WASHINGTON BUREAU — Two Republican senators say the Affordable Care Act is failing to address the top health care concerns of the American people.

Sen. Tom Coburn, R-Okla., and John Barrasso, R-Wyo. – GOP lawmakers who are both physicians – have combed through government budget analyst reports, think tank reports and other documents for what they say is evidence that the ACA – the legislative package that includes the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act – will hurt patients and employers, produce unintended consequences, and, in some cases, do less than Democratic supporters have promised.

The table of contents, headed “Prognosis: Grim Consequences,” includes chapters with titles such as “Health Costs Skyrocket” and “Millions Could Lose Their Current Health Plan.”

In a section on the new Pre-existing Condition Insurance Plan (PCIP) program, which is supposed to help uninsured people with health problems get access to affordable, subsidized health coverage before a ban on medical underwriting takes effect in 2014, Coburn and Barrasso cite estimates from the chief actuary of the Center for Medicare and Medicaid Services that the $5 billion in program funding will run out in 2011 or 2012.

“According to one report, between 5 million and 7 million individuals with pre-existing conditions may be eligible for the new risk pool, while only 200,000 would be able to be covered under existing funds,” Coburn and Barrasso say. “The question then becomes: What would happen to the patients enrolled in the program when the money runs out?”

One possibility is that PCIP managers will have to start rejecting applications from thousands of Americans with preexisting conditions as early as 2011, and “the other possible scenario is the administration and Congress could pass the buck onto the states,” Coburn and Barrasso says. “This may be the reason why 20 states are already opting out of participating in the new high risk pool program.”

Coburn and Barrasso predict in another chapter, on expanded Form 1099 tax reporting requirements, that complying with the requirements could force a typical small business to spend an additional $6,000 per year on accounting services.

Coburn and Barrasso also repeat earlier Republican predictions that the new health care laws will make health care more expensive, not less expensive.