The Supreme Court decision to uphold the Affordable Health Care Act affirms a new national entitlement –
- the primary objective of Congress while they hastily cobbled the Act together.
We’ve seen all the carrots –
- Children on parent’s insurance to age 26
- Pre-existing condition coverage
- Elimination of life-time limits
- Seductive temporary tax credits for businesses with less than 25 employees.
But we haven’t seen the sticks!
The Patient Protection and Affordable Care Act is —
- an affirmation of expanding government control
- less reform
- more cost shifting
But, if wisdom, good governance and adapting modern business techniques
can still prevail; we can have the benefits while avoiding a fiscal disaster.
That’s not going to be easy. It’s a 3000 page patchwork of
- tax credits
- budgetary gimmicks
- and backroom deals with insurance and pharmaceutical industry lobbyists.
At a minimum, the Affordable Health Care Act will cost $1T in the first 10 years.
- Half from new taxes
- Half from reductions in Medicare.
The Congressional Budget Office can’t estimate what it’s going to cost over a generation – or how it will be paid for.
There are just too many variables in the legislation.
- The biggest of those variables are so-called insurance mandates. A topic for another day.
- Then there are the low-income tax credits –
- Why an income cliff, and not a sliding scale?
- What if the estimated 96,000 small businesses choose to pay the lesser $2000 penalty for each employee and shift millions more into the state insurance exchanges?
- How will a potpourri of tax credits complicate or be changed in subsequent fundamental tax reform legislation?
- Will Medicaid mandates overwhelm individual state resources?
- Medicaid costs versus K-12 education funding versus higher taxes?
- Will “Don’t touch Medicare” or the Medicare Cost Reduction Board prevail?
- Revenue raised through excise taxes on prosthetics, FDA drug approvals fees etc.. will result in higher insurance claims that will raise premiums. A circle that makes no sense!
Congress must address these variables by simplifying and restraining the Affordable Health Care Act while there is still time.
The American people must have an opportunity to affirm both their priorities and their sense of limitation on unilateral government action before Health Care becomes the
- Job Outsourcing (Health Care) Act.
Justice Roberts wrote that not even the Supreme Court can save the “people from the consequences of their political choices”.
Only the people can and we must insist!