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A Closer Look at H.R. 3200 (Part I)
By Paul Ryan
Representing Wisconsin's 1st Congressional District
July 27, 2009

We all want to fix what’s broken in health care, but we need to get it right. With Congress out of session next month, August represents a unique opportunity for the American people to truly engage in this critical debate.

In Washington, the bill being rushed through the U.S. House of Representatives – H.R. 3200 – is known by its proponents as “The America's Affordable Health Choices Act of 2009.” This thousand page bill, which will dramatically impact the economic and personal health of every American, deserves an open, thoughtful debate with your active participation.

It is my hope to devote the next several pieces in The Journal Times to examine the facts of the current legislation before Congress. As I unpack what Congress is considering, your input would be welcomed. You are always welcome to give me a call, write me a letter, or send me an e-mail.  I’ll also be visiting the Racine community at a number of listening sessions at the end of August.

I intend to highlight specific provisions of the bill in future columns, but would like to start with a look at the costs.

According to the U.S. Department of Health and Human Services, here is an assessment of the current situation:

• U.S. health care expenditures in 2007 totaled $2.2 trillion, which amounts to roughly 2.5 times more per person than any other industrialized country;
• Government spending at the state and federal level accounted for roughly half of all health care expenditures ($1 trillion);
• The current government health care entitlements – Medicare and Medicaid – are already broke. Medicare alone has an unfunded liability of $38 trillion, while Medicaid’s increasing strains on State budgets contribute to fiscal crises from coast-to-coast;
• Costs incurred by families and business alike – in the form of higher premiums and out-of-pocket costs – continue to outpace wage growth, economic growth, and inflation.
• Exploding costs have forced families with insurance to do more with less, while leaving coverage increasingly out of reach for millions of Americans.

Rather than tackle the root causes of health inflation, H.R. 3200 would make matters worse. After the legislation had been passed out of the House Ways and Means Committee on July 17, 2009, the nonpartisan Congressional Budget Office (CBO) released its official cost estimate of H.R. 3200. With its objective analysis, the CBO dealt a serious blow to the legislation, demonstrating that the bill being rushed through Congress violated the very promises made by its proponents.

Among the CBO report’s chief findings as it relates to costs:

• Total costs would exceed $1 trillion;
• An economy already mired in a recession would be hit with tax hikes of $583 billion, while Medicare spending “cuts” would equal $219 billion;
• Despite the tax hikes and spending cuts, H.R. 3200 would still add $239 billion to the federal deficit;
• In a follow-up letter in response to my concerns on the long-term cost projection, the CBO Director warned of “substantial increases in federal budget deficits” for years to come.

Proponents of H.R. 3200 continue to argue that swift passage is urgently needed to get a grip on both the short-term deficit hole, as well as the imminent fiscal crisis in the years ahead. The CBO has made clear that this legislation falls short on both counts. H.R. 3200 not only fails to address sky-rocketing health care costs; the legislation exacerbates the problem.

The fundamental flaw with this government-centered approach is the misguided conclusion that we don’t currently spend enough on health care in America. I introduced an alternative reform proposal – “The Patients’ Choice Act of 2009” – which takes the money we already spend on health care, and spends it more efficiently, more effectively. To learn more my plan forward on health care reform, please visit: http://www.house.gov/ryan/healthcare

For additional resources on health care costs:

• Cost Estimates from the Congressional Budget Office: http://www.cbo.gov
• Health Care Spending Data, The Centers for Medicare and Medicaid Services, U.S. Department of Health and Human Services: http://www.cms.hhs.gov/NationalHealthExpendData/  

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