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This blog post originally appears on House Republican Leader John Boehner's (R-OH) blog

Members of Congress and the American people are just beginning to look at Speaker Nancy Pelosi’s (D-CA) 1,990-page government takeover of health care, but it’s already becoming clear just how costly and unsustainable this proposal is.  From higher taxes on middle-class families to job-killing mandates on small businesses to cuts in Medicare benefits for seniors, here are 10 facts every American should know about Speaker Pelosi’s 1,990-page government takeover of health care:

1. RAISES TAXES ON MIDDLE CLASS FAMILIES.  Speaker Pelosi’s health care bill imposes a range of tax increases on families with income below $250,000, breaking a promise made by President Obama.  Tax increases on middle class families include: an individual mandate tax of up to 2.5 percent of income for taxpayers earning as little as $9,350; repeal of a tax break on medicine purchased with funds from an HSA (health savings account); limits to tax relief through FSAs (flexible spending accounts); taxes on medical devices that will inevitably be passed on to consumers; and a new tax on all insurance policies.

2. MASSIVE CUTS TO MEDICARE BENEFITS FOR SENIORS.  Despite grave warnings from CBO, FactCheck.org, and the independent Lewin Group that cuts to Medicare of the magnitude included in Speaker Pelosi’s bill would have a negative impact on seniors’ benefits and choices, Speaker Pelosi’s health care bill stays the course and cuts Medicare by hundreds of billions of dollars.

3. NO PROTECTIONS FOR SMALL BUSINESSES.  Speaker Pelosi’s health care bill claims to exempt small businesses from the steep eight percent ‘pay or play’ employer mandate.  The facts tell a different story.  Using Census data compiled by the Small Business Administration, this so-called ‘exemption’ hammers small employers with only, on average, 17 or more employees to new taxes and mandates.  The outfits affected employ 70 percent of all small business employees, or 42.3 million workers.  Adding to the assault on small businesses, the bill does not index the small business “exemption” amounts, meaning more and more small businesses will be ensnared by this job-killing employer mandate each year.

4. INCREASES THE COST OF HEALTH INSURANCE.  Imposing a new $2 billion tax on insurance policies will be passed on to patients in the form of higher premiums.  Changes to the Medicare Part D prescription drug benefit will, according to estimates by CBO, will raise Medicare Part B premiums by $25 billion and Part D premiums by 20 percent.  And imposing an unfunded mandate on the states to pay for the bill’s Medicaid expansion will shift the burden of this expansion on state taxpayers who may experience tax increases to cover the cost.

5. USES GIMMICKS TO HIDE BUDGET-BUSTING COST, PILES UP DEBT ON FUTURE GENERATIONS.  Speaker Pelosi’s health care bill claims to be deficit neutral, but uses budget gimmickry to hide its massive total cost.  Working families across America know they cannot simply decide that a bill they get in the mail doesn’t exist, but that’s exactly what congressional Democrats are doing.  In order to meet the President’s ‘target’ spending total of $900 billion, Democrats have simply swept costly provisions under the rug, including the $245 billion ‘doc fix.’

6. IMPOSES JOB-KILLING EMPLOYER MANDATES.  Additional taxes on employers and new government mandates that dictate acceptable insurance will place new and crushing burdens on employers.  These are burdens that will ultimately fall squarely on the backs of workers in the form of reduced wages, fewer hours or lost employment. CBO agrees that “[e]mployees largely bear the cost of... play-or-pay fees in the form of lower wages.”  According to the National Federation of Independent Business (NFIB), the nation’s largest small business association, an employer mandate of this magnitude will disproportionately impact small businesses, triggering up to 1.6 million lost jobs.  Two-thirds of those jobs would be shed by small businesses.

7. TILTS THE PLAYING FIELD IN FAVOR OF THE GOVERNMENT-RUN INSURANCE COMPANY.  Speaker Pelosi’s health care bill promises not to give the government-run plan advantages over private insurers in the market, but the opposite is true.  The bill provides billions in start-up funding for the government-run plan, and while it requires the plan to repay the money over time it does not require the plan to pay interest on this “loan.”  This interest-free, taxpayer-subsidized loan is potentially worth millions of dollars and tilts the playing field in favor of the government-run plan.

8. THREATENS CASH-STRAPPED STATES WITH UNFUNDED MANDATES.  Speaker Pelosi’s health care bill swells the number of Americans on the government rolls by expanding Medicaid eligibility.  Medicaid is financed through a federal-state partnership, but the bill dumps nearly ten percent of the mandated expansion included in the bill onto the states.  States, already struggling with fiscal constraints, would be left on the hook for billions of dollars due to this unfunded mandate.

9. CREATES A NEW MONSTROSITY IN THE TAX CODE.  Starting in 2011, Speaker Pelosi’s health care bill imposes a 5.4 percent tax on adjusted gross income above $500,000 for individuals and $1 million for married couples.  Yet, the dollar amounts for which the tax kicks in are not indexed for inflation.  We’ve seen this horror film before: the Alternative Minimum Tax, another Frankenstein’s monster of the tax code, also wasn’t indexed for inflation and now affects millions of middle class families with incomes below the Democrat’s surtax.

10. MISSES AN OPPORTUNITY TO CURTAIL JUNK LAWSUITS.  Speaker Pelosi’s health care bill misses a critical opportunity to rein in junk lawsuits and costly defensive medicine.  The bill includes only a voluntary grant program to deal with the medical liability crisis instead of including real reform, which would produce tens of billions of dollars in savings, improve efficiency in our health care system and reduce costs for patients and providers.

BONUS: Republicans have offered better solutions to lower health care costs and expand access to quality, affordable coverage at a price our nation can afford.  Learn more by visiting healthcare.gop.gov