Obama's health care bill, the poisoned Kool-Aid making its way through the Senate, will not confer any of its supposed benefits on Americans until 2013. But they will find themselves chafing at its restrictions and paying its taxes immediately after the law takes effect. Then, they will see no gain, but plenty of pain, for the next three years.
This odd juxtaposition of "suffer now, benefit later" is the byproduct of the administration's sleight of hand in specifying 10 years worth of cuts and taxes in the legislation, but deferring its benefits for the first four years. By comparing six years of spending with 10 years of taxing, it managed to appear deficit neutral under the rules of the Congressional Budget Office. In fact, the annual revenues fall far short of covering any single year's worth of spending, adding to the deficit for each of the last six years over the next 10 -- but, viewing the decade as a whole, it appears deficit-neutral.
Yet the political price is hardly neutral. Democrats who misguidedly vote for this monstrosity will face immediate political repercussions.
The harshest of these backlashes will come from the elderly, who will visit their doctors and suddenly be told "no" when they ask for therapies or treatments. The rationing of medical care will start immediately on enactment, and one hopes, the outraged phone calls will start to descend on those whose votes enabled it.
The first "no" will hit the 10 million elderly who now rely on Medicare Advantage to pay for the care Medicare itself does not cover. In a payoff to AARP, Obama gutted this program in his bill, ending over $100 billion in federal premium subsidies. These 10 million voters will get the grim news that their premiums are going up and their benefits dropping early in 2010. The goal, of course, is to force them to drop Medicare Advantage and sign up, instead, for Medi-gap insurance -- offered, not coincidentally, by the AARP -- which provides less coverage at higher cost.
Young people without health insurance can expect to start writing $750 annual checks to Washington to pay the fines written into the bill. (And, after the Conference Committee finishes its work, the fines may be higher).
All Americans will soon find their insurance premiums rising as a result of the bill. The young, uninsured will not buy policies. Why should they? Why not just pay the $750 fine each year? Why pay between 2 percent and 10 percent of their household income before subsidies kick in? It makes no financial sense for anyone making more than $30,000 to pay for coverage. (And most of those under that threshold will be covered by Medicaid, not by private insurance.)
There is no reason for the young to buy private insurance. The legislation requires that health insurers take all comers and not raise rates based on pre-existing conditions. So the young can get coverage when they need it, having only paid $750 per year beforehand.
The difference in cost will, of course, be borne by families throughout America, who will see their health insurance premiums increase. President Obama and his Democratic rubber stamps may appreciate that they are not raising taxes on the middle class, just raising mandatory health insurance premiums, but the distinction is likely to be lost on swing voters.
From now on, any increase in health insurance premiums will become the political responsibility of the Obama administration. As Gen. Colin Powell once said of Iraq, "You break it, you own it." Since these premiums have been rising by an average of 10 percent per year for more than the past decade, this is a legacy most politicians would sensibly avoid if they could.