That was part of the message Hadley Heath, senior policy analyst at the Independent Women's Forum, delivered Tuesday during the opening address at AWB's 2012 Health Care Forum.
A sold-out crowd of 200-plus employers attended the forum at the Hilton Bellevue hotel to find out more about how the law will impact their businesses.
The Affordable Care Act, also known as Obamacare, has been one of the most politically charged subjects over the last few years, but Heath -- who is obviously not a big fan -- largely attempted to steer clear of politics and provide a clear-eyed overview of the law and where it's headed.
So far, 16 states -- including Washington -- are moving forward with the creation of health benefit exchanges, which are a centerpiece of the reform, she said. Eight states have said they won't establish an exchange, another eight have made no significant progress toward creating one, and 16 states say they're studying their options.
There are some good reasons for a state to take the lead, Heath said. Notably, states that take the initiative will end up with more control over what happens. On the other hand, sitting back and allowing the federal government to create the exchange may cost a state less money.
In any scenario, the health law is going to cost the nation more money and establish new layers of bureacracy, she said. Over 10 years, it will add an estimated $1.7 trillion in new spending and prompt creation of dozens of new bureacracies to monitor and enforce it.
To pay for it, the government will collect $1 trillion in new taxes and reduce planned Medicare spending by $716 billion, she said.
"It's going to be a very difficult situation given our national debt," Heath said.
The law will provide insurance to more people, Heath noted, but it will also cause some people to lose insurance.
Approximately 25 million people will be newly insured as a result of the law, and 11 million more will be added to Medicaid, but an estimated 9 million people will lose their employer-sponsored insurance, she said. Some 30 million people will still be left without insurance, including 11 million who will be subject to the government's mandate to buy insurance.
For individual consumers, the cost of health care insurance may go up or down but the overall cost to the nation -- and to employers -- will increase as a result of the Affordable Care Act, Heath said.
It's hard to predict where the law is going, partly because many details depend on the outcome of next month's election, Heath said. But if President Obama wins re-election, the effort to fully repeal the law is essentially over, she said. Republicans in Congress will likely push piece-meal repeal bills.
If Mitt Romney becomes president, he could repeal the law and replace it with something else, she said. He has called it a top priortiy. But Heath noted that Romney is "not the most free-market thinker" with respect to health policy, either.
For many in the room, Heath's message was not good news. But she finished her remarks by offering some reason for optimism.
"This whole thing is just a mess," one attendee said during a question-and-answer session. "Are you any more optimistic than I am?"
"Yes," Heath said.
The June day when the Supreme Court's announced its decision to uphold the constitutionality of the Affordable Care Act was her worst day at work, said Heath. Even so, Heath said she believes -- despite its flaws -- the U.S. health care system is among the best in the world, if not the best.
"I'm an optimist," she said, "because I choose to be."
