The Supreme Court is expected to rule on King v. Burwell by the end June. Here's what you need to know about it, in less than two minutes. (Kaiser Health News)


Repealing President Obama’s signature health care law would add significantly to the deficit, even under a new accounting method advocated by congressional Republicans who want to get rid of the Affordable Care Act.

The Congressional Budget Office on Friday projected that scrapping the law would cost $353 billion over the next decade using its traditional scoring method and $137 billion under the model favored by Republicans, which takes into account the economic impact of tax and spending policies.

The new report is the first time that the congressional scorekeeper has used so-called dynamic scoring to assess the cost of repealing the law, which it did at the request of Senate Budget Committee Chairman Mike Enzi (R-Wy.), adding a new wrinkle to the continuing political battle over the health care overhaul.

Republicans argue their scoring method gives a more realistic assessment of the cost of congressional policies by taking into account their macroeconomic effects, while Democrats have derided it as a way to play with the numbers to minimize the cost of tax cuts.

Republicans on Friday brushed aside the deficit numbers, which they called uncertain, and instead touted CBO’s projection that scrapping the law would help the economy grow by close to 1 percent.

“This law acts as an anchor on our economy by dragging down employment and reducing labor force participation,” Enzi said in a statement. “While CBO’s report notes that the deficit impact of repealing the law is highly uncertain, and could even reduce the deficit, it does show that repealing this law will boost nationwide employment and grow the economy.”

Democrats highlighted the report as evidence Republicans don’t have a plan for offsetting the cost of getting rid of the ACA.

“Any way you slice it, repealing the Affordable Care Act will add hundreds of billions of dollars to the deficit,” House Minority Leader Nancy Pelosi (D-Calif.) said in a statement.

The report comes as lawmakers prepare for a Supreme Court ruling on whether subsidies to buy insurance under the law are unconstitutional in the 34 states currently using the federal health care exchange. The court could deliver its decision as soon as next week, kicking off a new rounds of debate over ACA’s future.

A ruling against the law would be cheered publicly by Republicans but it would also present them with a set of political problems as many of their constituents would lose subsidies they are currently using to purchase health insurance.

That has led to discussions within the GOP of coming up with a stop-gap plan to continue providing the subsidies in some form for the remainder of the Obama administration while the party works on its broader effort to repeal and replace the law.

For instance, Senate Republicans met this week to discuss a plan that would end the parts of the law that require employers to provide health care and individuals to buy purchase insurance. They would also shift power to the states to make decisions about which insurers and plans are acceptable.

The latest report from CBO also found that repealing the law now would add more to the deficit than earlier estimates.

Budget analysts and economists at the Joint Committee on Taxation used traditional scoring methods to project it would cost $109 billion to repeal the law in 2012. This estimate is more than three times higher than three years ago because savings from Medicare resulting from the law have been bigger than expected.

The ACA includes measures that are supposed to cut down on the government’s share of treating Medicare patients. The CBO estimate repealing part of the law would cost the government $879 billion over a decade. That savings is currently used to offset spending under the law.

“The provisions with the largest effects reduced payments to hospitals, to other providers of care, and to private insurance plans delivering Medicare’s benefits, relative to what they would have been under prior law,” the report found.