Health care issues: Government spending

AP News
Posted: Nov 11, 2009 10:00 AM

A look at key issues in the health care debate:

THE ISSUE: Can taxpayers afford new subsidies to provide health insurance for millions in such a weak economy?

THE POLITICS: With a comprehensive policy averaging nearly $13,000 a year for a family, covering more than 30 million uninsured doesn't come cheap. The price tags of Congress' health care bills range to $100 billion a year and above. Voters are concerned about the costs of President Barack Obama's approach, and Republicans have tapped those fears effectively to undermine support. Obama says he wants to limit the package to about $900 billion over 10 years, and says he won't sign a bill that adds to the deficit. Nonetheless, polls show Americans are concerned the health care overhaul will mean higher taxes.

WHAT IT MEANS: To keep their legislation from adding to the deficit over the 10-year budget window that Congress uses, Democrats have already delayed the expansion of coverage to 2013 _ after the next presidential election. But taxes on the wealthy to pay for the plan will kick in much sooner, as will spending cuts in Medicare and Medicaid. The pain will be felt before anyone benefits from the plan, which could lead to calls for a repeal. And, Democrats have used some sleight of hand to keep the costs of the bill from exceeding Obama's $900 billion limit. They left out the $250 billion, 10-year cost of remedying a flawed Medicare physician payment formula _ which they'll have to do separately anyway _ and House Democrats are including only the costs of extending coverage in their bill's price tag, leaving out tens of billions more for a variety of programs like preventive care and paying for more primary care doctors. Even so, many Democrats fear that they won't be spending enough on subsidies to make coverage truly affordable for the uninsured.

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