The political and health care world is abuzz this morning over this report from the Centers for Medicare & Medicaid Services' Office the Actuary, which predicts the impact of federal health care reform on actual medical spending.

The surprising upshot? The 2,400-page, fiercely debated legislation's impact will be marginal. According to Associated Press coverage of the report, Americans will spend an average of $13,652 per year on health care in 2019, after the law is fully implemented. Without it, according to the AP, that average American would spend $13,387 that year - a $265 difference, or about 1.9 percent less.

Politically speaking, it's bad news for Democrats and other backers of the bill, because the report undercuts one of the original, central arguments in favor of health care reform - that it would lower overall health care spending. The White House spun the numbers their way in a blog post this morning. Politico reported in August that Democratic allies are being cautioned against claiming "the law will reduce costs and [the] deficit."

Health care business leaders have been saying all along that the bill will do little to actually lower costs. And, as far as CMS is concerned, they're right. CareFirst BlueCross BlueShield CEO Chet Burrell told the Washington Business Journal on Aug. 2 that the bill includes only modest, trial-run style attempts at lowering costs. In the same interview, he said that health care reform would add between 2 and 6 percent to premiums, at least in the short run.

But some of this depends on how you look at it. If your standard is merely overall costs, it looks to be neither neither a winner or a loser. But if you consider that, under the law, 32.5 million new people will get health insurance - thereby becoming more desirable, profitable patients for hospitals and doctors - it's a relative bargain. That's one point Actuary Richard Foster made, quoted in Business Week coverage.

Reuters' take on the report? Spending shifts: "New U.S. reforms are poised to dramatically shift the nation's healthcare spending, not only curbing Medicare costs but also pumping more money toward the private sector as roughly 32 million people gain coverage.