Last week, I voted against the payroll tax extension. Although I gave several reasons for voting no, attention has been paid to my objections that Louisiana was singled out to partially pay for the deficit spending included in the bill. These objections are best understood as part of a critique of President Obama’s health care plan.

There is a provision in President Obama’s health care plan (variously called Obamacare, the Affordable Care Act, ACA or PPACA) stating that Louisiana will receive extra money to pay for the state’s Medicaid program. The amount Louisiana is to receive is being cut by $2.5 billion. This money was part of a deal Senator Mary Landrieu negotiated as part of President Obama’s health care plan.

Senate Democrats recently suggested cutting the $2.5 billion from Louisiana. They say that the original legislative language was drafted poorly and Louisiana is receiving more money than it should. Some feel that since the Senate Democrats who pushed this actually sought to cut $3.5 billion, Louisiana is lucky that only $2.5 billion is cut and that this is a necessary correction to a drafting error.

I disagree. My perspective can be summarized as follows: why, with all the false, misleading assumptions in President Obama’s health care law, is only this one singled out? Why aren’t we revisiting the entire bill, rooting out every instance where it was poorly drafted and/or will cost more than it was billed as costing? Why are only Louisiana’s interests sacrificed? After all, from the very beginning, President Obama’s health care law was different than how it was presented to the American people.

When Mr. Obama ran for president in 2008, he claimed that his health reform law would cover all Americans with health insurance, that there would not be an individual mandate and that the average family’s health insurance premium would decrease by $2500.

The first year after President Obama’s health care law passed, the average family’s health insurance premium INCREASED by 9%.  The law has an individual mandate forcing Americans to buy insurance whether they wish to or not.  And while on paper President Obama’s health care law provides insurance to everyone, it does so principally by greatly expanding Medicaid, a government insurance program for the poor which is run by states and financed jointly by the federal and state governments.  That Medicaid is contributing significantly to our debt and deficit and is unsustainable in current form is ignored.

Medicaid is so expensive that “virtually every state” is cutting benefits and programs even before President Obama’s health care law greatly expands the program. In Louisiana, it is predicted that implementation of President’s Obama health care law will cost the Louisiana state general fund $7 BILLION DOLLARS over the 10 years after implementation. This is in our state where university budgets, public employee pensions, infrastructure, and almost every government service is being cut because of tight state finances.

Also, President Obama said that if you like your health care coverage you can keep it but the McKinsey Consulting Group predicts that as many as 60% of businesses will drop health insurancecoverage for their employees, forcing these employees onto taxpayer subsidized health insurance. This was predicted to only be 7%. This was minimized during the debate over President Obama’s health care law because the more people on taxpayer subsidized insurance, the higher the taxes will be to pay for the subsidies.

Additionally, President Obama and those supporting his health care law told the American people that it was “paid for” and “lowered costs.” Unfortunately, it was “paid for” with programs such as the Class Act. The Class Act was to collect taxes for 5  years before it began paying benefits. Because the benefits were to be paid in the future, total expenses were not included in the costs but the taxes collected were credited to President Obama’s health care law being “paid for.” The Class Act was so poorly structured and the legislation drafted so poorly, that the administration has said that they cannot implement this. Yet Congressional Democrats oppose repealing the Class Act. To do so would be an admission that President Obama’s health care law was not “paid for.” It is not just the Class Act. A Lewin Group analysis projects that total health care spending will increase by $265 billion dollars in the first 10 years of implementation.

It is public record that Senators who voted for President Obama’s health care law received special arrangements for their states. At the time, Senate Majority Leader Harry Reid said something to the effect that if a Senator voting for the bill didn’t get a special deal, they weren’t much of a Senator. Directly saying, “If they [Senators] don’t have something in it important to them then it doesn’t speak well of them.” This was taken to mean that the bill would not have passed if not for these special deals. Yet the embarrassing political circumstances that allowed President Obama’s health care law to pass will not be expiated by targeting the one benefitting Louisiana.

None of the above issues are acknowledged by those who support President Obama’s health care law. Yet it begs the question, why is Louisiana singled out when so much of President Obama’s health care law can be called into question?

There is a better way to reform our health care system.  For 22 years I have been treating uninsured and Medicaid patients in Louisiana’s charity hospital system. I have learned that if politicians and bureaucrats have the power, patients lose. If the patient has the power, the patient wins. President Obama’s health care law gives the power to politicians and bureaucrats. These problems will not be fixed by singling out Louisiana.

That none of the above problems are being addressed and that Louisiana is being singled out is but one of the reasons I voted against HR 3630.