Those on Medicaid are more likely than the uninsured to visit the emergency room. Given that ObamaCare assumes substantial cost savings from reduced ER visits after people who were previously uninsured become covered by Medicaid, its cost increases will likely be substantially higher than anticipated by the Administration.

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The only medical doctors in the Senate, John Barrasso (R-WY) and Tom Coburn (R-OK,) released “Bad Medicine,” a report on the 100th day of ObamaCare. It highlights the hidden costs and problems with the bill. “One of the most startling assertions in the Coburn/Barrasso report – which was obtained ahead of its release by The Daily Caller – is that nearly 100 million Americans will lose their current form of health insurance and will be required to obtain more expensive plans.

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Senate Finance Committee Chairman Max Baucus (D-MT) was one of the principle architects of ObamaCare. His committee has oversight over the Centers for Medicare and Medicaid Services, and he was waiting to receive materials from Dr. Don Berwick, the nominee to run CMS. But before Baucus’s committee received a reply or held a hearing, Obama made a recess appointment, infuriating the powerful Democrat.

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Dr. Don Berwick will be recess appointed as head of the Centers of Medicare and Medicaid Services, without even a single committee hearing. “This way, Berwick will assume his post without having to explain statements such as this: ‘Cynics beware, I am romantic about the (British) National Health Service; I love it.’… Obama could have announced his CMS appointment at any time after winning the election in November 2008 if it were so urgent, but he waited almost a year and a half — until April of this year — to name Berwick. Conveniently, this was after the health care law had already passed. Had he appointed Berwick during the health care debate, it would have exposed how much Obama’s ultimate vision for U.S. health care borrows from the British model.”

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“Just a few months ago, President Obama signed the health-care bill into law amid much fanfare. But we’re hearing a different tune from small-business owners. They’re asking: How much is this going to cost me, how can I opt out, isn’t there any way to stop this from taking effect?”

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While the White House highlights their favorite parts of ObamaCare, the real work is being done in the depths of the federal bureaucracy. “Track two is the regulatory process, where Obamacare is sinking its roots deeper and deeper into the bureaucracy and the health sector. This is below the radar of most Americans, but the implementation rules are beginning to frighten many industry groups that thought their seat at the table would inoculate them against the wrath of the regulators.

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The Patient Protection and Affordable Care Act represents more than a federal takeover of health care; it is a direct threat to federalism itself. Never before has Congress exercised its power under Article I, Section 8 of the Federal Constitution to force American citizens to purchase a private good or a service. Congress is also intruding deeply into the internal affairs of the states, commandeering their officers, specifying in minute detail how they are to arrange health insurance markets within their borders, and determining the products that will be sold to their citizens. If allowed to stand, this unprecedented concentration of political power in Washington will reduce the states to mere instruments of federal health policy. State legislatures and sympathetic Members of Congress should consider (among other actions) crafting a constitutional amendment to guarantee the personal liberty of every citizen in the area of health care.

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“If implemented as enacted, Obamacare will impose significant new Medicaid costs on states and constitute a major federal usurpation of long-standing state authority in regulating private insurance. This will be expensive and disruptive for those Americans who rely on individual or employer-based insurance for their health insurance.

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In addition to the direct costs of ObamaCare’s $500 billion in new taxes, there are also indirect costs from the new tax regulation. Section 9006 of the law puts vast new reporting requirements on businesses, forcing them to dramatically increase their administrative costs as they now have to report nearly every single business relationship.

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By tying its subsidy program to the federal poverty rate, ObamaCare strongly discourages marriage. The level of subsidization is based on a family’s income as a percentage of the federal poverty level, which changes based on a person’s marital status. Thus two individuals living together would receive a substantial decrease in their subsidy were they to get married.

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