“Politicians have deliberately written the ObamaCare rules, as they have for all entitlements, so the real costs are disguised and hard for taxpayers to figure out. During the ObamaCare debate, Mr. Foster was honest enough from his Medicare perch to expose the plan’s true costs, and his new Medicare demarche continues this public service. He ought to receive the Presidential Medal of Freedom, or at least some media attention. But in Barack Obama’s Washington, his honesty will be rewarded with obscurity.”

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With ObamaCare unlikely to be repealed until 2013 at the earliest, the promising tactic to defeat it is through defunding implementation. “Should Republicans regain control of Congress, they could theoretically use their new power of the purse to deny Obama the funding needed to administer his signature accomplishment. This prospect is already gaining steam among opponents of the law. The new group DeFundit.org has gotten more than 90 candidates and current members of Congress to sign a pledge supporting stripping ObamaCare of money.”

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ObamaCare cut over $500 billion in Medicare payments to health care providers over the next 10 years. These cuts were in an arbitrary, across-the-board manner, and are unlikely to work properly because it’s difficult to second-guess how medicine will advance over the next decade. “This is an inherent defect of Medicare not found in markets.  Competitive markets automatically translate productivity gains into lower prices for consumers.  Medicare protects providers at the expense of enrollees and taxpayers.”

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Indiana’s proven health reforms are about to be overturned by ObamaCare’s Washington-led directives. “A key part of American federalism is states’ ability to serve as laboratories where the consequences of various programs can be explored without committing the entire nation to what may turn out to be expensive blunders. For instance, Wisconsin successfully took the lead on welfare reform in the early 1990s, setting the template for national bipartisan legislation in 1996 that lifted millions of women and children out of poverty. But in health-care reform, President Obama and congressional Democrats didn’t wait for state experiments to run their course. State reform efforts—on the left and right—were still in their earliest stages in March 2010, when Congress passed the Patient Protection and Affordable Care Act, committing the nation to trillions of dollars of new health-care spending. The consequences of this rush to national reform could be dire.”

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“The precise number of new entities that will ultimately be created pursuant to PPACA is currently unknowable, for the number of entities created by some sections is contingent upon other factors, and some new entities may satisfy more than one requirement in the legislation. Although PPACA states that certain entities were ‘established’ by the legislation, in practical terms, these entities will not be able to function until members are appointed and appropriations are provided or made available… The degree of specificity in these provisions may have implications for congressional control and, conversely, the amount of discretion that agencies will have in the implementation of the legislation. PPACA significantly increased the appointment responsibilities of the Comptroller General of the United States, and it is unclear how the Government Accountability Office (GAO) will be able to independently audit entities whose members are appointed by the head of GAO.”

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Sen. Blanche Lincoln (D-AR) is the first Senate Democrat to endorse Sen. Mike Johann’s (R-NE) bill to repeal the restrictive new business reporting requirements in ObamaCare. The provision is entirely unworkable, and even the IRS has questioned its worth.

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The Medicare Trustees issued their annual report outlining the financial status of Medicare last week. At the end of the document was a formal rebuke from the chief Medicare actuary, casting doubt on the rosy portrayal of the main report. “It is difficult to overstate how unusual this development is. The normal process with the annual Trustees’ Reports is for the Trustees to develop and publish the best available projections for the future finances of Social Security and Medicare. The respective Social Security and Medicare actuaries then sign a pro forma blessing of those projections, which is tacked to the back of the report when released to the public.”

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“The American people can kill this monster in its crib. Handing Republicans the keys to Congress on November 2 could smother this $2.5 trillion extravagance in its infancy. While a GOP repeal vote surely would earn a presidential veto, a Republican Congress could defund this law’s implementation. Instead, Republicans should administer a pro-market antidote to ObamaCare’s poison: health-insurance vouchers, Medical malpractice reform; universal, tax-free Health Savings Accounts; and individual, portable medical plans — all available across state lines.”

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“The ‘spin’ surrounding the Trustees Reports will largely involve what the new health care bill did and did not do to ‘solvency’ and other metrics. Unfortunately, the real ‘news’ in the reports is that the window for reform to slow the growth of these programs and to keep taxes at historical levels has nearly closed. Program beneficiaries need to be told of changes before they retire so they can adjust their life plans accordingly. If someone knows in advance that Social Security benefits will be lower or Medicare Part B premiums higher, they can delay retirement and make other changes. When people are informed of these changes in retirement, that flexibility has been taken away, leaving them worse off. Yet, if reforms are passed in say 2013 (a soon but reasonable timeframe) and they exempt future beneficiaries within 10 years of retirement, the reforms will (or can only) address less than 40% of the entitlement cost growth.

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“In the 2010 Annual Report of the Board of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds, the Board warns that ‘the actual future costs for Medicare are likely to exceed those shown by the current-law projections.’ The Trustees Report is necessarily based on current law; as a result of questions regarding the operations of certain Medicare provisions, however, the projections shown in the report do not represent the ‘best estimate’ of actual future Medicare expenditures. The purpose of this memorandum is to present an alternative scenario to help illustrate and quantify the potential magnitude of the cost understatement under current law.”

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