As Erick points out, Obamacare took another heavy shot today, as the CBO concluded that the much-vaunted reforms pushed by Democratrs to control Medicare costs would have little or no effect. OMB Director Orszag has fired back quickly however, in an attempt to turn lemons into lemonade. He says that while CBO may have little faith in the provisions as they are currently drafted, a few little tweaks can make a world of difference:

With regard to the long-term impact, CBO suggested that the proposal, with several specific tweaks that would strengthen its operations, could generate significant savings.  (The potential modifications included items such as providing mandatory funding for the council, rather than having the council rely on the annual appropriations cycle, and requiring independent verification of the expected reductions in program spending rather than relying only on the Medicare actuaries for such verification, along with other suggestions, such as including an across-the-board reduction in payments as a fallback mechanism if the council did not produce proposals that generated adequate savings.)

This is interesting. The White House is willing to consider mandatory, automatic cuts in Medicare payments in order to reduce the cost of the bill. Yet it was just a few days ago that the White House agreed to increase the funding for Medicare doctors' reimbursements by $245 billion. Do you think the AMA will be quite as enthusiastic if their 'increased reimbursements' come along with mandatory cuts to those same reimbursements? Somehow I doubt it.

This is a shining example of how this effort is cannibalizing itself. The White House and the Democrat leadership are promising everyone that their needs will be taken care of in this bill: it will cover abortions while addressing the concerns of pro-lifers. It will include a government-run plan while not intruding too much into the private market. It will dramatically increase reimbursements for doctors while reducing the cost of Medicare. And all these interest groups are being promised that while their individual items may not be in the version that passes the House/Senate, it will be there in the final conference report - as long as you stick with us.

If this effort doesn't die, a whole lot of people will soon be shown as classic chumps: people who believed the White House when they said up was down and black was white. There's no way Obama can deliver on all his promises.

By the way - read a little further and you'll see that Orszag couldn't resist taking a shot at his successor, implying that the numbers generated by an independent entity like CBO can't be trusted as much as those of the experts at the White House:

A final note is worth underscoring. As a former CBO director, I can attest that CBO is sometimes accused of a bias toward exaggerating costs and underestimating savings. Unfortunately, parts of today’s analysis from CBO could feed that perception.

Right. Who are you gonna believe - the CBO, or the team that brought you the 'stimulus?'