The primary coverage expansions begin next year, but many pieces of the ACA--including those that aim at reforming the way health care is delivered, not just how health insurance markets work--have already begun.
The good news has been health sector-wide, with health care cost and price growth slowing across the board. The fact that Medicare is turning out to be cheaper than expected is part of that slowdown; this is on top of the slowing growth in Medicare costs required by the ACA. In fact, every time the CBO comes out with a new budget picture (twice a year), they have to keep revising downwards their estimates of how much Medicare will cost over the next few years.
If you compare different budget outlooks they've released at different times, you'll see how that's changed. For instance, if you compare the January 2010 numbers (pre-Obamacare) to the August 2010 numbers you can see them incorporate the ACA's Medicare changes. Medicare got just over $500 billion cheaper over the 2010-2020 interval in the period between those estimates being released. But if you compare those January 2010 estimates to this year's February 2013 estimates (which now obviously include the actual Medicare spending numbers for 2010-2012), you'll see that Medicare is now $999 billion cheaper over the interval.
That is to say, Medicare got about a trillion dollars cheaper this decade over the past three years and only about half of that is directly attributable to legislative directives made by the ACA. Now, the component that's indirectly attributable to the ACA due to its health care delivery reforms is open to debate; I'm optimistic.
Says the guy who had to go to a GOP senator's press release to find imaginary 75-year numbers? Please.
The NYTimes articles aren't from their editorial page, it's from their reporting on what the National Health Expenditures Accounts data are showing. Actual numbers tracking what our health sector has been spending.
You know what, I apologize, you aren't a BS artist. You really believe this stuff don't you? You honestly believe this won't be a complete and utter disaster. So, you're not a BS artist you are something either far worse or far sadder.