The Congressional Budget Office, following intense tweaking of the proposals and yielding to pressure from Speaker Pelosi to deliver a cost figure under $1 Trillion, offered a highly qualified cost report to Congress on the newest version of the health care reform package. Dubbed as “PelosiCare” by detractors, this bill proposes significant cuts in benefits to seniors on Medicare.

President Obama has demanded action and told Democrats passage of the health care reform bill was critical to the political future of the Democratic Party. That appeal is a strong push-back to the fear that is sweeping over Democrat Members of the House in marginal districts that a “yes” vote to health care reform will spell electoral defeat for them in November.

The Congressional Budget Office reported the cuts required to get the cost of this version of health care reform requires the following cuts in existing programs for seniors:

· $200 Billion in Cuts to Medicare Advantage

· $150 Billion in Cuts to Providers, including Hospitals, Nursing Homes and Hospice Care Facilities

· $40 Billion in Cuts to Home Health Care Services

· $20 Billion in Cuts to Hospitals Serving Low-Income Populations

In addition to these benefit cuts, the newest version of health care reform does not include the needed fix to the physician payment formula, and without it there will be a mass migration of doctors from treating Medicare patients. That fix is estimates to cost $340 Billion, and whether it will be passed separately, as Speaker Pelosi hopes, is in serious doubt if it is not included in the overall reform package.

The backroom deal making that attracted so much negative attention are largely still intact in the newest version of the health care reform, and more deals are being made to secure the last few votes needed in the House.

Critics claim the indirect cost to taxpayers to fund the various deals will total hundreds of billions before they are done.