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Politics and policy
Push for passage leaves a legacy of hyperpartisanship and rancor

After arm-twisting so intense it's a wonder some congressmen could still vote, the last few Democrats flipped from "no" to "yes" Sunday and ideologies yielded to politics. The health care bill passed.

Momentum built off a Congressional Budget Office projection that showed deficit reductions averaging just $13.8 billion a year, compared to increased costs of $200 billion a year by 2019 because of expanded coverage. The nonpartisan CBO is required to accept at face value congressional pledges that future congresses will take needed but politically unpopular steps to control costs, but we wonder what the House reaction would have been had the projections showed billions added to federal deficits.

One such revenue stream already is impacted. A tax on "Cadillac" health insurance plan benefits has been delayed until 2018 under union pressure, which will continue. And many provisions call for hiring staff "as needed," an open-ended government payroll expansion and cost.

The bill also assumes nearly $500 billion in 10-year savings from curbing waste, fraud and abuse -- perennial unrealized targets. Good luck with that.

And it cuts government-program payments to doctors by 21 percent, a practice Congress always has canceled in the past with what has become known as the routine "Doc Fix."

Crushed in the process of producing this bill was President Obama's promise of bipartisan legislation and public debate. When even chief of staff Rahm Emanuel was ordering cost estimates for scaled-down versions of this reform, House Speaker Nancy Pelosi was engineering intense back-room pressure on the ideologically opposed or poll-heeding Democrats needed to counter unanimous Republican opposition. Obama is now a "polarizing" president who will find difficulty in getting Republicans to join him in the future.

After his victory, the president disingenuously said, "this is not a political victory, but a victory of the people." The reverse is true. It was strictly a political victory, with far more Americans against it than for it.

If the deficit soars and Medicare taxes go up there will be resentment, but the moment of truth will come when the average worker's insurance renewal comes due. If it goes up substantially, the president and the Democratic Congress will have failed the people on the one aspect of health care reform the people most wanted them to do.

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