SURVEY SAYS: What Will Health Care "Reform" Mean?

March 25, 2010 ( - President Obama has now signed legislation that purports to reform health care (or at least health care insurance). 

Now, the Senate is still “reconciling” – and a baker’s dozen of state Attorneys General have already challenged the bill as unconstitutional (see Obama Signs Health Reform and the Fight Begins)  – but, to paraphrase comments made prior to the weekend’s events, now that the bill is passed, we can learn what is in it. 

This week I asked readers what YOU thought of the bill – its projected costs – and what you think it will all mean for YOUR health care costs.

“Bad” News

The take on the bill was mixed – but that doesn’t mean there wasn’t a clear directional sentiment.  In fact, asked what they thought of the bill, a plurality of this week’s respondents (37.4%) described it as “lots of bad”, while another 29.8% weighed in that it had “some good, lots of bad.”  Indeed, a closer examination of the 8.2% who chose “other” would say that most of that response would best be characterized as “a lot of very bad.”     

On the other hand, 13.5% opined that the bill had “some bad, but lots of good”, and 6.4% were of the opinion that it had “lots of good.”

As for the rest, just under 3% said they had “no real idea”, and roughly another 2% thought it was “not much change.”

The Congressional Budget Office (CBO) has taken a couple of stabs at estimating the cost of this bill.  Now, they’re non-partisan, so they have no "skin" in the game – but their scoring of such things is limited to the facts and assumptions put before them in legislation (if you’re not familiar with those nuances, it’s worth doing some research – consider that some of the savings associated with this legislation is associated with the federalization of the student loan program, not health care – and that a big chunk of the savings is predicated on Congress being willing to make some tough decisions on Medicare down the road - see

That said, I also asked readers what they thought of the projected costs of the health care reform package.  Here readers were much less diverse in their perspective – a full 68.4% said the costs were likely to run MUCH higher than projected, and another 9.4% said they were likely to run higher.  As in the prior question, while there were 6.4% in the “other” category, most of these were in the “likely to run MUCH, MUCH higher category.  “Twice the projected cost and half the savings”, noted one reader.  “Guaranteed to be exponentially higher than estimated. Every health care bill ever conceived has shown to be off by factor of 150% to 1000%,” observed another.  “What comes after a gazillion?”, asked another.  You get the point.      

Now, 5.8% were willing to give the CBO the benefit of the doubt, noting that the projections were “probably as accurate as they can be”, while 1.8% said they had no idea.  Just under 5% said that those projections didn’t matter, since this was just the first step in reform, and 1.2% also said it didn’t matter – but only so long as the bill’s provisions served to reduce the deficit (which, it should be noted, the CBO projections say it will).  However, just 2.3% said that the actual costs were likely to less – and no one thought they would be MUCH less.

Closer to Home

Finally, I asked readers what they thought the impact of the legislation would be on YOUR health care costs – and here again, the perspectives, while varied, were pretty much of a mind that costs were going to go up.  In fact, more than four-in-ten (43.9%) thought their costs were likely to run MUCH higher, while another quarter (25.1%) thought they would run higher.  Just 1.2% said costs would run MUCH higher, but for better coverage.

Only 3.5% said their costs were likely to be less, while 11.7% thought their costs were likely to be the same.  About 4% admitted they had no idea.

No one thought their costs would be MUCH less, nor was anyone inclined to think their costs would be higher, but they would get better coverage. 

Oh, and just over one-in-ten opted for “other” here as well – but the option they were looking for (in large part) was apparently that their costs were going to go up AND they were going to get less coverage.

Editor's Choice

Now, this is an emotional issue – and nerves on both sides of the discussion are still raw.  So raw, in fact, that I was pretty sure I wouldn’t be able to pick an Editor’s Choice without rubbing salt in someone’s eye.  But you guys never let me down – and this week’s Editor’s Choice goes to the reader who said “OMG...I can't believe you asked this question.  You will get so many responses that I bet it will take an extra day or two to compile ;-).

Needless to say, we got LOTS of responses this week, many of which appear on the pages that follow.  I can pretty much guarantee that however you feel about the need for health care reform and whether this legislation accomplishes that – you will find plenty of company for your position – and plenty of comments that will get your blood pressure going.  Enjoy – and thanks to everyone for participating in our survey – and the national debate!

The problem is not the insurance companies.  They are conduits which have done much to restrain the rising cost.  The problems are the things that make it cost $1,500 for a 1/2 day in the hospital, and $15,000 for a 1 hour surgery, and $300 pills, and $700 surgical screws, and $15 urinal recepticals (aka Dixie Cups) etc.  The Federal Gov't with mandated free care and all the rules and regulations is the main source  of the problems - not the cure.

I suspect that the cost for insurance will increase as the  federal government dictates benefits, which I suspect will expand to accommodate special interests.   The insurance companies will become nothing more than administrative service organizations who will take the heat.

Reform is much needed but what we got because of the"nattering nabob", just-say-no, "we can't let a democratic president have any success" republicans and the "what can I get out of this-I want special deals" democrats in congress is a watered down piece of legislation that takes a baby step that may do more harm than good when a giant (and, yes, courageous) leap forward is desperately needed.  Speaking as one who is intimately involved in the health care system as a employer plan administrator, it sickens me to see how the system has been corrupted and perverted by providers and special interests.  Throw all the bums out and let's get congressional representatives who really care about the American people, not the special interests and lobbyists who line their pockets.

Let’s see, I just went on Medicare, I plan to retire & relocate next year, I wonder if I'll be able to find a Dr who will be willing to see me?

From an employer's perspective, it appears to be a NIGHTMARE from what I've heard so far.  Auto enrollment, increased dependent coverage, free-rider penalties, Cadillac Taxes, etc. will not only have a negative effect on the coverage we will be able to provide but administratively, it is going to be complex.  The one good thing that came out of this is our Benefits Team can rest assured they have job security for a long, long time!  From a citizen's perspective, I'm glad something was finally done about pre-existing conditions.  However, the new taxes will impact me.  Time to retire!

A big, long-over due, step in the proper direction:  Toward a system that will be there for us when we need it, and away from one designed to expel and exclude individuals when misfortune renders them unprofitable.

Why gut the coverage of those who like their insurance at the expense of those 5% without coverage (which is much smaller than advertised)? Why force everyone to get coverage? Why put the insurers out of business, as well as many medical professionals? What business is it of the government's?

What program has the government ever run that the costs did not go up and the level of service go down? The same thing will happen here only worse than any other program before.

I'm concerned about whether this legislation will actually improve the crisis we're experiencing in health care or merely cost more money.  Based on the summaries that I've read from various sources since Monday's signing, I'm still trying to understand the potential impact.  Your quote in today's News Dash sums it up, now that the bill has passed, we can find out what's in it.  I was really disgusted with the political shenanigans and rhetoric that both parties engaged in during the final stages of the passing of the legislation and even more disgruntled with the politicians who voted for the legislation and hadn’t read it.  I read a quote by Margaret Thatcher last week that went something like this:  The problem with Socialism is that eventually you run out of other peoples' money.

There are no provisions in the legislation that target cost, except to tax rich benefit plans.  This means that employers who have tried to offer comprehensive health care benefits will have to raise their employees' contributions to cover the tax, or cut their benefits programs to avoid the tax.  Either way, working Americans are worse off than before, and employer-sponsored health plans have a whole new batch of paperwork to contend with.  It will be interesting to see how many employers throw in the towel and pay the tax, if this thing survives through 2018.

There is no reform.  Only a way for the Government to control the health insurance market at a huge added cost and burden to the taxpayer.  While the Federal deficit might theoretically be reduced, the hidden taxes (in higher premiums and costs of providing service) will overwhelm the public.

Implementing is going to be difficult, because of so many criteria/rules that are unclear once you get to the nitty gritty of administration. Plus, all will take time, and how successful will the states be in their fight against this reform. We could start down one path, spending money and resources only to change directions or stop entirely.

Generally, I think it is a move in the right direction for the Country. I am concerned about the impact on small business. Costs will certainly be higher than anticipated over the next decade and I am concerned about the ripple effect on inflation.

"OMG...I can't believe you asked this question.  You will get so many responses that I bet it will take an extra day or two to compile ;-).  I really am afraid of what is going to happen.  My family has a high-deductible plan where basically we take care of all minor stuff.  All preventive care is covered, but everything else we pay for up to the limits of our deductible (which we met last year after my older son spent a week in the hospital).

This plan has proven to be a bargain for us, even with our ER trips.  It's less than half the monthly cost of ""regular"" insurance.  How on earth will this new law improve that?  It won't.  PrezBo wants my relatively healthy family to subsidize the costs for the unhealthy.  So lard-asses on your motor scooters, come on down!  You're the next contestants on ""let's screw the healthy working people!"" 

I have distant hopes that legal challenges might find this law unconstitutional as this is the first time the Feds are forcing a US citizen to buy something he might not want to buy.  I do hope this ushers in some change this fall and we see Princess Nancy dethroned (perhaps for good) and Harry Reid dispatched to his multimillion dollar homes in Nevada.

The fact that most members of congress couldn't tell me what this bill means tells me that they have no idea what they've done.  Everything I've seen so far in the way of analysis seems to say my family will pay around $22,000 a year for insurance.  I pay nowhere NEAR that now, and even if my employer kicks in $2,000, that will make almost no difference.  What a crock."

"Please take a number." "Please step up to the reader and present the barcode on your left arm." "The first of several gov't medical czar representatives, then maybe a document tech, medical tech, nurse, PA, doctor, and/or mortician will see you in order and according to your number." "Have a nice day."

You don't want to know MY take.

Health Care Reform is absolutely necessary, but this is NOT the answer.

Band-aids being put in the wrong places.

Hate this version of it. Trying to do too much at once.  Take smaller steps. Let states try solutions.

Another level of control for government, and BIG step toward socialism!

This legislation is not perfect, but given the current political climate and the Republican unwillingness to compromise and take part in the process it is probably as good as it could be.  This is only a small first step.  It is time to end allowing insurance companies to make obscene profits on the backs of people with health problems.

Worst legislation every conceived.   Absolutely ruinous for America.

This law will devastate the US economy. The US will become less competitive in the global economy because of this law. The government will have free rein to violate our most personal, private information. The law has nothing to do with better healthcare. Everyone has access to healthcare. It is financial insurance through redistribution of wealth. It is truly un-American.

Repeal this disaster and vote out of office everyone who voted for it!

It is a redistribution of wealth by the government, an expansion of government, a threat to personal liberty, an entitlement we can't afford, a power grab by the federal government.  Is this what our country stands for?  Shouldn't we fix the entitlements we have (Social Security, Medicare, Medicaid)?  Shouldn't the economy be a higher priority?

Congress has no place in creating this legislation.  It's unconstitutional.  What ever happened to freedom in this country?

Like many other "reforms", this one will contribute to  Reform's bad reputation. This is insurance "reform," not health care reform. It amazes me that more is not made of the accounting sleight of hand that was needed to show that the new law will lower the deficit. And if it were really true that the Federal government won't be footing the bill for all of this new spending, who do you suppose will? There doesn't seem to be much discussion about that. The "what's in it for me?" sales pitch is a classic and odious example of the deceptive and cynical politics practiced by both major parties.

This whole bill is a bad idea.  What we really need is tort reform and reform of how the insurers do business that drive up costs. I'm very disappointed that 76% of people polled did not want this bill, but the House passed it anyway.  Time to throw all the bums out!

They only needed to focus on the 15% of the population that is uninsured/uninsurable.  We have wasted millions of dollars debating and arguing about something that a majority of the people DO NOT WANT!

Anyone who believes the CBOs initial cost estimates is living in a dream world.  Not that covering the uninsured is a bad thing (socially and hopefully financially), but someone has to pay for the coverage of those currently without coverage, so initial individual costs (which include not only increases in health care premiums, but increased taxes to support the additional coverage) have got to increase for us all.  Having worked in the health care benefits arena for over 20 years now, I am skeptical that these increased costs will be offset long term by efficiencies in delivery of care to the currently uninsured.  I have only skimmed the Act but several minor provisions already cause me concern as an employer providing health care benefits to our employees, such as imposition of a $2500 annual FSA maximum contribution and elimination of over-the-counter drugs as a reimburseable expense, which may encourage participants to use prescription drug alternatives, much costlier and I'm sure one the Rx companies are salivating about. This may signal the death knell for FSAs.  I hope the good outweighs the bad in the long term.

I think employer sponsored health plans are one of the few things that were close to working correctly.  I don't understand why they couldn't leave the piece that was working correctly alone!

I'm all for helping out people who can't afford health care but I don't want the government to jeopardize the great health care I have through my employer.

"This is the worst possible thing, a sham.  All those that voted yes are crazy and contributing to a major US downfall.  I would love to know all the sweet-heart deals and promises that were made to get votes.  It's all corrupt.  Our nation's budget deficit is the laughing stock of the world. 

When are people going to realize they aren't entitled to everything?   It's called the American dream and you have to WORK for it, not get it handed out for free.  Those that founded this country didn't just sit back and let others do all the work for them and get everything for free.  Everyone's pocketbook has a limit - be aware of what that limit is - individuals as well as government should be aware.


Now, given my rants I understand there is need for some reform but certainly not this make-believe Democrats cooked up."

Insurance is really just a bucket of money (you pass the bucket and everyone puts in money).  The more hands that reach in to take money out, the more money you need in the bucket.  The more times each hand can take money out, the more money you need in the bucket.  There are a lot more hands and a lot more reasons people can now take money out of the bucket.  This is going to cost us a lot more!

If the Republican Party had worried about the country, instead of the next election, then half of us would not have been excluded from discussions on the most important piece of legislation in decades.

I think this is a first step but it doesn't address the cost of health care.  My recent experience was that a small piece of equipment was going to be billed to the insurance at $250 and approved at $150 while I could buy the same machine online for $50.  I don't know how to do it but the extra cost has to be taken out so we pay a more reasonable amount for our health care.

Since the government has done a pretty poor job of managing everything else (Social Security, Medicare, etc), I seriously doubt they will have any success with Health Care.  It makes me very glad I don't have any children... I would hate to have to explain this generation's trillion dollar stupidity!!!

My feeling has always been that they tackled the wrong problem.  The first step should have been to work on the costs.  Then, expanding coverage would not have been as expensive.  As it is, healthcare costs will go up because 32 million more people will have health insurance, and it will be paid for by those of us who are already covered, either through taxes, increased premiums, or increased costs for goods and services.

Again the Government really over estimating how many this going to help, and once again is way under estimating the costs.  The over estimation how many this will help, well of the 34 million I doubt even half of them will still be able to afford health care.  It will still be cheaper for 20 million Americans to just pay the $695 fine every year, than to buy health care.  Then still go to the emergency rooms, where they can't be denied, and then the Government still foots that bill of the emergency room visit just like they do now.   The under estimation of cost is huge.  Not only will it be $1 Trillion of tax payers money just going to people, it's going to raise the cost of Health Care for those that have it through an employer.  Then they want to tax the Health Care we get from out employer at 40%.  That will take it's toll on the middle class.  So basically, not only the $1 Trillion dollars (which we all know is a low estimate, because it sounds better than $5 Trillion), it's also going to cost the United States it's middle class.  Give this a full decade and the United States of America will be on the verge of being a 3rd world coutry, with just the rich and poor and no middle class.  I feel sorry for the baby I am about to bring into this mess of a world.  But hey we made history.  That's all that counts right?

You omitted another consideration: an individual's health care costs may or may not change, but there will be much higher taxes to support the much higher additional costs.  IMO, most people know this, but assume it will be the other guy who has to pay more taxes.  Stupid.

This will be a huge drag on the economic recovery.  You could hear the brakes being put on expansion plans by employers, large and small, as they now have to figure out how much more they will have to pay for health care instead of growing their businesses.  Every product and service in America is going to cost more.

Needed, but be careful what you ask for.........

The bill is unconstitutional.  While the healthcare system needs some fixes, this bill is not the answer as it seeks to socialize the entire system and force people to get coverage.  It clearly runs along the lines of other government run social programs that don't provide for things the way they should and are enormously expensive and poorly run.

If it's such a great deal for the American citizens, why aren't the members of Congress required to use the new healthcare coverage? Can't wait for November to roll around!!!

See above

Social Security was supposed to pay for itself too.  And now every year they predict its demise not too far into the future.  It feels like the politicians are trying to fool everyone into thinking this is going to pay for itself when history shows that these sort of social programs only get costlier and drag down the economy as individuals struggle to keep up with the tax bills.

"To paraphrase Joe Biden, this bill is a big f$$king piece of crap.

I would have preferred to have the bill only include the restrictions on using pre-existing conditions to rate or deny coverage, and the increase in the age for dependent children.  These simple changes would have gone a long way in solving many of the problems in providing healthcare without the huge government bureaucracy that will be created."

More big government leaning further toward socialism which is more important than to the powers that be than real reform.  Rewards the do-nots who already have health care they don't pay for.  Many other opportunities to reform exist but were ignored (tort reform, competition across state lines, clean-up of Medicare/Medicaid sloppy processing and fraud.

"I pray for my children and grandchildren.  They may end up in a 3rd world country.

I've visited 3rd world countries where Gov't promises things (like water) just to get the vote.  Once the vote is in, the people don't get a say and remain thirsty."

Health care reform is very much needed.  We have a huge population of baby boomers who are getting older and will need care more and more.  This bill is just a start.  All health care (dental, eye care, preventative, long term, etc) will become more important as a public health issue.  And as the baby boom ages, and Medicare gets utilized more, health care will be the most important and largest sector of our economy.  The writing has been on the wall for about 50 years.  People can argue all they want about not wanting the government to be involved in their health care, but it has been on track to happen for a long time.  For-profit insurance companies have been involved in patient care for 30 years--and that business model is changing.  This bill is one step to single-payer coverage--and sigle-payer coverage is inevitable.  Our country has been marching toward it ever since the baby boomers were born.

Health care reform is a good idea but this bill is a mess.  Regardless of what is legislated now, most of the "benefits" won't be real until 4 years from now and a lot can happen in that time...  and in the meantime we lose some valuable benefits (I currently put $6,000/year in my health care FSA).  And if these "reforms" don't apply to Congress and the President -- they aren't good enough for me either!

Unconstitutional and forced down the majority's throat; not representative of what Americans want

I agree that there are a lot of changes that need to be made to the current healthcare/insurance system, but this bill totally ignores what really needs to be reviewed.  Just provide coverage for the 35 million uninsured but leave what I have alone.  I am afraid that what I have with my large employer will go away, the company will pay the fine and do away with insurance coverage that I have, and I will be forced to be on the "government plan".  Obama said "if you like what you have you can keep it", not true if my employer cancels the policy.  Another area that most have not even discussed are the changes to Flexible Spending Accounts.  Starting in 2013 there will be a $2,500 limit placed on the total healthcare dollars you may place in your FSA.  In addition, over the counter drugs, like Zytec and Tylenol, will require a doctors prescription.  How smart was that decision...more visits to the doctor to get prescriptions.  The Congress is totally clueless as to what is important to the American public.  November 2010 can't get here quick enough.

Pleased that, at some point soon, my 23 year old will be added back on to my company's health and denatl plan--saving me about $125 a month.

Did not go far enough.

The arrogance of the Democrats in Washington is appalling, and apparently they feel its OK to turn a deaf ear to the American public.  Then again, they didn't listen to the people of Massachusetts (an uber-liberal state, which already has mandated health care) when we elected Senator Scott Brown, so we should expect nothing less.  Maybe they will listen in November when they all get voted out of office......

I agree with the individual mandate, but believe that it is clearly unconstitutional.  There should be no mandate on business -- insuring my personal risk is my personal problem.  If the politicians want the feds to take over health care and health insurance, then they need to do it the right way and start with a Constitutional Amendment.  But that would let the proletariate (unwashed masses) have their say, and the liberal elite political class never likes that.  There's a revolution coming.

I'm delighted that Congress has done something to address this huge problem. I consider this bill a first step along the way to full reform. While I work for an employer now who provides coverage, I haven't always, and in the past getting it was sometimes very expensive & sometimes not even available.

It is also NOT OK for my tax dollars to be used to fund abortions.

Certainly not perfect, but at least it's a start.

The U.S. desperately needs health care reform, and this is at least a start in that direction.

It would have been nice if I had the feeling that someone actually knew what was going to happen - it feels more like we need to do something and good or bad this is something so lets do it and fix it later.  I guess what really scares me is the great possibility that the actual costs are going to be much greater than expected and the large possibility that this legislation has more than just health care hidden with in its pages.

Since the bill does not do much to address the cost of care, just the cost of 'insurance', so far it's not going to help out self-funded plan sponsors.  I foresee increased costs due to added dependents, elimination of annual/lifetime benefit maximums, additional mandated coverage, and eventually added taxes and penalties.  All these will increase our costs to provide coverage for employees, and require  higher cost sharing from those employees as well.

The lack of public option and real teeth to cutting costs is very disappointing. Still, we have to start somewhere, and I'm hopeful we can improve it as we go.

I hope these attorneys can prove their case.  I like some of the points of the law, but in general the price tag is too high and will raise taxes for most.

The process followed to get this legislation passed was an absolute abomination.  If Congress wasn't already polarized, it certainly will be now and for the foreseeable future.  President Obama made numerous false statements to the American public about how the legislative process would be conducted, and the overall cost of the Bill.  Sadly, our watchdog mainstream media chose to accept and report these falsehoods and not challenge him over them.  Regardless of the merits of the Bill, this was not a proud day for our nation or our system of government.  The Democrats should be ashamed of themselves and how this process was conducted, but I don't believe that is possible.

Medicare is broke, Medicaid is broke, Social Security funds have been stolen, what makes us think this won't add to the burden?  I'm also curious how charging fees to health insurance companies and drug companies will save money when we know where those higher costs will end up.  This is beyond belief.

Its needed, but not to be run by the government.  They will spend more and we will get less, as is usual.  They claim that they will save money, but someone has to pay--us!

"Since I use flex to cover my wife's non-cover disability expenses my it will now cost me close to $1,000 a year more was the $2,500 limit kicks in.

It will lead to businesses dropping their coverage. The middle class is the big loser and underwriter of this bill"

In general, reform is good.  If the new law does what it is suppose to do, which is: 1. extends coverage to millions of uninsured, 2. makes it affordable, 3.  makes it available, then this is good.  The one major item in this bill that I don't agree with is the mandate to make people purchase insurance against their will.  Other than that, it looks good.

A huge first step that will strengthen America.  Cost should not be the top concern.  It’s the right thing to do morally and pragmatically.

"Certainly this bill is not perfect.  However, it is better than the alternatives presented.  The interesting thing is if the Bush Administration's move toward privatizing Social Security had gone through, would those same right wing idealogues now be saying Social Security is unconstitutional as it forces individuals to buy into a retirement plan.  I am pretty sick of the immaturity of many of these publicity seekers who care not at all about the general population but only about pleasing the lobbyists who support their re-election campaigns; and this applies to both sides of the aisle.

I think my costs will be much higher and my health care will be of lower quality"

The bill is a 2,700-page monstrosity that will create a huge government bureaucracy, expand entitlements to unprecedented levels and give government more control of our lives.  The bill passed only because of all the back-room deals, bribes and arm-twisting, not on its merits.

Don't like the way the new administration came in promising change we can believe in and then resorting to the same old way.  This makes me very concerned about the new healthcare program.

Seems to me to be a whole lot of arm-waving and cursing about nothing. I don't think it can be a bad thing to force people to have insurance. That has to be good for both the pool (the law of large numbers) as well as the doctors/hospitals getting paid when they give emergency treatment. I'm disappointed in the FSA restrictions - don't know why they are tightening that back up with reducing/eliminating ability to use FSA for OTC (now will need prescription) and then putting an annual cap on it.

I'm less concerned about the cost of the bill, though it's certainly HUGE, than I am about the continued loss of freedoms we are experiencing with this Progressive President and Congress.  When more Americans wake up and smell the Socialism, the torches and pitchforks will be heading for Washington. Everyone should read the Constitution again - now.  It's been shredded and stomped and will continue to be until we take back our country.

Something really did need to be done, but with due respect for the "officials" in Washington, baby steps that people could understand would've made more sense.  I fear my children and grandchildren will be paying for this for ever and may never see the benefit of it.

"It amazes me that even as we CONTINUE to discuss the funding crisis in Social Security (something that should have been a TEMPORARY program), we are enacting a similar program that will cause even further funding crises.  Do we learn nothing from history, particularly a history that is still a present?

When did the tides turn to the government telling me I cannot make my own decisions?  Who is the government to tell me what to do when I am doing no harm to anyone else?  The purpose of this country from the very founding (of which one of my ancestors was a part as a signer of both the Declaration of Independence and the Constitution) was for the government to represent, not control, the people."

The american public - even the most angry constituents- do not really understand the massive manipulative maneuvering by the insurance industry.  We need to do something.  This may be imperfect, but it's a  start.  Those saying we need to go back to the beginiing and "start over" are the same ones who have obstructed any attempt at reform.  While the fat cats are getting fatter.

You can tell this legislation was drafted by individuals who have never worked a day in business. With all the taxes and fees imposed on plan administrators, insurers, medical device manufacturers and pharmaceutical companies, it will create a domino effect as each attempts to pass on the increases to others - most especially the consumers who have to buy medical plans. The penalties to employers who offer health coverage are unfair - how is a self-insured employer supposed to offer a decent plan but pass along premium cost-sharing to participants which still keeping in mind that the premium can't be "unaffordable" to participants or they'll be assessed a fee? Why didn't the Republicans at least sit at the table with the Democrats to get concessions on some issues? This whole thing was railroaded and we - the employers who are doing the right thing - are going to be penalized, which jeopardizes jobs and prices of goods. And why aspire to be a more highly paid individual when all you'll do is pay more taxes? I believe in everyone paying their fair share - but proportionally.

How is it possible that a bill that they admit to and extra $849 million is costs that don't exist today result is a savings to taxpayers?

There needs to be health care reform of some type, but it is not something that should be rushed and must be done correctly.

This is a "good start" in the reform process that was begun in the stimulus package.  The development of the electronic medical record together with the authority for independent medical "experts" to use the information which will be developed to determine which medical procedures are most likely to be effective for specific diagnoses will begin the process of changing medicine and making it more efficient and effective.

"This is a dark, dark week for our country.  By passing legislation that a majority of the American public oppose, our so-called ""representatives"" seems to have abandoned the very ideals of representative government that this country was founded on.  Talk about arrogance.

Our illustrious leaders seem to not understand that even something that seems like a good idea for so-called moral reasons still has a price.  The price of this legislation is far too steep - and I don't just mean the trillions of dollars it will cost us.  Any legislation that forces Americans to purchase something, penalizes employers for offering exceptional plans, puts additional burdens on small businesses, and creates more government bureaucracy can only be a bad idea.  I'm more terrified about where this will lead than I was after the terrorists hit on September 11 - who would've thunk that the enemy is us?"

If it is so great, how come congress is not giving up their Cadillac coverage for this package?

It's so much information to absorb - I appreciate the really concise summaries that are coming out to keep it all straight.

Not only is this bill unconstitutional by forcing Americans to buy a product (which eventually will only be offered by the government),  it will be so expensive that our country will lose it's credit rating because of the massive debt that is being accumulated.  This is not about health care, it's about power and control over the people.  We are becoming modern day slaves to the government.

The final provisions of the bill as passed do almost nothing to improve the health of the average person, they simply put more cost and useless reporting burden on employers, which will ultimately erode the ability of business to provide meaningful health care to employees and their families.

As the Bill is currently stated, it is likely to mean the end of employer-provided health care as we know it, unless there are major changes to the penalties for employers to opt out of providing. The penalty is so low, that it would be a real bargain to pay the penalty and send employees on their way to find their own health care.

Any comments from Hillary Clinton?

One of the lessons I have learned from studying history is that throughout the world and throughout time, people have more to fear from their own government than any other single threat.  My ancestors came to this country to escape tyranny and they fought for freedom and liberty.  These freedoms have been constantly eroded over the last 100 hundred years, but this has been the single largest infringement on freedom in my lifetime.  I am frightened for my children and grandchildren.

"what a sham on the people of this country who have always had their own health care and paid their own premiums, or even worse for an employer like me who has always provided no cost ee and family coverage to all employees - fully paid for -

I get hit with higher taxes and fees personally (over 200K in earnings), my company has more red tape - and the cost and services will go up and down respectively -

All this cause some people can't take responsibility for their actions and these politicians who moved this perpetrated the biggest sham I've seen in years"

I am proud that we finally had the guts to do the right thing.  This is only the first step of many to fix our dysfunctional medical insurance program.

WHY?  How can Congress so blatantly disregard the overwhelming majority opinion?!  I'm just disgusted.

I have never been this angry about anything in my life, and I will never vote for another Democrat so long as I shall live!

Americans like incremental change because that is the best way to assess the impact of decisions.  "Sweeping reform" may make a good sound bite, but it scares the wits out of me.  There are ways to address health care issues without full scale reform, especially for one of the best health care systems available in the world.

It is amazing to me that a large number of Americans objected to this bill, but President Obama and the Democrats were hell bent on passing something, just so they can say they did.  I guess we'll have to wait and see if this is the kind of "CHANGE" everyone seemed to be looking for.

It sucks!  There isn't any "reform".  The government is taking over our healthcare.  How can that possibly be any good?

It's amazing that our "brightest" are so foolish, uncaring for public opinion, and such spendthrifts.  Instead of attempting to craft legislation that would help the people of the United States, they rammed through a law that no one Nancy Pelosi alluded to.  However, I'm sure all of the special interests that needed to be massaged were...  Oh, BTW, I read through the Constitution yesterday as a there it mentions the President may be impeached for "bribery".....isn't that exactly what happened to push this through on Sunday night?  However, not just the President should be laid off....the entirety of the executive and legislative branches should be laid off...we can outsource the work to Columbia.

In 1965 the CBO (based upon the input it had at the time obviously) projected the current annual cost of Medicare to be approximately $60 billion. It is actually about eight times that much. Since all these social safety net programs tend to expand benefits and eligibility over time (see Social Security), how can anyone project accurately? It is altogether fitting that the Democratic Party be in charge as the cost of ever expanding social programs finally overwhelms the American tax base. From public sector pensions (absurdly high, massively underfunded, and overseen by incompetent bureaucrats) to government run health care (with free drugs) and  social security turning into welfare (once you take out more than you put in plus interest), we are ALL now permanently entitled to nirvana.

It's been needed for a long time.  Something had to be done for those folks who could not obtain insurance - or the cost was just too high.

No matter what, our health care cost will be higher whether the the working individual is being taxed on it or the employer increasing the employee premium because the employer is receiving a tax hit and/or the insurance carrier has increased its rates.  In addition, employers that are going to be forced to carry insurnace for their employees are still not going to because it will still be cheaper for the employer to pay the penalty to the Govt. then obtaining health insurance on their employees.  Also, not to mention, this is going to hurt employers in another way too, by those employees that don't want to work work 32-40 hours a week to maintain health insurance through their employer.  There statements being made my employees that are happy because now "they are not forced to work as full-time to maintain their health insurance."   Last!  I thought this country was made for FREEDOM (guess not)

Sure there are a few provisions that appeal to the masses, but ultimately this will lead to a government single payer system and either rationing of care to hold down costs or massive tax increases to avoid U.S bankruptcy.  It may take 10+ years to get there, but trust me, it will.

They pushed this through just for the sake of pushing it through and called it a victory.  They needed to THINK it through some more.  This is (I'm afraid) going to hurt a lot more people than it's going to help.  AND, we're all going to pay and pay and pay and .........

I don't think the law will affect my personal coverage that much.  But I have two college-aged children with serious pre-existing conditions.  I think the future is much brighter for them since the passage of this law.