health care reform

Two million seniors are expected to be dumped onto Medicare from company prescription medication plans, thanks to a poorly-vetted provision of the new health care law signed by the president this week. It will cost the taxpayers billions in higher Medicare costs, and the companies hundreds of millions of dollars in lost tax deductions.

It’s one of many penny-wise, pound-foolish provisions in the new health care law. It spends money on frills like “cultural competency,” while cutting spending on crucial things like anesthesia.

Fourteen attorneys general are challenging provisions of the new health care law in court. Their lawsuits argue that forcing people to buy health insurance is not a valid exercise of Congress’s power to regulate interstate commerce.

The new law imposes many middle-class tax increases, such as taxes on uninsured individuals, on cosmetic surgery, on medical devices, and on certain health care plans. It also increases taxes on many investors and imposes marriage penalties.

The new health care law will reduce lifesaving medical innovation, raise taxes, drive up insurance premiums, break many campaign promises, and increase state budget deficits. It will jeopardize the quality of medical care, while imposing restrictions that failed when tried at the state level. It ignores advice from doctors and federal experts, and lessons from countries with universal healthcare, about how to keep costs down.

Governors of both political parties assailed the health care bill as a job-killer that will drive up state deficits, increase taxes, and harm the economy. The governors of New York and California earlier warned that “their states will be crushed by billions in new costs.”

While the CBO has scored the health care bill as not increasing the federal deficit, thanks to the many tax increases in the bill, it has done so only by accepting many accounting gimmicks that even pro-administration journalists have admitted conceal the bill’s enormous cost and the fact that it will massively increase the deficit. The New York Times‘ David Brooks, once a staunch supporter of President Obama, recently said that the bill’s drafters were “corrupted by power” and called arguments for the law “unbelievable” and “insane.” The Atlantic’s Megan McArdle, who also voted for Obama, wrote that the law “is a fiscal disaster waiting to happen.”

Shortly after the House approved the massive, historic health-care legislation and sent it to President Obama for his signature, the president declared the vote “proved that this government – a government of the people and by the people – still works for the people.”

In fact, according to Pollster.com, which tracks surveys, eight non-partisan polls surveyed Americans about attitudes towards the legislation just before the vote. None showed a majority of support. In fact, Obama’s “the people” is closer to a third of the electorate.

But when you dig deeper, looking at specific responses such as those showing “strong” support or “strong” disapproval, it looks even worse.

Americans want health care reform, but they clearly didn’t want this bill. Why didn’t Congress go back to the drawing board to present more palatable legislation? Read about it in my NRO piece, “The People Speak.”

Virginia Attorney General Ken Cuccinelli and a dozen other attorneys general have filed lawsuits challenging the new health care law signed by President Obama.  Cuccinelli rightly argues that Congress lacks the power to force people to buy health insurance under the Constitution’s Commerce Clause, which only gives it the power to regulate interstate commerce, not to force people to buy products they don’t want.

As a news story notes, in Supreme Court rulings issued in 1995 and 2000, “the high court said the commerce clause is limited to economic activities that substantially affect interstate trade.”  (I was an attorney in the latter ruling, United States v. Morrison (2000).)  As UPI notes, “the weight of Supreme Court jurisprudence seems to favor a Commerce Clause challenge” to the health care legislation.

Earlier, Senator Orrin Hatch argued that the “individual mandate” in the healthcare bill legislation, which forces people to buy health insurance, is unconstitutional.  Florida Attorney General Bill McCollum likewise questioned whether it is constitutional to force people to do so.   McCollum and other attorneys general, like Washington’s Rob McKenna (R) and Louisiana’s James “Buddy” Caldwell (D), are now challenging ObamaCare in court as well.

This so-called “individual mandate” is unprecedented and appears to exceed Congress’s power under the Commerce Clause of the Constitution.  As the Congressional Budget Office noted in 1994, “A mandate requiring all individuals to purchase health insurance would be an unprecedented form of federal action. The government has never required people to buy any good or service as a condition of lawful residence in the United States.”

The individual mandate does not regulate activities, much less economic activities, but rather inactivity, by penalizing those who decline to buy health insurance. That exceeds Congress’s poers under the Supreme Court’s Morrison ruling, as I explained earlier.

The health care legislation also contains potentially unconstitutional racial preferences for minority applicants, and lower standards for treatment of patients in predominantly-minority institutions.  These drew criticism from the Civil Rights Commission.

ObamaCare discriminates against married people, containing massive marriage penalties.  If you get married, your income will be hit by ObamaCare’s increased tax rates a lot faster than if you just live together without getting married.  Under the bill, you will give up your right to federal health care subsidies at a lower income level if you are married than if you are an unmarried couple.  For many “low-income and middle-income couples, it could mean a hike of $2,000 or more in annual insurance premiums the moment they say ‘I do.’”  (While Obama won the 2008 election, he narrowly lost among married people.). The new tax on investors is a classic example of the marriage penalty, since it kicks in at a lower income level if you are a married couple than if you are an unmarried couple.

ObamaCare would also impose many middle-class tax increases, such as taxes on uninsured individuals, on cosmetic surgery, on medical devices, and on certain health care plans.

Governors of both political parties assail the health-care bill as a job-killer that will drive up state deficits, increase taxes, and harm the economy.  The governors of New York and California warned that “their states will be crushed by billions in new costs.”  Virginia’s governor says the new law will cost Virginia at least a billion dollars.

Tax experts say it would dangerously expand the power and responsibilities of the IRS.  The new version of the health care bill increases cuts to Medicare Advantage by billions of dollars.

The Washington Post falsely claims that the CBO says the health care bill will save $1.2 trillion over its second decade, but the CBO says the figure is not from it (it’s from congressional Democrats).  Amazingly, the CBO, under orders from Democratic leaders, has understated the bill’s cost for the first decade by including the present fiscal year — in which ObamaCare is not yet law and thus has no costs — while excluding its last year from cost calculations.  The result was to reduce the projected price tag for the bill from $1.2 trillion to $940 billion.

While the CBO has scored the health care bill as not increasing the federal deficit, thanks to the many tax increases in the bill, it has done so only by accepting many accounting gimmicks that even pro-Obama journalists have admitted conceal the bill’s enormous cost and the fact that it will massively increase the deficit.  The New York Times‘ David Brooks, once a staunch Obama supporter, now says the bill’s drafters were “corrupted by power” and calls arguments for the bill “unbelievable” and “insane.”  The Atlantic’s Megan McArdle, who also voted for Obama, says that the bill “is a fiscal disaster waiting to happen.”

The Congressional Budget Office, which would not question Obama’s gimmicks to lowball the cost of his health care plan, nevertheless admits that “President Obama’s policies would add more than $9.7 trillion to the national debt over the next decade.”

There are $3,000,000,000,000 in tax increases in Obama’s budget.  But he’s spending money at such a furious pace that the deficit will skyrocket anyway: “The president’s budget would borrow 42 cents for each dollar spent in 2010,” and “double the national debt over the next decade.”  Obama recently ran up the largest budget deficit in history, by a huge margin.

ObamaCare would reduce medical innovation, raise taxes, drive up insurance premiums, and break campaign promises.  It  would cut the quality of  care, while imposing restrictions that failed when tried at the state level.  It ignores advice from experts about how to cut costs.

As would be expected in the face of recently passed health care legislation this sweeping and controversial, pro-liberty citizens have been stepping out to oppose the bill.  One of the unusual tactics they have used is to turn to their state legislatures for what they see as protection from the encroachments on their liberties from the federal government. Legislation declaring a state’s opposition in one way or another to items in the federal health reform has been introduced in 37 states. Many states have even passed this legislation, and had it signed into law by their governors.

A hearing was recently held on one of these pieces of legislation, Maryland House Bill 603, the Health Care Freedom Act of 2010.  This bill would add an amendment to the Maryland constitution making it so that no person in Maryland would have to comply with an individual mandate to purchase health insurance, and that no person in Maryland will have to pay fees or penalties for refusing to buy health insurance. In short, it would preserve the freedom of Marylanders to contract with doctors they want to contract on their own terms, if they choose to do so.

There was much talk at the hearing about the Constitution, individual rights, and sovereignty of the states. One of the individuals providing testimony in favor of the bill at the hearing was Mark Kreslins, who leads a citizens’ political organization in Frederick, Maryland, known as We Surround Them (WST). WST is an organization dedicated to returning government to what they believe is the original intent of the Founding Fathers as enshrined in the founding documents of American.

They believe that the Constitution limits the federal government to 17 defined powers in Article 1, Section 8. Any government action which extends beyond the enumerated powers in Article 1, Section 8, is thus unconstitutional. They believe that the Constitution reserves the vast majority of state power for the states. The states, after all, existed before the federal government, and created it for clearly defined purposes. And the 10th Amendment to the Constitution states that all powers not delegated to the federal government are reserved to the states, or to the people. If the federal government was created with the intention that it have essentially limitless power to do as it wishes, then the 10th Amendment seems to be a nonsensical inclusion into the Constitution.

Mr. Kreslins testified that an individual mandate would be an unconstitutional exercise of federal authority, as the Constitution never gives the federal government the authority to mandate that all people buy insurance, and that it is the responsibility of the states to stand up for their sovereign rights, and to stand up for the rights of their citizens to own their own property and to do with it what they wish. It is thus entirely within the states’ authority, according to him, to refuse to obey this unconstitutional action on behalf of their citizens.

Many prominent constitutional scholars agree with state legislatures that an individual mandate for health insurance would exceed the power given to the federal government in the Constitution. For instance, Heritage Foundation legal scholars and well-known legal scholar Randy Barnett (who was a lead attorney in the Gonzales v. Raich case before the Supreme Court in 2005), have argued that the individual mandate is not only an unprecedented (few would debate this), but also an unconstitutional exercise of federal power.

Citizens fighting for individual liberty have gained some powerful allies in many state legislatures. The constitutional logic for state sovereignty is far from universally accepted by constitutional scholars. It will likely take a Supreme Court case to decide whether these nullification attempts will succeed in shielding state citizens from the most far reaching aspects of health care reform. But pro-liberty activists have not given up, even after passage of the vast health care reform bill.

In the spirit of full disclosure, Mark Kreslins is the author’s future father-in-law, the primary reason why the author was at the hearing at all.

As the House gets ready to pass the health care bill today, I’m reminded of one of the first lessons in economics I ever learned. Milton Friedman put it best:

There are four ways in which you can spend money. You can spend your own money on yourself. When you do that, why then you really watch out what you’re doing, and you try to get the most for your money. Then you can spend your own money on somebody else. For example, I buy a birthday present for someone. Well, then I’m not so careful about the content of the present, but I’m very careful about the cost. Then, I can spend somebody else’s money on myself. And if I spend somebody else’s money on myself, then I’m sure going to have a good lunch! Finally, I can spend somebody else’s money on somebody else. And if I spend somebody else’s money on somebody else, I’m not concerned about how much it is, and I’m not concerned about what I get. And that’s government. And that’s close to 40% of our national income.

The biggest problem with health care today is that patients only pay 12 percent of costs out of pocket. As far as each individual is concerned, it’s basically on sale for 88 percent off! No wonder we spend so much on health care.

Today’s bill consists almost entirely of spending other peoples’ money on other people. If it becomes law, that 12 percent figure will fall even further. This is no way to keep costs under control. However noble Congress’ intentions may be, its bill will not work as advertised. Human nature won’t allow it.

The new tax on investors in the health care bill has been increased from 2.9 percent to 3.8 percent, but only a few media outlets like Bloomberg and Business Week are reporting it.

As the Washington Times earlier noted, Obamacare discriminates against married people, containing massive marriage penalties.  If you get married, your income will be hit by Obamacare’s increased tax rates a lot faster than if you just live together without getting married.  Under the bill, you will give up your right to federal health care subsidies at a lower income level if you are married than if you are an unmarried couple.  For many “low-income and middle-income couples, it could mean a hike of $2,000 or more in annual insurance premiums the moment they say ‘I do.’”  (While Obama won the 2008 election, he narrowly lost among married people.)  The new tax on investors is a classic example of the marriage penalty, since it kicks in at $200,000 if you are single — that is, $400,000 for an unmarried couple — but only $250,000 for a married couple.

Obamacare would also impose many middle-class tax increases, such as taxes on uninsured individuals, on cosmetic surgery, on medical devices, and on certain health-care plans.

Governors of both political parties assail the health care bill as a job-killer that will drive up state deficits, increase taxes, and harm the economy.  The governors of New York and California warned that “their states will be crushed by billions in new costs.”

Tax experts say it would dangerously expand the power and responsibilities of the IRS.

The Washington Post falsely claims that the CBO says the health care bill will save $1.2 trillion over its second decade, but the CBO says the figure is not from it (it’s from Congressional Democrats).  Amazingly, the CBO, under orders from Democratic leaders, has understated the bill’s cost for the first decade by including the present fiscal year — in which Obamacare is not yet law and thus has no costs — while excluding its last year from cost calculations.  The result was to reduce the projected price tag for the bill from $1.2 trillion to $940 billion.

While the CBO has scored the health care bill as not increasing the federal deficit, thanks to the many tax increases in the bill, it has done so only by accepting many accounting gimmicks that even pro-Obama journalists have admitted conceal the bill’s enormous cost and the fact that it will massively increase the deficit.  The New York Times‘ David Brooks, once a staunch Obama supporter, now says the bill’s drafters were “corrupted by power” and calls arguments for the bill “unbelievable” and “insane.”  The Atlantic‘s Megan McArdle, who also voted for Obama, says that the bill “is a fiscal disaster waiting to happen.”

The Congressional Budget Office, which would not question Obama’s gimmicks to lowball the cost of his health care plan, nevertheless admits that “President Obama’s policies would add more than $9.7 trillion to the national debt over the next decade.”

There are $3,000,000,000,000 in tax increases in Obama’s budget.  But he’s spending money at such a furious pace that the deficit will skyrocket anyway: “The president’s budget would borrow 42 cents for each dollar spent in 2010,” and “double the national debt over the next decade.”  Obama recently ran up the largest budget deficit in history, by a huge margin.

ObamcCare would reduce medical innovation, raise taxes, drive up insurance premiums, and break campaign promises.  It  would cut the quality of  care, while imposing restrictions that failed when tried at the state level.  It ignores advice from experts about how to cut costs.

A retired federal judge says that the tactic congressional leaders are using to rush Obamacare into law violates Supreme Court rulings and the Constitution.

House health care bill dangerously expands IRS power,” say a tax law professor and GOP leaders.   The Washington Examiner says that “16,500 more IRS agents” will be “needed to enforce Obamacare.”  That’s “the biggest expansion of the IRS since World War II,” needed to “to collect, examine and audit new tax information mandated on families and small businesses.”

Governors of both political parties assail the health care bill as a job-killer that will drive up state deficits, increase taxes, and harm the economy.  The governors of New York and California warned that “their states will be crushed by billions in new costs.”

The most recent version of the health care bill contains additional tax increases and Medicare cuts.  It dramatically increases taxes on investors by adding a new 3.8 percent tax on investment income (much higher than the 2.9 percent previously proposed by Obama), but few newspapers have reported that.

The Washington Post falsely claims that the CBO says the health care bill will save $1.2 trillion over its second decade, but the CBO says the figure is not from it (it’s from congressional Democrats).  Amazingly, the CBO, under orders from Democratic leaders, has understated the bill’s cost for the first decade by including the present fiscal year — in which ObamaCare is not yet law and thus has no costs — while excluding its last year from cost calculations.  The result was to reduce the projected price tag for the bill from $1.2 trillion to $940 billion.

While the CBO has scored the health care bill as not increasing the federal deficit, thanks to the many tax increases in the bill, it has done so only by accepting many accounting gimmicks that even pro-Obama journalists have admitted are deceptive and conceal the bill’s enormous cost and the fact that it will massively increase the deficit.  The New York Times‘ David Brooks, once a staunch Obama supporter, now says the bill’s drafters were “corrupted by power” and calls arguments for the bill “unbelievable” and “insane.”

Earlier, health care cost expert James C. Capretta explained how “Obamacare Is A Budgetary Disaster” that will cost at least $1.4 trillion more than promised.

The Congressional Budget Office, which refused to question Obama’s gimmicks to lowball the cost of his health care plan, nevertheless admits that “President Obama’s policies would add more than $9.7 trillion to the national debt over the next decade.”

There are $3,000,000,000,000 in tax increases in Obama’s budget.  But he’s spending money at such a furious pace that the deficit will skyrocket anyway: “The president’s budget would borrow 42 cents for each dollar spent in 2010,” and “double the national debt over the next decade.”  Obama recently ran up the largest budget deficit in history, by a huge margin.

The revised health-care bill would add a new 3.8 percent tax on investment income for individuals who make $200,000 or more, and households making $250,000 or more.  More importantly, it would also impose many middle-class tax increases, such as taxes on uninsured individuals, on cosmetic surgery, on medical devices, and on certain health care plans.

ObamaCare would reduce medical innovation, raise taxes, drive up insurance premiums, and break campaign promises.  It  would cut the quality of  care, while imposing restrictions that failed when tried at the state level.  It ignores advice from experts about how to cut costs.

A retired federal judge says that the tactic congressional leaders are using to rush Obamacare into law violates Supreme Court rulings and the Constitution.

Declaring “I love numbers,” House Speaker Nancy Pelosi declared after getting a thumbs up from the Congressional Budget Office on Thursday just before a scheduled vote on health care legislation. The budget office found that the House changes to the Senate legislation will cut $138 billion from the federal deficit. Opponents have showed the figures are essentially mythical. Certainly numbers have worked against Pelosi in a very critical area, namely the idea that preventative care and wellness programs can save us money. That too, is a myth, as I make abundantly clear in “The Preventative Care Myth,” my article in today’s NRO.

Governors are now criticizing the health care bill backed by the Obama administration, saying it will cause health care costs and state deficits to skyrocket, while driving up unemployment.  Arizona Governor Janice Brewer said the bill would end up “exacerbating our state’s fiscal woes by billions of dollars.” Rhode Island’s Donald Carcieri said “this legislation is bad for Rhode Island, its taxpayers, seniors, and economy….This bill is not about health care. It’s about ideology and special interests.” Indiana’s Mitch Daniels said it would lead to insurance “premium increases ranging up to 78 percent,” “huge tax increases” for medical “device manufacturers” that employ many, and “job losses” and “a job killing tax of $2,000 per employee” that “will be levied on many companies.”

Earlier, Tennessee’s governor, Phil Bredesen (D), called the bill the “mother of all unfunded mandates,” saying it will force states to spend so much that they will have to either massively raise taxes, or run large budget deficits that violate state constitutions.

The health care bill has now been changed to add additional tax increases, such as increasing the tax on uninsured individuals by an extra $2 billion and on employers by $25 billion. Also added are new cuts to Medicare Advantage, increased by $13.7 billion (to $131.9 billion), and Medicare Advantage interactions, by $53 billion (to $70.4 billion).  This is according to the Congressional Budget Office.  But the CBO has cautioned that “the agency has not thoroughly examined the reconciliation proposal to verify its consistency with the previous draft,” so there may be additional major changes that remain undisclosed until the House votes on the bill.

While the CBO has scored the health care bill as not increasing the federal deficit, thanks to the many tax increases in the bill, it has done so only by accepting many accounting gimmicks that even pro-Obama journalists have admitted are deceptive and conceal the bill’s enormous cost and the fact that it will massively increase the deficit.

Earlier, health care cost expert James C. Capretta explained how “Obamacare Is A Budgetary Disaster” that will cost at least $1.4 trillion more than promised.

The Congressional Budget Office, which refused to question Obama’s gimmicks to lowball the cost of his health care plan, nevertheless admits that “President Obama’s policies would add more than $9.7 trillion to the national debt over the next decade.”

There are $3,000,000,000,000 in tax increases in Obama’s budget.  But he’s spending money at such a furious pace that the deficit will skyrocket anyway: “The president’s budget would borrow 42 cents for each dollar spent in 2010,” and “double the national debt over the next decade.”  Obama recently ran up the largest budget deficit in history, by a huge margin.

ObamaCare would reduce medical innovation, raise taxes, drive up insurance premiums, and break campaign promises.  It  would cut the quality of  care, while imposing restrictions that failed when tried at the state level.  It ignores advice from experts about how to cut costs.

New York Times columnist David Brooks, like other columnists at that staunchly liberal newspaper, supported Obama in the 2008 election. But even he can now see that Obama’s health care plan is full of dishonest gimmicks that hide its enormous cost and the fact that it will drive up the deficit and health-care costs:

They’ve stuffed the legislation with gimmicks and dodges designed to get a good score from the Congressional Budget Office but don’t genuinely control runaway spending.

There is the doc fix dodge. The legislation pretends that Congress is about to cut Medicare reimbursements by 21 percent. Everyone knows that will never happen, so over the next decade actual spending will be $300 billion higher than paper projections.

There is the long-term care dodge. The bill creates a $72 billion trust fund to pay for a new long-term care program. The sponsors count that money as cost-saving, even though it will eventually be paid back out when the program comes on line.

There is the subsidy dodge. Workers making $60,000 and in the health exchanges would receive $4,500 more in subsidies in 2016 than workers making $60,000 and not in the exchanges. There is no way future Congresses will allow that disparity to persist. Soon, everybody will get the subsidy.

There is the excise tax dodge. The primary cost-control mechanism and long-term revenue source for the program is the tax on high-cost plans. But Democrats aren’t willing to levy this tax for eight years. The fiscal sustainability of the whole bill rests on the naïve hope that a future Congress will have the guts to accept a trillion-dollar tax when the current Congress wouldn’t accept an increase of a few billion.

There is the 10-6 dodge. One of the reasons the bill appears deficit-neutral in the first decade is that it begins collecting revenue right away but doesn’t have to pay for most benefits until 2014. That’s 10 years of revenues to pay for 6 years of benefits, something unlikely to happen again unless the country agrees to go without health care for four years every decade.

There is the Social Security dodge. The bill uses $52 billion in higher Social Security taxes to pay for health care expansion. But if Social Security taxes pay for health care, what pays for Social Security?

Earlier, health care cost expert James C. Capretta explained how “Obamacare Is A Budgetary Disaster” that will cost at least $1.4 trillion more than promised.

The Congressional Budget Office, which refused to question Obama’s gimmicks to lowball the cost of his health care plan, nevertheless admits that “President Obama’s policies would add more than $9.7 trillion to the national debt over the next decade.”

There are $3,000,000,000,000 in tax increases in Obama’s budget.  But he’s spending money at such a furious pace that the deficit will skyrocket anyway: “The president’s budget would borrow 42 cents for each dollar spent in 2010,” and “double the national debt over the next decade.”

Obama’s healthcare plan will further increase deficits, as even Democrats have admitted.   ObamaCare would reduce medical innovation, raise taxes, drive up insurance premiums, break campaign promises, and increase state deficits.  It  would cut the quality of  care, while imposing restrictions that failed when tried at the state level.  It ignores advice from experts about how to cut costs.

Obama recently ran up the largest budget deficit in history, by a huge margin.