Saturday, April 5, 2014

What Might James Madison Say About the "Patient Protection and Affordable Care Act"?

  • There have been 38 changes to this law via administrative action, executive order or what I'll refer to as "amendment to prosecutorial discretion."  
  • Statute itself is over 2,400 pages.
  • If the regulations implementing the statute hold to the same ratio as Medicare’s regulations-to-statue ratio, that will mean PPACA’s regulations will exceed 140,000 when they are all done.


  • It will cost over $1.5 Trillion when fully implemented - CBO revised estimate, March 2014. Price at passage was $0.9T. 
  • In 1965, government experts projected that in 1990, on an inflation-adjusted basis, Medicare would cost $12 billion. In reality, Medicare cost $107 billion in 1990.

  • 2013's edition of the Federal Register passed the 80,000 page mark.  An average weekday represents another 330+ pages of new federal rules, orders and hearings. 

  • HCR creates 20 new federal fees and taxes. (Tanning salons, FSA max’s, robust plans, premium tax, insurer risk corridor tax, Medicare increase, investment income increase, Rx tax, device tax, etc.)


  • Analysis by the Joint Economic Committee and the House Ways & Means Committee estimates up to 16,500 new IRS personnel will be needed to collect, examine and audit new tax information mandated on families and small businesses in HCR. 


  • The Law will greatly increase the federal government’s role in healthcare by expanding Medicaid by 33% and involving HHS in the design, sale and regulation of health insurance products. 
  • For nearly one-third of calls into the Medicaid/Medicare hotline reporting waste, fraud and abuse, government workers take over 4 months to begin investigation.
  • President Obama called Medicaid a broken system in 2009.  

  • 31 million nonelderly residents of the United States are likely to remain without health insurance in 2024, roughly one out of every nine such residents. 
    • This means that we will go from 45 million uninsured to 31 million for a net reduction of 14 million.  
    • There are 314 million people in America. This equates to a 4.5% reduction.