Douglas Holtz-Eakin, a former director of the Congressional Budget Office, puts forward quite a few inconvenient truths about the plan proposed by Democrats and the Obama administration, which would increase the financial burden on middle-class families. This is ironic because the bill is being sold as a way to reduce medical costs.

The plan is predicated on the notion that its cost will grow over the long term at a rate of 8% annually. But neither the economy or tax revenues will grow that much. To “achieve a veneer of fiscal sensibility,” according to Holtz-Eakin, “the Senate did three things: It omitted inconvenient truths, it promised that future Congresses will make tough choices to slow entitlement spending, and it dropped the hammer on the middle class.”

The bill is written as if Congress can be trusted to do what congresses are traditionally loath to do: make cuts. Holtz-Eakin writes:

One inconvenient truth is the fact that Congress will not allow doctors to suffer a 24% cut in their Medicare reimbursements. Senate Democrats chose to ignore this reality and rely on the promise of a cut to make their bill add up. Taking note of this fact pushes the total cost of the bill well over $1 trillion and destroys any pretense of budget balance.

It is beyond fantastic to promise that future Congresses, for 10 straight years, will allow planned cuts in reimbursements to hospitals, other providers, and Medicare Advantage (thereby reducing the benefits of 25% of seniors in Medicare). The 1997 Balanced Budget Act pursued this strategy and successive Congresses steadily unwound its provisions. The very fact that this Congress is pursuing an expensive new entitlement belies the notion that members would be willing to cut existing ones.

The most inconvenient truth is what will happen to ordinary citizens:

Most astounding of all is what this Congress is willing to do to struggling middle-class families. The bill would impose nearly $400 billion in new taxes and fees. Nearly 90% of that burden will be shouldered by those making $200,000 or less.

Except for those who believe in a fundamental change in America, this bill is patently a disaster. And yet—thanks to the make-up of Congress—it may become reality.