A report by the CMS Office of the Actuary found that, under the Senate’s health care reform bill (HR 3590) as proposed on November 18, total national health care expenditures will increase $234 billion (0.7 percent) between 2010 and 2019 while expanding coverage to 93 percent of Americans.   The report also found that plans to cut Medicare spending by $493 million over 10 years through reduced provider payments and increased efficiency may cause service reductions for Medicare beneficiaries and loss of profitability for 20 percent of health care providers that predominately treat Medicare patients.  Unlike the CBO’s cost estimates, which focus exclusively on the impact legislation on federal spending, the CMS report assesses the legislation’s effect on all health care spending.

From the report:

This memorandum summarizes the Office of the Actuary's estimates of the financial and coverage effects through fiscal year 2019 of selected provisions of the proposed "Patient Protection and Affordable Care Act of 2009" (PPACA). The estimates are based on the bill as released by Senate Majority Leader Harry Reid on November 18 as an amendment in the nature of a substitute for H.R. 3590. Included are the estimated net Federal expenditures in support of expanded health insurance coverage, the associated numbers of people by insured status, the changes in Medicare and Medicaid expenditures and revenues, and the overall impact on total national health expenditures. Except where noted, we have not estimated the impact of the various tax and fee proosals or the impact on income and payroll taxes due to economic effects of the legislation. Similarly, the impact on the Federal administrative expenses is excluded. A summary of the data, assumptions, and methodology underlying our estimates of national health reform proposals is available in the appendix to our October 21 memorandum on H.R. 3200. 

Full report: Estimated Financial Effects of H.R. 3590 as Proposed on November 18, 2009 (PDF | 269.68 KB)

US Department of Health and Human Services. Centers for Medicaid and Medicare Services, Office of the Actuary. (2009). Estimated financial effects of the "Patient Protection and Affordable Care Act of 2009" as proposed by the Senate Majority Leader on November 18, 2009.