" Then there's the very real uncertainty surrounding the ACA's ultimate cost — illustrated by the impact of Medicare alone, which the Office of the Chief Actuary of Medicare estimates could cost cost $10 trillion more than claimed."
States that offer extremely generous health benefits for government retirees, and which have little to no pre-funding for those benefits, could choose to move their retirees into the Affordable Care Act's new exchanges.
.......The impact doesn't end with a collection of states relieved to have better balance sheets and financial positions. What does it mean for taxpayers?
It's not as if taxpayers in those states will suddenly be free of the financial burden of providing retiree health care benefits. A significant portion of the tab would be passed on to the federal government. But the overall tax burden will shift, and in ways that Americans in other more fiscally responsible states may not appreciate. Since the exchanges are federally sponsored, much of their cost will ultimately be shared among all the nation's taxpayers. So residents in those states who push retirees onto the exchanges will get to off-load some of their financial burden to the rest of us.
....So the impact of the insurance exchanges could be good news for some state and local governments and residents, while not so good news for the rest of us.
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