$20 Billion in ObamaCare Regulatory Costs Remain

The future of President Obama’s “Affordable Care Act” remains unclear.  The Supreme Court recently upheld the law as constitutional, but the House of Representatives plans to vote again this week on full repeal.  Let’s consider what components of the law have already been implemented since its passage in 2010 and what remains to be seen.

To date, the Affordable Care Act (ACA) has imposed more than $24 billion in lifetime costs on already-struggling American businesses, including more than 58 million paperwork burden hours.  To put the paperwork burden in perspective, it would take more than 29,400 employees (working a 2,000 hour year) to complete the appropriate federal forms.

Future implementation of the law depends not only on subsequent litigation, but also on what regulations legislators choose to rescind, amend, or ignore following the Court’s decision.  According to the data, only a small fraction of the law has actually imposed “sunk” (past burdens that are not recoverable) regulatory costs.  This is not too surprising, since the law will not be fully implemented until 2014. 

From 2010 to 2012, ACA has imposed $2.35 billion in private-sector and intergovernmental costs.  Of the rules with published sunk costs, more than $9.4 billion in costs remain after 2012. 

Top ACA Sunk Regulatory Costs

Beyond 2012, more than $20 billion in pending regulatory costs remain, totaling approximately 51 million paperwork burden hours.  The top ten prospective regulations could impose $19.1 billion in costs.  Of these rules, the administration has already published $1.29 billion in sunk burdens.

Top 10 Prospective Regulations (by cost)

Pending ACA Rules

According to data from the Office of Information and Regulatory Affairs, there are nine pending health care regulations.  Two of these have not been published in the Unified Agenda and there is no available cost or paperwork burden information on any of the pending proposals.  However, the White House identified four regulations as “economically significant” (economic impact greater than $100 million). 

In addition, five pending regulations have statutory deadlines.  However, the administration has yet to publish the proposals in the Federal Register; thus, the rules are unlikely to meet their statutory deadlines.  To date, ACA has missed 47 percent of its mandated statutory deadlines.

For example, four regulations (Rules for EFT, RA, Inpatient Rehabilitation, Prescription Drug Premiums, and Modifications to HIPAA) have already missed their target publication dates. 

Pending ObamaCare Rules (significant regulations bolded)

Conclusion

Although ACA has been law for more than two years, only a fraction ($2.3 billion of $24 billion) of its regulatory costs has been implemented.  The Supreme Court’s decision on the law’s constitutionality surely won’t end the debate over the legislation or the broader issue of health care reform.  However, as these data indicate, Congress and the administration will have to confront significant implementation hurdles in the future.