On October 29, 2009, Speaker Pelosi and the House Democrat leadership introduced H.R. 3962, the Affordable Health Care for America Act. The legislation combines provisions in earlier versions approved by the Committees on Education and Labor, Energy and Commerce, and Ways and Means, as well as other provisions negotiated behind closed doors by the Democrat leadership.
The bill sets the tone for a Washington takeover of the health care system-one defined by federal regulation, mandates, myriad new programs, and higher federal spending. The bill would ensure the heavy hand of federal bureaucrats over the United States health care system, levying costly new taxes on individuals and businesses who do not comply. Many Members may question how additional federal mandates and bureaucratic diktats raising costs appreciably for all Americans would make health care more "affordable." Many Members may also be concerned that the bill's provisions-only partially masked by budgetary gimmicks and "smoke-and-mirrors" accounting-cost nearly $1.3 trillion, financed largely by significant job-killing tax increases imposed on small businesses during a recession.
Buried within the contents of the 1,990 page bill-as well as a separate 13-page bill (H.R. 3961) that would increase the deficit by more than $200 billion-are details that will see a massive federal involvement in the health care of every American, including the following:
- Creation of a government-run health plan that experts say would result in up to 114 million Americans losing their current coverage-a clear violation of any pledge to allow individuals to keep their current health plan;
- Nearly half a trillion dollars in tax increases on certain income filers, a majority of whom are small businesses-and $729.5 billion in tax increases overall;
- Insurance regulations that would raise costs for nearly all Americans, particularly young Americans, and confine choice of plans to those approved by a board of bureaucrats;
- New price controls on health insurance companies that provide perverse incentives to keep individuals sick rather than managing chronic disease, while impeding patient access to important services just because those services do not provide a direct clinical benefit;
- Additional federal mandates that would significantly erode the flexibility currently provided to employers-and could result in firms dropping coverage;
- Massive expansion of Medicaid to all individuals with incomes below 150 percent of the Federal Poverty Level ($33,075 for a family of four), replacing the existing private health coverage of millions with taxpayer-funded health care-and imposing tens of billions of dollars in new unfunded mandates on States;
- Denial of health plan choice to 15 million Americans, consigning them instead to a Medicaid program riddled with bureaucratic obstacles and poor access to care, such that its own beneficiaries do not consider it "real insurance;"
- Language opening employers operating group health plans to State law remedies and private causes of action-subjecting employers to review by 50 different State court rulings, thereby raising costs and encouraging more employers to drop their current health plans;
- Liability "reforms" intended to ensure trial lawyers do not have their compensation reduced, rather than meaningful changes that would reduce the cost of health care by eliminating wasteful defensive medicine practices;
- Establishment of a bureaucrat-run health Exchange that would abolish the private market for individual insurance outside the Exchange-and could evolve into a single-payer approach due to the Exchange's ability to cannibalize existing employer plans;
- Creation of a new government board, the "Health Benefits Advisory Committee," that would empower federal bureaucrats to impose new mandates on individuals and insurance carriers;
- Taxation of individuals who do not purchase a level of health coverage that meets the diktats of a board of bureaucrats-including those who cannot afford the coverage options provided;
- New, job-killing taxes-$135 billion worth-on employers who cannot afford to provide their workers health insurance, resulting in up to 5.5 million lost jobs, according to a model developed by President Obama's chief economic advisor;
- Penalties as high as $500,000 on employers who make honest mistakes when filing paperwork with the government health board-which would likely dissuade businesses from continuing to provide coverage, increasing enrollment in the bureaucrat-run Exchange;
- "Low-income" health insurance subsidies to a family of four making up to $88,200;
- Arbitrary and harmful cuts to popular Medicare Advantage plans that would result in millions of seniors losing their current health coverage; and
- Expanded price controls on pharmaceutical products that would discourage companies from producing life-saving breakthrough treatments.
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