Health Care

Fiscal Fact Checker (Revisited): CBO's Record on Scoring the Affordable Care Act

Critics of CBO scoring like to cite past predictions that widely missed the mark. Sometimes, too, critics compare apples to oranges, and that is the case with the 2010 Affordable Care Act (ACA) again this week. As reported by National Journal, Congressman Phil Roe (R-TN) claims in referring to CBO's report on the fiscal cliff, "Remember that the CBO estimated two years ago that the Affordable Care Act would be $900 billion, and 24 months later it’s $1.7 trillion.

A Lively Debate on the Affordable Care Act

Yesterday, Medicare trustee Charles Blahous and former chief economist for Vice President Biden Jared Bernstein had a debate about the fiscal consequences of the Affordable Care Act (ACA). The event, hosted by e21 at the National Press Club, discussed Blahous's recent paper on the ACA that claimed the law would increase the deficit, contrary to CBO projections.

A Progressive Retirement Age?

Yesterday, Zeke Emanuel advanced an interesting proposal for Social Security and Medicare in a blog at The New York Times: varying the retirement ages for lifetime earnings. This policy is a response to a common criticism of raising the retirement ages that increases in life expectancy over time have been uneven across income groups. Emanuel's idea would work as follows:

Fixing Medicare Double-Counting

Donald Marron, who recently wrote a blog post on how budget limits are treated in Congressional rules, wrote a piece today detailing how Medicare Part A rules could be altered so that savings in Part A could not be used to both reduce the deficit and extend the life of the Hospital Insurance (HI) trust fund. Here's his take:

Ten Things to Know About Military Compensation

On Friday, Lawrence Korb, Alex Rothman, and Max Hoffman of the Center for American Progress wrote "The Top 10 Things to Know About Military Compensation," which provides context for compensation within the defense budget and how reforms can be done in minimally harmful ways.

The ten things are:

Bipartisan Physician Payment Reform Can Do Without the War Gimmick

Reps. Allyson Schwartz (D-PA) and Joe Heck (R-NV) have introduced a bill to overhaul the Medicare physician payment system. The bill includes a number of laudable reforms, but it does not have a legitimate pay-for, since it uses the war drawdown gimmick to pay for its costs.

The Temporary Budget

Over at Wonkblog, Sarah Kliff points out that the Affordable Care Act (ACA) may contain a new "doc fix" -- only this time in Medicaid. The current "doc fix" in Medicare cancels out huge scheduled physician payment cuts as required under law by the Sustainable Growth Rate (SGR) formula. Since it is very expensive to override the SGR permanently (about $300 billion over ten years), Congress usually just enacts temporary extensions.

Double Counting and Medicare Part A

Last month, Social Security and Medicare Trustee Chuck Blahous sparked a controversy by saying that the Affordable Care Act would add to the deficit, arguing that the law was double counting savings from Medicare Part A because Part A is already restrained by a trust fund that is scheduled to expire this decade. Thus, the Medicare savings from the law would only be used to extend the life of the trust fund.

How Is the House Replacing the Sequester?

Update: CBO has posted scores for the Energy and Commerce and Oversight bills. They would save $113 billion and $83.3 billion, respectively, over ten years.

The Medicare Trustees Report

While we have already broken down the Social Security Trustees report, the Trustees have also produced a report for Medicare. Considering that health care spending is central to our fiscal challenges and Medicare is the largest program in that category, understanding the report's findings is critical.

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