Is the battle over our health care law over? Not by a long shot. The new report by Richard Foster, Medicare’s chief actuary, will surely reignite resistance to the bill. From the beginning, many Americans questioned President Obama’s central (read: impossible) premise: that he could extend health care coverage to 30 million more people while at the same time reducing medical outlays. The president’s insistence that he could achieve this magic undermined his credibility and demolished his approval ratings. Now we know for sure it isn’t true.
Mr. Foster reports that “national health expenditures under the health reform act would increase by a total of $311 billion” between 2010 and 2019 compared to the level of outlays without the bill. This is in itself not a huge number, given the enormity of the industry. However, this projection belies the president’s promise upon signing the bill -- that it would “bring down health care costs.” Further, Mr. Foster assumes that Congress will follow through with the proposed cuts in Medicare contained in the legislation, a proposition he describes as “unrealistic” and which most analysts deem unlikely given that lowered reimbursements could bankrupt nursing homes and hospitals.
Further fuel for disputing the promises of Obama’s health care bill emerges from an effort underway in the Senate to allow states to cap insurance premiums. Why should Congress pave the way for state regulation? Because a close reading of the health care bill will convince any level-headed person that insurance rates around the country are going sky-high. And, that will be bad for the Obama team that forced it through.
Proof of that particular pudding is found in states like New York and Massachusetts which have adopted some of Obamacare’s central tenets—such as coverage of pre-existing conditions. As a direct result, insurance rates in those states have gone through the roof. In New York, which vies with the Bay State for the highest insurance rates in the country, the number of individuals signing up for policies through HMOs sank from 128,000 in 2001 to about 31,000. This fall-out of healthy people necessary to subsidize outlays for those who are sick has led to a ever-worsening spiral. Many have predicted the same will occur under the federal mandate. The modest fees contained in the Health care law will not persuade a healthy young person from opting out of buying much more expensive coverage. Especially since, if they become sick, they can jump right back into the pool. Just as in New York, the system will falter without the pay-in from those not needing medical care. The situation in Massachusetts, as has been widely reported, is equally dire. Insurance premiums have soared, costs such as emergency room outlays have not dropped, and the state faces monstrous budget issues.
As evidence piles up that the health care bill will cost more than expected and will likely lead to unmanageable budget deficits at both the national and state level, what can be done? Already there are legal challenges. More than a dozen state attorneys general have filed suit claiming that the bill is unconstitutional. This protest will play out in the courts, but it appears unlikely to pay off. The notion that the government is not allowed to impose a fine on Americans who do not sign up for insurance seems weak; time will tell.
The most optimistic scenario is that in November voters decide that the Democrats have over-reached, and elect a more balanced Congress. Moving forward, a legislature better grounded in fiscal realism may decide that the bill is too ambitious and scale it back. Americans understand that we need to address our mounting entitlements issues. We are also sympathetic to the need to provide health care to all of our citizens. However, as the country becomes aware of the deceptive promises behind this bill, surely we will demand a significant overhaul. As we crawl out of a deep recession, our priorities should be to put millions back to work, not to create a social revolution. We can’t afford it.
This should be the sole focus of Republicans going forward. On health care, they have a winning platform. As the Obama administration tries to jam through a bewildering number of other giant programs – financial industry reform, cap and trade, immigration reform among them – Republicans must keep their eye on the ball, and not get distracted. Obama is trying to make history; he also wants to turn attention away from a still-unpopular bill. Americans do not like the health care legislation, and only the Republicans will get it changed. That’s the promise, and this is one that can be kept.
Liz Peek is a financial, political and social columnist. She is a frequent contributor to the Fox Forum. For more, visit LizPeek.com.
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