Read further in the link and you'll see they're trying to pretend away significant costs:
Funny, I remember the same people being upset that Bush pretended away Iraq costs.
sd: Har-dee-har-har. You, of all people, do not want this to turn into a discussion of who's acted hypocritical. Don't think your occasional fig-leaf criticisms of Bush -- for whom you voted twice, no? -- will keep anyone from pointing out the same thing T EXP just nailed you with.
For the rest of you, a teaching moment!
The $245 billion outlay (the difference between adding $239b to the deficit or shaving $6b off of it) goes towards fees paid to doctors through Medicare. It is a long-term fix for a problem that's been temporarily patched over several times already.
For whatever reason, the laws and formulas that determine how much Medicare pays physicians are spitting out low numbers, so that there would be a pretty sharp cut and in turn many doctors might stop taking Medicare patients.
Last year they passed a bill to temporarily keep the current rates and put off the ~10% cut. There was a similar bill in 2006 which passed with big bipartisan support, and I think at least one in Bush's first term.
So the $245 billion over ten years represents how much more the government would be paying compared to the formulas as they're currently projected. It does
not represent the increase over what we've actually been spending over the last decade.
I understand why the CBO included it. It's coming out of the same committee right now and hasn't been attached to the PAYGO bill. But it's not a plank of the healthcare reform plan. This was going to happen anyway, just like it happened three times before this decade.
It's emblematic of the way Congress abetted the Bush admin in fudging numbers and shirking responsibility.
The Iraq and Afghanistan wars, cuts to the income tax, exemptions for the estate tax, and the AMT patches were all handled basically the same way: pass a temporary solution (sometimes annually), keep it off the books to make the long-term accounts look better, and kick it down the road.
Now we have a president who's supporting a permanent-ish solution to this issue, while focusing on making his health reform package revenue-neutral, following a Republican who had three initiatives of similar or higher cost which were
completely unfunded and the GOP starts bitching about deficits and financial chicanery? Now?
Come the fuck on.