In real life, implementing the health reform bill approved by the Senate Finance Committee Friday probably would increase the size of the federal budget deficit by $239 bill over 10 years, a critic says.

Sen. Max Baucus, D-Mont., the chairman of the committee, who supervised the team of staffers that developed the America’s Healthy Future Act bill, and some other Democrats on the committee said they voted for the bill only because they believe it will be “deficit neutral.”

The drafters of the bill achieved that result by including a provision that automatically would cut Medicare payments to hospitals and other providers by $227 billion over 10 years, according Joseph Antos, a health care policy watcher at the American Enterprise Institute,

Congress has never let an automatic Medicare provider reimbursement reduction provision to take effect in the past, and it is unlikely to do so in the future, Antos says.

If the Medicare cut provision and other unrealistic provisions were left out of AHFA bill budget impact calculations, then projections would show that the bill would lead to a big increase in the deficit, Antos says.