The projected cost of the subsidies provided by the Affordable Care Act to low- and moderate-income people to make health insurance affordable has escalated 24 percent since the law was enacted in 2010, and is likely to rise even further.  That is the estimation of Douglas Holtz-Eakin, former director of the Congressional Budget Office (CBO) and a persistent critic of the health care reform law.

"The ACA subsidies are the most substantial new entitlement program in the United States since the creation of Medicare and Medicaid in 1965," Holtz-Eakin wrote in a four-page paper for the American Action Forum, a center-right group of which he is president. The paper, The Growing Budget Cost of Insurance Subsidies in the Affordable Care Act, was released Oct. 28.

Holtz-Eakin noted that CBO has already revised its cost estimate for the subsidies upwards twice, to $574 billion for fiscal years 2012 to 2019 in its most recent estimate in June. "Given the risks of faster than expected health care inflation, slow growth in incomes, and the potential for less employer-sponsored insurance in the future, there is good reason to anticipate that the cost could rise further yet," he concluded.