Transcript Bill Hoagland`s Presentation

Show Me the Money!
Alliance for Health Reform: Briefing
July 31, 2009
G. William Hoagland
VP Public Policy, CIGNA
Congressional Budget Totals: FY 2008 – 2014
S. Con. Res. 13
(In Billions of Dollars – % of GDP)
2008
2009
2010
2011
2012
2013
2014
% ∆ annual
2008-2014
• Receipts
2,524
2,186
2,322
2,624
2,856
3,057
3,298
+ 4.6 %
• Spending
2,983
3,879
3,555
3,541
3,476
3,639
3,821
+ 4.2 %
• Deficits
459
1,693
1,233
916
620
581
523
NA
• % of GDP
3.2%
12.0%
8.5%
6.1%
3.9%
3.5%
3.0%
NA
• Public Debt
5,803
7,723
8,778
9,683
10,345
10,931
11,499
+ 12.1%
• % GDP
41%
55%
61%
64%
66%
66%
67%
• Debt Subject to Limit
9,986
12,016
13,233
14,349
15,277
16,160
17,022
• % GDP
70%
85%
92%
95%
97%
98%
99%
Source: Concurrent Resolution on the Budget for FY 2010, S.Con.Res. 13 . April 29, 2009.
Congressional Budget Office, A Preliminary Analysis of the President’s Budget and an Update of CBO’s Economic Outlook. March 2009.
+ 9.3%
Concurrent Resolution on the Budget FY 2010
Health Care Reserve Funds
U. S. House of Representatives: Passed April 29 – 233 to 193
U.S. Senate: Passed April 29 – 53 to 43.
Title III – Reserve Funds
Subtitle A – Senate Reserve Funds
• Sec. 301: Deficit-Neutral Reserve Fund to Transform and Modernize America’s
Health Care System. “The Chairman of the Committee on the Budget may revise
allocations…aggregates…limits in this resolution ….provided such legislation would not
increase the deficit over either the period of the total of fiscal years 2009 through 2014 or the
period of the total of the fiscal years 2009 through 2019.”
Subtitle B – House Reserve Funds
• Sec. 321: Deficit-Neutral Reserve Fund for Health Care Reform. “The Chairman of
the House Committee on the Budget may revise allocations …aggregates…levels in this
resolution …if such measure would not increase the deficit or decrease the surplus for either
time period provided in clause 10 of rule XXI of the Rules of the House of Represenatives.”
(Clause 10, Rule 21 = Pay-Go)
National Health Expenditure Amounts
Cumulative Federal Costs for Medicare and Medicaid
2008-2019
$5,000
2019
Total National
Health Expenditure
Amounts Estimate
$4,643B
$4,500
$4,000
$3,311B
$ in Billions
$3,500
$3,000
$2,500
$2,379B
Other Public/Private
Expenditures
$2,000
$1,500
2019
Cumulative Federal
Medicare/Medicaid
Estimate
$1,223B
$900B
$1,000
$586B
Federal Medicare
$500
Federal Medicaid
$0
2008
2009
2010
2011
2012
2013
Year
2014
2015
2016
2017
2018
2019
Preliminary Estimates of Health Care Reform
on the Federal Deficit: FY 2010 – 2019
(In Billions of Dollars)
House of Representatives
(H.R. 3200)
(H.R. 3200)
2010–2019
2019
Coverage Impact
Exchange Subsidies
Employee Payments/Net Subsidies
Payments by Uninsured Individuals
Medicaid/CHIP
Small Business Tax Credits
Associated Tax Revenues
Class Act/Reinsurance
Net Coverage Impact
Change in Other Programs/Provisions
Medicare Advantage
SGR Reform
Part A & B Market Basket/Home Health/etc.
Waste/Fraud/Abuse
Other
Net Change in Other Programs
Change in Revenues
Deficit Impact
+773
-208
-29
+438
+53
-15
–
+1,042
+160
-51
-5
+84
+10
+4
+202
-162
+228
-282
**
-3
-219
+583
+239
-27
+38
-56
0
-6
-51
+86
+65
HELP
2010–2019
+723
-52
-36
-36 (+500)*
+56
-10
-48
+597 (+1,097)*
–*
–
–
–
–
–*
–*
+597 (+1,097)*
Senate
HELP
2019
+140
-9
-7
-4
(+100)*
+8
-5
-3
+120 (+220)
–*
–
–
–
–
–*
–*
+120 (+220)
Finance
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* = Committee has no jurisdiction over Medicaid, Medicare or tax policy. However, policy assumption expressed is to expand Medicaid eligibility to 150% Federal Poverty Level.
Numbers in ( ) reflect this policy.
** = Less than $100 million.
Sources: CBO July 17 letter to Chairman Charles Rangel. CBO July 1 Table to HELP Committee members. G. William Hoagland author’s aggregation.
© The New Yorker Collection 1996 Peter Steiner from cartoonbank.com. All rights reserved. Royalty fee has been paid for this presentation.