“Obamacare? Expensive?” says a photo-quotation mashup that a reader sent us on Facebook.
Beneath a photo of President George W. Bush making a face, the caption reads, “Bush’s Medicare D was far more expensive than the Affordable Care Act, and, unlike the ACA, was never budgeted.”
The Facebook-shared image is unattributed, but its caption tracks word-for-word with an Oct. 18, 2013, tweet and blog post by writer and pundit Andrew Sullivan.
Sullivan’s post doesn’t elaborate on Part D — Medicare’s prescription drug program, created in 2003.
But others have made similar comparisons.
Economist Paul Krugman wrote in a Dec. 29, 2009, New York Times blog entry about “the trouble Republicans have been having as they try to explain why, if they consider the fully-funded, deficit-reducing Democratic health care reform unaffordable, they voted for the completely unfunded Medicare drug benefit six years ago.”
Did Congress “budget” enough for the promises made under the Obamacare law but not those in Medicare Part D — and was Part D “far more expensive”?
Via e-mail, Krugman told us, “Not sure about what ‘never budgeted’ means, or exactly how ‘more expensive’ is defined. But the ACA designated cost savings and revenues to pay for the outlays; Part D just specified outlays with no offset.”
Alan Auerbach, an economist at the University of California-Berkeley and research associate at the National Bureau of Economic Research (a nonprofit, nonpartisan organization), told us by email, “It’s certainly true that the ACA was funded while Medicare Part D was not.”
Part D is an optional insurance program for prescription drugs for senior citizens on Medicare. Private insurance companies offer a variety of plans subsidized by the government, and beneficiaries get to choose the plan that’s best for them. Obamacare requires Americans to buy health insurance, extends Medicare to cover more people and makes numerous other changes.