The Bottom Line

May 26, 2015
To Balance, Budget Would Need Implausible Levels of Growth

The Congressional budget resolution proposes to bring the budget into balance by reducing spending $5.3 trillion over the next decade while keeping revenue at current law levels (i.e., no tax cuts). But at the same time, it calls for roughly $2 trillion worth of tax cuts from repealing taxes in the Affordable Care Act (ACA) and extending various expired tax breaks. Some have suggested (subscription required) this $2 trillion difference could be bridged with dynamic growth effects that must now be scored by the Joint Committee on Taxation (JCT) and the Congressional Budget Office (CBO). However, we find that even under very generous assumptions, the use of dynamic scoring could only recover about one-third of the lost revenue.

Source
Direct Revenue Impact Dynamic Impact (Generous) Max Percent of Revenue Recovered
Repeal ACA Tax & Coverage Provisions ~$1.3 trillion ~$0.3 trillion
~25%
Revive Extenders and Enact Tax Reform ~$0.7 trillion ~$0.4 trillion ~55%
Total Revenue Lost ~$2 trillion ~$0.7 trillion ~35%

Source: CRFB calculations based on Senate Budget Committee and Joint Committee on Taxation documents.

The $2 trillion revenue gap in the budget resolutions comes from two sources. First, the budget calls for the repeal of the tax increases enacted in the Affordable Care Act ("Obamacare") to help pay for the expansion of health insurance coverage. We estimate this would cost roughly $1.3 trillion over the next ten years, based on 2012 estimates. The budget resolution also calls for budget process reforms that would allow temporary or expired tax breaks to be continued without offsets, a move that could reduce revenue somewhere in the range of $700 billion, depending on the exact details.

At the same time, the budget calls for repealing the coverage provisions of the Affordable Care Act and enacting tax reform, two changes which could produce additional economic growth and therefore higher revenue collection. Yet this additional revenue – at least as scored by JCT and CBO – will almost certainly fall short of the $2 trillion in revenue losses.

May 22, 2015

This week, Representatives John Carney (D-DE) and Jim Renacci (R-OH) introduced a bipartisan bill to improve the budget process.

May 21, 2015

Earlier this week, Senate Budget Committee Ranking Member Bernie Sanders (I-VT) introduced the Medicaid Generic Drug Price Fairness Act, a bill designed to hold down spending on generic drugs in Medicaid. The bill, which has also been introduced in the House by Rep. Elijah Cummings (D-MD), is a reprise of similar legislation introduced in the last Congress.

Skyrocketing Generic Drug Prices

The legislation comes in the wake of a huge jump in generic drug prices in 2014 -- even among certain drugs that have been on the market for a considerable amount of time -- without a clear cause. In some cases, the generic drug is now barely cheaper than the brand-name equivalent that benefited from patent protection. Forbes cites a report showing that several drug groups at least doubled in price and some jumped by much more than that. A few drugs whose prices jumped by an order or two of magnitude drew the particular ire of Sen. Sanders and Rep. Cummings last year.

Some of the price increases are almost certainly the result of raw material shortages or price markups for specific compounds needed in production, but many experts suspect that consolidating market power among generic drug producers and decreasing competition may be playing a significant role. Generic drug-makers, including during testimony at Sen. Sanders' Subcommittee hearing late last year, have generally refused to clarify what the causes have been.

May 21, 2015

Note: Last updated 5/21/15. The status table below will be updated regularly throughout the FY 2016 appropriations process.

The appropriations process is in full swing on Capitol Hill. The budget conference agreement laying out the topline spending levels, known as 302(a) allocations, passed the House by a vote of 226-197, and passed the Senate by a vote of 51-48. As we noted, the House has already moved to floor consideration of some bills, while the Senate is holding hearings and markups. As we did last year, we'll be tracking the bills as they move from committee to the House and Senate floor, and on to the President's desk.

The table below shows the status of each appropriations bill. To learn more about the appropriations process, read our report: Appropriations 101.

May 21, 2015

Marc Goldwein is the Senior Vice President and Senior Policy Director of the Committee for a Responsible Federal Budget. He wrote a guest post that appeared on the RealClearPolicy blog. It is reposted below.

Congress faces yet another deadline, and yet again is set to stall. This time, there literally could be a bumpy road ahead.

The current legislation authorizing highway and mass-transit spending is scheduled to expire at the end of the month. Not long after that, the Highway Trust Fund (HTF) will run out of reserves, which will cause road-improvement projects across the country to grind to a halt. Legislative action is required to avoid delaying critical infrastructure projects and the jobs they produce.

A two-month extension of highway funding has already been passed by the House and is likely to be enacted soon. Lawmakers should use the extra time to end the cycle of temporary fixes and produce a long-term solution that is free of gimmicks and is fiscally responsible.

Another short-term extension is in keeping with Washington's recent track record in dealing with similar circumstances. Time after time, deadlines have been nearly missed or even outright disregarded when it comes to important budget and fiscal matters. Lawmakers have often kicked the can down the road with short-term patches, only to be forced to address the same issue again and again. Steering haphazardly over these "fiscal speed bumps" has imperiled the nation's finances and caused voters to question the ability of Congress to function.

May 21, 2015

The Peterson Foundation's Solutions Initiative III produced five different fiscal plans that would improve the current long-term budget outlook. We have already gone over the topline numbers for the plans, but another important aspect is how they get to those numbers. Below are four takeaways from the policies that the plans propose.

Consensus on the Gas Tax

Lawmakers will have to find a way to fund the Highway Trust Fund in the next few months, and one of the possible solutions that has gained popularity with the current relatively low gas prices has been raising the gas tax. Four of the five plans - the American Action Forum (AAF) being the exception - proposed increasing the gas tax by a significant amount. The American Enterprise Institute (AEI) would increase it by 11.7 cents and index it to inflation, the Bipartisan Policy Center (BPC) would increase it by 15 cents and index it to inflation, and the Center for American Progress (CAP) and Economic Policy Institute (EPI) would increase it by an unspecified amount. AEI's and BPC's increases would fully close the trust fund shortfall through 2025. We also proposed increasing fuel taxes by 9 cents in our plan The Road to Sustainable Highway Spending.

No One Likes the Sequester

The sequester will be a big deal in the coming months when lawmakers will have to decide the level of spending for appropriations. The President's budget would repeal most of the sequester for FY 2016, while the Congressional budget would leave the sequester in place but provide backdoor sequester relief for defense through the war spending category. A notable theme in the think tanks' plans is that all of them propose some form of sequester relief, and three of them would provide sequester relief to both defense and non-defense. The only plans that left the sequester in place were AEI's for non-defense spending and EPI's for defense spending. Clearly, none of the plans were satisfied with the tight caps that the sequester prescribes, although they varied on how much to lift them (AEI stood out in particular on defense, while EPI had much, much higher non-defense caps). Although these plans do not make changes to the budget until FY 2017, their approaches can be instructive for lawmakers for FY 2016.

May 19, 2015

The Peter G. Peterson Foundation (PGPF) hosted its 2015 Fiscal Summit today, which brought together leading lawmakers and policy experts to discuss the nation's economic and fiscal challenges. Part of the agenda was the "Solution Initiatives III," where five think tanks – the American Action Forum (AAF), the American Enterprise Institute (AEI), the Bipartisan Policy Center (BPC), the Center for American Progress (CAP), and the Economic Policy Institute (EPI) – presented their ideas to improve the nation's finances and prioritize different programs. As the title indicates, this is the third time PGPF has had think tanks present fiscal solutions after previous rounds in 2011 and in the run-up to the fiscal cliff in late 2012.

In contrast to current projections, which have debt rising continuously starting later this decade to over 100 percent of Gross Domestic Product (GDP) by 2040, the plans would all either stabilize debt at about its current level or put it on a clear downward path. AAF is the most aggressive, getting debt down from 74 percent of GDP this year to 16 percent by 2040. CAP, EPI, and AEI also put debt on a downward path to 46, 54, and 63 percent, respectively, while BPC stabilizes debt at about its current level.

 

May 18, 2015

In our recently released plan, The Road to Sustainable Highway Spending, we propose a variety of measures to support the Highway Trust Fund (HTF), including providing fully offset funding for previous commitments, raising the gas tax, making sure we spend within our means in the future, and creating a "fast track" plan for tax reform to provide alternative financing. Additionally, we propose a few new reforms that will fix the inconsistency within the budget process that effectively exempts highway spending from budget discipline.

As we've explained before, the budget has a hybrid system for the HTF that treats contract authority (akin to budget authority in this case) as mandatory spending while treating outlays as discretionary spending. This nuance allows increased HTF spending to bypass both the Budget Control Act (BCA) caps on discretionary budget authority and pay-as-you-go (PAYGO) rules on mandatory outlays, permitting Congress to approve additional infrastructure investment without providing the means to pay for it. In addition, under existing budget rules, the Congressional Budget Office is required to assume that highway spending continues at inflation-adjusted levels in the baseline, even after the trust fund is depleted. As a result, Congress can enact legislation increasing spending for highways without increasing revenues and can make general revenue transfers to cover the inevitable shortfalls in the trust fund without paying for the added costs.

May 18, 2015

CQ is reporting (subscription required) that the House will take up bills in June to repeal the medical device tax and the Independent Payment Advisory Board (IPAB), two deficit-reducing policies in the Affordable Care Act (ACA).

Unlike full ACA repeal, these policies stand a chance of overcoming a Presidential veto due to the bipartisan support already exhibited for each: as of this writing, the medical device tax repeal bill in the House (HR 160) has 279 cosponsors while the IPAB repeal bill (HR 1190) has 229 cosponsors. However, repealing these policies without offsetting savings from health care or revenue would be a mistake. IPAB, in particular, should not be abolished without a replacement that can similarly restrain long-term Medicare cost growth.

As we explained earlier this year, repealing the 2.3 percent medical device tax would cost about $25 billion over ten years. Although the original co-sponsors of the bill, Reps. Erik Paulsen (R-MN) and Ron Kind (D-WI), said they expect the bill to be offset, no cost-savers have been produced yet. We suggested bundling payments for inpatient care as one option, which not only would produce enough savings to fully offset repeal but also achieve much of its savings from providers cutting their medical device costs. Thus, the medical device industry would still be asked to contribute to deficit reduction, but in a more efficient manner. There are many other options available as well, as we showed at the time and in our latest health care options.

Potential Offsets for Medical Device Tax Repeal
Policy Ten-Year Savings
Memo: Repeal Medical Device Tax -$25 billion
Health Options
Expand bundled payments for inpatient care $25 billion
Reduce state Medicaid provider taxes to 4.5 percent of patient revenues $35 billion
Reduce Medicare coverage of hospital "bad debts" $30 billion
Encourage use of generic drugs by low-income Part D beneficiaries $20 billion
Equalize payments for similar services performed in different settings $20 billion
Increase Medicare Advantage coding intensity adjustment $20 billion
Increase Medicaid drug rebates $10 billion
Revenue Options
Move up "Cadillac tax" by one year to 2017 $35 billion
Eliminate tax breaks for oil and gas companies $40 billion
Increase cigarette tax by 50 cents $35 billion
Close "John Edwards/Newt Gingrich" loophole $35 billion
Limit tax benefit of retirement accounts $30 billion
Eliminate tax exclusion for private activity bonds $30 billion
Require Social Security numbers for refundable portion of child tax credit $25 billion
Eliminate the mortgage interest deduction for second homes and yachts $15 billion

Source: CBO, JCT

May 14, 2015

With the Social Security trust funds facing a significant shortfall over the next 75 years and expected to run out of money within 20 years, Alicia Munnell of the Center for Retirement Research at Boston College highlights two loopholes that could be closed to improve the program's solvency in a small but meaningful way.

Noting that creative ways to maximize Social Security benefits have been gaining popularity in recent years, Munnell focuses on two strategies to exploit loopholes she and her colleagues discussed in 2009 policy briefs, which have yet to be closed (the third loophole she highlighted has since been shut down through a new Social Security Administration regulation).

The first allows married beneficiaries reaching the normal retirement age (NRA, currently 66) to choose either to claim their own worker or spousal benefits (which is equal to one-half of your spouse's benefit), and the option to switch their choice later. This gives them the option of claiming a spousal benefit at age 66 and then switching over to their own unaffected retirement benefit when it maxes out at age 70, effectively giving the individual up to four years of the spousal benefit entirely on top of their own earned benefit. This loophole achieves no policy goal, and appears the result of a historical accident.

May 14, 2015

The budget resolution conference agreement has passed both the House and Senate. While we previously wrote about the conference's deficit reduction and budget process issues, a likely flash point between Congress and the President will be how the Congressional budget handles discretionary spending and the sequester. While the budget resolution does not call for changes in the discretionary spending limits set under sequestration, the discretionary spending levels in the budget directly and indirectly deviate from the Budget Control Act (BCA).

The conference agreement does this by cutting both non-defense discretionary (NDD) spending below sequester levels and using Overseas Contingency Operations (OCO) funding to allow the defense budget to go above the sequester levels. For FY 2016, the conference agreement would keep spending at the levels set by the sequester. In addition the conference agreement leaves open a mechanism for sequester replacement in a fiscally responsible way, though this may still lead to conflicts between the House, Senate, and White House.

Discretionary spending in FY 2016

For the FY 2016 appropriations season, which we will continue to update on The Bottom Line as bills develop, the agreement abides by the sequester levels for non-war spending, although it would also effectively raise defense spending by creating a $38 billion slush fund in war spending. In effect, this takes the congressional budget to the total defense request in the President's budget, which instead provided sequester relief through the normal defense channel offset with other savings. The President’s budget also provided NDD funding above the sequester with offsets.

May 13, 2015

With the deadline for extending the surface transportation authorization just a few weeks away and Highway Trust Fund (HTF) bankruptcy approaching this summer, CRFB has released the The Road to Sustainable Highway Spending, a detailed plan to fix the HTF's finances and bring greater rationality to the process of determining highway spending and revenue. The plan would fully close the $175 billion trust fund shortfall through 2025 and set up processes to make future general revenue transfers to the fund much less likely.

Click here to read the full plan.

The plan first articulates three principles that any responsible highway solution should abide by:

  1. Act quickly to ensure adequate funding. Congress must extend the highway bill this month and provide sufficient funding to avoid disruptions this summer.
  2. Offset any general revenue transfers with real savings. While at least a short-term general revenue transfer is likely needed, it would be irresponsible to enact a transfer without equal-sized spending cuts or revenue increases to offset the cost. Resorting to gimmicks such as pension smoothing undermines the trust fund’s credibility.
  3. Close the structural imbalance. Lawmakers cannot rely on general revenue transfers in perpetuity and must ultimately bring highway spending and dedicated revenue in line. Plans should close this gap, and any that fail to do so should acknowledge that further action will need to be taken in the future.
May 8, 2015
CRFB Releases Mandatory Spending and Revenue Options Compendium

CRFB has released a new compendium of over 150 options to reduce mandatory spending and raise revenue. Despite declining in deficits in recent years, the debt is still projected to rise substantially over the long term. In addition, a series of upcoming Fiscal Speed Bumps will force lawmakers to make decisions about spending and revenue that could require large amounts of offsets, or potentially add almost $2 trillion to the debt.

Click here to see the full list of options.

Our list of options is meant to assist in finding fiscally responsible Speed Bump solutions, achieve some of the unspecified savings in the budget resolution, and help make the country's fiscal situation sustainable.

This paper updates and expands a health care and revenue options report released during the fiscal cliff discussions in late 2012. The new list also focuses on revenue and health care but also includes options for other mandatory (non-health, non-Social Security) spending that may be useful in the months ahead.

May 7, 2015

In an homage to former Senator Tom Coburn's (R-OK) commitment to bringing attention to wasteful programs through his annual Wastebook and similar to freshman Rep. Steve Russell's (R-OK) Wastebook Watch No. 1, Senator John McCain (R-AZ) recently published America's Most Wasted, a catalog of what the Senator calls "questionable Washington spending habits." Senator McCain identifies at least $1.1 billion in waste and at least another $294 billion spent on programs that are no longer authorized to receive funding. 

As Senator McCain explained:

Today I am releasing a report titled America’s Most Wasted, which continues the remarkable work that Oklahoma Senator Tom Coburn did for years with his annual Wastebook by highlighting, naming and shaming outrageous pork projects funded with your taxpayer dollars. This is just the first in a series of reports I will release this year, which will also spotlight wasteful spending at the Pentagon that I am committed to fighting as Chairman of the Senate Armed Services Committee.

May 6, 2015

During the consideration of the FY 2016 budget, we continually wrote about the budget process provisions in the major budget resolutions as well as previewing the budget process issues heading into conference. As we noted in our initial analysis of the Good, the Bad and the Ugly in the conference report, the final budget resolution includes some useful budget process and enforcement improvement. Unfortunately, some of the better provisions were dropped or watered down from earlier versions, and some provisions that move budget process in the wrong direction made it into the final conference report.

CHIMPs

The budget begins to limit phony savings from Changes in Mandatory Programs (CHIMPs) used to pay for real increases in discretionary spending, although these limits were watered down relative to those in the Senate budget resolution. The conference report freezes the amount of CHIMPs that don't produce real savings at the FY 2015 level of $19 billion for 2016 and 2017, and then it gradually reduces the limit to $15 billion by 2019. The conference report also limits capping spending from the Crime Victim's Fund as an offset. However, a related provision prohibiting the use of mandatory spending rescissions with no outlay savings as an offset was dropped. An appropriations bill that exceeds the new limits on CHIMPs would be subject to a point of order in the House and Senate, with 60 votes required to waive the point of order in the Senate. For more information on CHIMPs, see our recent blog, complete with the requisite use of puns.

May 1, 2015

Yesterday, we discussed The Good, The Bad, and The Ugly of the Budget Conference, where we showed how the budget conference agreement was a mixed bag when it came to important procedural and policy issues. This blog takes a step back to look at the overall savings the budget intends to produce and how it compares to the original House and Senate budgets.

Like the House budget, the conference agreement proposes bringing the budget into balance starting in 2024. Compared to a baseline that includes the physician payment law (HR 2), a drawdown of war spending, and the removal of one-time emergency spending, the conference agreement assumes savings of $5.3 trillion over ten years, splitting the difference between the House and Senate, which had savings of $5.6 and $5.1 trillion, respectively. The $5.3 trillion total consists of $4.4 trillion of policy savings, $718 billion of interest savings, and $124 billion from the fiscal dividend that incorporates the economic effects of deficit reduction.

These savings would put debt on a clear downward path from 74 percent of GDP this year to 56 percent by 2025, again splitting the difference between the House and Senate. This path would be a clear improvement on current law and well below where the President's budget is. However, the President's budget is much more specific, listing individual policies to claim deficit reduction, while the budget resolution leaves many of its savings unspecified; indeed, the Senate committee allocations put nearly $5 trillion of savings in the "unallocated" category, so no committee is responsible for achieving them.

 

April 30, 2015
Congress Should Not Use OCO as a Slush Fund

One of the most troubling elements of the budget conference agreement was the use of the Overseas Contingency Operations (OCO) account as a slush fund to circumvent the spending limits under the Budget Control Act (BCA). Specifically, the budget conference report allocated $96 billion in spending for OCO in FY 2016, $38 billion more than the President’s request, with the expectation that the additional spending would be used to increase funding for the base Department of Defense (DoD) budget above the limits under the BCA (it also provided funding above the President's budget for 2017-2021 for the same purpose). This strategy will face its first test today when the House of Representatives votes on a series of amendments by Representative Mick Mulvaney (R-SC) and Budget Committee Ranking Member Chris Van Hollen (D-MD) striking OCO funding in the appropriations bill for Military Construction and Veterans Affairs (MilCon/VA).

The MilCon/VA bill reported by the House Appropriations Committee included a new section for OCO that provided $532 million in spending for construction projects that were in the DoD budget request. Reps. Mulvaney and Van Hollen offered a series of amendments that would strike this funding. While the amount of funding involved is relatively modest, the principle is very important. The votes on whether or not to maintain funding for the base defense budget that uses OCO to get around the BCA caps will set an important precedent about whether or not Congress will follow through on the plan to use OCO to circumvent spending limits.

During the House debate on the amendments, Rep. Mulvaney argued that if Congress believes the BCA spending limits are too low, it should change the law and increase the spending limits instead of using OCO to circumvent the spending limits. Ranking Member Van Hollen noted that the use of OCO to fund items in the base defense budget was in conflict with the position taken by the House Budget Committee last year in their report accompanying the FY 2015 budget resolution. The report described the use of OCO for spending in the base defense budget as a “backdoor loophole that undermines the integrity of the budget process” and pledged to exercise oversight on the use of OCO that is not war-related and oppose increases above the levels military commanders say are needed to carry out operations.

April 29, 2015

With the budget conference complete, it is now up to each chamber of Congress to pass the FY 2016 concurrent budget resolution. We've already written about the House and Senate budgets in detail, and the final budget resolution aims to find compromise between the two.

As CRFB President Maya MacGuineas said in a press release today:

Congress should be commended for actually having a budget this year and for proposing to put the debt on a sharp downward path relative to the economy. Unfortunately, the budget fails to give lawmakers the tools to accomplish this important goal, and in some areas actually facilitates higher deficits.

Below we take a more detailed look at the good, the bad, and the ugly of the final product.

April 29, 2015

A group of House Democrats introduced a bill yesterday to repeal the tax on high-cost health insurance plans, commonly known as the "Cadillac tax," set to take effect in 2018. The repeal joins a similar House Republican bill released back in February. Needless to say, repealing the tax would be very expensive - CBO has estimated the tax raises $87 billion through 2025 while raising growing amounts over time - and likely counter-productive to health care cost control efforts. Importantly, the tax already seems to be having clear effects on the design of employer-provided health plans and has shown itself to be an important tool to slow private health spending growth (and may be playing a role in the recent slowdown). At the very least, lawmakers should plan to offset the lost revenue from repeal, but they should focus on policies that can also bend the health care cost curve.

The Cadillac tax is a 40 percent excise tax on employer-provided health insurance plan premiums that exceed $10,200 for individuals and $27,500 for families. Those thresholds are adjusted for inflation in future years so they would provide tighter limits over time since health care costs have almost always grown faster than inflation. As a result, it will raise growing amounts of revenue over time.

April 28, 2015

Lawmakers cleared their second Fiscal Speed Bump of the year - the expiration of the one-year "doc fix" - earlier this month, scuttling the Medicare Sustainable Growth Rate (SGR) formula for good by adding $141 billion to deficits through 2025 ($175 billion with interest). As a result, CBO's last baseline in March is now slightly out of date, and the agency usually doesn't release new ten-year numbers until August, so here's our estimate of what the baseline looks like in the post-SGR world.

The new law increases debt by about one percentage point of Gross Domestic Product (GDP) by 2025, from 77 percent to 78 percent. It also increases ten-year deficits and health care spending by about one-tenth of a percent of GDP while slightly increasing interest spending from 2.9 to 3 percent of GDP in 2025. Not surprisingly, the law slightly increases the share of spending going to health care and interest.

The New Ten-Year Budget Outlook (Percent of GDP)
  2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2016-2025
Revenue 17.7% 18.4%
18.3% 18.1% 18.1% 18.1% 18.1% 18.1% 18.2% 18.2% 18.3% 18.2%
                         
Health Care* 5.2% 5.4% 5.3% 5.2% 5.5% 5.5% 5.6% 5.9% 5.9% 5.8% 6.1% 5.7%
Medicare 3.0%
3.0% 2.9% 2.8% 3.0% 3.1% 3.2% 3.5% 3.4% 3.3% 3.6% 3.2%
Medicaid/CHIP 2.0% 2.0% 2.0% 2.0% 2.0% 2.0% 2.0% 2.1% 2.1% 2.1% 2.1% 2.1%
Exchange 0.2% 0.3% 0.4% 0.4% 0.4% 0.4% 0.4% 0.4% 0.4% 0.4% 0.4% 0.4%
                         
Social Security 4.9% 4.9% 4.9% 5.0% 5.1% 5.2% 5.3% 5.4% 5.5% 5.6% 5.7% 5.3%
Other Mandatory 2.6% 2.9% 2.8% 2.6% 2.5% 2.5% 2.4% 2.5% 2.3% 2.2% 2.3% 2.5%
Discretionary 6.5% 6.3% 6.0% 5.8% 5.7% 5.6% 5.5% 5.4% 5.3% 5.2% 5.1% 5.5%
Interest 1.3% 1.5% 1.7% 2.0% 2.2% 2.4% 2.6% 2.7% 2.8% 2.9% 3.0% 2.4%
Total Spending 20.5% 20.9% 20.7% 20.6% 21.0% 21.2% 21.4% 21.9% 21.8% 21.7% 22.2% 21.4%
                         
Deficit -2.7% -2.5% -2.4% -2.5% -2.9% -3.2% -3.3% -3.8% -3.7% -3.5% -3.8% -3.2%
                         
Debt 74.2% 73.9% 73.5% 73.2% 73.5% 73.9% 74.5% 75.4% 76.2% 76.8% 77.8% N/A

Source: CRFB calculations based on CBO data
*Includes net Medicare, Medicaid/CHIP, and health insurance exchange subsidies

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