Senators are in the midst of taking a series of career-killing votes to fulfill President Obama’s goal of getting a health overhaul bill — any bill — passed before Christmas.
Even as they walk the plank, many of them are telling constituents that the legislation is not that bad because they got special favors for their state. Or because Sen. Harry Reid was forced to drop the “public plan.” Or because the Congressional Budget Office says the bill is paid for (albeit with big tax increases and cuts to Medicare).
But a torrent of dangerous, collectivist provisions remains in the legislation, targeting Americans from coast to coast. Here are a dozen constituencies that will be gored, to whom senators will have to answer next time they go before the voters:
Seniors: Even though they are being told otherwise, seniors will pay the biggest price for reform. Half of the reason that Sen. Reid got a favorable cost estimate from CBO is because his bill cuts Medicare by $471 billion over the coming decade. An earlier report from the program’s chief actuary says cuts this deep would cause many providers to stop seeing Medicare patients or even to close their doors.
Everyone: The federal government would, for the first time, require every American to have health insurance. The government would stipulate what that mandatory insurance must cover and how much of their incomes people can afford to pay for it, and penalize them if they don’t comply. While some would be eligible for subsidies or waivers, most Americans would face tax penalties of $750 a year or 2 percent of their incomes, whichever is higher, to force compliance.
People buying their own insurance: The CBO says that families purchasing insurance in the individual market would not see a reduction, but rather an increase, in their premiums by $2,100 in the year 2016. That’s over and above the increases they already will be facing as health-insurance premiums continue to rise at about twice the rate of general inflation. A family would pay $15,200 for health insurance by 2016 if Sen. Reid’s bill passes, and $13,100 if it doesn’t. The CBO concluded that premiums in the individual market will be 10 to 13 percent higher in this market than if Congress did nothing.
People who work for small businesses: Those receiving health insurance through their employers will continue to see higher costs, with premiums for a family getting coverage though a small business increasing to $19,200 by 2016 — about the same pace as they would without reform.
People who work for large companies: The White House boasted that under the Senate bill, premiums for employees of large firms would remain mostly unchanged. But that means they would continue to go up almost as fast as they have been, reaching $20,100 for a family and $7,300 for an individual by 2016.
All employers: Companies also face an avalanche of new reporting requirements, penalties, and potential fines. Firms face fines whether or not they provide health insurance if any of their workers get taxpayer-subsidized coverage. And with subsidies available for families earning up to $80,000 a year, the exposure is significant.
Young people: Most haven’t a clue that the federal government is about to slap them with a new mandate requiring them to purchase expensive health insurance. Studies show that they would likely pay premiums two or three times the amount they would normally be charged based upon their age and expected use of health services.
Patients: A new independent board will have the power to cut Medicare benefits, and its decisions can only be overruled by another act of Congress. Private plans are likely to follow its recommendations. Congress doesn’t want to be held directly responsible for the rationing decisions the board inevitably will make, but the voters will quickly figure it out.
Doctors: Starting in March, doctors, hospitals, nursing homes, and others who treat Medicare patients will face a 21 percent cut in their Medicare payments. This means doctors face a permanent lobbying campaign just to keep payments from being slashed.
Health-sector companies: While few people have sympathy for health-insurance companies and drug plans, they, too, will also face onerous new federal regulations and higher taxes — costs that can only be passed on to consumers in the form of reduced benefits or higher premium costs.
States: While about 10 states receive special favors (as in, pay-offs) in the Reid bill, the others will wind up with higher costs for their already budget-busting Medicaid programs. Another 15 million people will be added to the rolls of this program, which was originally intended for low-income people.
Budget watchers: The Reid bill would increase federal spending by $2.5 trillion in the first decade it goes into effect, but it is paid for by a combination of job-killing taxes and unrealistic cuts to Medicare. No one — including the CBO — believes these “pay-fors” are sustainable. As a result, the health overhaul bill inevitably will swell the federal budget deficit.
Health-insurance costs are likely to begin soaring right away, most of the new subsidies for insurance don’t kick in until 2014, higher taxes go into effect almost immediately, and seniors will find it harder and harder to find a doctor to see them and to get the care they need.
Had enough? Is this really something senators want to try to sell to the voters?
Published in National Review Online: Critical Condition, Dec. 20, 2009.