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The Lie of Fiscal Responsibility
...A little more than 24 hours after releasing the reconciliation bill's preliminary score—the one that picked up the majority of the headlines and votes—the CBO released another report, this one produced at the request of Rep. Paul Ryan (R-Wis.). It said that if in addition to the health care bill, the Democrats also pass legislation known as the "doc fix"—which would cost an additional $208 billion—the total effect would be to add $59 billion to the deficit over the first 10 years.

Defenders of the reform bill now argue that the doc fix is a separate issue. But Democrats didn't always think so: Last summer's first draft of the House health care bill included the doc fix. And Senate Majority Leader Harry Reid (D-Nev.) has reportedly used the provision to ensure support from the American Medical Association. Are we somehow supposed to believe that it's good enough to bargain with but not good enough to figure into the budget?

Maybe the problem is something more elementary: Democrats just don't know how to count. Hard to believe? The CBO's letter also says that, contrary to administration claims, the bill won't both reduce the deficit and extend the solvency of Medicare. One or the other, perhaps, but not both.

Nor is that the only double count. The score for the Senate bill includes $72 billion in revenues generated by the CLASS Act, a federally-backed disability insurance program. But that $72 billion is just premium revenue that will eventually have to be used to pay out benefits. The score counts that revenue anyway, despite the fact that, according to the CBO, it would likely add to the deficit in the long term.

Eventually, the deficit damage starts to add up. Toss out a few of the bill's more fanciful assumptions—the implementation of the tax on so-called "Cadillac" insurance plans (already successfully delayed by a full five years by benefits-rich unions), cuts to Medicare payments, and a planned slowing of the growth of insurance subsidies—and the CBO reports that, two decades out, the deficit would spike “in a broad range around one-quarter percent of GDP”—something like $600 billion. Fiscally responsible! ...

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Don't Buy It
The crazy constitutional logic of the individual insurance mandate

A few weeks before Congress passed a law that orders every American to buy health insurance, the Virginia legislature passed a law that says "no resident of this Commonwealth…shall be required to obtain or maintain a policy of individual insurance coverage." Two weeks later, Idaho’s governor signed a law that declares "every person within the state of Idaho is and shall be free to choose or decline to choose any mode of securing health care services without penalty."...

...This sort of reasoning leaves nothing beyond the reach of Congress, since anything you do (or don't do) can be said to affect interstate commerce. In its 1995 decision overturning a federal ban on possessing guns near schools, the Supreme Court cautioned against the temptation "to pile inference upon inference in a manner that would bid fair to convert congressional authority under the Commerce Clause to a general police power of the sort retained by the States." That kind of analysis, the Court warned, threatens to "obliterate the distinction between what is national and what is local."

In a recent Heritage Foundation paper, Georgetown University law professor Randy Barnett and two co-authors note that the decision upholding wheat quotas does not mean "Congress can require every American to buy boxes of Shredded Wheat cereal on the grounds that, by not buying wheat cereal, non-consumers were adversely affecting the regulated wheat market." Likewise, federal regulation of carmakers does not mean "Congress could constitutionally require every American to buy a new Chevy Impala every year."...