With health care reform back on the policy agenda this week, it is important for Congress to keep cost controls and the country’s enormous fiscal challenges at the forefront of the discussion.The law that was passed last year had the fiscally responsible goals of controlling long-term health care costs and of seeking to pay for its new benefits, particularly expanded coverage. Those goals should not be abandoned in any attempt to repeal, replace or amend the legislation.Simply repealing unpopular elements of the law while keeping the popular ones would likely leave fiscal policy in even worse shape. That’s because the unpopular elements like the individual mandate to buy insurance help make possible the popular features, such as requiring insurance companies to accept people with pre-existing conditions.The most complete and up-to-date estimate for the costs and savings from the legislation will be released as part of CBO’s annual Budget and Economic Outlook toward the end of January. But the size and complexity of the legislation create substantial uncertainties about such projections.Even if the law provides the promised amount of deficit reduction, it would hardly make a dent in total projected deficits over the coming decades. Much more work would remain to achieve a sustainable fiscal policy.