It turns out that Harry Reid picked up a few tricks in Las Vegas.

Last week’s highly-publicized report by the Congressional Budget Office that estimated the Senate Finance Committee’s health care bill would reduce federal deficits over time included this important caveat: “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.” As an example, the CBO noted that lawmakers have never followed through on proposed cuts to Medicare’s payments to doctors.

And as the Hill reports, they’re at it again:

The Senate is poised to take action on a costly bill to hike Medicare payments to physicians just weeks before bringing a sweeping healthcare overhaul to the floor.

Majority Leader Harry Reid (D-Nev.) on Wednesday morning quietly set in motion legislation that could cost more than $200 billion over 10 years – without cuts or revenue to offset the spending — on a separate track from a larger healthcare bill that President Barack Obama and Senate Democratic leaders have vowed would not add to the budget deficit.

So, while loudly touting a CBO report that estimates one of the Democratic health care bills would cost $829 billion over 10 years and reduce deficits, Reid is working below the radar to restore $200 billion in Medicare funding that would bring the total cost of health care legislation to over $1 trillion, and add to deficits.

UPDATE: The Wall Street Journal reports that it will actually cost $247 billion, and Republicans are seeking offsets.