Justin Miller: Health Care Reform Isn't Very Historic





[Justin Miller is a staff editor at TheAtlantic.com. Previously he was an assistant editor at RealClearPolitics, a political reporter in Ohio, and a freelance journalist. He is a graduate of the University of Michigan and lives in Washington, D.C.]

Just how historic is the new health care law? You can't look at the news without seeing the adjective used or listen to people talk for an hour without hearing the president's name mentioned with FDR or LBJ. No matter what someone's political persuasion, he's likely to believe this bill is a big deal.

But maybe it's not quite so big.

In terms of magnitude, cost, and novelty, the health care law is a large domestic policy achievement but not as revolutionary as the creation of Social Security or Medicare and Medicaid. At first glance, this bill looks big for two reasons: it affects virtually 300 million people and costs just shy of $1 trillion. But breadth shouldn't be mistaken for depth.

The law's deepest impact is on 32 million people who don't have health insurance, or less than 10 percent of the population. In other words, there's little change for the other 90 percent who have insurance and can keep it if they so choose.

If you have insurance now, your premiums will still rise, but maybe the rate of increase will be a little slower than it has been recently. Your plan will cover more procedures after "pre-existing conditions" are moot. You may lose several thousand dollars - at most - to a penalty for not buying insurance or to new taxes. For those people, the financial effect will be similar to any number of tax cuts or hikes have been made in recent history and not been labeled "historic." (Yes, it's still a lot of money.)

The bill is projected to cost $940 billion over the next decade, or a little more than the stimulus package that now costs $862 billion, up from the original price tag of $787 billion. While the programs spend their money at different annual rates, for the sake of illustration, the spending difference between them is a paltry $7.8 billion per year. That hardly puts health care reform in a league of its own when it comes to spending.

Virtually lost in the year's worth of health care reform arguments is the fact that this reform is rather conservative...


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