Health Care Endgame

The Democrats’ plan for a government takeover of health care enters the back stretch this week.  But for all the controversy swirling around the Pelosicare bill released last week — especially Dems’ risible clams that it would reduce the federal deficit — that bill isn’t going to be brought up for a vote.

Sorry, folks, but all of you who wasted your weekend trying to read the 1990-page monstrosity are in for an unpleasant surprise in the form of an 800-page (or longer) “manager’s amendment” that’s going to be tacked on to the bill to “repair” the things that liberals don’t like about the bill.

As of deadline, there was no word on whether or not House Speaker Nancy Pelosi (D-Calif.) will allow Republican floor amendments, fearing Republicans would pass bans on things like federal funding for abortion and enforcement measures barring coverage of illegal aliens.  Those elements are still in the bill.  But those aren’t the changes to watch for as those two amendments very likely won’t be allowed.

As intentionally discombobulated as the 1,990-page bill already is, the “manager’s amendment” will be dropped in before the vote to substantially change the contents of the bill yet again and make the CBO cost estimate irrelevant.

This manager’s amendment is expected to be an additional 800 pages.  That will bring the final bill closer to the 3,000-page range.  Pelosi promised to post this new amendment on the internet for 72 hours before the vote.  Regardless, a bill of this size and scope can hardly be properly examined in three days or three weeks or more likely three months. It is intentionally vaguely worded and mired in Congress-speak because too many average Americans understood its predecessor:  H.R. 3200, the bill which was the subject of all the townhall anger in August.

The question everyone should be asking the Speaker of the House this week is why hundreds more pages of changes will be dropped at the eleventh hour on a bill she just released late last week?

The answer is a simple one that she does not want to give: the final bill she’s trying to ram through the House (without anywhere near adequate time to assess the consequences) will be a government takeover of health care on steroids.

What is in the 1,990 pages is already bad enough.  The parade of horribles is still there: federal funding of abortion, coverage of illegal aliens (there is no enforcement measure to require proof of citizenship for coverage), bureaucrat access to your financial records to assess coverage and access to your bank account for auto-debits payments. Death panels that will ration health care, comparative effectiveness research, the Health Choices Czar — every single element those taxpayers across the country turned out by the millions at tea parties and at town hall meetings and marches on Washington to reject are still in the bill.

Making Legal Tax Deductions Not So Legal

Americans for Tax Reform (ATR), a Washington-based public policy group opposed to tax increases, found an item in the health care bill that codifies into law the “Economic Substance Doctrine.”  On page 349 of the bill, the IRS is empowered to disallow a perfectly legal tax deduction or other tax relief merely because the IRS deems that the motive of the taxpayer was not primarily business-related.  
There is no exception for families making less than $250,000 per year, so this pertains to everyone.

ATR says what this provision does is empower the IRS to assess your motive when claiming a tax deduction or other tax relief.  If they determine you merely wanted to lower your tax liability, and would not have done this action for any “economically substantive” reason besides this, they can disallow it.

Currently, taxpayers are allowed to claim any sort of legitimate tax benefit for any reason.  Say you bought a new van for your flower delivery business.  If the IRS decides you didn’t “need” a new van for your business — that you only purchased the van as a tax write-off — they will disallow the perfectly legitimate tax deduction.

Leaving aside for a moment the notion of IRS Thought Police: what does a taxpayer’s motive when making a purchase have to do with health care?  Do they think people who need a tax deduction will go have their gall bladder removed for a write-off?

Grover Norquist, President of ATR, told HUMAN EVENTS, “Not content to give the IRS the power to take our earnings, Congressional liberals now seem to want to give the IRS the power to read our minds.  Assessing the motive and intent of a taxpayer is simply not possible.  The result will be that the IRS will always determine that a taxpayer was merely looking to minimize taxes.  This is a pure cash grab.”

Adjusting the CBO Numbers

The CBO has already had to adjust (pdf) their first estimate of the health care bill.  Initially, the CBO and House Democrats tried the same accounting scam that puts corporate executives into prison.  Enron immediately comes to mind.

The CBO had originally tried to claim that the bill would cost $894 billion.  What they did to reduce the cost of the bill, instead of honest accounting procedures, is deduct from the cost of the bill the revenue projections on fines from the mandates on employers and individuals requiring everyone to purchase health insurance.  The CBO projected the fines on mandates will reach a whopping $168 billion.  Regardless, you cannot deduct these revenue projections to bring down the cost of a bill.  People go to jail for that sort of fraudulent accounting.

Likewise, under the CBO’s fuzzy math, the bill increases taxes by $572 billion.  But if you include their estimate of fines assessed on employers and individuals as tax revenue, the bill increases tax increases by a whopping $740 billion.

The CBO’s deduction of projected revenues has now been “adjusted” bringing the cost of the bill to the $1.05 trillion — which does not include the cost of the “doc fix” that was stripped out into a separate bill to give the appearance of lower cost.  The attempt to pass separate “doc fix” legislation (an adjustment to doctors for the underpayments that have driven many out of the Medicare system) was recently defeated in the Senate.  

Rep. Dave Camp (R-Mich.), the top Republican on the House Ways and Means Committee, spoke with HUMAN EVENTS about the CBO adjustment and “doc fix.”

“This bill isn’t $800 billion; it isn’t $900 billion; it isn’t even $1 trillion,” Camp said.  “Once you cut through all the rhetoric, you end up with a $1.3 trillion bill — that’s $1.055 trillion in the base bill plus another quarter trillion dollars for the Medicare doc fix.  They ordered everything on the menu, but only want to pay for the appetizer.  It just doesn’t work that way and the American people know it.”

Barton Wants a Hearing on the Health Care Bill

Rep. Joe Barton (R-Texas), the ranking Republican on the House Energy and Commerce Committee, has sent a letter (pdf) to committee Chairman Henry Waxman (D-Calif.) asking for a hearing on the new, Goliath bill to give members and the public an opportunity to understand the legislation and its implications.  

Barton asked that Waxman include both Health and Human Services Secretary Kathleen Sebelius and Congressional Budget Office Director Doug Elmendorf as witnesses. Back in September, Sebelius had offered to return to the committee and testify when the final legislation became publicly available for examination and discussion.

“As you know, H.R. 3200 included a government-run health care plan where physicians were to be reimbursed at Medicare’s rate plus 5 percent,” Barton wrote in the letter. “The new legislation, H.R. 3962, creates a government-run health plan where the Secretary of HHS would be permitted to negotiate rates with providers. However, it seems clear from the legislative language of H.R. 3962 that doctors could, and most likely would, be paid a base rate at Medicare levels and the HHS Secretary would be authorized to pay providers less than the Medicare rate.”

A hearing would allow time for the American people to get expert opinions and testimony on the impact of this government takeover of our health care system on jobs and the economy (health care is one-sixth of the nation’s economy).

“It looks like the only lesson Democrats have learned from the August town hall meetings was that if the American people know what’s in the bill, they probably won’t like it,” Barton said.  
“So the practical application of the lessons learned is this: write it in private, withhold it until the last moment, and then rush it through before people know too much.”

More tomorrow on new provisions in the bill — like allowing school-based health clinics to take your under-age child to have an abortion without your knowledge or consent.

Stay tuned.