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State and local governments will pay $10.6 billion more through 2019 under ObamaCare than they would have under existing law. Private spending on health care will increase even more, $77.2 billion through 2019. These numbers come directly from the Centers for Medicare and Medicaid Actuary’s office in a recent paper published in the journal Health Affairs.

Assuming the law does everything it says, Medicare spending will decrease $86.4 billion, but that decrease will be more than offset by $93.8 billion more spent on Medicaid and CHIP. But few people really expect Congress to stick to the scheduled reductions in Medicare payments to doctors. A 21 percent reduction has already been delayed from June to November.

President Obama claimed at his press conference last Friday that he expected these increases all along. He might have given more clues of his expectations while selling the law — the Associated Press fact-checked his press conference assertions.

While the entire nation pays more for care, consumers will pay less directly to their doctors or other care providers. Instead, more payments will channel through insurers. So the single biggest problem in health care — having somebody else pay the bills — will continue to worsen.

Next week I’ll share some of the ways states are fighting back.