The “2010 Financial Report of the United States Government” released by the Government Accountability Office (GAO) on December 21, 2010 highlights the fiscal challenges facing the country. With regard to the ACA, the GAO points out that while the new law “improves the financial outlook for Medicare substantially,” the effects of certain provisions on Medicare are uncertain, especially in the longer run. For instance, while the law calls for lower payment updates for most categories of Medicare providers, if providers cannot reduce costs correspondingly, “they would eventually become unwilling or unable to treat Medicare beneficiaries”. Moreover, if Medicare price constraints become unworkable, “Congress would likely override them, much as they have done to prevent the reductions in physician payment rates otherwise required by the sustainable growth rate formula in current law.”