The Hill | January 14, 2014
By all accounts, 2014 is unlikely to be the year of the grand bargain…or anything close. Neither the President nor any of the political leadership is actively trying to fix the nation’s fiscal problem; there is no immediate crisis; and the issues of major entitlement reforms and revenues are hard enough that most politicians are quite happy to just look the other way.
That said, Congress has returned to DC to find many outstanding issues including the expiration of extended unemployment benefits, an impending 25 percent cut in Medicare payments to physicians, and the expiration of various targeted tax cuts known as “tax extenders”, all of which will create a number of important fiscal litmus tests.
These policies all come with a cost, and the question is; will congress find ways to pay for them or will they resort to their old habit of charging them to the national credit card?
One of the important achievements of the Ryan-Murray budget deal passed at the end of last year was that while it lessened the constricting caps of the sequester, it not only fully paid for the changes, it banked a little extra savings.
Congress should, at the very least, hold itself to the same standard for all of the mini-fiscal moments of 2014. One way to do this would be to pursue three bite-sized $150 billion packages focused on each of these policies.
Already, discussions are underway about an extension of unemployment insurance. Given the still weak condition of the economy, it makes sense to extend unemployment benefits and to consider doing a larger package to create jobs and spur the economy. A package could extend and reform unemployment benefits, along with other measures such as infrastructure investments, job training, or targeted tax breaks aimed at promoting job growth or investment.
One option to pay for this, would be to switch to chained CPI—a more accurate way of measuring inflation—and use $150 billion of the non-Social Security portion of the savings to pay for the growth package and some deficit reduction. (The additional savings that would come from the Social Security program should be used to help shore up the program and provide enhancements to low income beneficiaries.) Such a deal would have the multiple benefits of helping the economy, the fiscal situation, and, separately, Social Security.
A second $150 billion package could pay for fixing the impending 25 percent cut in doctors’ payments, or the unsustainable “Sustainable Growth Rate” (SGR). The Congressional health committees have put forward packages which would replace the SGR with a formula that promotes quality over quantity of care and encourages participation in coordinated care models. What they have not done? Proposed how to pay for it.
Congress could pay for these reforms with a $150 billion package of structural health reforms that help slow its cost growth. Such a package could include expanding new forms of cost-controls like bundled payments and readmission penalties; restricting supplemental health plans which lead to the overconsumption of health care; reforming overly-complicated cost-sharing rules; increasing the use of generic drugs; and expanding the means testing of Medicare premiums.
Finally, a third $150 billion package could pay for a one-year extension of the “tax extenders” which expired at the end of 2013, along with a permanent extension of the low-income support from the child tax credit and earned income tax credit scheduled to expire in 2017. One payfor option would be a plan developed by myself, Dan Feenberg and Martin Feldstein of Harvard University, where the amount of tax breaks any one individual can claim are limited to a certain dollar amount, or share of one’s income. It’s not comprehensive tax reform which we need, but it’s a step in the right direction.
These packages won’t be nearly enough to solve our debt problem – much more would need to be done. Still, enacting this series of incremental $150 billion packages would be consistent with the simple principle our lawmakers need to re-learn—if something is worth doing, it’s worth paying for.
Each of these three packages would save more money than they cost, particularly over the long-term. But none would be about simply making numbers add up, they’d be about improving the way we tax and spend to better promote growth, offer certainty, improve the health system, and moving us toward more responsible budgeting.
Forbes | December 18, 2013
The Congressional Budget Conference Agreement is a paradox. On its face it is underwhelming. It ignores the pressing long-term problems. It “kicks the budget can” for another 2 years. Its savings are not all clean-cut. There is no way to guarantee the out-year savings. Measured against the need, it fell far short.
On the other hand, compared to the fiscal squabbling of the past several years, it was a major reversal, a surprising bipartisan compromise from a Congress which had made that phrase oxymoronic. There has been no budget resolution for years. There has been precious little agreement on anything. Suddenly, it appears that the warring parties have decided that government closings and potential defaults may not be the best policies.
The budget agreement actually did some good things. It cancelled some of the most objectionable parts of the sequester which were threatening immediate harm, especially in defense spending. It replaced those lost savings with small reductions in mandatory spending and small increases in fees.
Even better, it was a two-year agreement. To move from no budget to a 2-year budget is nearly miraculous. The debt ceiling problem aside, government closures seem to be out of the picture for 2 years. It probably does not signal a sea change in Congressional comity, but it does give the Appropriations Committees a chance perform as they are intended, both in FY ’14 and is FY ’15.
Sen. Murray and Rep. Ryan took the Congress as far as it could possibly go. They gave no important help to the debt and deficit problems, but they did make important changes in the way that the parties and the houses have been dealing with one another. There is no assurance that the Congress has done an about face on its fiscal fisticuffs, but the budget agreement is a welcome change from the unrelenting warfare of the past 5 years.
The debt ceiling hurdle still looms ahead, probably in March. Other policy issues, including trade, immigration, and energy remain untouched. There is hope that Ryan-Murray will be infectious, but 2014 is an election year. Good things seldom happen in election years. But, perhaps, 2014 may be a bit more peaceful than 2013.
What now seems certain is that hope for Grand Budget Bargain is gone, probably until after the next presidential election in 2016. Until then, budget improvements will be incremental at best. At worst, there may be back-sliding. Both parties will cling to their standards. Democrats will defend the big entitlements to the death. Ditto for Republicans in defense against all tax increases.
So, one on hand, the paradoxical Budget Agreement gives reason to celebrate, and, on the other, reason to mourn. Optimists can cheer the first bipartisan budget compromise in years, and the strong House vote. Pessimists can bemoan the unsolved deficit/debt problems, and the expected weak Senate vote.
Los Angeles Times | December 16, 2013
The budget agreement reached by the House and Senate this week is a small step forward in restoring some sanity and order to the process. By putting in place a bipartisan plan for the next two years, the agreement represents a much-needed improvement over the uncertainty of governing by crisis that has dominated fiscal policy the last several years.
But the fundamental fiscal challenges we identified in the 2010 report of the National Commission on Fiscal Responsibility and Reform, and the need for reforms of entitlement programs and the tax code, go unaddressed.
The agreement will put in place a slightly more rational fiscal policy — by replacing a portion of the abrupt, mindless across-the-board cuts in discretionary spending resulting from sequestration with smarter and somewhat more permanent cuts, and with reforms to mandatory programs.
The deal also takes some modest steps in addressing long-term fiscal liabilities by adopting scaled-back versions of policies we recommended, such as reforming civilian and military retirement benefits and reducing the unfunded liability facing the federal Pension Benefit Guaranty Corp.
Perhaps most important, this agreement demonstrates that leaders in Washington can actually work together to reach some agreement on fiscal policy. The sad lack of trust between the two parties has been perhaps a greater obstacle to a "grand bargain" than the policy details themselves. We hope that this agreement can serve as a confidence-building measure that will lead to compromise on significant deficit reduction, as other lawmakers follow the good example set by House Budget Committee Chairman Rep. Paul D. Ryan (R-Wis.) and Senate Budget Committee Chairwoman Patty Murray (D-Wash.).
But the agreement also represents another missed opportunity to address our long-term fiscal problems. Doug Elmendorf, director of the Congressional Budget Office, recently warned that despite some improvement in the budget outlook, "the fundamental federal budgetary challenge has hardly been addressed." There is nothing in this agreement that would change that assessment.
The small reforms in this agreement do not address the real long-term drivers of our debt, including the growth of healthcare entitlement programs and Social Security's funding shortfall. We still desperately need to reform the tax code, which is riddled with trillions of dollars in economy-distorting loopholes. The agreement also leaves in place sequester cuts that could have adverse effects on economic productivity and military readiness.
With this agreement, Congress has exhausted nearly all of the easy choices available. That leaves only tough choices for future deficit reduction or sequester replacement, which are critically necessary to keep entitlement programs affordable and the economy vibrant.
Reforms to entitlements and the tax code need not wait for the next election.
Policymakers should take advantage of the need for legislation to fix the flawed Medicare payment formula — which is scheduled to cut physician payments by almost one-quarter — by enacting changes that make Medicare more cost-effective. In avoiding this cut, we must start paying doctors based on quality rather than quantity of care, and we must fully offset the costs of this "doc fix" with structural reforms that slow the rate of growth in federal healthcare spending.
At the same time, Congress should follow the lead of Senate Finance Committee Chairman Max Baucus (D-Mont.) and House Ways and Means Chairman Dave Camp (R-Mich.) to enact comprehensive tax reform that promotes growth and makes the U.S. more globally competitive globally. With $1.3 trillion of annual "tax preferences" in the tax code, there is plenty of money that can be raised from eliminating or scaling them back to reduce rates and deficits.
Policymakers should also go further in paring back the sequestration cuts. They should pay for that additional relief by eliminating unwarranted subsidies and low-priority spending, further reducing Medicare costs and improving the way we measure inflation in the federal budget and tax code.
Finally, we must reform Social Security to make the program financially sound for future generations.
We are pleased the two sides have proved they can find common ground on a small agreement. Now they have to "get crackin'" and come to grips with difficult challenges to solve our nation's grave long-term fiscal problems and put the budget on a fiscally sustainable course.