Everyone remembers Nancy Pelosi's famous words about the Affordable Care Act (ACA): "We have to pass the health care bill so that you can find out what is in it."  Since January 2010, when the ACA was signed into law, we have gradually discovered what's in it.  What we are finding is not what we want and certainly not what was advertised.

Every expansive promise made by the president for his signature legislation has been shown to be smoke and mirrors.  Though touted as healthcare reform (change for the better), the ACA is more accurately described as Obama's Act of Healthcare Exacerbation (change that makes things worse).

A new study by the Pioneer Policy Institute in Massachusetts adds number 10 to the list (below) of reasons why Americans hate the ACA.

1. First, there was the way ACA was rammed down our throats.  Arm-twisting, phony statistics, bribery, for-show executive orders, deferred implementation, and outright lies were all used to get the ACA passed against the will of We The People, even with a Democrat-controlled Congress.

2. Then there is a mandate that absolutely wasn't a tax until SCOTUS said it wasn't commerce.  Therefore, it had to be a tax -- on the middle class, no less.

3. The ACA would cover all Americans who had no health insurance -- i.e., 45 million...until the president discovered that 12-15 million of those uninsured Americans were illegal residents.  Presto!  Forty-five million instantly became 30 million.

4. Illegal residents weren't covered, then maybe they were, and now they are exempt, for sure.  Illegals are the leading users of ERs, where they receive mandated-but-uncompensated care: free to them but costing roughly $2,500 per year per tax-paying family.

5. The ACA will save money, promised Nancy Pelosi with a broad smile.  In fact, the ACA will cost one to 2.7 trillion dollars.  That is more than has been spent so far on the wars in both Iraq and Afghanistan.  That is money -- dollars we don't have -- which the ACA will spend on bureaucracy, not on patient services.

6. "Health exchanges will save money through the use of free market forces."  Yet the government (ACA) controls both supply and demand, making the market in healthcare totally controlled -- the opposite of "free."

7. "If you like your doctor, you can keep your doctor," promised President Obama over and over.  Not true.  Under the ACA, doctors cannot afford to care for Medicare- and Medicaid-covered patients.  So even though your doctor wants to care for you, if you have government insurance coverage, your doctor cannot "keep" you.

8. Exemptions: if the ACA is good for us, why are there over 1,400 exemptions granted, including foro Congress and the White House, various unions and selected businesses, 40% of the uninsured (per J. Gruber of MIT), and Muslims?  Why is one religious group exempt?  Aren't all Americans equal under the law regardless of "race, religion, or country of national origin"?

9. The IPAB (Independent Payment Advisory Board) is in fact the "death panel" that Sarah Palin was lampooned over.  By establishing what it won't pay for, the IPAB makes those treatments unavailable.  If you need a therapy deemed "not cost-effective," you die...by government decision.

10. Now we have an addition to this list: another disingenuously titled component of the ACA called the "Cadillac Tax," which is a con, a scam in savior's clothing.

The Cadillac Tax is an excise tax: one levied on the amount of business done.  The ACA penalizes (taxes) insurance plans where health benefits exceed $10,200 for an individual and $27,500 for a family.  If you think these are benefits needed only by billionaires and members of Congress, you haven't seen hospital bills for having a baby or removing a gallbladder, much less for heart surgery.

The Cadillac Tax level of coverage applies to any profession that has robust healthcare benefits, like construction workers, teachers, police, and most public workers. Indeed, it is estimated that over half of all individuals having private, employer-provided insurance plans will be subject to this tax rather than only the "super, gold-plated Cadillac" top one percent, as asserted by the president.

The Pioneer Policy Institute has calculated the average cost of the excise tax on a middle school teacher ($2,081 per year), a police patrol officer ($5,391 per year), and a small business owner ($8,690 per employee per year).  Nationally, business leaders say this last is a huge damper on economic growth.  The ACA excise tax is quite clearly a middle-class tax, not "Cadillac" at all, and a job-killer to boot.

Dr. Seuss said, "The more that you read, the more things you will know."  The more we read and learn about the ACA -- a bill that was supposed to "protect" us, that was advertised as "affordable," and that absolutely wasn't a tax -- the more things we learn to hate.  (That's Dr. Seuss' least favorite word in the English language.)

Deane Waldman, M.D., MBA is emeritus professor of pediatrics, pathology, and decision science; adjunct scholar a for New Mexico think-tank called the Rio Grande Foundation, and the author of Uproot US Healthcare as well as Not Right! (January 2013).