Sen. Ben Nelson is defending his vote to pass the Senate’s health-care legislation in a new television ad in his home state of Nebraska, but the points he makes show he either needs to force Congress to change the legislation to match his claims or rethink his support for final passage.
In an attempt to quell a firestorm of opposition to his casting the crucial 60th vote for the Senate bill, Nelson says, “With all the distortions about health-care reform, I want you to hear directly from me.”
He argues that the bill “lowers costs for families and small business, protects Medicare, finally guarantees coverage for preexisting conditions, and reduces the deficit. And it’s not run by the government.” Nelson adds, “I’m convinced this is right for Nebraska.”
Who wouldn’t vote for such a bill? If only Nelson’s comments were accurate.
Nelson wisely doesn’t mention the controversial “Cornhusker Kickback” that granted federal funding for his state’s Medicaid expansion, or the abortion language that the U.S. Conference of Catholic Bishops says does not guard against federal funding of abortion. But there are serious problems with the claims the senator does make.
Independent analysts show that health costs would continue to rise, access to care could be jeopardized for seniors, deficit reduction is an illusion created by budget gimmicks, and the preexisting-condition clause would come at the price of big-government control.
Let’s take Nelson’s first claim — that the bill “lowers costs for families and small business.”
The independent, nonpartisan Congressional Budget Office (CBO) says insurance costs for families and small businesses would continue their rapid rise.
Families purchasing insurance in the individual health-insurance market would be hardest hit, with premiums $2,100 higher than if Congress did nothing. A family would pay $15,200 for health insurance by 2016 if the Senate bill were enacted, compared with only $13,100 if the bill were not enacted, the CBO says.
Premiums for a family receiving coverage though a small business would increase to $19,200, on average, by 2016 — about the same as without reform.
In addition, most companies would face an avalanche of new reporting requirements and potential penalties and fines. Health reform will add to, not lighten, the regulatory and financial burden on companies that had hoped to get relief from rising health costs.
The National Federation of Independent Business came out strongly against the Senate bill, saying it “is short on savings and long on costs, is the wrong reform, at the wrong time and will increase health-care costs and the cost of doing business.”
Bill proponents argue that some people and businesses would see lower premiums because they would qualify for subsidies. But this is just another Washington budgetary game. Subsidies aren’t free. Taxpayers always pay. And only about 20 million Americans would qualify for the premium subsidies, even though everyone would be required to carry government-approved health insurance.
Senator Nelson says that the bill “protects Medicare.” Even though they are being told otherwise, seniors would pay a high price for reform. The Senate bill would reduce Medicare spending by $471 billion over the coming decade. Rather than reinvesting that money to improve and modernize the program, the money instead would be diverted to create a new entitlement program to subsidize health insurance for working Americans.
Cuts this deep would cause many providers to stop seeing Medicare patients, or perhaps even to close their doors. Medicare’s chief actuary, Richard Foster, says that doctors, hospitals, and other providers “could find it difficult to remain profitable and, absent legislative intervention, might end their participation in the Medicare program (possibly jeopardizing access to care for beneficiaries).”
And the claim that bill lowers the deficit means that, in addition to cutting Medicare by half a trillion dollars, the Senate would also raise half a trillion in new taxes — during a recession.
Only a series of accounting gimmicks — such as implementing benefits beginning in 2014 but raising taxes starting in 2010, and double-counting Medicare savings — allowed Senate majority leader Harry Reid to get a CBO cost estimate that pretends to add “not one dime” to the deficit.
Medicare actuary Foster found that the Senate bill would bend the cost curve up, not down, and that the new taxes on drugs, devices, and health-insurance plans would increase prices and health-insurance costs for consumers.
Guaranteeing coverage for preexisting conditions unfortunately would mean federalizing health-insurance regulations, which challenges Senator Nelson’s claim that health care would not be “run by government.”
Senator Reid’s bill contains more than 2,500 references to powers and responsibilities of the secretary of health and human services. It would centralize Washington’s control over health spending and coverage. The federal government would regulate the health-insurance market (until now a purview of the states) and would require virtually all Americans to have the health insurance it specifies. Washington would also dictate how much of their income people had to pay for health insurance, and it would set up a system of federal fines and penalties for those who didn’t comply.
Given all this, Senator Nelson may want to rethink his support for the legislation.
Published in National Review Online: Critical Condition, Jan. 4, 2010.