Two Tracks of ObamaCare

Obamacare is moving forward on two tracks. The one we hear most about is the glitzy and expensive public-relations show, with President Obama in the center ring tapping into the seemingly unlimited resources of the federal government to produce campaign-style propaganda to sell the massively unpopular health overhaul.

Track two is the regulatory process, where Obamacare is sinking its roots deeper and deeper into the bureaucracy and the health sector. This is below the radar of most Americans, but the implementation rules are beginning to frighten many industry groups that thought their seat at the table would inoculate them against the wrath of the regulators.

The Centers for Medicare and Medicaid Services just issued a 1,250-page proposed rule on Medicare payment policies for 2011. That follows a 121-page proposed rule limiting how companies can grandfather their employee health-insurance plans to avoid even more onerous federal mandates. The IRS has invited public comment on how to carry out the rules requiring businesses to report all vendor payments of more than $600 on 1099 forms. And the administration and insurance commissioners are wrangling over the definition of the “medical loss ratio,” which could put many insurance companies out of business if it is defined too narrowly.

While this avalanche of rules and regulations pours forth from the bureaucracy, the business community is rethinking its support for Obamacare. The Business Roundtable is going public with buyer’s remorse after helping to pass health-care reform: Business Roundtable chairman Ivan G. Seidenberg gave a speech to the National Press Club on concerns about the negative effects of current government policies, especially the debt and deficit.

The American people also are more focused than ever on the cost of this massive entitlement. Four out of five Americans say that the reckless spending of this Congress and administration is an “extremely serious” or “very serious” threat to the U.S.

A report out this week shows that we are right to be very, very afraid. The Congressional Budget Office has issued its long-term budget outlook, and it should send chills up everyone’s spine. Under the most realistic forecast of likely congressional actions, CBO says the nation’s debt will swiftly be pushed to “unsustainable levels.” And that takes into account “all the effects of the recently enacted health care legislation.” So much for health reform helping to reduce the deficit. In fact, Obamacare will cost many times the estimates that Congress tortured out of CBO.

Rep. Paul Ryan makes a credible and forceful case in a speech at the U.S. Chamber of Commerce, saying that the new entitlements created under Obamacare “will rival the size and liabilities of Medicare in the very near future.” Ryan, the ranking Republican on the House Budget Committee, will become ever more important going forward with his visionary “Roadmap for America’s Future.” It is a detailed plan to put the nation’s entitlement programs on a sustainable path, boost economic growth, lower taxes, and increase the income of working Americans.

But despite the onerous rules and fear over the burgeoning debt, the White House thinks it is winning the PR battle. Kaiser Health has a new survey on public opinion about Obamacare. It says that those with “favorable views of the new law increased seven percentage points over the past month to 48 percent, compared to 41 percent who have ‘generally unfavorable’ views.” Reporters concluded this means that people are warming to Obamacare. But the biggest reason that the needle has moved is that a slightly larger percentage of people think the overhaul law is not going to affect them or their care.

But it will, of course, affect them . . . as health costs go up faster than they did before . . . as people start to find out that their employers are rethinking whether they can continue to offer health insurance . . . as seniors find it harder to find a doctor to see them . . . as the costs of the individual mandate start to sink in . . .

And the individual mandate is, by the way, the single most unpopular provision in Obamacare, with only 14 percent of those surveyed by Kaiser thinking this is a very good idea. How on earth can you impose a mandate on everyone to purchase very expensive health insurance with this level of public support? You can’t. This will have to be changed. The American people don’t want this. Freedom and liberty must prevail. Substance will triumph over PR every time.

Published in National Review Online: Critical Condition, July 2, 2010.

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Obamacare is moving forward on two tracks. The one we hear most about is the glitzy and expensive public-relations show, with President Obama in the center ring tapping into the seemingly unlimited resources of the federal government to produce campaign-style propaganda to sell the massively unpopular health overhaul.

Track two is the regulatory process, where Obamacare is sinking its roots deeper and deeper into the bureaucracy and the health sector. This is below the radar of most Americans, but the implementation rules are beginning to frighten many industry groups that thought their seat at the table would inoculate them against the wrath of the regulators.

The Centers for Medicare and Medicaid Services just issued a 1,250-page proposed rule on Medicare payment policies for 2011. That follows a 121-page proposed rule limiting how companies can grandfather their employee health-insurance plans to avoid even more onerous federal mandates. The IRS has invited public comment on how to carry out the rules requiring businesses to report all vendor payments of more than $600 on 1099 forms. And the administration and insurance commissioners are wrangling over the definition of the “medical loss ratio,” which could put many insurance companies out of business if it is defined too narrowly.

While this avalanche of rules and regulations pours forth from the bureaucracy, the business community is rethinking its support for Obamacare. The Business Roundtable is going public with buyer’s remorse after helping to pass health-care reform: Business Roundtable chairman Ivan G. Seidenberg gave a speech to the National Press Club on concerns about the negative effects of current government policies, especially the debt and deficit.

The American people also are more focused than ever on the cost of this massive entitlement. Four out of five Americans say that the reckless spending of this Congress and administration is an “extremely serious” or “very serious” threat to the U.S.

A report out this week shows that we are right to be very, very afraid. The Congressional Budget Office has issued its long-term budget outlook, and it should send chills up everyone’s spine. Under the most realistic forecast of likely congressional actions, CBO says the nation’s debt will swiftly be pushed to “unsustainable levels.” And that takes into account “all the effects of the recently enacted health care legislation.” So much for health reform helping to reduce the deficit. In fact, Obamacare will cost many times the estimates that Congress tortured out of CBO.

Rep. Paul Ryan makes a credible and forceful case in a speech at the U.S. Chamber of Commerce, saying that the new entitlements created under Obamacare “will rival the size and liabilities of Medicare in the very near future.” Ryan, the ranking Republican on the House Budget Committee, will become ever more important going forward with his visionary “Roadmap for America’s Future.” It is a detailed plan to put the nation’s entitlement programs on a sustainable path, boost economic growth, lower taxes, and increase the income of working Americans.

But despite the onerous rules and fear over the burgeoning debt, the White House thinks it is winning the PR battle. Kaiser Health has a new survey on public opinion about Obamacare. It says that those with “favorable views of the new law increased seven percentage points over the past month to 48 percent, compared to 41 percent who have ‘generally unfavorable’ views.” Reporters concluded this means that people are warming to Obamacare. But the biggest reason that the needle has moved is that a slightly larger percentage of people think the overhaul law is not going to affect them or their care.

But it will, of course, affect them . . . as health costs go up faster than they did before . . . as people start to find out that their employers are rethinking whether they can continue to offer health insurance . . . as seniors find it harder to find a doctor to see them . . . as the costs of the individual mandate start to sink in . . .

And the individual mandate is, by the way, the single most unpopular provision in Obamacare, with only 14 percent of those surveyed by Kaiser thinking this is a very good idea. How on earth can you impose a mandate on everyone to purchase very expensive health insurance with this level of public support? You can’t. This will have to be changed. The American people don’t want this. Freedom and liberty must prevail. Substance will triumph over PR every time.

Published in National Review Online: Critical Condition, July 2, 2010.

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About the author