Here is a pretty good analysis from Bob Laszewski. When you look at the cost over 10 years, if you only pay for benefits for 6 years (expense) and begin raising taxes and cutting Medicare immediately (income and/or expense reductions), you can claim this won’t add to the deficit. Again, this doesn’t contemplate fixing the Physician’s Fee Schedule in Medicare which would cost $250 Billion to do. The Physician’s fix is the #1 priority of the AMA. Also, you are assuming you can cut the real growth rate (growth less inflation) of healthcare spending by 50% over the next 10 years versus the last 10 years (from 4% down to 2%). That’s probably easier said than done considering the goal is to expand access to healthcare for people who can’t afford or can’t qualify for health insurance.