Again this argument doesn't make sense. The CBO included the "doc fix" cuts beside it's analysis of the overall affects of the ACA on healthcare spending but the ACA itself doesn't require those cuts to remain deficit neutral. Again it's like asking for the affects of the doc fix to be included in a bill renaming a post office.
We have Bill Clinton to thank of course for garbage legislation like the "doc fix" that prevents the facade of accomplishment. Appropriate as it's reflective of his entire eight years in office.