Within three weeks of his inauguration, President Obama made a “down payment” on health reform that would put any used-car buyer to shame. Last month, we noted that President Obama had increased the fragmentation, bureaucracy, and cost of health care in at least three ways. Mr. Obama’s kids’ health program has an unhealthy addiction to tobacco funding, and more than half of the kids roped into it will drop their families’ health coverage. By bailing out state Medicaid programs that have spent beyond our means, Mr. Obama punishes fiscally responsible states, while Medicaid’s failure to pay its bills will result in an increased “cost-shift” causing private premiums to rise by about $18 billion. Subsidies to COBRA, the already flawed program that compels workers with employer-based health benefits to subsidize their departed colleagues, dramatically favor unemployment or part-time work, instead of full-time work with benefits.

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