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Let's make a deal

"Let's make a deal" Continued...

The 2,309-page bill, posted 72 hours before the vote, cuts $523 billion from Medicare and increases taxes by nearly $650 billion, with many of those taxes falling on the middle-class.

It includes a significant $434 billion expansion of Medicaid that would place an additional 16 million Americans into the government plan, with families making as much as $88,000 now eligible for federal assistance. The Congressional Budget Office estimates that 9 million people will lose their current insurance coverage by 2019 under the current proposal. The CBO also predicts that individual premiums will increase 10 to 13 percent.

To keep its budget estimates artificially low, the bill calls for collecting 10 years of taxes for just six years of benefits-many of its coverage provisions will not take effect until 2014 while its related tax increases are slated to begin right away. With much of the cost pushed outside the 10-year budget window, the bill's real cost over a decade of actual operation could top $3.5 trillion.

"The American people know that you can't create an entirely new government entitlement program without exploding spending and the deficit," explained Rep. Dave Camp, R-Mich.

The bill mandates that individuals buy and employers provide insurance or face fines-provisions that will surely face court challenges for their constitutionality.

"This bill is the mother of all unfunded mandates," said Rep. Paul Ryan, R-Wisc. "This bill is a fiscal Frankenstein."

The yearlong debate and final passage will be marked for its strong partisan divide-rarely has a bill that so drastically changes the American landscape passed with so little bipartisan support.

For example, the Social Security Act of 1935 passed with support from 76 percent of the minority Republicans and 84 percent of House Republicans. Congress created Medicare in 1965 with support from 43 percent of Senate Republicans and 51 percent of House Republicans. But with healthcare, zero Republicans in the House and Senate voted for the final bill.

The attention now shifts to the Senate and its majority leader, Harry Reid of Nevada. While Obama can now sign into law the Senate version of healthcare approved by the House, the Senate must also take up a bill of changes that also passed the House. These changes were necessary to win needed support from House Democrats who oppose elements of the Senate bill.

Senate Republicans have promised that the passage of those changes will not go flawlessly for Democrats. Expect a Senate slugfest: Sen. John Cornyn, R-Tex., told Fox News Sunday that Republicans will offer hundreds of amendments during this week's debate: "We're going to help the American people understand by these amendments what is in the bill and why they are right when they think it's a bad bill."

Edward Lee Pitts
Edward Lee Pitts

Lee teaches journalism at Dordt College in Sioux Center, Iowa, and is the associate dean of the World Journalism Institute.


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