“While many of Obama Care’s major pieces won’t kick in until 2014, a few big changes are already under way–and offering an early taste of what’s in store for American health care. It ain’t pretty. Think: greater government control, less competition and fewer options for consumers.”

When ObamaCare was being debated, the Congressional Budget Office concluded that the law would lower the deficit by $124 billion dollars. CBO has now released more numbers providing new context to that number. ObamaCare will raise taxes by $525 billion and increase spending by $401 billion over the next ten years. This represents a massive increase in the size of government.

A consequence of the government take-over of the health sector is the vast new influence that health lobbyists will have. On the federal and state level, influence-peddlers will become more important, violating a key campaign promise that President Obama would reduce corporate influence in government.

Progressive ObamaCare supporter Health Care for America Now (HCAN) is organizing a field campaign to help Democrats in tough re-election races. But HCAN staffers aren’t going around touting the success of ObamaCare, because it’s so unpopular. “Now, HCAN’s field crews are finding that the best way to support reform-friendly lawmakers is to talk about something else: jobs, the economy or other issues likely to resonate more with voters.”

“An interesting pattern has started to emerge in this midterm election, which could be dominated by the continuing debate over the health care reform law passed earlier this year. A whole bunch of Dems from Republican-leaning districts have been running ads in which they tout their opposition to the bill.”

With new medical-loss ratio regulations and an expansion of government involvement in the insurance purchasing process, insurance brokers are likely to cease to exist as an industry. “Insurance agents and brokers and small insurance companies are among those who may have to scramble to stay afloat over the next few years. This is partly by design and partly an unintended consequence of a new law that is so sweeping, it will affect nearly every corner of an industry that accounts for one-sixth of the U.S. economy.”

“I note with special sadness that first and foremost amongst the bill’s consequences will be the probable demise of the Healthy Indiana Plan (HIP). This program is currently providing health insurance to 50,000 low-income Hoosiers. With its Health Savings Account-style personal accounts and numerous incentives for healthy lifestyle choices, it has been enormously popular and successful. Obamacare’s expansion of Medicaid, soon to cover one in every four citizens, will not only scoop up most of HIP’s participants, but will also cost the state between $3.1 and $3.9 billion over the next decade. It is hard to see how my successors as governor will be able to avoid a steep state tax increase to pay for it.”

“The real wallop of ObamaCare will come in 2014, when most of the spending begins and businesses and individuals are hit with intrusive and expensive mandates. The main job of Republicans, should they capture Congress, will be to slow down implementation of the law and explain to the American people the damage it will do—and already is doing—to our economy. If the White House changes hands in 2012, they can be ready to start with a clean slate and begin a step-by-step approach to sensible reform.”

Regulators are discussing how to write regulations governing ObamaCare’s rules on “medical-loss ratios” which restrict the operating flexibility of insurers. “Democrats prefer an extremely narrow definition, the better to hasten the conversion of insurance companies into public utilities. This political pressure is giving most state commissioners night sweats, because they’re responsible for preventing coverage disruptions and premium increases in the insurance markets they oversee. When the commissioners met last week in Seattle, they largely declined to endorse the medical loss restrictions that Democrats favor.”

ObamaCare will restrict the ability of colleges to give students low-cost health plans. “As the new law currently stands, it’s unclear whether student health plans would meet federal requirements to qualify as minimum essential coverage. If they don’t, students would have to find coverage elsewhere or pay the individual mandate in addition to the premiums of their student health plan.”