As America creeps closer and closer to the full launch of Obamacare, Americans are finding out why Congress did not want to read the bill before they passed it into law.

On February 10th, Reason.com told us that Obamacare will not lower Americans’ medical costs. Au contraire…

“We have to pass the bill so you can find out what’s in it,” said Nancy Pelosi during the debate over Obamacare. The Affordable Care Act passed, and Americans are now finding out. It’s not a pretty picture.

Take employment. “Medical device makers in Massachusetts and elsewhere are warning of potential job losses,” reports The Boston Globe, because of a 2.3-percent tax on medical devices imposed by law. Even liberal-heartthrob-turned-Massachusetts-Senator Elizabeth Warren, a supporter of the law, says repealing that tax is “essential.” (To paraphrase a cliché, if it saves one job – hers – it’s worth it.)

But the ACA’s effect on jobs goes well beyond medical device makers. Reporting on January’s employment numbers, Investor’s Business Daily notes an “apparent shift to part-time work ahead of a key Obamacare deadline.” Although more people are working in the retail sector, they are working fewer hours per person – now just a hair above 30 hours a week. “A similar trend,” IBD notes, “showed up in leisure and hospitality.”

Why? No great mystery: Under the ACA, companies with 50 full-time employees or more must provide health insurance or pay a fine. As Paul Christiansen writes in The Wall Street Journal, “thousands of small businesses across the U.S. are desperately looking for a way to escape their own fiscal cliff” through layoffs or shifting to more part-time employees. (He advises a third route: “going protean,” an approach in which a small cadre of managers sets strategy and outsources everything else – from accounting and IT to product development and manufacturing – to contractors.)

This employment shift may frustrate one of the aims of the Affordable Care Act: increasing the percentage of Americans who have employer-based health insurance. Won’t the downsized be able to buy subsidized health insurance through the new state exchanges, though? Sure. In fact, they will be forced to, or pay a fine. But that only highlights another area where the law is falling short: cost control. Back in 2010 the Congressional Budget Office estimated the average subsidy at $3,970 per individual. It’s now up to $5,510 – bringing the overall cost between now and 2022 to more than $1 trillion.

This is the trajectory of a law President Obama insisted was necessary to “bend the cost curve downward.” Indeed, three years ago Health and Human Services Secretary Kathleen Sebelius explained the “urgency” of health-care reform this way: “Working families have been saddled with huge rate increase in their health insurance premiums” – 39 percent in California, 56 percent in Michigan, and so on.

Yet as Michael Cannon of the Cato Institute notes, a recent survey of insurance companies finds that “if the law’s insurance rules were in force [now], the premium for a relatively bare-bones policy for a 27-year-old male nonsmoker on the individual market would be nearly 190 percent higher.”

Okay, so maybe the conservative group that conducted the survey cherry-picked that case. What about other sorts of policies, and other people? The news isn’t much better: Wisconsin predicts “an average premium increase of 41 percent.” Ohio’s Department of Insurance says “the individual health insurance market premiums are estimated to increase by 55 percent to 85 percent above current market average rates.”

But, hey, at least the “least among us” as Obama likes to call lower income Americans, will be taken care of. Especially, if they have pre-existing conditions, right?

Err…not so much.

The Washington Post reports that

Tens of thousands of Americans who cannot get health insurance because of preexisting medical problems will be blocked from a program designed to help them because funding is running low.

Obama administration officials said Friday that the state-based “high-risk pools” set up under the 2010 health-care law will be closed to new applicants as soon as Saturday and no later than March 2, depending on the state.

But they stressed that coverage for about 100,000 people who are now enrolled in the high-risk pools will not be affected.

“We’re being very careful stewards of the money that has been appropriated to us and we wanted to balance our desire to maximize the number of people who can gain from this program while making sure people who are in the program have coverage,” said Gary Cohen, director of the Department of Health and Human Services’ Center for Consumer Information and Insurance Oversight. “This was the most prudent step for us to take at this point in time.”

The program, which was launched in summer 2010, was always intended as a temporary bridge for the uninsured. But it was supposed to last until 2014. At that point, the health-care law will bar insurers from rejecting or otherwise discriminating against people who are already sick, enabling such people to buy plans through the private market.

From the start, analysts questioned whether the $5 billion that Congress appropriated for the Pre-Existing Condition Insurance Plan — as the program is called — was sufficient.

Initial fears that as many as 375,000 sick people would swamp the pools and bankrupt them by 2012 did not pan out. This is largely because, even though the pools must charge premiums comparable to those for healthy people, the plans sold through them are often expensive.

But it was also because the pools are open only to people who have gone without insurance for at least six months. The result is that, while only about 135,000 people have gotten coverage at some point, they are proving far more costly to insure than predicted.

Many people who are uninsured go untreated, exacerbating their medical problems. When they finally do get coverage through a high-risk pool, they are in immediate need of expensive care.

“What we’ve learned through the course of this program is that this is really not a sensible way for the health-care system to be run,” Cohen said.

Of the original $5 billion, about $2.36 billion remains available for the last three quarters of 2013 — enough only to continue coverage for those already in the pools, according to administration estimates.

The law gave states the option of either administering their pools directly or allowing federal authorities to operate them. In 27 states that have chosen direct management, applications for new enrollment can be accepted only through March 2. In 23 states and the District, where the pools are operated by the federal government, only applications received through Friday will be considered.

Obama administration officials said they did not have estimates for how many more people would have sought coverage through the pools beyond then. But Cohen said that new enrollment has averaged about 4,000 people per month in the past several months, suggesting that the figure could number in the tens of thousands.

Asked why the administration has not requested additional money from Congress to keep the program open — admittedly a tough sell in the current political and budgetary environment — Cohen said, “My responsibility is to work with the appropriation we have.”

About 129 million people nationwide have a medical condition or prior illness that would make it hard for them to buy their own insurance plan.

Large numbers of them can and still do obtain full coverage through employer-sponsored plans, which generally do not treat sick people differently.

An additional 215,000 people are insured through separate high-risk pools that 35 states fund through their own budgets — although the policies often do not pay for treatment of the person’s preexisting illness, only covering new illnesses the person may develop.

Between 9 million and 25 million people with preexisting conditions are uninsured, depending on the estimate.

And, just think…Obamacare is not even fully implemented, yet.

Oh, and if someone offers you “Soylent Green”, don’t eat it.

Until He Comes,

KJ