Well, it is one step closer to a done deal as they say. Health care reform that will save the government money and by 2019 still have 23 million Americans without health insurance (although 1/3 of that number would be illegal immigrants). Of course, the money saved comes from reduced payments under Medicare, cuts in Part C of Medicare, a new 10% sales tax on tanning salons (who cares), the 40% excise tax on high cost plans (expected to generate $35 billion in revenue in 2019) good luck with that and penalties paid by people who do not obtain coverage plus an increase of .9% in the Medicare tax for individuals who earn more than $200,000 a year.
Sen Ben Nelson cut a deal (despite the fact his office staff told me there was no way he was voting for the bill for many reasons) part of which is that Nebraska will have the entire additional cost of the Medicaid expansion under the legislation picked up by the federal government while other states will see an added expense for Medicaid in 2017. There is a national view of doing the right thing. I suspect Nebraska has a huge Medicaid population compared with New York, New Jersey and California.
The CBO estimates a lowering of the deficit by $132 billion over ten years as a result of this legislation (but an increase in insurance premiums for many people who already have coverage). That includes $72 billion in revenue for the new long term care insurance that will automatically enroll workers unless they opt out.
If there is anyone who believe that the federal government can estimate anything accurately over a ten year period or that future Congresses will not tinker with all this starting in 2010, make sure you leave some cookies and milk for Santa.
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