Nobody can agree on what caused the good news in the latest Medicare trustees report. The trustees certainly can't. In the Washington Post, Amy Goldstein writes matter-of-factly that "Medicare’s financial stability has been strengthened by the Affordable Care Act and other forces." At Vox, Sarah Kliff warns that "some senior administration officials I spoke with cautioned against reading too much into these particular figures; receipts for services rendered in 2013, for example, might trickle after the year has ended." In the Washington Examiner, Philip Klein quotes Medicare's actuary to point out that the cuts may not "be viable in the long range." And in the Boston Globe, Stephen Ohlemacher runs the bases: "Experts debate whether the health-spending slowdown is the result of a sluggish economy or represents a dividend from President Obama’s health care law, and more recent Medicare cuts by Congress." Isn't that just like the experts! 

Perhaps the best way to read the good news, that Medicare Part A spending fell from $266.8 billion to $266.2 from 2012 to 2013, is to imagine what the reaction might have been had the numbers moved the other direction. How would we be talking about the phase-in of Obamacare, and its Medicare spending reductions? Pretty obvious: We'd be branding it a disaster, failure, debacle, impeachment-fodder, etc. After all, it's four years since the law passed, and ads for Republican candidates still scorch the Democrats for "cutting $700 billion from seniors' Medicare."

The ads are not wrong, as the doctors already dropped from Medicare Advantage eligibility will happily tell you. But the obsession of Washington's dealmakers is Medicare spending, and finding some way to prevent a demographic apocalypse. The trustees point out that the Obamacare cuts had added, since 2010, 13 years to the life expectancy of the Medicare trust fund. Democrats don't want to campaign on the cost reductions; Republicans prefer to focus on the cuts than on the savings. The result: The White House bragging about savings, some versions of the Medicare story putting it in the lede, and public awareness remaining close to nil.