“If the health care legislation passed in 2010 is implemented fully and on schedule, public attention will turn to features of the legislation that were perhaps less obvious during the debate. For example, who ultimately controls the new health exchanges-the states or the federal government? Resolution of this issue could determine the nature of health insurance in America. The so-called OPM alternative will soon be seen as an end-run for the public option and, if it remains on the statute book, could lead to a far stronger public option than anyone thought possible. Employers and employees will soon wake up to the fact that the legislation will accelerate the erosion of employer-based insurance. And rosy projections that health spending will taper down will most likely prove to be an illusion-forcing choices about price controls and budgets. However Congress responds to these decisions, it will mean big changes in access to services and control of the system.”

ObamaCare is substantially worse than most people think. “The length and complexity of the legislation, combined with a debate that often generated more heat than light, has led to massive confusion about the law’s likely impact. But, it is now possible to analyze what is and is not in it, what it likely will and will not do. In short, the more we learn about what is in this new law, the more it looks like bad news for American taxpayers, businesses, health-care providers, and patients.”

New ObamaCare regulations to increase tax revenues by adding paperwork to small businesses will sock businesses with onerous regulations. “An Internal Revenue Service watchdog warned Wednesday the paperwork burdens on small businesses may outweigh the benefit of tax collections generated as part of the new health-care law. Starting in 2012, about 40 million businesses, charities and other entities will be required to report to the IRS payments they make to suppliers and service providers, the IRS Taxpayer Advocate Service said in its midyear report to Congress.”

The lieutenant governor of Missouri filed suit against ObamaCare on the grounds that it interferes with individual freedom and state authority. “In his lawsuit, Kinder contends the federal health care law could cause Missouri to raise state taxes to pay for the expanded Medicaid program and that it improperly affects the compensation of state officials by making changes to the state health care plan. He also contends the law is unconstitutional because he says it interferes with Missourians’ personal health care choices.”

According to surveys, only about a third of Texas primary care doctors accept Medicaid patients, because the government-run insurance program sets very low doctor fees. Over half of the people who will become newly insured because of ObamaCare will be added to Medicaid, which means their insurance will likely not actually allow them access to medical care.