Facts and Contents of Health Care Reform Bill Unveiled Today by Democrats

One thousand, nine hundred and ninety pages. 1,990. That’s the number of pages in H.R. 3962, the so-called Affordable Health Care for America Act unveiled by House Speaker Nancy Pelosi at a press conference this morning.

Three thousand, four hundred and twenty-five. 3,425. That’s the number of times the word "shall" appears within those one thousand, nine hundred and ninety pages, representing all the ways the government shall become more and more involved in the daily lives of Americans. By contrast, the word "shall" occurs 306 times in our entire Constitution, which of course lays out our entire system of limited government as established by our founders. (And subsequently forgotten, it seems.)

Just from a cursory look and from what I’m reading elsewhere, it seems that there are no provisions in the 1,990-page health care reform bill which will increase freedom and drive down costs either through tort reform or by providing for portability of insurance or opening up the industry to interstate competition. Those are the ways which would allow many of the uninsured to obtain coverage and would drive down costs for all involved. But the Democrats haven’t included those provisions — because, remember, the health care reform bill is not about health care at all, but rather about expanding the size, scope and reach of the federal government.

It’s a nightmare, folks. Believe me, there will be more on this legislation here at America’s Right. In the meantime, grab some popcorn, unfold your Snuggie and clean off your reading glasses — because you can read the bill for yourself HERE.

Check back here for updates from me as I look through things and learn more.

Congressional Intervention in Vending Machines

Here’s one fun selection :

(viii) VENDING MACHINES.-In the case of an article of food sold from a vending machine that (I) does not permit a prospective purchaser to examine the Nutrition Facts Panel before purchasing the article or does not otherwise provide visible nutrition information at the point of purchase ; and (II) is operated by a person who is engaged in the business of owning or operating 20 or more vending machines, the vending machine operator shall provide a sign in close proximity to each article of food or the selection button that includes a clear and conspicuous statement disclosing the number of calories contained in the article.

A couple of things jump out about this particular tidbit. First, it appears that the federal government is in the business of regulating vending machines now. Excuse me while I thumb through my pocket Constitution and look for the provision providing authority for that. Second, Congress is establishing itself as the ultimate alternative to personal responsibility. I know that I shouldn’t be inhaling Twinkies by the dozen, and don’t need a calorie count to understand that. Third, look for vending machine costs to skyrocket. For those kids who aren’t fed breakfast because their parents cannot afford it, no longer will the two quarters found in the sofa cushions or on the floor of the school bus suffice for a six-pack of peanut butter crackers.

Dems : Color, Not Competence Should Govern Health Care Staffing

Also on the minds of Democrats in the 1,990-page bill is so-called "workplace diversity." Supplemental materials released with the health care reform bill tout "greater support" to be provided to "workplace diversity programs to help ensure that the nation’s health workforce reflects the population it serves." Three cheers for social justice !

I don’t know about you, but when I’m in the hospital with a javelin sticking out of my chest and a super-apologetic teenager in a track team outfit pacing frantically outside the room, I don’t care whether my doctor’s name is Dr. John Smith, or Dr. Moojibooji Ooberjavango. I don’t care what my nurses look like. I don’t know about you, but I want a health workforce with competence as its defining characteristic ; race, color, sex, national origin, political affiliation, favorite color, astrological sign and whether they’re left-handed or right-handed doesn’t figure into it.

The Unveiling of the Public Option Was Anything But

These videos show ordinary Americans being denied access to the press conference this morning at which Nancy Pelosi unveiled the health care bill. That’s right — for all the talk of "open and transparent," the public unveiling of the public option at a public place was closed to the public.

In a Twitter entry, South Carolina Sen. Jim DeMint called it "a very disturbing trend from this administration in favor of secrecy and against transparency." I agree.

On the other hand, that the Democrats have gone through with this brand of health care reform shows that they don’t give a rat’s posterior for the opinions of the people they represent anyway, so why should we expect them to want involvement from the unwashed masses now ?

Didn’t Obama Promise No New Taxes on the Middle Class ?

At 1,990 pages, it’s going to take a while for folks to work their way through the health care reform bill unveiled today by the Democrats. Thank goodness for folks like those at Americans for Tax Reform, who have been doing more than any one guy like me could ever hope to do.

According to that group, along with the word "shall" being used 3,425 times in the legislation, the word "tax" was used 87 times, "taxable" used 62 times, "excise tax" used ten times, "taxes" used 15 times, "fee" used 59 times, and "penalty" used 113 times. They also provided a list of 13 specific tax hikes contained within the bill, and even were so kind to include page numbers.

Here you go, from Americans for Tax Reform :

• Employer Mandate Excise Tax (Page 275) : If an employer does not pay 72.5 percent of a single employee’s health premium (65 percent of a family employee), the employer must pay an excise tax equal to 8 percent of average wages. Small employers (measured by payroll size) have smaller payroll tax rates of 0 percent (<$500,000), 2 percent ($500,000-$585,000), 4 percent ($585,000-$670,000), and 6 percent ($670,000-$750,000).
• Individual Mandate Surtax (Page 296) : If an individual fails to obtain qualifying coverage, he must pay an income surtax equal to the lesser of 2.5 percent of modified adjusted gross income (MAGI) or the average premium. MAGI adds back in the foreign earned income exclusion and municipal bond interest.
• Medicine Cabinet Tax (Page 324) : Non-prescription medications would no longer be able to be purchased from health savings accounts (HSAs), flexible spending accounts (FSAs), or health reimbursement arrangements (HRAs). Insulin excepted. Cap on FSAs (Page 325) : FSAs would face an annual cap of $2500 (currently uncapped).
• Increased Additional Tax on Non-Qualified HSA Distributions (Page 326) : Non-qualified distributions from HSAs would face an additional tax of 20 percent (current law is 10 percent). This disadvantages HSAs relative to other tax-free accounts (e.g. IRAs, 401(k)s, 529 plans, etc.)
• Denial of Tax Deduction for Employer Health Plans Coordinating with Medicare Part D (Page 327) : This would further erode private sector participation in delivery of Medicare services.
• Surtax on Individuals and Small Businesses (Page 336) : Imposes an income surtax of 5.4 percent on MAGI over $500,000 ($1 million married filing jointly). MAGI adds back in the itemized deduction for margin loan interest. This would raise the top marginal tax rate in 2011 from 39.6 percent under current law to 45 percent-a new effective top rate.
• Excise Tax on Medical Devices (Page 339) : Imposes a new excise tax on medical device manufacturers equal to 2.5 percent of the wholesale price. It excludes retail sales and unspecified medical devices sold to the general public.
• Corporate 1099-MISC Information Reporting (Page 344) : Requires that 1099-MISC forms be issued to corporations as well as persons for trade or business payments. Current law limits to just persons for small business compliance complexity reasons. Also expands reporting to exchanges of property.
• Delay in Worldwide Allocation of Interest (Page 345) : Delays for nine years the worldwide allocation of interest, a corporate tax relief provision from the American Jobs Creation Act.
• Limitation on Tax Treaty Benefits for Certain Payments (Page 346) : Increases taxes on U.S. employers with overseas operations looking to avoid double taxation of earnings.
• Codification of the “Economic Substance Doctrine” (Page 349) : Empowers the IRS to disallow a perfectly legal tax deduction or other tax relief merely because the IRS deems that the motive of the taxpayer was not primarily business-related.
• Application of “More Likely Than Not” Rule (Page 357) : Publicly-traded partnerships and corporations with annual gross receipts in excess of $100 million have raised standards on penalties. If there is a tax underpayment by these taxpayers, they must be able to prove that the estimated tax paid would have more likely than not been sufficient to cover final tax liability.

Just a few notes from the top of my head (the location of an as-yet-untaxable flesh yarmulke), if I may do so :

First, I cannot help but wonder how our nation’s seniors will be able to escape rising health care costs considering the inherent Medicare cuts involved in this bill, as well as the measures like the denial of tax deductions for employer health plans coordinating with Medicare Part D, and the excise tax on medical devices. These are people already on a fixed budget. Those seniors that do work could see employers drop plans which coordinate with Medicare Part D, and those who don’t work are going to see the price go up on motorized wheelchairs and other devices that have become a part of their everyday life.

Second, I cannot help but notice that the taxes here go right at the heart of American liberty. Health savings accounts and flexible spending accounts provide perhaps the most freedom for Americans with regard to managing their own health care. Increasing the tax burden on these people and increasing the taxable nature of these accounts only serve to make Americans more dependent upon private insurers and, after the public option pushes them out of the market, upon the federal government.

Third, look at the potential effect on small business, the engine of our nation’s economy. Surtaxes, excise taxes and mandates will make it more difficult and expensive for these people to do business, and will stifle growth and job creation. My goodness — an excise tax of eight percent of average wages ? On top of the rising cost of doing business in America ? On top of the increased energy costs which could come along with cap-and-trade ? It’s absolutely insane, and it goes to the heart of the new Democratic Party’s War on Success and Prosperity.

$500 Million Per Page

I’m only now learning how to use Twitter, and I’m still not very proficient. Still, a very interesting note—I refuse to use the word "tweet"—popped up on Louisiana Sen. David Vitter’s Twitter page :

DavidVitter According to GOP Leader’s office:2000 pg health care bill that costs $1 trill. means that every pg costs the U.S. citizens a half-billion $.

Translated into English from the constraints of Twitter’s 140-character limit, what Sen. Vitter is saying is that the health care reform bill released today will cost approximately $500 million per page given its cost and length, both of which will prove to be grossly underestimated by the time all is said and done.

Boehner : ’1,990 Pages of Bureaucracy’
You know me. I’m not Congressman Boehner’s biggest fan. As far as I’m concerned, he’s on the wrong side of where the GOP should be going politically, and is largely responsible for the nonfeasance which allowed for so many House seats to be lost in 2006 and 2008. However—and this is a big, big "however"—he was absolutely phenomenal when it came to debating the Waxman-Markey cap-and-trade bill a few months back, and I’m seeing that same passion here as well.

Four Legs Good, Two Legs Bad

Section 340(M)—found on page 1254—establishes the Public Health Workforce Scholarship Program. To be eligible for the $283 million in scholarships, grants and loan forgiveness measures, Section 340(M)(b)(B)(i) says that students must be enrolled full-time or part-time in a course or program at "an accredited graduate school or program of nursing ; health administration, management, or policy ; preventative medicine ; laboratory science ; veterinary medicine ; or dental medicine."

Now, don’t get me wrong — I love animals. We have a dog and two cats at home (in fact, one of them is pictured here). I grew up with dogs and cats. And I value veterinarians, and while I was doing my undergraduate work at Auburn University I knew quite a few in my Alma Mater’s fantastic School of Veterinary Medicine.

This bill, however, is about health care reform for people. At a time when we’re already spending trillions of dollars we don’t have, we could be spending hundreds of millions to educate veterinarians as well.

It just makes me wonder which of those soulless Democrats has the ear of the Purina lobby.

More Statements From the House Republican Leadership

Say what you want about the Republican Party, but one thing they’ve got going for them is unity, especially when compared with their fractured counterparts across the aisle. What we need to do is to take that unity and take that passion and ensure they know that the American right will be behind them so long as they do not abdicate conservatism.

House Leader John Boehner (OH) : The American people have spoken. Speaker Pelosi and House Democrats have ignored them. Through the month of August, the American people let Members of Congress from both parties know that they didn’t want a government takeover of health care. That hasn’t changed.

But instead of listening to the American people, Democrats hid behind closed doors and came back with a bill designed to appease the liberal special interests. Three things about Speaker Pelosi’s health care bill are already clear : it will raise the cost of Americans’ health insurance premiums ; it will kill jobs with tax hikes and new mandates ; and it will cut seniors’ Medicare benefits. The fact that it weighs in at nearly 2,000 pages - more than 620 pages longer than the government takeover of health care Hillary Clinton proposed in 1993 - is as good an indication as any of just how costly and unsustainable Speaker Pelosi’s proposal is.

There is a better way. Republicans have offered solutions to lower health care costs and expand access at a cost our nation can afford. You can read about them at healthcare.gop.gov. Democrats need to listen to the American people, and work with us on the real reforms families want and need.

Rep. Phil Roe (TN) : While I will be reading the 1900+ page bill over the next week to find out what other problems are buried in the text, one thing is clear - this bill will lead to decreased access to care, decreased quality of care, and increased cost to beneficiaries. It needs to be rewritten before we do irreparable harm to our health care system.

Rep. Judy Biggert (IL) : Instead of producing a bipartisan proposal that delivers the solutions Americans want, Democrat leaders are simply pushing ahead with a go-it-alone approach that raises costs, slashes Medicare, and will drive families into government-run care. Americans need common-sense health care solutions, and those don’t require massive new costs on individuals and small businesses at the worst possible time for our economy.

Rep. Gregg Harper (MS) : After weeks of negotiating behind closed doors, Democratic leaders emerged today with a plan that will increase premiums for Mississippi families by $3,869 per year according to an analysis by the Blue Cross Blue Shield Association. Negotiators claim they were able to ‘lower the price tag’ of the legislation by expanding Medicaid. The truth is the federal government has irresponsibly pitched the burden to individuals through increased premiums for private policy holders and states in the form of unfunded mandates that will cost Mississippi an additional $200 million a year. This bill is bad for my state and our country.”

Rep. Patrick McHenry (NC) : Nowhere in this 1,990-page bill are the common sense reforms that everyone agrees on. Insurance companies are not forced to compete with one another across state lines. Small businesses are not permitted to join together to purchase affordable coverage for their employees. Lawsuit abuse will continue to thrive so the real victims are denied justice and the cost of healthcare can continue to escalate.

Rep. Blaine Luetkemeyer (MO) : Even though the American people spoke loud and clear this past summer against a government takeover of health care, Speaker Nancy Pelosi and her fellow liberals in the House have decided to ignore them and instead have chosen to proceed with a bill that puts government bureaucrats in control of health care.

Rep. Steve King (IA) : The Pelosi Democrats are willing to spend nearly a trillion dollars to reduce the percentage of uninsured from less than four percent of Americans without affordable options down to perhaps two percent, and in the process put in place the framework for socialized medicine. This is a bad deal for every American, those present and grandchildren yet to be born. The American people need to rise up, shut down the phone lines in Congress and kill this bill.”

Rep. Jeff Flake (AZ) : The House Democrats’ bill takes us in the wrong direction...This bill does nothing to control healthcare costs. It simply shifts billions of dollars of liability to taxpayers. It just creates a whole new set of problems.

Ten Facts Every American Should Know About H.R. 3962

From Congressman Boehner’s Web site, released only a few minutes ago :

Members of Congress and the American people are just beginning to look at Speaker Nancy Pelosi’s (D-CA) 1,990-page government takeover of health care, but it’s already becoming clear just how costly and unsustainable this proposal is. From higher taxes on middle-class families to job-killing mandates on small businesses to cuts in Medicare benefits for seniors, here are 10 facts every American should know about Speaker Pelosi’s 1,990-page government takeover of health care :

1. RAISES TAXES ON MIDDLE CLASS FAMILIES. Speaker Pelosi’s health care bill imposes a range of tax increases on families with income below $250,000, breaking a promise made by President Obama. Tax increases on middle class families include : an individual mandate tax of up to 2.5 percent of income for taxpayers earning as little as $9,350 ; repeal of a tax break on medicine purchased with funds from an HSA (health savings account) ; limits to tax relief through FSAs (flexible spending accounts) ; taxes on medical devices that will inevitably be passed on to consumers ; and a new tax on all insurance policies.
2. MASSIVE CUTS TO MEDICARE BENEFITS FOR SENIORS. Despite grave warnings from CBO, FactCheck.org, and the independent Lewin Group that cuts to Medicare of the magnitude included in Speaker Pelosi’s bill would have a negative impact on seniors’ benefits and choices, Speaker Pelosi’s health care bill stays the course and cuts Medicare by hundreds of billions of dollars.
3. NO PROTECTIONS FOR SMALL BUSINESSES. Speaker Pelosi’s health care bill claims to exempt small businesses from the steep eight percent ‘pay or play’ employer mandate. The facts tell a different story. Using Census data compiled by the Small Business Administration, this so-called ‘exemption’ hammers small employers with only, on average, 17 or more employees to new taxes and mandates. The outfits affected employ 70 percent of all small business employees, or 42.3 million workers. Adding to the assault on small businesses, the bill does not index the small business “exemption” amounts, meaning more and more small businesses will be ensnared by this job-killing employer mandate each year.
4. INCREASES THE COST OF HEALTH INSURANCE. Imposing a new $2 billion tax on insurance policies will be passed on to patients in the form of higher premiums. Changes to the Medicare Part D prescription drug benefit will, according to estimates by CBO, will raise Medicare Part B premiums by $25 billion and Part D premiums by 20 percent. And imposing an unfunded mandate on the states to pay for the bill’s Medicaid expansion will shift the burden of this expansion on state taxpayers who may experience tax increases to cover the cost.
5. USES GIMMICKS TO HIDE BUDGET-BUSTING COST, PILES UP DEBT ON FUTURE GENERATIONS. Speaker Pelosi’s health care bill claims to be deficit neutral, but uses budget gimmickry to hide its massive total cost. Working families across America know they cannot simply decide that a bill they get in the mail doesn’t exist, but that’s exactly what congressional Democrats are doing. In order to meet the President’s ‘target’ spending total of $900 billion, Democrats have simply swept costly provisions under the rug, including the $245 billion ‘doc fix.’
6. IMPOSES JOB-KILLING EMPLOYER MANDATES. Additional taxes on employers and new government mandates that dictate acceptable insurance will place new and crushing burdens on employers. These are burdens that will ultimately fall squarely on the backs of workers in the form of reduced wages, fewer hours or lost employment. CBO agrees that "[e]mployees largely bear the cost of... play-or-pay fees in the form of lower wages." According to the National Federation of Independent Business (NFIB), the nation’s largest small business association, an employer mandate of this magnitude will disproportionately impact small businesses, triggering up to 1.6 million lost jobs. Two-thirds of those jobs would be shed by small businesses.
7. TILTS THE PLAYING FIELD IN FAVOR OF THE GOVERNMENT-RUN INSURANCE COMPANY. Speaker Pelosi’s health care bill promises not to give the government-run plan advantages over private insurers in the market, but the opposite is true. The bill provides billions in start-up funding for the government-run plan, and while it requires the plan to repay the money over time it does not require the plan to pay interest on this “loan.” This interest-free, taxpayer-subsidized loan is potentially worth millions of dollars and tilts the playing field in favor of the government-run plan.
8. THREATENS CASH-STRAPPED STATES WITH UNFUNDED MANDATES. Speaker Pelosi’s health care bill swells the number of Americans on the government rolls by expanding Medicaid eligibility. Medicaid is financed through a federal-state partnership, but the bill dumps nearly ten percent of the mandated expansion included in the bill onto the states. States, already struggling with fiscal constraints, would be left on the hook for billions of dollars due to this unfunded mandate.
9. CREATES A NEW MONSTROSITY IN THE TAX CODE. Starting in 2011, Speaker Pelosi’s health care bill imposes a 5.4 percent tax on adjusted gross income above $500,000 for individuals and $1 million for married couples. Yet, the dollar amounts for which the tax kicks in are not indexed for inflation. We’ve seen this horror film before : the Alternative Minimum Tax, another Frankenstein’s monster of the tax code, also wasn’t indexed for inflation and now affects millions of middle class families with incomes below the Democrat’s surtax.
10. MISSES AN OPPORTUNITY TO CURTAIL JUNK LAWSUITS. Speaker Pelosi’s health care bill misses a critical opportunity to rein in junk lawsuits and costly defensive medicine. The bill includes only a voluntary grant program to deal with the medical liability crisis instead of including real reform, which would produce tens of billions of dollars in savings, improve efficiency in our health care system and reduce costs for patients and providers.

BONUS : Republicans have offered better solutions to lower health care costs and expand access to quality, affordable coverage at a price our nation can afford. Learn more by visiting healthcare.gop.gov.

CBO Scores Sub-$900B Bill at $1.055 Trillion

So, the Democrats aren’t much for promises. Tell me something I don’t know. This time around, it’s the Congressional Budget Office which, despite being kind to bills in committee over the past few weeks, burst the bubble when it came to White House assurances that health care reform would cost less than $900 billion.

Instead, the CBO says, by the end of the next ten years, the bill will cost $1.055 trillion. Furthermore, there’s some other things which need to be considered about that number : First, remember that the primary measures within the bill will not come into effect for three years—conveniently after the next presidential election—while the increases in the tax burden necessary to pay some of the associated costs will come right away. Second, remember that in 1965, when Medicare first was on the scene, Congress estimated that it would only cost $12 billion yearly by 1991. Point being, not only is Congress fudging the numbers to begin with, but they’re also not too good with numbers at all anyway.

Speaking of number-fudging, consider this from the Dow Jones Newswire report :

Penalties imposed on individuals who did not purchase insurance, and employers who did not offer coverage to their workers, would raise $161 billion over that time-frame. That brings the net cost of the bill to $894 billion through 2019, CBO said.

House Democrats have seized on that net cost figure to claim that their bill is below President Barack Obama’s upper limit which he set for health-care legislation of $900 billion.

The $1.055 trillion estimate also does not include $245 billion needed to stop Medicare payments to doctors from decreasing, which the House plans to address through separate legislation introduced Thursday.

The costs of the bill are fully offset by cuts to existing spending programs— including the Medicare Advantage and other programs—saving $426 billion through 2019, and by tax increases raising $572 billion over that time, CBO said. In fact, the combined impact of provisions in the bill would be a net deficit reduction of $104 billion in the next decade, according to CBO.

So, in order to even be able to argue that they’ve come below the $900 billion threshold, Democrats extracted a $245 billion portion of the bill and is working to pass it separately. That’s like going out to a nice dinner, spending $200 on the meal and $75 on martinis, only to argue later that you only spent $200 that evening.

Furthermore, the idea that the costs associated with the Democrats’ health care reform bill will offset through excising waste is preposterous. When has the government ever cut $426 billion from anything ? And don’t even get me started on the tax increases, when balanced with promises from presidential candidate Barack Obama that Americans making less than $200,000 yearly would not face a single dime of increased taxes.

For the full text of the CBO report, click HERE.