The projected increase in deficits will not be exactly the same, says CBO, as the reduction in deficits that CBO originally estimated to result from the Patient Protection and Affordable Care Act (PPACA) and the relevant provisions of the Reconciliation Act, because a number of developments have occurred since CBO and the Joint Committee on Taxation produced the cost estimate for PPACA. For example, CBO has made technical changes to its spending and revenue projections related to health care programs. Additionally, subsequent legislation has already modified the laws enacted by PPACA, in particular the Medicare and Medicaid Extenders Act of 2010.

According to CBO, the $145 increase in deficits by enacting the Job-Killing Health Care Law Act (HR 2) would come from 2 components: (1) the net reduction in deficits estimated at $130 billion over the 2012-2019 period expected to result from the health care provisions of the enacted legislation, and (2) the approximate $15 billion reduction brought about by the Medicare and Medicaid Extenders Act of 2010 in the estimated cost of subsidies to be provided through the insurance exchanges through 2019.