The Congressional Budget Office has doubled the estimated increases of some costs resulting from the sweeping health care reform legislation passed this year.
A CBO report sent Tuesday to Rep. Jerry Lewis of California, the ranking Republican on the House Appropriations Committee, said the estimated rise in discretionary spending - which is spending requiring annual congressional authorization - over the first 10 years under the new legislation could exceed $115 billion.
On March 11, exactly two months earlier, the non-partisan CBO reported the estimated increase for discretionary spending could exceed $55 billion.
Douglas Elmendorf, the CBO director, said the latest report "updates and expands" on the previous report. He noted that assessing effects on discretionary spending was speculative because such appropriations require congressional action, and could be larger or smaller than initially anticipated.
The health care legislation was estimated by CBO to cost $940 billion over 10 years and reduce the federal deficit by $143 billion over the same period.
Increased costs in discretionary spending would not necessarily offset the estimated deficit reduction. Congress requires most discretionary spending to have available resources under so-called "pay to go" rules.
According to the CBO report, the estimated higher costs would come from increased administrative expenses for the Internal Revenue Service and Department of Health and Human Services, as well as grants and other programs contained in the health care bill.
In a letter to Lewis, Elmendorf said some of the increased cost estimates in the May report included extensions of existing spending authorizations not included in the March report, as well as future discretionary spending for initially mandatory grants.
Spending for some specific programs not included in the March report, such as provisions of the Indian Health Care Improvement Reauthorization and Extension Act and the National Health Services Corp., also are in the May report, according to Elmendorf.