As reported in the New York Times, the Congressional Budget Office has thrown a bucket of cold water on President Obama’s plans to reform the health care system. According to the CBO analysis, the leading Senate plan would only decrease the ranks of the uninsured by 16 million, leaving 36 million without insurance. This finding poses many problems for the push to reform health care. Much of the anticipated cost savings from reform come from the fact that expanded coverage means more preventive care and fewer emergency room visits. But if coverage does not expand much, these savings are illusory. Consquently, a deficit-neutral plan will be hard to fashion. As I pointed out last week, deficit neutrality is crucial procedurally in order to pass legislation by a simple Senate majority. Moreover as the public becomes more concerned about deficits, a plan that increases red ink will be more difficult to sell politically. Finally, the analysis gives opponents of reform a real opening. Their argument will now be that Obama wants to spend a trillion dollars and completely reorganize the health care sector only to cover a third of the uninsured.