And we worry about Goldman & the Oil Co. lying

Congressional Budget Office estimates released Tuesday predict the health care overhaul will likely cost about $115 billion more in discretionary spending over ten years than the original cost projections.

The additional spending — if approved over the years by Congress — would bring the total estimated cost of the overhaul to over $1 trillion.

Republicans pounced on the news, which they called another sign that the Obama administration makes promises it cannot deliver.

“The American people wanted one thing above all from health care reform: lower costs, which Washington Democrats promised, but they did not deliver,” said House Minority Leader John A Boehner (R-Ohio). “It was clearly irresponsible for Washington Democrats to force this legislation through Congress without being truthful about its full impact on the nation’s finances. Republicans are fighting to repeal this job-killing health care law and replace it with reforms focused first on lowering costs and protecting American jobs.”

But a Democratic leadership aide on Capitol Hill said the Congress will have to stay within the budget.

"Just like other authorized programs, the discretionary programs in health reform will need to compete for funds within set budgetary limits,” the aide said. “Republicans fighting to repeal reform can say what they want, but the bottom line is that CBO says reform will reduce the deficit and slow the growth of health care costs — period.”

The Congressional Budget Office expects the federal agencies to spend $10 billion to $20 billion over 10 years on administrative costs to implement the overhaul. The CBO expects Congress to spend an additional $105 billion over 10 years to fund discretionary programs in the overhaul.

The CBO released the estimates in response to a request from California Rep. Jerry Lewis, ranking Republican on the House Appropriations Committee. A spokeswoman for Lewis said the inquiry was filed before the House voted on the bill.

“arge sums of discretionary spending in both the House and Senate versions of the health care reform bills have not yet been included in estimates by the CBO, rendering it impossible to make informed decisions regarding the outcome of this legislation,” Lewis wrote in a February letter to House Speaker Nancy Pelosi, asking her to postpone votes until the discretionary spending analysis was complete.

The CBO estimated in March that the gross cost of the overhaul would be $940 billion over 10 years. The net cost was estimated at $788 billion over 10 years. But the group cautioned that it couldn’t make an estimate of the discretionary costs without more time and information.

The figures represent estimates as to how Congress will decide to spend money. The CBO cautions that lawmakers could decide to spend less. They would still have to respect the administration’s nonsecurity discretionary spending freeze.

The Department of Health and Human Services is expected to need $5 billion to $10 billion to implement changes in Medicare, Medicaid, the Children’s Health Insurance Program and insurance industry reforms, according to CBO estimates.

The nonpartisan CBO expects the Internal Revenue Service to spend another $5 billion to $10 billion on implementing the rules regarding premiums and cost-sharing credits.

An administration official cautioned that Congress doesn't always spend all that it is authorized to and that lawmakers would have to make other cuts to make up for any new spending they approve to stay within the budget and avoid adding to the deficit.

"The Affordable Care Act will reduce the deficit by more than $100 billion in the first decade, and that will not change unless Congress acts to change it," said Kenneth Baer, an OMB spokesman. "If these authorizations are funded, they must be offset somewhere else in the discretionary budget. The president has called for a non-security discretionary spending freeze, and he will enforce that with his veto pen."

The legislation says that the agencies would receive the funding to implement the programs through the appropriations process.

“The law establishes a number of new programs and activities, as well as authorizing new funding for existing programs,” CBO director Douglas W. Elmendorf said in the letter. “By their nature, however, all such potential effects on discretionary spending are subject to future appropriation actions, which could result in greater or smaller costs than the sums authorized by the legislation.”