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The Congressional Budget Office said on Wednesday that the Finance Committee's health care bill would reduce the deficit by $81 billion over 10 years, but that analysis assumes that future lawmakers will follow through on the Medicare cuts proposed in the legislation. And as the CBO acknowledged, historically Congress has not followed through on cuts to government programs.

"These projections assume that the proposals are enacted and remain unchanged throughout the next two decades, which is often not the case for major legislation," the CBO noted. "For example, the sustainable growth rate (SGR) mechanism governing Medicare's payments to physicians has frequently been modified (either through legislation or administrative action) to avoid reductions in those payments."

Writing for Investor's Business Daily, David Hogberg reminds us:

The SGR is a formula put into law in the late 1990s that is supposed to trigger automatic cuts in Medicare payments to physicians if those payments grow too quickly....

But physicians groups have opposed the SGR since 2003 and successfully pushed Congress to suspend the cuts every year since.