The U.S. Senate is locked in an intense floor debate over the Patient Protection and Affordable Care Act (H.R. 3590), a massive 2,074-page health care bill that would directly affect every man, woman, and child in the United States. Its enactment would shape the character and quality of life in America for generations to come.
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The Senate bill's complex and sweeping provisions would affect virtually every aspect of the huge health care sector of the U.S. economy.
• Like the House bill, it would transfer massive regulatory authority from the states to the federal government and make enormous changes in the nation's health insurance markets;
• It would dramatically alter the financing and content of employer-provided and individual health insurance and significantly change Medicare and Medicaid;
• It would change how hospitals, doctors, and other medical professionals are paid and how physicians and other medical professionals deliver care; and
• It would impose controversial and unprecedented mandates on businesses and individuals, including an individual mandate to buy insurance, thus restricting the personal and economic freedom of American citizens.
In effect, the Senate bill would produce the greatest concentration of political and economic power over one major sector of the U.S. economy in the nation's history.
It is not surprising that the Senate bill is highly unpopular. For ordinary Americans, the legislative process has definitely not been a demonstration of the way a law is made as portrayed in civics textbooks or the kind of rational deliberation envisioned by the Founding Fathers. Surprising provisions, unintended consequences, and unreliable assumptions characterize this proposal. Key provisions, such as the provision of a "public plan" to compete against private health plans, are particularly controversial, and the Senate leadership is rapidly floating and rejecting new schemes to secure the 60 votes necessary to end the debate and quickly pass the bill.
Without the benefit of legislative language, hearings, expert testimony, or committee deliberation and debate, various untested proposals have been floated for press and popular consumption. Writing of the latest scheme to secure a compromise, the editors of The Washington Post noted, "The only thing more unsettling than watching legislative sausage being made is watching it being made on the fly."
Regardless of one's views of the Senate bill, it does not comport with the broad popular themes articulated by President Barack Obama and the many congressional leaders who have championed these policies. Contrary to the President's repeated promises to the American people, the Senate bill, like its House counterpart, would:
• Cause many Americans to lose their current health insurance. The Congressional Budget Office (CBO) estimates that up to 10 million Americans would no longer be covered by their employers. Given the bill's incentives for employers to discontinue job-based coverage, independent analysts expect the loss of employer-based coverage to be much higher.
• Bend the cost curve up. According to independent analysts and government actuaries, the bill would substantially increase total health care spending instead of reducing it as promised. Richard Foster, Chief Actuary of the Centers for Medicare and Medicaid Services (CMS), recently judged the projected savings from the Medicare updates as "doubtful" and estimated that the total national spending on health care would increase.
• Impose many new taxes on middle-class Americans. The Senate bill contains over a dozen new taxes, including a 40 percent excise tax on high-priced health plans and special fees and taxes on insurance, drugs, medical devices, and anyone who violates the new mandates.
• Reduce many seniors' access to Medicare benefits and services. The bill would reduce Medicare payments by an estimated $493 billion over 10 years, including payment reductions for Medicare Advantage, hospital care, home health care, and nursing homes.
• Provide federal funding for abortion. Contrary to the President's clear statement to Congress and the nation on health care reform, the Senate bill would provide funding for abortion. The House would prohibit using taxpayers' dollars to finance abortion, but a similar amendment to the Senate bill was tabled without even a floor vote.
Surveys consistently show that the American people clearly want health care reform but do not support the bills sponsored by the House and Senate leadership. While they want Congress to enact policies that would increase choice and competition, and thereby help to control costs and rectify inequities in the health insurance markets, they do not favor a federal takeover of the health care system. Nor do they want the power to make key health care decisions transferred from individuals, families, and medical professionals to government agencies, departments, commissions, and advisory boards.
Composed by The Heritage Foundation ~ www.Heritage.org
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