Politically unbiased budget projections for this final Health Care Bill?

Are there any?

The CBO seems to be the most cited one, and the one used by Congress when scoring the bill.

Here’s the PDF. IIRC, its net effect is to cut the deficit by 130 billion over the first decade, and more then a trillion over the second decade.

The CBO is, of course, talking about Federal Government costs. The overall spending on health care, nationally, is unlikely to change in any significant way. I say this because the US is the only modern nation to not have universal health care, so we can go back and look at the change in health spending as other countries converted to UHC: There wasn’t any. The spending before and after, and the rate at which spending increased from year to year before and after are indistinguishable. You wouldn’t know when UHC was implemented or if it was from looking at spending charts. You have to look it up as an independent piece of data.

I don’t know of anything specific about our legislation which should make any difference from what happened elsewhere so I expect the same to happen.

And it makes sense. We already, unofficially, have universal health care. If you’re sick, you go to the ER. Now, people will go to their doctor. Preventative care ends up costing about the same as emergency care, so you’re even. You are still ahead though in that preventative care allows people to continue going to work and work hard in full health.

So there is a net bonus to the new legislation, but finances isn’t one of them. The spending decrease that the Federal government has created for itself will simply move to State or individual costs. Bringing US health costs down is a impending crisis that will still need to be dealt with in the coming decade.

The UHC bill has a raft of cost control measures that are hoped to slow the growth of (total, not just Federal) Health Care spending. No one knows how well they’ll work, so the CBO, which tries and come up with conservative estimates, doesn’t include their savings in their totals, But hopefully they’ll have at least some effect on the growth of costs.

But this is certainly true in anycase, since even the optomists don’t think current measures will be adequate to cut spending growth to sustainable levels.

Health costs will go down due to one simple rule: The USG will decline to pay for anything over x…

Finances is indeed one of the bonuses of this new legislation. In answer to the OP, the non-partisan Congressional Budget Office had scored the bill. The CBO is thorough and widely respected; neither party has questioned their neutrality yet in this debate.

The CBO predicts that the legislation will reduce the deficit by $143 billion in the first 10 years, and by $1.2 trillion in the second 10 years. This is because of a number of cost controls in the bill including the excise tax (a tax on high-value plans that is supposed to act as a deterrent), the Medicare Commission, and bundled payments to hospitals, which means that doctors will get paid once for treating a patient in total, rather than at present where they get paid per scan or test. At the same time, you’re right that this bill doesn’t do enough to solve the problem and that healthcare, in particular Medicare, will need to be significantly reformed again very soon.

While Republicans have not questioned the CBO’s scoring of the bill, what they have claimed is that the Democrats have sneakily taken certain costs out of the bill to make it look cheaper. This case has been championed by Rep. Paul Ryan: this link has a video to Ryan’s original criticisms at the healthcare summit, with Ezra Klein’s responses to each one, and this is an interview between Paul Ryan and Ezra Klein where they go back and forth debating his criticisms. It’s an excellent debate and I’d recommend both links.

The basic summary is that Ryan makes three points:

  1. Double counting: The first accusation is that Democrats have double-counted money by using trust funds, which will eventually have to pay out for Social Security, as collateral for health care payments. I have to admit this discussion went over my head - you can read it in the links yourself - but Ezra Klein seems to disagree that this is a genuine criticism of the bill’s fiscal responsibility.

  2. The Doc Fix: The second is the “doc fix”: a bipartisan law passed in 1997 indexed doctor’s payments against GDP. But since then GDP has fallen and doctor’s payments have risen, so to avoid having to slash doctor’s payments by 20% or more, every few years Congress implements a “doctor fix” which temporarily overrides this law. This has to be fixed permanently at some point. Democrats originally planned to fix it in this bill, but realized it would cost too much, so they took it out and said “we can do it separately”. Paul Ryan thinks the doc fix should be included as part of the cost of the bill, while Ezra Klein and Obama himself argue that it’s a problem which has existed for the last 10 years and which will exist anyway regardless of the bill, so it’s not fair to consider part of the bill’s costs. Personally I think that’s clearly right.

  3. Future implementations: The third is that the bill proposes cost controls in the future. The excise tax kicks in in 2017 for instance, and the Medicare Commission will implement savings in Medicare in the future. Ryan argues that future congresses will probably scrap these changes, so they can’t be considered as saving any costs. Klein says that if we can’t trust future congresses to not change the law, that implies we can’t do anything to cut the deficit at all, and we’ll go bankrupt. Ryan just agrees.
    Personally I don’t find any of those criticisms convincing, but there’s the debate for you!

But instead might just mean we spend even more on insurance. If we had an eye towards minimizing our health spending, we wouldn’t be where we are to begin with, after all.

You’re conflating two notions of ‘spending’ here: we’re not talking about how much everyday Americans have to spend on their premiums, we’re talking about the federal budget deficit. If the excise tax results in people continuing to buy high-value plans and just paying the extra tax for them (rather than deterring people from buying those plans, and encouraging insurers to cut down on waste, as it’s intended to), then that would decrease the deficit even more, because the government would take in extra revenue from those taxes.

If you want to talk about premiums though, the CBO estimates that under the new law premium levels will stay level or decrease for anyone on an employer-provided plan by 0% to 3%. For anyone buying in the individual market, the premiums for comparable plans will decrease by 14% to 20%. However, the bare-bones, high-deductible plans some people have at the moment will no longer be legal - premiums for anyone who wanted to buy one of those plans would go up by about 10% to 13%, because they’d have to get a more comprehensive plan instead. More than half of those people buying on the individual market would get subsidies to help them afford that new insurance.