DID the "Democrats cut Medicare"??

The calculations of longer-term effects are based on the assumption that the provisions
of PPACA and the Reconciliation Act will remain unchanged throughout the
next two decades. However, those laws put into effect a number of policies that may
be difficult to sustain over a long period of time.

Specifically, last year’s legislation restrains the rate of increase in payment rates for
many providers of Medicare services to less than the expected rate of increase in the
cost of the providers’ inputs, in expectation of ongoing productivity improvements in
the delivery of health care. If providers do not improve their productivity sufficiently
rapidly to offset the reductions in payment rates, those rates will fall over time relative
to the cost of providing services. By holding the rate of increase in payment rates
below what would have prevailed under prior law, PPACA will generate savings that
are projected to increase considerably during the next 10 years and in the decade
beyond that. However, it is unclear the extent to which providers will achieve greater
efficiencies in the delivery of health care and the extent to which cost pressures will
instead reduce access to care or diminish the quality of care (relative to the situation
under prior law) outcomes that might increase pressure on the Congress to increase
payments to providers. It is also unclear whether and how the Congress would
respond to such pressure if it arose and what effects the response would have on total
federal health care spending, revenues, and deficits.

Last year’s legislation will restrain the increases in Medicare payment rates for many
providers other than physicians. At the same time, the so-called sustainable growth
rate mechanism—which has been in effect since 1997—is projected to cause Medicare’s
payment rates for physicians’ services to be reduced sharply during the next few
years. That mechanism has frequently been modified (either through legislation or
administrative action) to avoid an abrupt and large reduction in those payment rates
that might have reduced Medicare beneficiaries’ access to physicians’ services.
On the basis of the cuts in payment rates under PPACA and the Reconciliation Act,
along with the effects of the sustainable growth rate mechanism, CBO projects that
Medicare spending per beneficiary (adjusted for inflation) will increase at an average
annual rate of less than 2 percent during the next two decades—compared with the
rate of roughly 4 percent that has occurred over the past two decades (a figure that
excludes the effect of establishing the Medicare prescription drug benefit).