The ad, embedded below, is scheduled to appear in the upper northwest quadrant Monday through Thursday of this week, and asks “What were you thinking?”

In addition to King, the organization has nearly identical ads airing in criticism of U.S. Reps. Ryan, Chip Cravaack (R-Minn.) and Sean Duffy (R-Wis.). In total, the ad buys are costing five figures and are being done in conjunction with an automated call campaign in 23 Congressional districts throughout the country that began last week.

In Iowa the automated calls follow this script:

I’m calling from Americans United for Change.

On April 15th, your Congressman Steve King voted to end Medicare and its guaranteed health care benefits. Instead, he wants to give seniors a voucher, forcing them to go out and find coverage from private insurance companies. The nonpartisan Congressional Budget Office estimates this proposal will increase seniors’ out-of-pocket costs by $6,000 each year — and Congressman King is using the savings to give corporations and millionaires another tax break. Congressman King even voted to slash Medicaid funds that pay nursing home care for seniors and the disabled.

Call Congressman King at 202-225-4426 and tell him that cutting Medicare, Medicaid and Social Security to pay for tax cuts for corporations and millionaires is just wrong. Tell him to keep his hands off our Medicare, Medicaid and Social Security.

While there has been little shortage over the years of progressive outrage directed at King, it hasn’t been commonplace for national groups to spend money in an effort to target him. This has been because the existing 5th District hasn’t been considered competitive. This particular ad buy signals that either national organizations view the newly remapped 4th District as being somewhat more competitive or that they believe a high-profile Democrat could make inroads come 2012 — or perhaps a bit of both.

Defending the new law, U.S. Department of Health and Human Services Secretary Kathleen Sebelius wrote an editorial in Friday’s Columbus Dispatch debunking arguments that the health care act has not destroyed the Medicare Advantage program or harmed small businesses.

“The Affordable Care Act is not perfect; no law ever is,” Sebelius writes. “The Obama administration continues to be open to any ideas to improve it. For example, Obama has joined with Democrats and Republicans in calling for the repeal of a bookkeeping provision in the law that was too burdensome on small businesses.”

Sebelius also claims that the law is, in fact, not bad for our economy, arguing that since the president signed PPACA into law, the economy has grown at an average annual rate of 2.7 percent and created nearly 1.4 million private-sector jobs.

But it’s on this last note that opponents have come out strongly against the law, armed with Congressional Budget Office’s recently released preliminary analysis of the president’s 2012 budget, which notes:

The provisions related to expanding health insurance coverage were projected to increase the deficit between 2012 and 2021 by $1.04 trillion, on net, in CBO’s January baseline; they are now projected to increase the deficit by $1.13 trillion over that period.

Subsequent figures related to how much the health care legislation is costing American taxpayers inspired The Washington Post to call “fuzzy math” on some of the assumptive projections, pointing to the GOP-led House Energy and Commerce Committee that claimed “Obamacare Price Tag Spikes by 54%” and The Wall Street Journal, which suggested costs from the new law have risen by 8.6 percent. The Energy and Commerce Committee released a statement this week saying the cost of the health care act has increased by $500 billion, “meaning, in only one year, the cost has increased from an already staggering $938 billion price tag to $1.445 trillion.”

From the Post:

Last week was the third time that CBO has provided an estimate for the cost of the health care bill. Each time, the number has been a little different because of various technical factors, and also because different budget windows are being used, such as 2010-2019, 2012-2019 or 2012-2021. The longer the budget window, the bigger the costs and the revenues, in part because the population is getting larger and the gross domestic product is expected to increase.

The Energy and Commerce Committee came up with its increase by mixing apples and oranges. It compared the gross cost of insurance coverage provisions calculated for 2010-2019 (that’s the $938 billion number) with new figures for a different budget window, 2012-2021 (that’s the $1.445 trillion figure.) That’s kind of like saying the cost of pizza went up by comparing last year’s price for a 12-inch pie with this year’s price for a 16-inch pie.

[...]

Yes, certain provisions do not kick in immediately, but neither do many of the new taxes. The revenue estimate by the Joint Tax Committee shows that $58 billion of revenue is raised in the first four years, compared to $380 billion over the last six years. As mentioned before, the cost numbers also get larger in later years because of population and GDP growth.

The Wall Street Journal came up with its increase by comparing a different set of numbers: the net cost (which strikes us as more reasonable than the gross cost used by the House committee) for the same time period, 2012-2021, as estimated in February 2011 and March 2011. But the Journal failed to note that the CBO cost estimate in February was actually lower than its initial estimate last year, so the overall effect from last year to this year is minimal.

Doing its own health care “myths” fact-checking, the St. Petersburg Times’ PolitiFact analyzed several common statements about the PPACA and gave them ratings of true or half-true.

The following statements were rated “true.”

• Under the new health care law, “if a landscaper wants to buy a new lawnmower, or a restaurant needs a new ice-maker, they have to report that to the feds.”
• New provisions of the health care law bar the use of flexible spending accounts and health savings accounts to pay for aspirin and other non-prescription health needs.
• “With this reform, every insured American gets valuable consumer protections, and every uninsured American can become insured.”
• “Obama put a 10 percent tax on tanning.”
• Orrin Hatch (and other Republicans) co-sponsored a 1993 health care bill that had an individual mandate.

These were rated “half-true”:

• The health care bill “cuts the deficit by over $1 trillion dollars.”
• The health care reform law pays for “6 years of benefits with 10 years of tax increases.”
• The majority of people in polls do “not support Obamacare.”
• Under the clear letter of the law,” Justice Clarence Thomas “must recuse himself” from the case challenging the constitutionality of the health care law.
• The federal government “may put 16,500 IRS agents in charge of policing President Obama’s health care bill.”

Read PolitiFact’s full analysis here.

Three other CBO observations given during the presentation include:

• Eliminating waste and inefficiency alone will not put fiscal policy on a sustainable path. What is needed are policy changes that significantly affect popular programs or taxes. Or both.
• Policymakers will have to face difficult tradeoffs when deciding how quickly to implement policy changes that would reduce future budget deficits.
• Washington is focusing more on federal budget problems today than any other time since the late 1990s. That focus has led  to a wide variety of proposals that vary in their priorities and would fundamentally change the tax code as well as certain government activities.

The CBO presented the following shares of federal spending in 2010:

• 47%: Transfer payments to people in the U.S.
• 19%: Purchases of goods and services for defense
• 14%: Grants to state and local governments
• 9%: Purchases of goods and services for non-defense
• 8%: Interest
• 4%: Other (includes transfers to people outside the U.S.)

From the Congressional Budget Office's March 7 presentation to the National Association for Business Economics

Elmendorf went over several advantages and disadvantages of reducing deficits gradually rather than quickly.

Advantages:

• Could benefit older generations.
• Could minimize the drag of spending cuts or tax increases on the economic expansion.
• Could give more planning and adjustment time to families, businesses and state and local municipalities.

Disadvantages:

• Reduces U.S. savings devoted to productive capital investment.
• Requires greater federal spending on interest payments.
• Gives policymakers less flexibility when unexpected problems arise.
• Increases the likelihood of a fiscal crisis.

Enacting policy changes now, the CBO says, could allow the government to simultaneously implement change gradually while limiting further increases in federal debt and would likely boost economic activity by holding down interest rates and reducing uncertainty.

However, health care costs are rising anyway meaning less care, and SSDI payments are only $12,800 a year, reports the Air Force Times:

Her list of cuts doesn’t explain the impact of freezing veterans’ health care funding, but the Congressional Budget Office (CBO) said in a report issued in October that health care costs have been quickly increasing. VA’s health care budget was $44 billion in 2009, $48 billion in 2010 and is at $52 billion this year. The report forecasts a health care budget of $69 billion or higher by 2020 if trends continue, the report estimates.

Another measure in her cuts is to repeal “Obamacare,” which she claims has “unknown” savings. Actually, the CBO measured that its repeal would not save, but add $230 billion to the deficit over 10 years.

You can see the full list of cuts on her website here (PDF).

The CBO expects the tax cuts deal to cost $858 billion over 10 years, while the American Reinvestment and Recovery Act had a cost of $787 billion. A Congressional Research Service study shows that the extension of all of the Bush tax cuts for two years will cost $675.2 billion over ten years.

Influential conservative columnist Charles Krauthammer wrote in the Washington Post this morning that President Obama “won” the tax cut debate by negotiating “the biggest stimulus in American history.” Meanwhile, House Democrats in a private meeting gave a vote of ‘no-confidence’ to the tax cut deal, as the House already voted to extend the Bush tax cuts for the middle class.

Will it be possible for House Republicans to get any immigration bills signed into law? No one is quite sure, but over the next few days I’ll be looking at some of the bills that pro-enforcement and pro-immigration reform groups think stand a chance. First on the list: an expansion of E-Verify, a controversial program that allows employers to use their workers’ Social Security numbers to verify that they can legally work in the United States.

Rep. Lamar Smith (R-Texas), who is expected to lead the Judiciary Committee, co-sponsored a bill in the current session to make use of E-Verify mandatory for all employers. The program is already mandatory for federal agencies and their contractors, but Republicans have said E-Verify should be expanded nationwide to better prevent undocumented workers from finding work.

Mark Krikorian, executive director of the pro-enforcement Center for Immigration Studies, told TWI that an expansion of the employment verification program could be passed in an effort by Democrats to show their commitment to immigration enforcement.

“I could see the administration deciding they need to back [mandatory E-Verify] to show their bona fides on enforcement so they can make a more conceivable case for amnesty in the future,” Krikorian said, referring to Obama’s support for paths to legal status for some of the illegal immigrants already in the country. “It undercuts the criticisms of the president as opposing enforcement and strengthens his hand for a possible second term.”

Of course, the Obama administration has already stepped up its immigration enforcement, sending more troops to the border and increasing deportation levels. Democrats may be unwilling to go further due to reported problems with E-Verify, said Grisella Martinez, director of policy and legislative affairs at the pro-reform National Immigration Forum.

Critics of the program say it contains flukes that allow some undocumented immigrants to escape detection and deny some legal workers employment. The Social Security Administration reportedly has an error rate of more than 4 percent in the databases E-Verify uses to check legal status. Critics in the business community say E-Verify puts unfair burdens on human resource departments that will have to be trained to use the program.

The projected high cost of implementing E-Verify nationwide could also deter Senate Democrats and Obama from supporting a bill. The Congressional Budget Office reported in 2008 that mandating E-Verify use could decrease federal revenues by about $17.3 billion between 2009 and 2018. Many experts say employers would still have a demand for labor from illegal immigrants, who in some sectors are likely to accept work that legal Americans often do not. E-Verify would therefore starve the government of tax dollars through a huge increase in the number of undocumented workers being paid untaxed wages under the table.

“I don’t think mandating E-Verify without a legalization program is possible,” Martinez said. “If it were to occur, we’d be looking at a real economic tailspin. Numerous government reports have all pointed to the fact that to mandate a program like E-Verify without legalizing the workers who are already in our economy would be absolutely catastrophic.”

To be honest, the testimony isn’t the easiest to understand. It is pretty wonky, and the descriptions of the impact on government revenue, gross national income, employment and dozens of other factors become pretty arcane.

But the analysis ultimately argues that making the Bush tax cuts permanent would not benefit the economy in the long run:

Permanently or temporarily extending all or part of the expiring income tax cuts would boost income and employment in the next few years relative to what would occur under current law. However, even a temporary extension would add to federal debt and reduce future income if it was not accompanied by other changes in policy. A permanent extension of all of those tax cuts without future increases in taxes or reductions in federal spending would roughly double the projected budget deficit in 2020; a permanent extension of those cuts except for certain provisions that would apply only to high-income taxpayers would increase the budget deficit by roughly three-quarters to four-fifths as much. As a result, if policymakers then wanted to balance the budget in 2020, the required increases in taxes or reductions in spending would amount to a substantial share of the budget — and without significant changes of that sort, federal debt would be on an unsustainable path that would ultimately reduce national income.

I think this analysis is a bit easier to understand in graphs, which the CBO provides. Over the next two years, extending some or all of the tax cuts helps the economy, boosting the gross national product anywhere from 0.2 percent to 1.9 percent. (In the chart, “partial” means Congress has said the cuts will expire in 2012, and “permanent” means Congress has said income taxes will not go up.)

But by 2020, any extension of the cuts will prove bad for the economy, because of the burdens of the national debt.

But extending the tax cuts for just two years obviously has a much smaller impact than making the income tax cuts permanent, which would cut economic growth.

Yesterday, Rep. Nancy Pelosi (D-Calif.), the speaker of the House, announced on Twitter that she has called House members back from their districts to vote on the bill on Tuesday. The House has already recessed for its August break, and was not due back until Sept. 14. But most states’ fiscal budget years started July 1, and Republican and Democratic governors alike were panicked about not receiving the funds and being forced to start the layoff of public employees.

The Senate passed the bill 61 to 39. The vote came down on party lines, save for Maine Republicans Olympia Snowe and Susan Collins. They voted for cloture on Monday, and voted to approve the bill today as well. The measure only needed 50 votes for passage.

The bill contains $16.1 billion in Medicaid funding, extending a transfer of funds from the federal government to states, a stimulus measure, for an additional six months. And it contains $10 billion to prevent the layoffs of teachers and other public employees, including police officers and firefighters.

“The legislation we fought for is about our teachers, the families they need to feed and the children they inspire every day. And it’s about our civil servants, the paychecks they need to make ends meet and the communities they keep moving,” Sen. Harry Reid (D-Nev.), the majority leader, said at a press conference today. “The other side has come to work every day trying to kill jobs and make sure our economic recovery doesn’t interfere with their campaign message.  But these public servants have always been there for us. The least we can do is be there for them.”

The bill is fully offset, meaning it does not add to the deficit. In fact, the Congressional Budget Office expects the bill to raise $1.4 billion over the next 10 years. To pay for itself, it closes a $9 billion tax loophole, rescinds unspent funds from a variety of programs and, controversially, cuts some an extension of Supplemental Nutrition Assistance Funds created by the stimulus.

Most Republicans opposed the bill on the grounds that it “bails out” the states. “The trillion dollar stimulus bill was supposed to be timely, targeted and temporary,” Sen. Mitch McConnell (R-Ky.) said this week. “Yet here we are, a year and a half later, and they’re already coming back for more. The purpose of this bill is clear: It’s to create a permanent need for future state bailouts, at a time when we can least afford it.”

The initial version of the state aid bill — championed by Republican and Democratic governors, as well as congressional Democrats — cut approximately $6.7 billion from the Supplemental Nutrition Assistance Program (SNAP, formerly known as food stamps). It did so by taking back some of an expanded benefit created in the American Recovery and Reinvestment Act, the Feb. 2009 stimulus bill. The state aid bill made a number of cuts to provide $10 billion for teachers’ jobs and $16.1 billion for Medicaid funds.

Sen. Harry Reid (D-Nev.) thought the bill was deficit-neutral, but the Congressional Budget Office said it came up approximately $5 billion short. (The Democrats had not cut enough because they had not factored in the timing of the bill’s passage. The changes cannot go into effect until mid-September, at the earliest, as the bill needs a House vote.) Democrats tinkered with the bill, cutting unspent funds from a number of programs.

And they expanded the cuts to SNAP. A CBO score released last night shows the revised version more than pays for itself, reducing the deficit by $1.37 billion over the next ten years. SNAP benefits face a $11.9 billion rollback starting in April, 2014. A family of three can expect their benefits to drop about $50 a month.

Never before have congressional policies actually created a month-to-month cut in food stamps. Even in the 1996 rollback of numerous welfare programs, SNAP benefits just grew more slowly than food inflation. Congress has always attempted to avoid a “cliff.” And, as I reported yesterday, policy experts describe that “cliff” in benefits as “devastating”:

The ARRA increase to SNAP benefits boosted benefits from meager to less-meager, advocates say. “We have been very supportive of the ARRA boost,” says Ellen Vollinger of the Food Research and Action Center. “But it underscored that these benefits are not generous. Anecdotally, we heard that the ARRA boost let some SNAP recipients keep going to the supermarket in the third or fourth week of the month, rather than going to a soup kitchen starting after the second week. They were stretching out their benefits, and purchasing some more nutritious food, like fresh fruit and vegetables.” Vollinger notes that even with the ARRA funding the average SNAP benefit is not really enough to eat.

And FRAC argues that that the situation where the government might actually cut benefits… would be “devastating” for recipients. “In the 1990s, there were terrible cuts to the program,” Vollinger explains. “But nobody ever started receiving less money [because the benefits increased more slowly than the price of food increased]. That situation — what will happen if people aren’t well-informed about the cut? What if they don’t recognize that the benefit will be lower?” It has never happened in the history of the program, Vollinger notes.

Rep. Lynn Woolsey (D-Calif.) is leading the charge for a new public option health plan. (Santa Rosa Press Democrat/ZUMApress.com)

Four months after President Barack Obama enacted the Affordable Care And Patient Protection Act, House Democrats have revived a top liberal priority that was eliminated from the sweeping health care law in the latter stages of a grueling year-long debate: the public option.

[Congress1] Armed with a new line of attack aimed at soothing deficit fears, Democratic Reps. Lynn Woolsey (Calif.), Jan Schakowsky (Ill.) and Pete Stark (Calif.) last Thursday unveiled a bill that would offer consumers the choice of a “robust” government-run insurance plan alongside the private plans in the law’s exchanges. The Congressional Budget Office projects that the bill, which has gained 128 co-sponsors, will reduce the federal deficit by $68 billion between 2014 and 2020.

“As the deficit continues to grow, so does the need for a program that can save billions of dollars and improve health care while doing it,” Woolsey, the co-chair of the progressive caucus, told The Washington Independent. “We are introducing the public option now so it will be available as a ready-made offset or deficit reducer in this or the next Congress.”

Schakowsky argues that the lower overhead costs of government plans such as Medicare would allow the public option to create a better deal for consumers. “We could offer that kind of plan at a lower cost, and it would compete with private insurance companies, who would have to be more efficient and lower their costs,” she told TWI. “It would follow the same rules as private insurers.”

The measure is unlikely to reach the floor this year, and could face even steeper odds next Congress. If nothing else, it appears part of a concerted effort by Democrats to galvanize disenchanted progressives and attack Republicans ahead of the tough November midterm elections.

“You’re the deficit hawks,” said Rep. Raul Grijalva (D-Ariz.), referring primarily to Republicans, “and we’re giving you a tool to be able to deal with the deficit.” Grijalva labeled deficit-minded lawmakers who refuse to consider the public option “hypocrites,” alleging that “the excuse that it was going to be too expensive is phony.”

For Democrats in election mode, catering to liberal wishes could help bridge the wide enthusiasm gap among voters — a key predictor of midterm victories, where the main objective is to turn out the party base. A Reuters/Ipsos poll last month found that 72 percent of Republicans were “certain” they would vote in November, compared to only 49 percent of Democrats.

“I do think this turnout issue is really going to be the crucial indicator, and the election hangs in the balance on how many of those less-committed Democrats actually turn out again,” said Ipsos pollster Julia Clark.

“That is a very real issue that we’re focused on,” Rep. Chris Van Hollen (Md.), the head of the Democratic Congressional Campaign Committee, admitted to Reuters. Apart from the public option bill, the White House on Monday strongly hinted it will choose liberal favorite Elizabeth Warren to lead the consumer protection agency. On Tuesday, Senate Democrats forced a cloture vote on the DISCLOSE Act, also a progressive priority, despite widespread expectations that it wouldn’t pass.

Republicans, who have depicted the public plan as a slippery slope to a national single payer system, derided the attempt to revive it and dismissed the CBO report. “House Democrats still don’t get it,” National Republican Campaign Committee spokesman Paul Lindsay told TWI. “As if it wasn’t enough to vote for their party’s overreaching health care takeover that was soundly rejected by Americans, they now have the audacity to propose a government option which would put health care in the hands of bureaucrats and further bankrupt our nation.”

The CBO estimates that the public plan’s premiums would be, on average, 5 to 7 percent lower than the private plans in the exchanges. Providers would be paid Medicare rates plus 5 percent, a figure that would rise alongside physicians’ costs.

“Although skepticism about big government is growing, the CBO estimate gives [Democrats] an important selling point at a time of rising concern about deficits,” said Jack Pitney, a political scientist at Claremont McKenna College.

Popular among the populace but highly controversial in Congress, the public plan has the political disadvantage of facing fierce opposition from insurance companies, which fear competition from the government. And progressives shouldn’t hold their breath for a vote. “It’s unlikely it’ll be taken up this session,” a House Democratic aide conceded, saying only that it’s “quite possible” next Congress. But is it?

“For the progressives, it’s now or never,” Pitney argues. “They know that Republicans will make big gains in 2010, probably winning the House and maybe even the Senate. The numbers favor further GOP Senate gains in 2012.”

Despite the historic accomplishment, liberals cannot help but look back on the vexing health care debate with wistfulness, if not bitterness. Even though the bill covers 30 million Americans, liberals felt short-changed by its lack of a public insurance program. While the House passed a version of a public option in its November legislation, it was removed from the Senate version due to a lack of votes, and subsequently pronounced dead. (For a few liberal activists, this was the final straw that made the legislation no longer worth passing.) One day later, a CBS poll found that six in ten Americans favored the opportunity to choose between private insurance plans and a government plan. Surveys have consistently found that a large majority of the American public support the idea.

At the time, President Obama, soothing concerns of House progressives unsure whether to back a bill without it, reportedly assured them in private that it was merely a first step and he’d be willing to return to the public option later.

But major domestic initiatives are more likely to occur early in presidential terms, Pitney noted, arguing that the measure’s chances of success during this Congress are slim – but not nil. “It’s a Hail Mary pass, to be sure,” Pitney said. “But Hail Mary passes sometimes work. And Speaker Pelosi likes the Hail Mary. And if they fail to make the effort now, they will regret it in the future. Better a Hail Mary in 2010 than an Act of Contrition in 2011.”