Check out Jim Capretta’s must-read post from Monday, which covers a lot of ground. Here’s one noteworthy piece of news on the revenue side:

The actuary says the new long-term care insurance program created in the bill faces “a significant risk of failure” due to adverse selection — meaning that the program will attract the kind of enrollment that will require higher costs than can be covered by the premiums collected. That, however, did not stop the Democrats from double-counting the program’s $70 billion in premiums as an offset for the massive health entitlement program. So not only did the bill use a budget gimmick to hide the costs of the health expansion, it also set taxpayers up for another bailout when the long-term care program runs aground.

So do revenue measures like collecting the long-term care insurance premiums represent making a start on the long-term debt problem, as Bob Greenstein of CBPP and Ezra Klein of the Post suggest, or are we talking about something quite different?

Ezra has been revisiting the health debate this week, and he raises a number of good points and objections. I’d like to address a few of them.

First, conservatives aren’t casting doubt on the realism of the Medicare cuts because they are nihilists. Ezra writes:

The first strategy has found expression in the arguments saying that the law’s savings and taxes won’t be implemented. That argument inflicts a lot of collateral damage, however. It means Congress can’t pay for bills it passes, and that’s as destructive to Republican priorities as to Democratic priorities. It’s also a message to the bond markets that we can’t pay back our debts and the price of U.S. treasuries should shoot way up. If Congress can’t be trusted to follow the laws it passes, then we should all give up and go home. Or maybe move to Greece.

Rather, they are casting doubt on the realism for the same reason that SGR failed: the cuts envisioned will likely jeopardize care for seniors, as the chief actuary’s memo suggests per Capretta:

The memo says the Medicare cuts will total nearly $600 billion through 2019, and that they will almost certainly jeopardize access to care for seniors by driving scores of institutions into financial distress.

In fairness, Medicare’s chief actuary writes the following:

Thus, providers for whom Medicare constitutes a substantive portion of their business could find it difficult to remain profitable and, absent legislative intervention, might end their participation in the program (possibly jeopardizing access to care for beneficiaries). [Emphasis added.]

The docfix problem emerged precisely because the planned cuts really did jeopardize access to care. Now, Medicare’s chief actuary could be wrong about this — we could all be wrong about everything, lest we forget — but let’s think through what “absent legislative intervention” means: it presumably means reversing some of the planned cuts, a la the docfix.

Furthermore, if the revenues from the CLASS premiums won’t materialize as envisioned, if we’re overestimated the costs savings from the (entirely defensible) student loan reforms, if workers respond to implicit marginal taxes (we don’t know that they definitely will), is it fair for Ezra to say the following?

The easiest way to show that a bill increases the deficit is to show that revenues don’t equal or exceed spending. That was true for, say, the Iraq War and the Medicare Prescription Drug Benefit and the Bush tax cuts. It is not true for the Affordable Care Act.

The trouble is that these claims are contested, i.e., we don’t actually know that revenues will not match the new spending, and we have good reason to believe that they will not.