Ten Inconvenient Truths About ObamaCare

President Obama, with Vice President Biden at his side, makes a statement Sunday night following the final vote in the House for comprehensive health care legislation. (Pablo Martinez Monsivais/AP)

President Obama is promising a massive campaign to sell the health care plan just approved by Congress -- starting with his signature on the Senate version of the legislation on Tuesday. The sales pitch begins even as the Senate considers a raft of modifications to the plan already approved by the House. But as the president makes his pitch, critics will be looking to knock down many of the central claims he and other Democratic leaders have made. Here are 10 inconvenient truths that could dog the president:

1. The cost of coverage will rise for the middle class.

According to Dr. Scott Gottlieb, a health care scholar at the free-market American Enterprise Institute, the new bill will actually make it more costly for middle class families to buy health insurance by forcing those who shop on the individual market to buy generous, but expensive plans mandated under the new law. Middle class families earning $88,000 or more a year won't qualify for health care subsidies. A family earning $100,000 would end up spending nearly a quarter of their net income on health care.

2. Health insurance premiums will go up for nearly half of Americans.

Health care premiums for those in the individual insurance market will rise 10 percent to 13 percent by 2016 under the plan, according to the Congressional Budget Office. While the cost of premiums will be subsidized with taxpayer dollars for 57 percent of those enrolled in the new government-run insurance exchanges, the 43 percent of enrollees who do not qualify for assistance will have to pay higher costs.

3. Health reform is unlikely to create new jobs.

The Center for American Progress, a liberal think tank, says that the health care reform bill will create "between 2.5 million to 4 million additional jobs over the next 10 years." But the fiscally conservative Beacon Hill Institute, part of Boston's Suffolk University, conducted its own analysis and found that in response to higher taxes and mandates on companies to provide insurance, "firms would be induced to fire or lay off workers" to the tune of 120,000 to 700,000 employees by 2019. The Heritage Foundation, a conservative think tank, found that the new taxes would kill 690,000 jobs per year.

4. Federal funding may cover abortion.

Obama agreed on Sunday to sign an executive order to reaffirm the Senate bill's "consistency with long-standing restrictions on the use of federal funds for abortion." But pro-life groups say the executive order does not carry the force of a law and will do nothing to curb the provision in the bill they believe will allow taxpayer dollars to cover the procedure. "The president cannot amend a bill by issuing an order, and the federal courts will enforce what the law says," the National Right to Life Committee said.

5. Four million people will lose their employer-based plans.

The new health care law will impose a list of benefits each health care plan will have to offer if they are to remain in business. The Congressional Budget Office also estimates that about 4 million people would lose their employer-based plan and be forced to buy plans on the new government exchanges.

6. Medicare will cut services along with costs.

The bill makes $528 billion in cuts to Medicare, including a $136 billion reduction for Medicare Advantage. The Medicare Advantage cuts will force 4.8 million seniors off the popular plan by 2019. An additional $23 billion in cuts to Medicare will come from a panel charged with slashing Medicare spending.

7. The bill will not pay for itself.

The CBO found that the bill would reduce the deficit by $138 billion over 10 years, but the savings was achieved by leaving out a $208 billion provision lawmakers will have to enact later to ensure doctors are adequately paid for treating Medicare patients. When the "doc fix" is included in the bill, it runs $59 billion in the red over the next decade. And former CBO Director Douglas Holtz-Eakin said that "if you strip out all the gimmicks and budgetary games" the 10-year deficit would exceed $560 billion.

8. Higher Medicaid costs will gradually shift to the states.

The health care reform bill expands Medicaid to all non-elderly individuals up to 133 percent of the poverty line. The federal government would foot the bill for this expansion, but only until 2016. Beginning in 2017, states would gradually begin paying a portion of it. By 2020, states would cover 10 percent of the cost of Medicaid expansion.

9. Doctor shortages could lead to rationing.

A survey conducted by the Medicus Firm, a medical recruitment company, found that 46 percent of physicians said they would quit or retire if the Democratic health care reform bill becomes law. The survey noted that "even if a much smaller percentage such as ten, 15, or 20 percent are pushed out of practice over several years at a time when the field needs to expand by over 20 percent, this would be severely detrimental to the quality of the health care system."

10. The bill raises taxes for many individuals and businesses.

The bill imposes a 40 percent excise tax on insurance plans costing $10,200 for individuals and $27,500 for families. It also raises revenue by increasing the Medicare payroll tax for those earning more than $200,000, plus a new 3.8 percent tax on unearned income for these earners. The bill also imposes new taxes on drug makers, medical device manufacturers and health insurers that are likely to be passed on to consumers.

sferrechio@washingtonexaminer.com