“Of all the conservative complaints about health care reform, the one I find most baffling is the notion that the financing is phoney because it fails to account for physician pay increases. The complaint is 100% phoney. And yet it continues to be repeated over and over in the conservative media, recycling through a misinformation feedback loop. The complaint gained new momentum and publicity last week, when right-wing icon Paul Ryan requested that the Congressional Budget Office calculate the cost of health care reform combined with physician pay increases. The result was cited as proof of the ‘true’ cost of Obamacare. Let me explain this again. In 1997, Congress changed the formula for reimbursing doctors under Medicare. Due to poor design, they created a formula that would impose massive reimbursement cuts that were never intended by Congress. As a result Congress has regularly restored the unintended cuts. Yet because the law remains on the books, the budget assumes the cut will go into effect every year even though it won't. In other words, the budget baseline is off by about $200 billion a year, which is the rough cost of filling in this hole.”