Elmendorf says effects of health care likely to change from initial estimates

Elmendorf also addressed questions about the effects on discretionary spending, explaining that the CBO estimates don't misrepresent or hide certain effects of the law. Instead he explained the estimates provided focus on direct spending and revenues because those figures are relevant for pay-as-you-go rules and they will go into effect without further legislative action. CBO has said the law will lead to increases in discretionary spending that aren't included in the current estimates. 

Although CBO doesn't make policy judgments or recommendations, Elmendorf noted that he has "frequently noted the long-run unsustainability of the nation's current budgetary polices and indicated that using savings in existing programs to finance new programs would necessitate even stronger policy actions in other areas."