Access to Care: Health care providers will be more reimbursed by Medicare for the quality of care they deliver. Support will be extended for the the Children's Health Insurance Program and the adoption tax credit. Substantial investment in Community Health Centers will provide health care for in-need communities. Rural communities will have more access through funding for health care providers and training programs. Programs will be initiated for certain diseases, improvements of the Indian Health System and programs for pregnant teens and domestic violence survivors.

States will also have grants to test alternatives to civil tort litigation in matters of patient safety and health care errors.


CBO Estimates

The Congressional Budget Office (CBO) and the staff of the Joint Committee on Taxation (JCT) have estimated that on balance, the direct spending and revenue effects of the Patient Protection and Affordable Care Act with Senate Amendment 2786 would result in a net federal deficit reduction of $132 billion over the 2010-2019 period. Out of that amount, $81 billion would be on-budget and other savings would be through Social Security revenues and other spending classified as off-budget.

In the decade after the initial period, the provisions will likely continue to reduce the deficit if fully implemented; the CBO and JCT note these are just estimates.

The CBO/JCT estimate has projected net costs of $614 billion over 10 years due to the proposed expansions in insurance coverage. The net costs reflect a gross total of $871 billion in a) subsidies provided through the exchanges; b) increased net outlays for Medicaid and the Children's Health Insurance Program (CHIP); and c) tax credits for small employers. The costs are offset by $149 billion in revenues from the excise tax on high-premium insurance plans and $108 billion in net savings from other sources. Over the 2010-2019 period, the coverage expansions would be offset by the combination of other spending changes that CBO estimates would save $483 billion and the other provisions that JCT and CBO estimate would increase federal revenues by $264 billion.

Bottom line: CBO and JCT estimate that the legislation increases outlays by $366 billion and increases revenues by $498 billion in the ten years between 2010 and 2019.

Read more details:

Senator Reid's Remarks: http://democrats.senate.gov/newsroom/record.cfm?id=321039&
CBO Analysis: http://www.cbo.gov/ftpdocs/108xx/doc10868/12-19-Reid_Letter_Managers.pdf

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