Responding to an inquiry from Rep. Paul Ryan, the Congressional Budget Office has confirmed that when you remove certain accounting gimmicks from the Democrats' health care legislation, it actually increases the deficit.
Democrats have touted a CBO report that found that their health care bill would reduce the deficit by $138 billion from 2010 to 2019. But that number assumes that hundreds of billions of dollars in Medicare cuts would be used to pay for the new health care entitlement. In a letter to Ryan, the CBO estimates that if the Medicare cuts were used to help shore up the effectively bankrupt Medicare trust fund instead, then the Democrats health care bill would run $260 billion in deficits over the next decade.
In an earlier version of the House bill, Democrats included a measure to avoid scheduled cuts in doctors' payments under Medicare. They removed the measure when they couldn't get the numbers to add up, but they have continued to pass temporary delays of the cuts and have vowed to tackle the issue separately from the current health care bill. In the letter, CBO projects that if the so-called "doc fix" were added to the legislation, it would produce deficits of $59 billion from 2010 to 2019.
Earlier CBO estimates also asume that future lawmakers would actually enact some of the unpopular measures, such as the Medicare cuts and the "Cadillac tax." These are crucial to Democrats' claims that the bill will reduce deficits even more -- by $1.2 trillion -- in the second decade. But in the letter, the CBO says that without the changes, deficits would actually increase -- by a quarter of a percent of GDP, or $600 billion -- in the second decade.
Liberals have tried to portrat any criticism of the Democrats' deficit reduction claims as an attack on the integrity of the CBO itself. But as this letter demonstrates, this isn't about attacking the CBO. It's just simply acknowledging that CBO analysis can vary greatly based on the questions you ask them. And clearly, Democrats kept tweaking the language until they were able to get the CBO score they wanted.