Conservative Principles Now

America stands on the precipice of sweeping liberal health care reform that will radically reshape one-sixth of the U.S. economy, and a 153-page House bill is all that stands between us and a fundamentally changed America.

What will that change look like? Speaker Nancy Pelosi (D-CA) said, “we have to pass the bill so that you can find out what is in it,” and President Barack Obama said, “By the time the vote has taken place, not only will I know what’s in it, you’ll know what’s in it.”

In other words, here’s a ticket to ride, get on board, we can’t tell you where it’s going, but you’ll like it once you get there. We promise.

A picture of America’s future under Obamacare can be revealed, though, after peeling away the pages and digging through the dirt. Here’s 10 things you can expect:

1. A Massively Engorged Government, to the tune of $2.5 trillion in new entitlement spending. According to the Congressional Budget Office (CBO), new entitlement spending in the plan would cost $216 billion by 2019, then increase by 8 percent every year thereafter.
2. A Cornhusker Kickback for All. No, special deals aren’t removed from Obamacare this time around. Instead, the House bill extends new federal funding for Medicaid to all states. Incidentally, you’re paying for it.
3. A Freight train of taxes, slamming the American people in 2018. You’ve heard of the “Cadillac” tax on high-cost insurance plans? It will be pushed back to 2018, and given the way “high-cost” plans will be defined, a large segment of the middle class would get hit with the tax over time.
4. Beware the shape-shifting tax monster. New taxes will take many forms, including taxes on prescription drugs, medical devices (like wheel chairs), and health insurance.
5. Unconstitutional mandates, courtesy of Congress. Don’t want to buy health insurance? Congress will penalize you if you don’t, regardless of income.
6. Lock your back door. Higher health care costs will be sneaking in. The plan gives subsidies to low-to-moderate wage families, but the subsidies will increase at a lower rate than the rate at which premiums increase. In other words, those families will pay more every year.
7. Lights out for small businesses? Companies that hire certain low-income Americans will have to pay $3,000 per employee, per year, even if the company offers insurance.Oh, and if a company employs 50 or more workers, they’ll face higher tax penalties to the tune of $2,000 per full-time employee.
   
8. Abortions. You will pay for them, like it or not. The House bill includes major funding for community health centers with no restrictions on federal taxpayer funding of abortions.
9. Want to play the stock market? Maybe not, after you hear this. The House bill slaps a 3.8% tax on investment income.
10. It’s not a federal system, after all. States will have less power. They’ll no longer have authority to regulate health care premiums. Instead, the federal government will take on the job. States and local governments won’t be able to control their own employee health plans; they’ll have to abide by new federal regulations.

This week, the House is preparing to vote on the Senate-passed health care bill, which depends on a massive expansion of Medicaid to reduce the number of uninsured.

However, as has become apparent in the months of debate surrounding Democrats’ health care proposals, all that glitters is not gold—especially in the case of expanding Medicaid, a low-quality, poorly-functioning federal-state program which fails to meet the needs of its beneficiaries.  Increasing the number of citizens dependent on this program fails to address its numerous shortcomings, and instead applies them to millions more.

A recent article in the New York Times portrays the plights of current Medicaid beneficiaries which are slowly becoming the norm.  Since Medicaid reimburses doctors significantly below the cost of providing care, more and more doctors are being forced to turn patients away.  According to Dr. Saed J. Sahouri, “…we’re really losing money on seeing those patients, not even breaking even. We were starting to lose more and more money, month after month.”

As it becomes harder for Medicaid beneficiaries to find providers, more and more rely on emergency room care—in fact, Medicaid enrollees are more likely than even the uninsured to end up in emergency rooms in lieu of primary care.

As former Heritage analyst Dennis Smith points out, Medicaid spending is demanding a larger portion of state budgets, squeezing out other state priorities from education to transportation. This is a trend which is expected to continue in the years ahead.

If the federal government is serious about health care reform, expanding Medicaid is the worst way to go.  Making more Americans dependent on this program may decrease the number of uninsured, but will do nothing to improve the access and quality issues plaguing the program.   Moreover, federal funding to cover the expansion only offers states temporary relief and simply shifts these costs to federal taxpayers. Eventually states (and state taxpayers) will be left to pick up the cost, only intensifying the problems in the future.

Washington can do better by reforming Medicaid so that it works for those who currently use it.  Heritage analyst Nina Owcharenko outlines what states legislators and Congress can do to improve the quality of Medicaid:

States … should mainstream some Medicaid enrollees into private coverage and adopt consumer-directed models to promote personal responsibility and enable individuals to take control of their health care decisions… federal policymakers should look for ways to make this process easier and remove obstacles to change.

…Congress should enact key health care initiatives, such as health care tax credits, and private long-term care incentives that complement Medicaid reform and relieve the increasing pressures on state Medicaid budgets.

Millions of Americans currently struggle to receive adequate care due to Medicaid’s inadequacies.  Adding more families to these poor performing programs will make these problems worse.