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The costs of health care reform being pushed through Congress by Democrats will be felt long before the benefits.
Proposed taxes and fees on upper-income earners, insurers, even tanning parlors, take effect quickly. So would Medicare cuts.
Benefits, such as subsidies for lower middle-income households, consumer protections for all, and eliminating the prescription coverage gap for seniors, come gradually.
"There's going to be an expectations gap, no question about that," said Drew Altman, president of the nonpartisan Kaiser Family Foundation. "People are going to see their premiums and out-of-pocket costs go up before the tangible benefits kick in."
Most of the 30 million uninsured helped by the bill won't get coverage until 2013 at the earliest, well after the next presidential election.
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