How did Pelosi slip this one in there? The words "such sums as may be necessary" was included in the bill, along with a long list of health care priorities. "Such sums," are estimated by the CBO "to exceed" $115 billion, though they can't really be sure. To be clear, this new bill is separate from the original $270 billion cost of "doc fix."
The original health care bill reportedly costs $940 billion. So you can add a cool $400 billion on to that.
If pay-go remains the law of the land, it will mean that each successive Congress will have to cut something out of the existing budget in order to comply with the costs of this newfound $115 billion. If they don't, the quality of coverage declines. But we all knew that was going to happen anyway...