1. Obamacare in Pictures
Visualizing the Effects of the Patient Protection and Affordable Care Act
Kathryn Nix
Spring 2012 John W. Fleming

2. Obamacare Health Care Enrollment in 2020
expands Government Other
dependence on 50.7% 49.3%
50%
government Exchange
Subsidies:
health care 7.3%
40%
Obamacare dumps
millions into Medicaid Medicare:
18.3% 30%
and creates new federal
subsidies for
government-approved
20%
coverage. As a result, by
Medicaid
the end of the decade and CHIP:
most Americans will 25.1% 10%
receive health coverage
through government
programs. 0%
Source: Centers for Medicare and Medicaid Services,
Office of the Actuary, January 2012 report. Obamacare in Pictures heritage.org

3. Millions remain Health Coverage, With and Without Obamacare (2016)
uninsured under UNINSURED MEDICAID GOVERNMENT
EXCHANGES
Obamacare 56
million
President Obama promised
universal coverage under his 49
million
health care overhaul. (–30 (+17
million) million)
However, even with
Obamacare, millions of
Americans will remain 32
uninsured. Those who do million
gain coverage will do so 26
million
primarily through 20
government exchanges or million
(+20
Medicaid. million)
n/a
Without With Without With Without With
Note: Figures have been rounded. Obamacare Obamacare Obamacare Obamacare Obamacare Obamacare
Source: Congressional Budget Office, March 2012 report. Obamacare in Pictures heritage.org

4. If you like your Estimated Loss of Employer Coverage
After Full Implementation
health care,
Congressional
can you really Budget Office 11 million
keep it?
CMS Office of 14
President Obama the Actuary million
promised reform would
not affect existing The Lewin
coverage. While it remains Group
uncertain exactly how
many Americans will lose 17.2 million
employer-sponsored plans
under Obamacare, studies American
show it will be millions. Action Forum
35 million
Sources: Congressional Budget Office, March 2010; CMS
Office of the Actuary, April 2010; The Lewin Group, June
2010; and the American Action Forum, May 2010. Obamacare in Pictures heritage.org

5. Premiums Average Annual Cost of Employer-Based
continue to Health Insurance
rise under $15,000
$13,770
$15,073
Obamacare
$12,000
President Obama
promised premiums
would fall under his $9,000
health law, but
Americans continue +9.5%
to pay more every $6,000 $5,049 $5,429
year. In fact,
Obamacare is
responsible for a
portion of the
$3,000
+7.5%
increase in cost.
$0
2010 2011 2010 2011
Family Policy Individual Policy
Source: Kaiser Family Foundation and Health Research and
Educational Trust, Employer Health Benefits 2011 Annual Survey. Obamacare in Pictures heritage.org

6. States: Obamacare is unconstitutional
Twenty-eight states have filed suits against the individual mandate and the Medicaid
expansion. The issue will be settled by the Supreme Court in 2012.
WA
VT NH
MT ND ME
OR
MN
ID
SD WI NY MA
WY MI RI
NE IA PA CT
NV NJ
UT IN OH
IL
CO WV DE
CA
KS VA
MO KY MD
DC
NC
TN
AZ OK
NM AR SC
States joining
MS AL GA Florida v. Dept. of
TX Health and Human
LA Services suit
AK
FL States filing
suits separately
HI
Source: Independent Women’s Forum, healthcarelawsuits.org. Obamacare in Pictures heritage.org

7. A Medicaid monster
Obamacare increases coverage by adding millions of Americans to the low-quality,
low-access Medicaid program, requiring billions of dollars from state budgets.
WA VT NH
22.8% 11.2% 24.3%
MT ME
ND 12.1%
43.4% 32.5%
OR
49.5% MN
ID 21.1% WI
35.8% SD NY MA 8.7%
WY 28% 17.7% 17.3%
MI RI 21.8%
32.3% 23.5%
NV IA PA CT 21.0%
NE 22.3% 17.6%
65.6% 36.1% IL OH NJ 42.8%
UT IN 24.7%
34.5% CO 24.7% 25.7% WV VA
CA DE 18.1%
44.2%
30% KS MO KY 23.9%40.7% MD 30.9%
39.6% 30.8% 31.4%
NC DC 13.3%
AZ OK TN 25.1% 36.8%
36.4% NM AR SC
34.5% 30.7% 28.3%
MS 36.1%
36.3% AL GA Increase in Medicaid
26.2% 41.1% Population Under
TX
56.7% LA Obamacare by 2014
AK 29.5%
34.3% 0% to 20%
20.1% to 30%
U.S. total: FL 30.1% to 40%
HI 13.1% 30.4% 42.6%
40.1% to 70%
Sources: Heritage Foundation calculations based on data from the Centers for Medicare
and Medicaid Services and the Kaiser Family Foundation’s statehealthfacts.org. Obamacare in Pictures heritage.org

8. Medicaid expansion burdens state budgets
The cost of Obamacare’s huge Medicaid expansion will burden both federal and
state governments, and states are already struggling to afford the program.
WA VT NH
$509 $32 $72
MT ME
ND $68
$89 $41
OR
$443 MN
ID $321 MA $235
$155 SD WI NY
WY $60 $351 MI $1,884 RI $82
$47 $835 CT $229
NV IA PA
NE $188 $841 NJ $919
$339 $150 IL OH
UT IN $988 DE $72
$197 CO $1,336 $513 WV VA
CA $533 MD $515
$5,419 KS MO KY $166 $754
$246 $524 $508 DC $38
NC
TN $674 $1,084
AZ
NM OK AR Estimated State
$851 $389 SC
$306 $330 $523 Costs for Medicaid
MS
$471 AL GA Expansion, 2014-
$425 $1,314 2020 (millions)
TX
$4,229 LA
$30–$99
AK $609
$100–$499
$71
$500–$999
U.S. total: FL $1,000–$1,999
HI $65 $33.48 billion $2,439 $2,000–$5,500
Sources: Heritage Foundation calculations based on data from the Centers for Medicare
and Medicaid Services and the Kaiser Family Foundation’s statehealthfacts.org. Obamacare in Pictures heritage.org

9. Did Obamacare slow private-sector recovery?
Between the recession’s Month-to-Month Net Change in Private-Sector Jobs
low point in January BEFORE OBAMACARE
2009 and April 2010, +600,000 Monthly improvement
net private-sector job in job-growth rates:
growth improved at a +400,000 +67,000 jobs/month
rate of 67,000 jobs per +200,000
month. After Obama
signed his health care 0
legislation into law at
the end of March 2010, –200,000
the improvement stalled. AFTER OBAMACARE
Over the next two years –400,000 Monthly improvement
in job-growth rates:
private-sector job –600,000 +4,600 jobs/month
growth improved at a
rate of just 4,600 jobs –800,000
Trend
per month. Actual
–1,000,000
Jan. Jan. Jan. Jan.
2009 2010 2011 2012
Source: Heritage Foundation calculations based on data from the U.S. Department
of Labor, Bureau of Labor Statistics, Establishment Survey/Haver Analytics. Obamacare in Pictures heritage.org

10. Taxed Enough Already? Just wait until
Obamacare kicks in
To pay for generous subsidies to purchase health insurance, a huge expansion of
Medicaid, and other new spending, Obamacare raises taxes and adds 17 new taxes or
penalties that will affect all Americans.
$100 million Excise tax on “Cadillac”
employer health plans
Total Annual Costs
$80 of Obamacare Individual and Employer
Taxes, 2010–2019: Mandate penalties
$502 BILLION Health insurance premium tax
$60
Increase in Medicare Hospital
Insurance (HI) tax and extension
to investment income for
$40 high-income earners
Excise tax on medical devices
$20
New restrictions on HSA, FSA plans
Fee on pharmaceutical companies
$0 Revenue from 8 other taxes
2010 2011 2012 2013 2014 2015 2016 2017 2018 2019
Source: Heritage Foundation calculations based on data from
the Joint Committee on Taxation, March 2010 report. Obamacare in Pictures heritage.org

11. Obamacare’s bundle of budget gimmicks
+$400
When billion … but after accounting for these budget
Obamacare gimmicks, the health law actually adds
was enacted, $698 billion to the deficit.
its proponents
said it would +$208
reduce the billion
deficit by $143 +$115
billion in its billion +$70
first decade … billion +$29 +$19
billion billion
Double- Unpaid-for Unaccounted- Revenue Double- Unrelated
counted “doc fix” for cost of from the counted student
Medicare implementation failed savings loan
savings CLASS from Social savings
program Security
payroll
–$143 taxes
billion
Source: Senate Budget Committee. Obamacare in Pictures heritage.org

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