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  • The House Health Bill: Rolling The Dice On The Big Bang Approach to Policy

    Very soon, the House of Representatives is expected to vote on legislation ( H.R. 3962). That 1990 page bill, if enacted, will have an unprecedented impact on our economy, the federal budget, and the lives of all Americans. You can read that bill right here.

    Here is a crucial question: Do members of Congress have any idea how this massive legislation will really affect us? Does anyone in the Speaker’s Office or in the Congressional leadership really know how moving the various parts of health care legislation will interact with one another and impact our care, our spending, our pocketbooks?

    Straight talk and honesty are at a premium. Taxpayers can be sure of the honesty of one top level public official: The Chief Actuary at the Centers for Medicare and Medicaid Services (CMS). He does not know the answers to these questions, and he told us that he doesn’t.

    The Stakes. Consider that national health care spending will represent 17.9 percent of our entire economy next year. By 2019, under current law, CMS forecasts we will spend $4.67 trillion.

    The Chief Actuary of the CMS did not analyze H.R. 3962. But he did analyze its successor, H.R. 3200, and, given that the basic policies in the earlier version are the same, the analysis should give House members pause. Indeed, under the earlier analysis, CMS says spending will increase to $4.796 trillion. This is important precisely because President Obama promised repeatedly that health care reform that would lower the cost of health care.

    Words of Warning. Consider the words of warning of the Chief Actuary:

    • “The actual future impacts of H.R. 3200 on health expenditures, insured status, individual decisions, and employer behavior are very uncertain.”
    • “The legislation would result in numerous changes in the way that health care insurance is provided and paid for in the U.S., and the scope and magnitude of these changes are such that few precedents exist for use in estimation.”
    • “Consequently, the estimates presented here are subject to a substantially greater degree of uncertainty than is usually the case with more routine health care proposals.”
    • “… the longer-term viability of the Medicare update reductions is doubtful.”
    • “Many of the provisions, particularly the coverage proposals, are unprecedented or have been implemented only on a smaller scale (for example, at the State level). Consequently, little historical experience is available with which to estimate the potential impacts.”
    • “The behavioral responses to changes introduced by national health reform legislation are impossible to predict with certainty.”
    • “In particular, the responses of individuals, employers, insurance companies, and Exchange administrators to the new coverage mandates, Exchange options, and insurance reforms could differ significantly from the assumptions underlying the estimates presented here.”

    Simply put, one of the top experts in Washington doesn’t know what all of this means.

    Unsafe Estimates. The estimates are based on a number of assumptions which CMS acknowledges may not turn out to be correct. For example, CMS assumes smaller employers are likely to drop coverage while more employees of large employers will take up employer sponsored insurance. On net, the number of people with employer sponsored insurance will decline by 15 million. However, the decline of employer coverage could be even greater if employers continue to cover the employee but drop other family members which would be shifted to government assistance. There is an underlying assumption that all states will continue to participate in the Medicaid program. We already know the current program is unsustainable for states and the additional costs of covering 18 million more individuals as CMS estimates would occur could result in states leaving the program. Collectively, states would save more than $2 trillion by getting out of Medicaid, leaving the federal government to pick up the entire cost. Nothing in federal law would prevent that from happening.

    It is becoming clearer as to how much of a gamble the politicians in Washington are willing to take with our lives, our fortunes, and our futures.

    Posted in Obamacare [slideshow_deploy]

    11 Responses to The House Health Bill: Rolling The Dice On The Big Bang Approach to Policy

    1. Pingback: Chief Actuary at Centers for Medicaid and Medicare Services on HR 3200 – Actual expenditures “very uncertain”.

    2. Bobbie Jay says:

      unless it's intentional of government, their ideas are not thoroughly thought through. they are dangerous and unnecessary. their hearing, thinking, speaking are all selective. their minds are weak and unable to think beyond what they've been programmed to. part of their programmed thinking, is punishment to the people. they have no empathy for the independent who wish to remain that way. they are insulting, disrespectful and dishonorable.

    3. Foggy Too, New Jerse says:

      It's a gamble only if Acorn can't perpetuate those who have the power to destroy the legal citizens of this nation. Soon we will get maybe a last shot at the voting booth and I would strongly suggest that everyone hold their noses and vote out anyone who has supported this dreadful bill in any way at all.

      Those elitists from the government must go and now or this will just go on and on. It's bad enough that the government took over the automobile business and banking and lord knows what else, but here they are eliminating people's ability to get reasonable health care.

      Right now if you are over 64, there won't be a HINI shot coming your way because the so-called government has decided younger folks need it more. Problem is doctors are reporting most kids get over it in six days. I have it right now and have had it much longer and know that just the way they let loose with their priorty list of those who would and would not get the shot (that seems to be a phantom anyway) is an indication of the direction we are headed if we don't vote by stomping our feet – even in front of Acorn as brought to us by Mr. Soros who wasn't even born here but feels his is the only way.

      We are being led to slaughter but we are not sheep and must fight anew to restore that fought for Constitution. We need candidates who will never recuse themselves and their families from the pain and suffering they are planning to dole out to we whom they represent.

      But right now, just vote them out and let them know we have had ENOUGH. Please, please vote with your brain.

    4. Pingback: Big bill, giant disappointment « liberty · equality · eternity

    5. Lloyd Scallan - New says:

      The answer is NO! The member of the House don't know what's in this pile of crap. They don't care!

      They vote the way they are told to by the Obama


    6. Tim AZ says:

      Those responsible for this bill are just demonstrating the depth of their inhumanity toward their fellow man. Until they can top that with something like CAP and TRADE. Of course maybe the citizenry will escort them to their own private rubber rooms for the remainder of their stay here on earth.

    7. Jerry from Chicago says:

      Most voters have no idea of what an actuary is, or what he/she does.

      Actuaries are like Supreme Court Justices of the numbers world. The Chief Actuary of the Center for Medicare and Medicaid Services (CMS)is thee person to whom we should all defer when it comes to determining the price tag for the HR 3962 bill. No one in government, except for the Chief Actuary of CMS, has any idea of what this will cost, regardless of what the proponents may claim.

      This government run, national health care plan is not in the best interests of all Americans. It would only be in the best interests of those who do not have insurance, including illegal aliens, those who can afford health insurance and choose not to buy it and the working poor who can't qualify for Medicaid. NO federal employee (from the President, the Senate or Congress, on down to the lowest level clerk) will give up the feredal employee's health plan in favor of Obamacare.

      If they push this through, all we can do is to wait until 2010 and try to undue the damage, if possible.

    8. Al, The Villages, Fl says:

      On pages 1431/32 it talks about medical liabililty alternatives employed by the States and requires among other things " the law does not limit attorneys’ fees or impose caps on damages" if the State is to get incentives. Another special interest feature of this grotesque so-called health care bill. Some States have been successful in bringing down health care costs by limiting liability cases. The dems taking care of us again.

    9. Jeanne Stotler, wood says:

      I wrote to my congressman and got a letter back saying the opposite of what I di, of course it's a form letter. Hope we get these people out next year. I heard a Congressman from Iowa on Wilkow's radio today and he says they are having trouble getting it together among Dems, also Reid is not holding his guys either, hope he's right

    10. Taylor Hoynes says:

      Government at the bottom may have the mindless minions following the pack. Those at the top of government are calculating, focused and very very deliberate in their agenda. That agenda is socialism/humanism and they are now empowered to dismantle our great Constitution and our Rule of Law. This is the result of the teaching socialism/humanism over the last 70 years. It started out first in our colleges and then K thru 12 and is in every text book in the country except conservative schools. History shows us very clearly that socialism leads to communism and it has failed all over the world and is failing all over Europe now and yet we keep going after it. We have made progress, but if Americans don’t get involved and vote we are lost.

      “The only thing necessary for the triumph of evil is for good men to do nothing.”

      Edmund Burke

    11. Leon, Durango, CO says:

      It bothers me how these big fat bills start by striking out fifty or a hundred years of respectable Law, and we don't know what we just lost. What is left is pure fascism, big fines, mandates, every crazy thing to take every bit of joy out of Medical practice. The Health Czar will destroy at will, any medical establishment that won't pay homage to them and their junk science. Let's see, take the best Health Care System in the world and totally change it? That's audacity, but in the end it is not hope. You usually don't change everything in the best system in the world, what? Do you thing every other person is stupid? Every other Congress?

      These Pseudo Democrats are out to wreck US.

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