What's Hiding in the Health Care Bill?

To me, some of the most important questions regarding Obamacare have always been, why are they trying to pass it so quickly, and why won't it take effect until after 2012, and Obama's possible reelection? What are they trying to hide from us? Well, Mark Hemingway from National Review points out some of that hidden legislation:

1. Democrats are hiding the true cost of the bill.

The actual cost of the Baucus bill is $1.7 trillion over ten years, but Democrats prefer to say it will cost $900 billion over the next ten years — this is true, but only because the main spending provisions don’t kick in until 2013. The Democrats also aren’t advertising that the $838 billion in new taxes and fees in the legislation begin being collected next year.

Further, the bill’s long-term deficit-reduction plans depend on cuts to Medicare — year after year — that Congress seems unlikely to support once Baucus’s bill is passed. Even when the Congressional Budget Office tallied up the costs of the bill based on the assumption that these cuts would be made, the CBO voiced doubts that they will be. “These projections assume that the proposals are enacted and remain unchanged throughout the next two decades, which is often not the case for major legislation. For example, the sustainable growth rate (SGR) mechanism governing Medicare’s payments to physicians has frequently been modified to avoid reductions in those payments,” reads the CBO score of the Baucus bill. That’s bureaucrat-speak for “Not gonna happen.”

2. Democrats don’t know how much the bill will cost — and don’t want anyone else to know, either.

So far, some 500 amendments have been proposed for the Baucus bill, many of which will make the legislation more expensive — how much more expensive, no one knows. Just last Wednesday, the Senate Finance Committee approved a supposedly cost-neutral amendment by Sen. Debbie Stabenow (D., Mich.). A few hours later, the CBO informed the committee the bill would cost $600 million. Once the Finance Committee is done considering the amendments in the ongoing mark-up hearings, we could be looking at a radically different and far costlier piece of legislation. Remember all the giveaways that were required to secure enough House votes to pass the Waxman-Markey cap-and-trade bill? Expect similar add-ons to Obamacare.

And then, it will be hard to tell how much the legislation costs; the Senate Finance Committee doesn’t work with the actual legislative language. They work in “conceptual” language or what they call “plain English.” Senator Baucus himself admits, “This probably sounds a little crazy to some people that we are voting on something before we have seen legislative language.” It doesn’t just sound crazy, the CBO says that it is. Without the actual legislative language, any CBO review of the bill “does not constitute a comprehensive cost estimate” and makes it impossible to get an accurate sense of the cost. When CBO said they would need two weeks to do another formal cost estimate of the amended bill, Baucus balked.

It's not just the CBO who won't get a chance to look over the bill. Senate Democrats voted down an amendment by Sen. Jim Bunning (R., Kent.) that would have required that, after mark-up, the final language be made available to the public for 72 hours on the Internet. Senator Baucus says he’s against putting the bill online because that, too, would take two weeks.

Let’s say it would take (an implausible) two weeks to post the bill on the Internet — why would that be a problem? Even Senate moderates were taken aback by Baucus’s reasons for denying the public and the CBO a better look at the bill. “If it takes two more weeks, it takes two more weeks. . . . Is there something happening in two weeks that we can not wait? . . . I want to do our job and I want to sit here and do it as long as it takes,” said Sen. Olympia Snowe (R., Maine), whose support for the bill was once considered crucial. “We shouldn't be afraid of numbers and facts,” Snowe added.

Apparently, Democrats are afraid that you'll find out what's in the billl and what it will cost.

3. The Democrats aren’t telling the truth about getting to keep your coverage.

The legislation contains over $500 billion in cuts to Medicare. That includes $122 billion in cuts to Medicare Advantage, a program that allows seniors to receive Medicare benefits through private insurance plans rather than the typical fee-for-service arrangement in Medicare. The number of seniors enrolled in a Medicare Advantage program has nearly doubled from 5 million to 10 million in the last six years, or 22 percent of all Medicare recipients. That’s because Medicare Advantage plans make it easier to get access to doctors and often offer services that go beyond what the traditional Medicare plan does. But Medicare Advantage also costs more, so Democrats have targeted it for cuts. This could mean lots of seniors are kicked out of Medicare Advantage.

Medicare spending is unsustainable, and Medicare Advantage in particular is expensive. It would be fine if Democrats acknowledged this as a matter of tough choices in the name of fiscal rectitude. Instead, Democrats insist that under the current legislation, “if you like your coverage you can keep it.” Noting the conflict between the specific rhetoric used to sell the bill and what it actually does, Sen. Orrin Hatch (R., Utah) proposed an amendment to the bill designed to protect Medicare Advantage. It didn’t pass. Hatch proposed another amendment designed to ensure no more than a million people would lose their current coverage. It didn’t pass. And Sen. John Cornyn (R., Texas) proposed another amendment to protect the coverage people currently have through their employers from becoming more expensive due to government mandates. It didn’t pass.

4. The bill promises to provide more coverage to more people with less money and fewer doctors.

The bill would put some 11 million more Americans into Medicaid. There’s bipartisan agreement that Medicaid doesn’t pay doctors enough. A 2009 survey by Merritt Hawkins and Associates on physician wait times found that over half of all specialists in many major metropolitan areas are refusing to take on new Medicaid patients. According to the survey, “Medicaid is not widely accepted in most markets surveyed, in at least some of the medical specialties reviewed, and, in some cases, all of them.”

Sen. Charles Grassley (R., Iowa) proposed an amendment that would raise the reimbursement rates for children in Medicaid to 100 percent of Medicare levels. It was rejected, as was an amendment (from Wyoming Republican Mike Enzi) to give people enrolled in Medicaid the right to choose to enroll in private insurance plans.

Until Democrats present a concrete plan for addressing doctor shortages, their promise to cover more Americans and keep costs down at the same time seems dubious at best. (And that’s not taking into account the fact the CBO says that the Medicaid expansion will force $37 billion in unfunded mandates on the states, even as most struggle to balance their budgets.)

Further, the bill does nothing to address the fraud problem in Medicaid. The Baucus bill is expanding Medicaid even though the Government Accountability Office says 10 percent of all Medicaid spending is fraudulent.

The bill also does nothing to staunch the hemorrhaging of health-care dollars that flow to the trial bar every year. The lawsuit industry annually imposes costs on the U.S. health-care system that run into the hundreds of billions, estimates Jim Copland of the Manhattan Institute’s Center for Legal Policy.

This is just what we know about the Baucus legislation after one week of Senate Finance Committee hearings — without knowing which of the over 500 amendments will be tacked on to the bill, with the Senate actively preventing the public from seeing the legislative language, and without an accurate assessment from the Congressional Budget Office on what the final bill is going to cost.
Ah, well, now I see why they are trying to keep the bill from the public, but that doesn't make it right.

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