Congressional Budget Office (CBO) officials estimate killing major components of the Affordable Care Act would cost $455 billion over 10 years.

CBO Director Douglas Elmendorf gives that estimate in a CBO letter sent to Sen. Mike Crapo, R-Idaho.

Crapo asked Elmendorf about the budget impact of the Affordable Care Act, the package that includes the Patient Protection and Affordable Care Act (PPACA); the cost of a proposal to prevent Medicare physician fee schedule reductions; and the budget impact if many of the major Affordable Care Act provisions that affect programs such as Medicaid and Medicare were repealed.

Analysts at the CBO and at the Joint Committee on Taxation still believe the Affordable Care Act provisions will save about $143 billion from 2010 to 2019, Elmendorf says.

In August, CBO analysts looked at the legislation again and estimated the health care provisions in the Affordable Care Act would reduce the projected 2020 deficit by $28 billion, Elmendorf says.

Eliminating provisions designed to hold down Medicare payments to physicians would cost $272 through 2019 period and $330 billion through 2020, Elmendorf says.

Repealing the Affordable Care Act provisions that Crapo asked about repealing would increase the deficit by about $455 billion over the 2010-2019 period, Elmendorf says.

“CBO’s earlier estimate was based on the forecasts of economic conditions, health care spending, and other technical factors that CBO published in 2009,” Elmendorf says. “We have not updated the estimate of health-related savings reported in March, but CBO has no reason to believe that such an estimate would differ substantially from the original one.”