Knoxville News Sentinel: Op-Ed by Sen. Alexander: One year later, health care reform remains a mistake
Posted on March 27, 2011
By U.S. Sen. Lamar Alexander
This past Wednesday marked the one-year anniversary of President Barack Obama's signing into law the health care bill that some in Washington consider a historic achievement. I believe it was a historic mistake.
Republicans were clear about our position on health care reform during last year's debate: We said that, instead of expanding a health care system that costs too much, it would be better to go step-by-step to reduce its costs so more people can afford insurance.
Several days before the bill became law, Obama invited a bipartisan group of senators and House members to discuss health care in a "summit" that lasted several hours. I was asked to speak on behalf of Republicans, and said that, according to the Congressional Budget Office (CBO), the president's plan would raise the cost of individual premiums by 10 to 13 percent. The president replied: "That's just not the case." Unfortunately, it is.
We often talk about the law of unintended consequences in dealing with legislation. In this case, I believe the health care law is a situation where we have had predictable consequences. Republicans and the CBO said premiums would rise because of the president's health reform plan. And, predictably, they have.
It was predictable because the health care law requires that individuals buy a better policy than what they have today. If you're forced to buy a Cadillac to replace a Chevy, it will cost you more.
It was predictable because there are many new taxes in the law - notably, a $20 billion tax on medical devices - that will be passed on to the consumer and will increase premiums.
It was predictable because 20 million new Medicaid enrollees will be entering a system of government health care where doctors aren't properly reimbursed. Many of the doctors shift the costs over to the people who buy insurance, a process called "cost shifting."
We have seen regular reports that, over the last year, individual premiums have gone up in California, Nevada, Wisconsin and Connecticut - in part because of mandates in the new law.
We said the bill would raise taxes, and it does, by about $813 billion. We said it would cut Medicare, and it has: 11 million Medicare Advantage recipients, or about one-fourth of everyone who has Medicare, are seeing or will see their benefits reduced.
We said there would be thousands of pages of new regulations that would hamper small businesses and individuals as they go about their daily lives. The most notorious is the law's 1099 reporting provision, which forces 40 million businesses to file a report every time they buy something that costs more than $600.
We said the law would force unfunded mandates on state governments. College tuition in the University of California system is going up 30 to 40 percent because the cost of California's Medicaid program is eating up the money that ought to go to the system - or here, to the University of Tennessee system - isn't there. So, where does the university find the money to maintain its excellence? It raises tuition.
Former Tennessee Gov. Phil Bredesen said the Medicaid expansion in the health care law imposes more than $1.1 billion in new costs on Tennessee between 2014 and 2019.
Republicans believe it would be better to reduce health care costs step by step so more people can afford insurance, instead of expanding a system that costs too much, and we will continue to advocate that position.
We voted to repeal the health care law. We lost that vote. But we are continuing to work: we will work to repeal the 1099 provision. Sen. Orrin Hatch and I and others are working to give governors more flexibility in the Medicaid program. And we will continue to advocate solutions such as allowing people to buy insurance across state lines.
Wednesday was an important anniversary. Some believe it marked a historic achievement. I believe it was the anniversary of a historic mistake and that there is a better solution to lower health care costs.