Economist admits misreading ACA's cost-control promise and calls for reforms

Dana P. Goldman, director of the USC Schaeffer Institute, recalls signing a 2009 letter with other economists urging Congress to pass the Affordable Care Act. He supported the bill because it promised to expand coverage and to bend the health-care cost curve.

At the time, a 2010 Institute of Medicine report estimated $750-$765 billion in wasteful spending, about 30 cents of every health-care dollar. More recent analyses suggest waste may be as high as $1.6 trillion annually, still roughly a third of total spending.

Goldman notes that many cost-control and financing provisions in the ACA were later stripped or watered down by bipartisan legislation. The Independent Payment Advisory Board, intended to trigger automatic Medicare cuts if spending exceeded targets, was repealed in 2018.

Reflecting on these outcomes, he now regrets backing the original cost-containment promise and argues that fixing the ACA will require a renewed focus on affordability and stronger mechanisms to curb wasteful spending.