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NRO’s health-care blog.

Pain Before (Limited) Gain



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Politico has reported that health-care talks will likely go into February, after the State of the Union. From the Democrats’ perspective, the later this goes, the harder it gets, especially as people realize what the first few years — the pre-benefit years — of the reform regime will be like. AP’s Ricardo Alonso-Zaldivar lays out what is likely to happen in this pre-benefit period, until 2013 in the House bill and 2014 in the Senate.  According to Alonso-Zaldivar, “costs of health care reform being pushed through Congress by Democrats will be felt long before the benefits.” Furthermore, he notes that “most of the 30 million uninsured helped by the bill won’t get coverage until 2013 at the earliest, well after the next presidential election.”

As Drew Altman, president of the Kaiser Family Foundation, describes it in the article, “There’s going to be an expectations gap, no question about that.” Altman further notes that “people are going to see their premiums and out-of-pocket costs go up before the tangible benefits kick in.” Of course, this cost-first, benefits-later approach was necessary to make the bill appear to be revenue neutral in the first ten years, as ten years of taxes and Medicare cuts will be needed to offset six (or seven) years of subsidies.

Even beyond the first few years, Alonso-Zaldivar notes, “Congress can’t abolish medical inflation, so don’t hold your breath waiting for premiums to drop.” (A touch cheeky for AP, I think, but the point is a good one.)

I was recently speaking about the health bill with my former boss — and former HHS Secretary — Mike Leavitt, who said “There is no doubt that the Democrats own this.” This ownership will likely be heavy burden in the years, not to mention election cycles, ahead.



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