The Massachusetts Health Plan: Much Pain, Little Gain | Aaron Yelowitz and Michael F. Cannon: Cato Institute

January 20, 2010

Aaron Yelowitz and Michael F. Cannon. The Massachusetts Health Plan: Much Pain, Little Gain. Washington, DC: Cato Institute Policy Analysis No. 657, January 20, 2010. [Full Text (pdf)]

In 2006, Massachusetts enacted a sweeping health insurance law that mirrors the legislation currently before Congress. After signing the measure, Gov. Mitt Romney (R) wrote, “Every uninsured
citizen in Massachusetts will soon have affordable health insurance and the costs of health care will be reduced.” But did the legislation
achieve these goals? And what other effects has it had? This paper is the first to use Current Population Survey data for 2008 to evaluate the Massachusetts law, and the first to examine its effects on the accuracy of the CPS’s uninsured estimates, self-reported health, the extent of  “crowd-out” of private insurance for both children
and adults, and in-migration of new Massachusetts residents.
We find evidence that Massachusetts’ individual mandate
induces uninsured residents to conceal their true insurance status.

Even setting that source of bias aside, we find the official estimate
reported by the Commonwealth almost certainly overstates the law’s impact on insurance coverage, likely by 45 percent. In contrast to previous studies, we find evidence of substantial crowdout of private coverage among low-income adults and children. The law appears to have compressed self-reported health outcomes, without necessarily improving overall health. Our
results suggest that more than 60 percent fewer young adults are relocating to Massachusetts as a result of the law. Finally, we conclude that leading estimates understate the law’s cost by at least
one third, and likely more.

Our results hold important lessons for the legislation moving through Congress. As in Massachusetts, there has been no effort to estimate the cost of the private health insurance mandates that legislation would impose on individuals and employers. The costs may therefore be far greater than legislators and voters believe,
while the benefits may be smaller than the conventional wisdom about Massachusetts suggests.


Estimates Of Federal Tax Expenditures For Fiscal Years 2009-2013 | JCT

January 11, 2010

Joint Committee on Taxation. Estimates Of Federal Tax Expenditures For Fiscal Years 2009-2013. JCS-1-10, January 11, 2010. [Full Text (pdf)]

Includes estimates for tax expenditures related to the tax exclusion for employer-based health coverage, the tax deduction for large medical expenses, and other health-related tax expenditures.


Estimated Financial Effects of the “Patient Protection and Affordable Care Act,” as Passed by the Senate on December 24, 2009 | CMS Office of the Actuary

January 9, 2010

Richard S. Foster. Estimated Financial Effects of the “Patient Protection and Affordable Care Act,” as Passed by the Senate on December 24, 2009, Office of the Actuary, January 8, 2010. [Full Text (pdf)]

The Office of the Actuary has prepared this memorandum in our longstanding capacity as an independent technical advisor to both the Administration and the Congress. The costs, savings, and coverage impacts shown herein represent our best estimates for the Patient Protection and Affordable Care Act. We offer this analysis in the hope that it will be of interest and value to policy makers as they develop and debate national health care reforms. The statements, estimates, and other information provided in this memorandum are those of the Office of the Actuary and do not represent an official position of the Department of Health & Human Services or the Administration.


Congressional Budget Office – Additional Information on the Effects of Tort Reform

January 4, 2010

Congressional Budget Office. Additional Information on the Effects of Tort Reform. Letter to the Honorable John D. Rockefeller IV, December 10, 2009.


CRS: Comparative Analysis of Private Health Insurance Provisions of H.R. 3962 and S.Amdt. 2786 to H.R. 3590

January 4, 2010

Congressional Research Service.

A Comparative Analysis of Private Health Insurance Provisions of H.R. 3962 and S.Amdt. 2786 to H.R. 3590. R40981, December 16, 2009.

On November 7, 2009, the U.S. House of Representatives approved health insurance reform legislation, H.R. 3962, the Affordable Health Care for America Act. The “Senate Amendment” (S.Amdt. 2786 to H.R. 3590, the Patient Protection and Affordable Care Act) was offered by Senate Majority Leader Harry Reid on November 21, 2009. This report compares the private health insurance provisions of H.R. 3962 and the Senate Amendment. Individuals currently receiving health insurance through a large employer would likely see the least direct impact from the bills. The largest changes would occur in the private health insurance market for small businesses and for nongroup coverage (currently, insurance obtained directly from an insurance company, broker or agent).


Congressional Budget Office – Patient Protection and Affordable Care Act, Incorporating the Manager’s Amendment

January 4, 2010

Congressional Budget Office. Patient Protection and Affordable Care Act, Incorporating the Manager’s Amendment. December 19, 2009.
Cost estimate for the amendment in the nature of a substitute to H.R. 3590, incorporating the effects of changes proposed in the manager’s amendment released on December 19, 2009


CBO – Correction Regarding the Longer-Term Effects of the Manager’s Amendment to the Patient Protection and Affordable Care Act

January 4, 2010

Congressional Budget Office. Correction Regarding the Longer-Term Effects of the Manager’s Amendment to the Patient Protection and Affordable Care Act. December 20, 2009. Letter to the Honorable Harry Reid.