Health reform costs $1 trillion over 10 years

Rep. Ginny Brown-Waite sent a mailer to constituents explaining her opposition to the Democratic health care reform plan.

"Unfortunately, I believe the legislation currently being considered in the House of Representatives could spark the government takeover of health care," she wrote. "The American people will have fewer choices, rationed care and higher costs. This is the last thing we need right now."

Brown-Waite, a Florida Republican, also lists bullet points for why she opposes reform:

"Any Government-Run 'Public' Plan - Why it's the WRONG solution to America's Health Care Problems - Creates an entitlement that will cost another $1 trillion over the next 10 years, on top of the trillions the government is already planning to spend on health care."

We found the phrasing here odd. As we've noted before , the Democratic plans for health reform leave employer-provided insurance in place. The House bill seeks to make it easier for individuals to buy health insurance on their own by creating a national health care exchange, a kind of one-stop shop for health insurance. One of the plans on the exchange will be a government-run plan that provides basic coverage at a price likely to be lower than private insurers. (For a fuller explanation of the basics of health care reform, read our story Health care reform: a simple explanation .)

It's not correct to characterize the overall health bill as a "government-run 'public' plan." Rather, the government will run one of the insurance plans, and people can choose to buy it or not.

Nevertheless, if we're talking about the overall bill, Brown-Waite is correct about its cost. The Congressional Budget Office has determined that the overall health care reform bill from the House would cost $1 trillion over 10 years. The bill includes cost-saving measures and tax increases on the wealthy, so its impact on the deficit would be lower: $239 billion over 10 years, according to the CBO.

If you're wondering how much the public option alone would cost, we're not sure. Obama has said he wants the public option to be self-supporting through the premiums it charges its customers. But the public option would need, at a minimum, some sort of seed money to get going. The CBO estimated all the costs associated with "exchange subsidies," and that came to $773 billion, but that includes tax credits (called "affordability credits") to help people of modest means buy insurance on the exchange, and they might or might not choose the public option.

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We also want to address Brown-Waite's statement that the health plan "creates an entitlement." An entitlement is "a right to benefits mandated by government," and sometimes a euphemism for welfare, according to Safire's Political Dictionary . Strictly speaking, the bill creates entitlements for some people, but not for everyone. As we noted earlier, it gives tax credits to people of modest means, and it expands Medicaid for the poor.

We asked Brown-Waite for the reasoning behind her claims on the mailing, but we didn't get a response.

In some ways, Brown-Waite's mailer seems like a classic campaign tactic: Take your opponent's position and distort it so that it appears scary or stupid. But in this case, the mailer was paid for with tax dollars. Members of Congress get to mail their constituents without paying postage, a perk known as "franking," and Brown-Waite's mailer clearly states it was "prepared, published and mailed at taxpayer expense."

Waite says that "Any Government-Run 'Public' Plan ... Creates an entitlement that will cost another $1 trillion over the next 10 years, on top of the trillions the government is already planning to spend on health care." But, to be clear, the overall health bill is not a "government-run 'public' plan. The public aspect is just a part it, which people can choose to participate in or not. She also offers a confusing way to explain the cost of the health care reform bill, and we want to be clear that $1 trillion includes all aspects of the bill. So we rate her statement Half True.