Joint Committee on Taxation. Obamacare in Pictures heritage.org
Obamacare’s bundle of budget gimmicks
Proponents +$529 ... but after accounting for these
of the health billion budget gimmicks, the new law
care law say it actually adds to the deficit.
will reduce the
budget deficit
from 2010 to +$283
2019 by $124 billion
billion...
+$115
billion +$70
billion +$29
billion
Double- Unpaid-for Discretionary Double- Double-
counted “Doc Fix” spending counted counted
Medicare savings savings from
cuts from Social
–$124 CLASS Security
billion Program payroll taxes

Sources: Senate Budget Committee, Congressional Budget Office. Obamacare in Pictures heritage.org
A Medicaid Monster
Obamacare increases coverage by adding millions of Americans to the low-quality,
low-access Medicaid program, requiring billions of dollars from state budgets.

WA VT NH
22.8% 11.2% 24.3%
MT ME
ND 12.1%
%
43.4% 32.5%
OR
49.5% MN
ID 21.1% WI
35.8% SD NY MA 8.7%
WY 28% 17.7% 17.3%
MI RI 21.8%
32.3% 23.5%
NV IA PA CT 21.0%
NE 22.3% 17.6%
65.6% 36.1% IL OH NJ 42.8%
UT IN 24.7%
34.5% CO 24.7% 25.7%% WV V
CA DE 18.1%
44.2% KS MO KY 2 % VA
23.9%
30% 39.6% 40.7% MD 30.9%
30.8% 31.4%
NC DC 13.3%
AZ OK TN 25.1% 36.8%
36.4% NM AR SC
34.5% 30.7% 28.3%
MS 3
36.1%
36.3% AL GA Increase in Medicaid
26.2% 41.1% Population Under
TX
56.7% LA Obamacare by 2014
AK 29.5%
34.3% 0% to 20%
FL
42.6% 20.1% to 30%
U.S. total:
30.4% 30.1% to 40%
HI 13.1% 40.1% to 70%

Sources: Centers for Medicare and Medicaid Services, statehealthfacts.org. Obamacare in Pictures heritage.org
The Paperweight Bureaucracy
At 2,700 pages, the Patient Protection and Affordable Care Act is one of the
most bloated bills in congressional history.
Senate America’s Senate Patient
HELP Affordable Bill Clinton’s Finance Protection and
Committee Health Choices 1994 health Committee Affordable
Bill (2009) Act (2009) care bill Bill (2009) Care Act (2010)
839 1,018 1,342 1,502 2,700
pages pages pages pages pages *

* Includes 150 pages from reconciliation bill.

Source: Library of Congress THOMAS, at http://thomas.loc.gov. Obamacare in Pictures heritage.org
If you like Of the 17.2 million who no longer will have their
employer-sponsored health plans under Obamacare ...
your health
care, can you 1 million
will become
really keep it? uninsured.

President Obama
promised health care 3.7 million
will end up in
reform would not affect Medicaid.
those who already have
coverage. But one inde- 3.9 million
pendent study shows will end up in a
more than 17 million government
people will be forced out exchange
without subsidies.
of employer-sponsored
health care plans. That’s 8.6 million
more than one out of will end up in a
every 10. government
exchange
with subsidies.
Source: The Lewin Group. Obamacare in Pictures heritage.org
Obamacare Difference in National Health Expenditures Under
bends the Obamacare Compared to Prior Law, in Billions
cost curve ... +$80 billion +$77

in the wrong Net Change,

2010–2019
direction
+$60
+$311
billion
Health care reformers +$40
touted Obamacare as a
way to reduce skyrocket-
ing health care spending. +$20 Obamacare
However, in 2014, when INCREASES
Spending
several key provisions 2011 2012 2013
kick in, spending will 2010 2014 2015 2016 2017 2018 2019
Obamacare
begin to rise even faster. DECREASES
–$20 Spending

–$40

Source: Centers for Medicare and Medicaid Services. Obamacare in Pictures heritage.org
Obamacare Percentage of National Health Expenditures
accelerates Under Government Control

government 54%

Under
control over 53% Obamacare* 53.0%
health care 52%
Government has been 50.9% 51.5%
taking greater control of 51% Before
health care for decades. Obamacare
But under Obamacare, 50% “Tipping
government will quickly 49.9% Point”
cross the “tipping point,” 49%
controlling more than 50
percent of all health care 48%
spending faster than
under prior law. 47%
2010 2011 2012 2013 2014 2015 2016 2017 2018

* Excludes private spending on health plans in the exchanges.

Source: Centers for Medicare and Medicaid Services. Obamacare in Pictures heritage.org
By 2020, Obamacare will ...
1 ... increase the interest
on the national debt
by an average of $23.1
billion per year.
2 ... raise the national 3 ... increase annual
debt by more than budget deficits by an
$753 billion. average of $75 billion.

Change in Federal Change in Total Debt Change in Federal Budget

Net Interest Payments Held by the Public Surplus/Deficit
$60 billion $800 billion 2010 2015 2020
0
$753.2 billion
$50 $52.8 billion
$600 –$20
$40
–$40
$30 $400
–$60
$20
$200 –$80
$10
–$100
–$106.3 billion
0 0
2010 2015 2020 2010 2015 2020 –$120 billion

Sources: Calculations based on IHS Global Insight’s macroeconomic model. Obamacare in Pictures heritage.org
States: Obamacare is unconstitutional
The Attorneys General of 21 states have filed suits to protect their citizens from
being forced by the federal government to purchase health insurance.

WA
VT NH
MT ND ME
OR
MN
ID
SD WI NY MA
WY MI RI
NE IA PA CT
NV NJ
UT IN OH
IL
CO WV
V DE
CA
KS VA
MO KY MD
DC
NC
TN
AZ OK
NM AR SC
MS AL GA
TX LA States filing suits
AK against Obamacare’s
FL
“individual mandate”
HI

Source: American Legislative Exchange Council. Obamacare in Pictures heritage.org

About the Freedom of Choice in Health Care Act
The bill, filed by state legislators across the U.S., would protect patients’ rights to pay
directly for medical services and to choose not to carry health insurance.

WA
VT NH
MT ND ME
OR
MN
ID
SD WI NY MA
WY MI RI
NE IA PA CT
NV NJ
UT IN OH
IL
CO WV DE
CA
KS VA
MO KY MD
DC
NC
TN
AZ OK
NM AR SC
MS AL GA Initiative on ballot
TX LA Announced intention
AK to file legislation
FL
Note: Arizona has Filed legislation
HI
already passed legislation
and has another initiative Passed legislation
on the ballot.

Source: American Legislative Exchange Council. Obamacare in Pictures heritage.org

Budget trick: Projected Effects of the CLASS Program on the
The CLASS Federal Budget
Program +$12 billion

Part of Obamacare, the

+$10
CLASS Program creates
an entitlement for long- Congressional
Budget Office CMS and CBO
term care. Participants +$8 project CLASS
pay premiums for five will generate
years before receiving deficits by 2025
benefits, creating the +$6 and 2030,
respectively
illusion of deficit
reduction at the onset. In +$4
reality, CLASS will add to
deficits by 2030. Centers for
+$2 Medicare and
Medicaid Services
0
Sources: Congressional Budget Office 2011 2015 2020 2025 2030
and Centers for Medicare and
Medicaid Services. Obamacare in Pictures heritage.org
 The Health Care Initiative is one of 10 Transformational Initiatives making up The Heritage Foundation’s
Leadership for America campaign. For more products and information related to this initiative or to learn
more about the Leadership for America campaign, please visit heritage.org.

The Heritage Foundation is a research and educational institution—a think tank—whose mission is to
formulate and promote conservative public policies based on the principles of free enterprise, limited gov-
ernment, individual freedom, traditional American values, and a strong national defense.
Our vision is to build an America where freedom, opportunity, prosperity, and civil society flourish. As
conservatives, we believe the values and ideas that motivated our Founding Fathers are worth conserving.
As policy entrepreneurs, we believe the most effective solutions are consistent with those ideas and values.

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