The exciting conclusion to yesterday’s post about what a shameless fraud the CBO numbers are. How do you slap a $940 billion pricetag on what’s actually a multitrillion-dollar bill? Well, as we’ve seen, the first thing you do is make sure not to start the program until almost halfway through CBO’s window of time for measuring how much it’ll cost. That cuts a trillion or two right off the top. But what if that still leaves you with budget deficits, thus crippling your sub-moronic talking point about how this massive new federal entitlement will save money over time?

Simple. You break the bill up and pass one of the expensive parts separately later. Here’s how a supposed $118 billion reduction in the deficit becomes another case of Obama bloat:

You asked about the total budgetary impact of enacting the reconciliation proposal (the amendment to H.R. 4872), the Senate-passed health bill (H.R. 3590), and the Medicare Physicians Payment Reform Act of 2009 (H.R. 3961). CBO estimates that enacting all three pieces of legislation would add $59 billion to budget deficits over the 2010–2019 period.

Under current law, Medicare’s payment rates for physicians’ services will be reduced by about 21 percent in April 2010 and by an average of about 2 percent per year for the rest of the decade. H.R. 3961 would increase those payment rates by 1.2 percent in 2010 and would restructure the sustainable growth rate mechanism beginning in 2011. Those changes would result in significantly higher payment rates for physicians than those that would result under current law. CBO estimates that enacting H.R. 3961, by itself, would cost about $208 billion over the 2010–2019 period. (That estimate reflects the enactment of two short-term extension acts, which lowered the cost in 2010 by about $2 billion compared with CBO’s estimate of November 4, 2009.)…

CBO estimates that enacting H.R. 3961 together with those two bills would add $59 billion to budget deficits over the 2010–2019 period. That amount is about $10 billion less than the figure that would result from summing the effects of enacting the bills separately. The $10 billion difference occurs primarily because H.R. 3590 and the reconciliation proposal would modify how the government’s payments to Medicare Advantage plans are set.

Still waiting to find out that if that memo urging Democrats not to talk about “doc fix” is real or not, but you can see why it’s good advice either way. Not only are they hiding another $208 billion in costs, but their dishonesty in passing doc fix separately will cost another $10 bil that could be avoided by passing everything together. Except, of course, that trying to pass everything together would send “fiscally conservative” Democrats fleeing for the hills — not because they care about a trillion-plus pricetag, but because they care that you might care. Or maybe they don’t even care about that, given the way the votes are falling today. Add Suzanne Kosmas to the roll of the shame.

WASHINGTON (AP) -- Congressional budget scorekeepers say a Medicare fix that Democrats included in earlier versions of their health care bill would push it into the red.

The Congressional Budget Office said Friday that rolling back a programmed cut in Medicare fees to doctors would cost $208 billion over 10 years. If added back to the health care overhaul bill, it would wipe out all the deficit reduction, leaving the legislation $59 billion in the red.

The so-called doc fix was part of the original House bill. Because of its high cost, Democrats decided to pursue it separately. Republicans say the cost should not be ignored. Congress has usually waived the cuts to doctors year by year.

Late Update: I asked House Minority Leader John Boehner's spokesman Michael Steel, who sent reporters the memo this afternoon after the Politico item was posted, about the accusation. Here's his response: "The underlying fact is the Democratic leadership is going to move a doc fix, they are going to spend another $300 billion. If not, why did AMA endorse the bill?"

Politico published this note this afternoon, removing the memo after we first posted this piece:

An earlier post in this spot detailed what was purported by Republicans to be an internal Democratic memo regarding the upcoming health reform vote Sunday. Democratic leadership has challenged the authenticity of the memo. POLITICO has removed the memo and the details about it until we can absolutely verify the document's origin.


Later Update: House Speaker Nancy Pelosi was asked why the "doc fix" wasn't included in the legislation at her weekly press conference this morning.

Her response:

Well, we have been including it in legislation for a long time, because it's not about a doctor fix, it's about our seniors or anyone who relies upon Medicare to have access to physicians, that they be in their region and in their program.

So this is again, you call it the doctor fix, but it is really about access to health care for Americans. It's not in this bill, but we will have it soon. And we have made a commitment to do this. This is very important.

A reporter followed up with a question about the cost and adding to the deficit.

Well, we will see how we advance the bill. But last year, when we did our budget, we had a number of issues that were not part of pay as you go. They were a CR, the sustainable growth rate, which is what you are referencing; they were middle class tax cuts; and the AMT. And that is what we are, that's what we have addressed. As we go forward, and it will be soon, we will address that, because it is necessary mostly for our seniors, but anyone who has access to Medicare services.

Third Update: Stephanie Lundberg, spokeswoman for House Majority Leader Steny Hoyer says the memo is not credible. "It's not a Democratic leadership memo and it didn't come from the committee and it is certainly being presented that way," she tells TPMDC.

And, indeed, the memo reads as guidance to rank and file members--and those sorts of talking points tend to come from leadership.

"No House or communications staff has seen it," Lundberg said.

The memo was blasted out to reporters after it first appeared on Politico by Republican leadership aides.


Fourth Update: GOP leaders were asked about our story and said the memo isn't important in a press conference this afternoon.

There would seem to be two possibilities. One is an outright hoax, with some dirty trickster hunched over a keyboard to fashion a memo so realistic-sounding in substance and tone that even seasoned health reporters could get fooled.

The other is a more complicated explanation – perhaps a draft that somehow got into circulation, even before it was widely seen within the party staff and committees, but nonetheless represents the point of view of the Democrats heading into a critical weekend vote.

The memo’s most explosive statement is that Democrats planned a so-called “doc fix” to Medicare reimbursement rates later this year, but don’t want to talk about it ahead of Sunday’s vote because it’s going to cost billions.

So if the memo’s a fake, does that mean there’s no “doc fix” in the works?

No, Democrats are planning to adjust Medicare reimbursement rates, just not until later this year. In fact, House Speaker Nancy Pelosi said as much in a news conference Friday.

Read more: www.politico.com...

Is it that outrageous that these 'business' people figure out ways to 'make things look one way' in order to avoid them 'looking another?'

So many object to the notion that these politicians would massage data and manipulate data to make it appear less costly or seem more desirable, without changing what they want it to actually be.