John C. Goodman
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In the standoff over the fiscal cliff, all the discussion has been about the Bush tax cuts. There has been no discussion about the ObamaCare tax increases. That's a mistake.

Five of the tax increases Americans will face on January 1 are new taxes created under the Affordable Care Act (ObamaCare). And they are not just for the very rich. Three of the five will hit people who are solidly middle class.

The new ObamaCare taxes will hit everything from dividends and capital gains to day care and services for special needs children. They will increase the tax bill for those who have extraordinary medical expenses ? at the very time when they can least afford to pay higher taxes. They will hike the tax burden for the chronically ill who have several thousand dollars of out-of-pocket prescription drug expenses every year. The taxes will fall on medical devices ranging from pacemakers and artificial hips to bedpans and stents.

All told, these new taxes will create a burden in excess of $250 billion over the next 10 years.

The case for delaying these taxes is strong. Clearly they will depress economic activity and slow the recovery. But there is also another reason: we don’t need the money. The new ObamaCare taxes are supposed to provide the revenue to furnish subsidized health insurance to millions of people who will begin buying it in health insurance exchanges in January 2014. But the subsidies won't be needed if the insurance is not available and it won't be if the exchanges are not up and running at that time.

Here is my prediction: aside from two states that already have exchanges (Massachusetts and Utah), only one other state (Maryland) will make the deadline. Maybe Colorado will make it if they are lucky. But that's it. No other state is going to have operational exchanges on time.

In fact, half the states aren't even planning to set up exchanges. That responsibility will then fall to the federal government. But no money has been budgeted to fund such a large federal operation. The full implementation of ObamaCare could actually take years. In the meantime, let taxpayers keep more of their income to meet their own needs.

Clearly, the White House doesn't want to talk about any of this. When President Obama says he wants to protect middle income families from January tax hikes, he's not talking about the ObamaCare taxes. But what's wrong with the Republicans? They have allowed Democrats and the mainstream media to pull off a gigantic bait and switch. Everyone is talking about tax rates for the rich. No one is talking about the middle class tax burden needed to fund health reform.

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John C. Goodman

John C. Goodman is President and CEO of the National Center for Policy Analysis, Senior Fellow at The Independent Institute, and author of the acclaimed book, Priceless: Curing the Healthcare Crisis. The Wall Street Journal and National Journal, among other media, have called him the "Father of Health Savings Accounts." He is also the Kellye Wright Fellow in health care. The mission of the Wright Fellowship is to promote a more patient-centered, consumer-driven health care system.