In February 2009, as the Obama administration was beginning to make its pitch for a major health care overhaul, then-White House budget director Peter Orszag made his closing pitch for the law at a summit in Washington: "To my fellow budget hawks in this room and in the rest of the country, let me be very clear: health care reform is entitlement reform," he said. "The path of fiscal responsibility must run directly through health care." A little more than a year later, the law that would become known as ObamaCare passed.
So how is Medicare, the nation's biggest health care entitlement, doing now? Not so well. Two years after the passage of the Patient Protection Protection and Affordable Care Act, the program's Trustees are reporting that the seniors' health program is on a glide path to insolvency—perhaps by as soon as 2016. The technocratic reforms that were supposed to remake the program aren't working nearly as well as hoped. And, writes Senior Editor Peter Suderman, there are already signs that the Medicare spending reductions called for by the health care law will be delayed or undercut just as many critics warned.