Archive for October, 2009
Among the fallacies in Speaker Nancy Pelosi’s health care bill is the pretense that bureaucrats are smarter than the rest of us. An unelected bureaucrat would be given czar-like control over our lives, our health, and our pocketbooks. Even super powers.
This new all-powerful “health choices commissioner” would be entrusted with more power than most superheroes. The laundry list of that special power is proof that it’s a government takeover of health care.
This presidential appointee will both control the new government-run insurance plan AND decide how private insurance companies are to operate, by creating the standards for their coverage and enforcing compliance. Likewise, employer-run health plans would answer to super-czar. (more…)
Members of Congress too often just forget: Medicaid is a welfare program. It is also one of the most poorly performing of all the federal welfare programs. Instead of doing anything innovative or imaginative to fix it, Members of Congress are intent on ramping up Medicaid spending and expanding it. Many currently uninsured Americans are going to be in for a rude surprise when they discover that they won’t be enrolling in superior private health plans, but rather Medicaid, courtesy of the U.S. Congress.
The Chief Actuary at the Centers for Medicare and Medicaid Services (CMS) provides insightful data about how the cost of health care will be shifted among the different sources of funding. In an analysis of the House bill (H.R. 3200), the earlier version of the most recent incarnation ( H.R. 3962) , CMS shows that Medicaid spending would surpass Medicare spending, and grow nearly twice as fast as spending in employer sponsored insurance. By 2019, one in five health care dollars will be spent through Medicaid. More than half of all health spending would flow through Medicare, Medicaid, or other public spending in 2019. See chart below. (more…)
Very soon, the House of Representatives is expected to vote on legislation ( H.R. 3962). That 1990 page bill, if enacted, will have an unprecedented impact on our economy, the federal budget, and the lives of all Americans. You can read that bill right here.
Here is a crucial question: Do members of Congress have any idea how this massive legislation will really affect us? Does anyone in the Speaker’s Office or in the Congressional leadership really know how moving the various parts of health care legislation will interact with one another and impact our care, our spending, our pocketbooks?
Straight talk and honesty are at a premium. Taxpayers can be sure of the honesty of one top level public official: The Chief Actuary at the Centers for Medicare and Medicaid Services (CMS). He does not know the answers to these questions, and he told us that he doesn’t.
The Stakes. Consider that national health care spending will represent 17.9 percent of our entire economy next year. By 2019, under current law, CMS forecasts we will spend $4.67 trillion. (more…)
Galen Institute President Grace Marie-Turner in a new blog questions how President Barack Obama can back the new House health care bill when it breaks many of the promises he and his Administration have been making for months.
Turner details how the legislation would break the following reform pledges:
– The health reform bill would lower health spending. In fact, the House bill pushes the federal cost curve up, not down, by costing $1.05 trillion in the first 10 years. And that’s not even addressing the “doc fix” issue that will cost $245 billion.
– Middle-class families would not be taxed. There are a wide buffet of tax increases in the House bill that violate the president’s pledge. And add to that the $33 billion individuals would pay because they didn’t want to buy expensive, federally mandated health coverage, according to the Congressional Budget Office.
– If you like your health insurance, you can keep it. A coalition of major business groups already said the House bill jeopardizes the health care insurance that employers provide to 160 million workers. Additionally, previous research has shown 88.1 million Americans would be shifted out of their employer-based health coverage if a public plan was introduced.
“The 400,000-word House health reform bill is absolutely astonishing in the level of government intrusion it would shove into the lives of every American, every business, and every health care professional. I won’t bore you here with the legislative jargon, but pick a page, any page, and you will see what I mean,” Turner writes.
Any hope for a health reform bill that would garner wide bipartisan support in Congress and accolades from the health care industries has been torpedoed by the latest House bill, HR 3962, according to respected health economist James Capretta, with the Ethics and Public Policy Center.
In the National Review’s Critical Condition, Capretta lays out the budget gimmicks and taxes that are central to the new legislation. “To sum it up, the House bill is nothing but a massive, uncontrolled federal entitlement expansion — at a time when central, looming threat to the nation’s long-term prosperity is the unaffordable health-care entitlements already on the federal books,” he writes.
Among the mentionable items in the bill that all Americans should be aware of:
– To say that the new House bill costs less, the new version lacks any repeal of the so-called “sustainable growth rate,” or payment formula for physicians treating Medicare patients. It’s scheduled to cut doctors’ fees by 20 percent next year. As Capretta notes, “Everyone knows it must be fixed, but the full, 10-year costs of repeal approaches $250 billion.” The Democrats’ solution is to repeal the cuts in a separate bill that doesn’t count toward the overall health reform tab.
– The bill massively expands Medicaid, the federal health program for the poor. Raising the eligibility limit to people making 150 above the federal poverty line will swell the program to 50 million Americans by 2019 (currently there are 35 million in Medicaid). This program already is costing most states billions of dollars and causing budget deficits. The Congressional Budget Office says the House bill increases Medicaid spending on an annual 8 percent level indefinitely.
– Payment-rate reductions in Medicaid and Medicare are not the health care efficiencies that Congress had promised. This will shift more health-care costs onto the middle class who are enrolled in private coverage while failing to slow down increasing health costs.
“There’s much else in this bill that would do great damage to the health sector and the American economy,” Capretta writes. “Heavy payroll taxes that will reduce low-wage employment. Mandates on employers that will drive up costs and reduce wages. Intrusive federal bureaucracies that will come between patients and doctors. They can do a lot of damage in nearly 2,000 pages.”
The House health bill (H.R. 3962) creates a new minimum federal standard benefit package that will eventually apply to nearly all health plans, and establishes a new “Health Benefits Advisory Committee”. The Committee, housed within HHS, will make detailed recommendations, which the Secretary of HHS would then impose on all private insurers and employers through regulation.
HHS would have broad, permanent authority to continually update and expand the federal benefit requirements for all private health insurance and could regulate not only specific items and services than must be covered but also the minimum frequency or duration of a required covered service and the maximum allowable patient cost sharing.
All existing employment-based health insurance coverage would have to be modified or replaced to meet the new federal benefit package by 2018. Starting in 2013, all new individual or employment-based coverage would have to conform to the federal minimum benefit rules. (more…)
The new House health care bill (H.R. 3962) unveiled by Speaker Nancy Pelosi (D-CA) yesterday clocks in at 1,990 pages and about 400,000 words. As written, the bill purports to cost only $1.05 trillion over the first ten years and is paid for by over $700 billion in tax increases and cuts to Medicare Advantage and Medicare prescription drug payments. But as troubling as those numbers are, the scariest thing about the bill is the solid foundation it lays for a complete government take over of the health care sector of our economy.
The Washington Post describes the bill as “creating an expensive new entitlement program (subsidies to purchase health insurance) and dramatically expanding an existing one (Medicaid).” This is true by itself, but the Post later dismissively adds: “If you’ve noticed that we haven’t talked about the public option in the House bill, that’s not an oversight. For all the fury over the issue, it doesn’t matter that much; the CBO estimates that the government-run plan would actually have slightly higher premiums.” This is a breathtakingly naive statement by the Post and demonstrates that they have not yet fully grasped how all the different elements of the bill are designed to interact to produce President Barack Obama’s desired outcome. (more…)
The new House bill, H.R. 3962, builds on its predecessor from July in increasing the financial burden on low-income and moderate-income Americans.
The Individual Mandate. Like the earlier version, this bill requires the uninsured to pay an extra income tax — 2.5% of adjusted gross income above the filing threshold, capped at the national average premium. Paying that tax wouldn’t “buy” anything; those paying this tax would remain uninsured. However, in a bid to decrease the government’s costs, this bill contains higher premiums that low- and moderate-income individuals and families would have to pay for health coverage to avoid the tax. Those premiums would increase rapidly with income, amounting to an additional tax on those with incomes below 4 times the federal poverty level (equivalent to about $88,000 per year for a family of four) ranging from 1.5% to 12%. This tax on low and moderate income Americans would be in addition to a “surtax” on higher incomes ranging up to 5.4%. (more…)
Just in time for Halloween, Speaker Nancy Pelosi (D-CA) and House Democrats gave birth to a giant, 1,990-page spawn of health care reform, lovingly titled the Affordable Health Care for America Act. Lurking within, though, are 13 new tax hikes (yes, 13) that will strike at the heart of the American people.
Americans for Tax Reform laid them out in detail; The Foundry includes them below:
The New House Health Care Plan has several tax increases that will cost taxpayers $700 billion in the next ten years. Several of these taxes are new and were not in the earlier House bills.
The new Pelosi plan establishes a 5.4% surtax on joint filers with over $1 million in adjusted gross income or $500,000 for single filers. This is a single rate, which is different from the earlier House bills that had surtaxes at lower income levels. This surtax is not based on final adjusted gross income, but instead modified gross income. Thus the effective rate of the surtax is higher than just increasing marginal tax rates by 5.4%. (more…)
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