Democrats are on the brink of enacting an imperfect, historic bill that will provide health coverage to an estimated 31 million people, that will correct egregious defects in our current health insurance system, and that will make large investments in community health centers and other critical public health resources.
By 2019 when the reforms are fully implemented, the Senate bill would provide about $196 billion per year down the income scale in subsidies to low-income and working Americans.
Even policy wonks have trouble getting their heads around such a big number. With due allowance for the back-of-the-envelope nature of this calculation, $196 billion exceeds the combined total of federal spending on Food Stamps and other nutrition assistance programs, the Earned Income Tax Credit, Head Start, TANF cash payments to single mothers and their children, all the National Institutes of Health, and the Department of Housing and Urban Development. (I admit to some uncertainty about that last one. We may have to leave HUD behind…)
Some progressives have decided that they cannot support this imperfect bill. We have 196 billion reasons to disagree.