History or Travesty, Health Care Reform Becoming a Reality

The Congressional Budget Office has got the Democrats excited over their "scoring" of the manager's amendment because they report it actually lowers the deficit some:

The CBO said that the final legislation, unveiled Saturday by Senate Majority Leader Harry Reid, would cost $871 billion over the next 10 years and reduce the deficit by $132 billion over the same period. That's more than the first Senate bill had cost.

Roughly 31 million people would receive new coverage under the legislation.

The final Senate bill will cost more than the 2,074-page bill first unveiled by Reid last month. The Congressional Budget Office (CBO) said that bill would cost $848 billion over 10 years.

That's not too bad, is it? It wouldn't be except the Democrats are using smoke and mirrors to make the bill appear better than it is. Writes the Heritage Foundation's James Capretta at the NRO's Critical Condition blog:

For starters, as CBO notes, the bill presumes that Medicare fees for physician services will get cut by more than 20 percent in 2011, and then stay at the reduced level indefinitely. There is strong bipartisan opposition to such cuts. Fixing that problem alone will cost more than $200 billion over a decade, pushing the Reid plan from the black and into a deep red.

Then there are the numerous budget gimmicks and implausible spending reductions. The plan’s taxes and spending cuts kick in right away, while the entitlement expansion doesn’t start in earnest until 2014, and even then the real spending doesn’t begin until 2015. According to CBO, from 2010 to 2014, the bill would cut the federal budget deficit by $124 billion. From that point on, it’s essentially deficit neutral — but that’s only because of unrealistic assumptions about tax and Medicare savings provisions. By 2019, the entitlement expansions to cover more people with insurance will cost nearly $200 billion per year, and grow every year thereafter at a rate of 8 percent. CBO says that, on paper, the tax increases and Medicare cuts will more than keep up, but, in reality, they won’t. The so-called tax on high cost insurance plans applies to policies with premiums exceeding certain thresholds (for instance, $23,000 for family coverage). But those thresholds would be indexed at rates that are less than health-care inflation — forever. And so, over time, more and more plans, and their enrollees, would bump up against it until virtually the entire U.S. population is enrolled in insurance that is considered “high cost.”

Nice trick if you can pull it off, and the Democrats are prepared to do it.

The reaction of many liberal Democrats is a lot of grumbling over the strictures on abortion and a lack of a "robust" public option. But they are making no bones about the idea that once health care reform is a reality, they are going to start tinkering with it almost immediately in order to get it "just right."

It seems a fait accompli that the House-Senate conference to hash out the remaining issues will be difficult but doable now that Majority Leader Reid and Speaker Pelosi have shown that they are willing to use as much taxpayer money as it will take to bribe, cajole, and sweeten the pot for individual members. The momentum for passage appears irreversible and it seems likely that sometime before the president's State of the Union message, he will have his "Pyrrhic victory."

Bill Kristol:

[N]ever before has so unpopular a piece of major legislation been jammed through on a party-line vote. This week, Rasmussen showed 57% of voters nationwide saying that it would be better to pass no health care reform bill this year instead of passing the plan currently being considered by Congress, with only 34% favoring passing that bill. 54% of Americans now believe they will be worse off if reform passes, while just 25% believe they'll be better off. Making the 2010 elections a referendum on health care should work--if Republicans don't let up in the debate over the next year.

Those numbers won't change anytime soon. But since most of the big changes are years away, it is likely that the health care issue will fade into the background and some other "historic" piece of legislation will come to the fore.

History or travesty, it won't matter. It's all about change. As for the companion to change in the Obama mantra, we might take heed of the sign over hell in Dante's Divine Comedy when thinking of the doors to the Capitol:

"All hope abandon ye who enter here."