So yes, there’s a bump when 35 million people who would otherwise have been uninsured get coverage; but growth is slower after that, which will mean big savings in the long run. It really doesn’t matter at all whether your estimate says that overall health spending will be slightly higher or slightly lower in 2019 as a result of the law; aside from the fact that covering all those people with at most a minimal rise in costs is itself a policy triumph, it’s spending in the decades that follow that matters for cost.
And let’s be clear: you could not have gotten the cost savings without the move to near-universal coverage, for both political and technical reasons. This thing really is a package — a package that, with all its flaws, both makes our society more decent and improves our long-run budget outlook. ...Paul Krugman
Next step: universal coverage. Sooner, better, cheaper.
