You have to go back sixteen years, to the Clinton 1993 budget reconciliation act, to find a bigger bill that did more to improve the long-run U.S. fiscal picture:
CBO Score On Health Care Bill Released: Boosts Democrats' Hopes Of Passing Reform: Comprehensive health care reform will cost the federal government $940 billion over a ten-year period, but will increase revenue and cut other costs by a greater amount, leading to a reduction of $138 billion in the federal deficit over the same period, according to an analysis by the Congressional Budget Office, a Democratic source tells HuffPost. It will cut the deficit by $1.2 trillion over the second ten year period.
Briefly, in the first decade we are spending about $520 billion on coverage subsidies, public health, and other stuff but taxing and reducing Medicare growth by about $660 billion. In the second decade we are spending about $1.2 trillion on coverage subsidies, public health, and other stuff but taxing and reducing Medicare growth by about $2.4 trillion--if the laws hold, if we can maintain PAYGO.
But, as Doug Elmendorf warns:
Cost Estimate for Pending Health Care Legislation: That calculation reflects an assumption that the provisions of the legislation are enacted and remain unchanged throughout the next two decades, which is often not the case for major legislation. For example, the sustainable growth rate mechanism governing Medicare’s payments to physicians has frequently been modified to avoid reductions in those payments, and legislation to do so again is currently under consideration by the Congress. The current legislation would maintain and put into effect a number of policies that might be difficult to sustain over a long period of time.
So we are out of the tunnel, but not yet into the light. Instead, we have moved into the tunnel at the end of the tunnel.
On the other hand, the people running the government--the executive branch and those in the majorities in the legislative branch--are or were taught by the people who stuck to their guns and made Clinton-era policy such a smashing success.