In a letter to John Boehner today, the Congressional Budget Office estimates that abolishing the Affordable Care Act would increase the deficit by $109 billion over the next ten years. Is this estimate credible? The CBO is required to assume the ACA is implemented the way the law is written. But the law requires $523 billion in cuts to Medicare. These are cuts that the Office of the Medicare actuaries say will cause one in seven hospitals to close by the end of the decade and will keep seniors from having reasonable access to physicians. This outcome is so unbelievable that the CBO has published an “alternative report” showing much higher Medicare spending and the Medicare Actuaries Office not only publishes an “alternative report,” they are now including the alternative report in the official report official report.