At a time of record deficits and a $12 trillion national debt, President Obama and the Democrats are pulling out all of the stops to pass a plan that dramatically expands government powers over health care.

According to a Nov. 23 Rasmussen survey, only 38 percent of Americans polled now support the Democrats' health reform plans, and 56 percent oppose them. That's unlikely to change as people learn more about what's in the 2,074-page bill.

Here are the top 10 reasons why:

1. Exploding costs: The actual 10-year cost of the legislation, once the spending begins, will be at least $2.5 trillion. Budget expert James Capretta estimates that the bill will lead to a $4.9 trillion spending increase over 20 years.

2. Losing your current coverage: At least five million people would lose their current employment-based coverage, and millions of seniors would lose their private Medicare Advantage coverage as the program is cut by $118 billion.

3. Job-killing taxes on employers: Employers will be faced with new penalties, taxes, and regulatory hassles. One example: Firms with more than 50 workers that don't offer insurance would have to pay a penalty of $750 for each full-time worker if any of their workers qualify for subsidized health insurance.

4. Budgetary gimmick — tax now, spend later: The bill starts collecting new and higher taxes next year, but the coverage benefits don't start until 2014 or later. Sending collections agents out four years before benefits begin is one of the budget gimmicks that Senate Majority Leader Harry Reid, D-Nev., used so he can claim that the cost of his bill is under $900 billion, as the president has demanded.

5. Increasing future health care spending: Despite the president's promise to lower the cost curve, the nonpartisan Congressional Budget Office says that the federal commitment to health spending "would be about $160 billion higher under the legislation than under current law."

6. Cost-shifting gimmick: Reid's bill on paper would slash Medicare payments to doctors by 23 percent after one year. This won't actually happen because Congress always blinks to restore the payments, adding another $210 billion to the actual cost of the bill.

7. Taxpayer-financed abortion: The public does not support using federal taxpayer dollars to finance abortions. Yet the Reid bill would require some plans to cover abortions, allow the newly created government insurance plan to cover abortions, and allow companies that receive federal funds to offer policies that include abortion coverage.

8. Twenty-four million uninsured — still. The bill leaves 24 million people without insurance by 2019, not even close to the promised goal of universal coverage. This will be a serious problem for hospitals that still will be treating uninsured people, including illegal immigrants, but which will be facing payment cuts of $43 billion.

9. Scarce subsidies: Despite spending $338 billion on new subsidies through the health insurance exchange, just 19 million people will qualify for help with their costs — even though everyone is required to have government-defined health insurance or pay a penalty.

10. Mandates cause higher premiums and more uninsured: Individuals will be required to purchase health insurance, and younger workers will be forced to pay higher premiums to subsidize older Americans. This will create a death spiral for health insurance, as young people opt to pay penalties rather than expensive premiums, and premiums soar higher and higher for those left in the insurance pool.

This is one Christmas present the American people hope they don't receive.

Published in The Washington Examiner, November 25, 2009.

At a time of record deficits and a $12 trillion national debt, President Obama and the Democrats are pulling out all of the stops to pass a plan that dramatically expands government powers over health care.

According to a Nov. 23 Rasmussen survey, only 38 percent of Americans polled now support the Democrats' health reform plans, and 56 percent oppose them. That's unlikely to change as people learn more about what's in the 2,074-page bill.

Here are the top 10 reasons why:

1. Exploding costs: The actual 10-year cost of the legislation, once the spending begins, will be at least $2.5 trillion. Budget expert James Capretta estimates that the bill will lead to a $4.9 trillion spending increase over 20 years.

2. Losing your current coverage: At least five million people would lose their current employment-based coverage, and millions of seniors would lose their private Medicare Advantage coverage as the program is cut by $118 billion.

3. Job-killing taxes on employers: Employers will be faced with new penalties, taxes, and regulatory hassles. One example: Firms with more than 50 workers that don't offer insurance would have to pay a penalty of $750 for each full-time worker if any of their workers qualify for subsidized health insurance.

4. Budgetary gimmick — tax now, spend later: The bill starts collecting new and higher taxes next year, but the coverage benefits don't start until 2014 or later. Sending collections agents out four years before benefits begin is one of the budget gimmicks that Senate Majority Leader Harry Reid, D-Nev., used so he can claim that the cost of his bill is under $900 billion, as the president has demanded.

5. Increasing future health care spending: Despite the president's promise to lower the cost curve, the nonpartisan Congressional Budget Office says that the federal commitment to health spending "would be about $160 billion higher under the legislation than under current law."

6. Cost-shifting gimmick: Reid's bill on paper would slash Medicare payments to doctors by 23 percent after one year. This won't actually happen because Congress always blinks to restore the payments, adding another $210 billion to the actual cost of the bill.

7. Taxpayer-financed abortion: The public does not support using federal taxpayer dollars to finance abortions. Yet the Reid bill would require some plans to cover abortions, allow the newly created government insurance plan to cover abortions, and allow companies that receive federal funds to offer policies that include abortion coverage.

8. Twenty-four million uninsured — still. The bill leaves 24 million people without insurance by 2019, not even close to the promised goal of universal coverage. This will be a serious problem for hospitals that still will be treating uninsured people, including illegal immigrants, but which will be facing payment cuts of $43 billion.

9. Scarce subsidies: Despite spending $338 billion on new subsidies through the health insurance exchange, just 19 million people will qualify for help with their costs — even though everyone is required to have government-defined health insurance or pay a penalty.

10. Mandates cause higher premiums and more uninsured: Individuals will be required to purchase health insurance, and younger workers will be forced to pay higher premiums to subsidize older Americans. This will create a death spiral for health insurance, as young people opt to pay penalties rather than expensive premiums, and premiums soar higher and higher for those left in the insurance pool.

This is one Christmas present the American people hope they don't receive.

Published in The Washington Examiner, November 25, 2009.