A new study examining a major comprehensive health care reform proposal looks at the cost to employers and any burdens that might be placed directly on Americans with employer-sponsored health plans. The Lewin Group's analysis of America's Affordable Health Choices Act of 2009, as amended by the Energy and Commerce Committee, is the first critical analysis of health care reform costs that would extend beyond 2019.

The study shows President Obama's promise that reform legislation will pay for itself during the next 10 years is achievable. As for his pledge that it will not add to the federal deficit, the figures are not in his favor.

During the first 10 years, from 2010 to 2019, under the bill's implementation, the cost (net federal cost) is estimated at $39 billion and would be "nearly fully funded." But beyond that, in its second decade, the proposal would add an estimated $1 trillion to the federal deficit. This is due to rapid growth in health care costs that will outpace the growth in incomes and revenues over the longer term, according to the study.