•    The majority’s leaders claim their bill is paid for. That is false. The bill includes a provision that fills the “doughnut hole” in Medicare Part D. However, the costs of doing so are largely outside of the 10-year budget window for this bill. In fact, the government will not stop paying for this until 15 years from now.

•    According to the CBO, “The federal budget is on an unsustainable path, primarily because of rapidly rising spending on health care.” Moreover, CBO notes that “federal debt held by the public is set to jump from 41 percent of GDP at the end of 2008 to more than 60 percent by the end of 2010, the highest level since the mid-1950s.”

•    CBO believes “a large-scale expansion of insurance coverage would represent a permanent increase of roughly 10 percent in the federal budgetary commitment to health care.”

•    CBO has cautioned that the long-term budgetary impacts may be less favorable than the short term impact of health reform. CBO says there are two general reasons for this:

o    (1) “an expansion of insurance coverage would be phased in over time to allow for the creation of new administrative structures such as insurance exchanges. As a result, the cost of an expansion during the 2010–2019 period could be a poor indicator of its ultimate cost;” and
o    (2) “savings generated by policy actions outside of the health care system would probably not grow as fast as health care spending.”

•    Recently, the CBO director told the Senate Budget Committee that the legislation “significantly expands the federal responsibility for health care costs.” He further stated that the legislation does not “represent the sort of fundamental change, the order of magnitude that would be necessary to offset the direct increase in federal health costs that would result from the insurance coverage proposals.”