Health Care In The United States

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Source: Httpwwwforbescomsitesaroy20130207health Care In Th Source: Httpwwwforbescomsitesaroy20130207health Care In Th SOURCE: Robert Book, Contributor I cover news on health care policy PHARMA & HEALTHCARE | 2/07/2013 @ 7:21PM |1,174 views Health Care in the New CBO Forecast Robert Book, Contributor Earlier this week, the Congressional Budget Office (CBO) released an updated federal budget outlook for the next 10 year “budget window.” Included in this report were some telling revisions to the previous baseline projection for the effects of the Affordable Care Act (ACA). The first thing to note is that they have increased the number of people projected to be uninsured, and at the same time reduced the projected federal revenue from the penalty for not having insurance. How is this possible? Recent regulations issued by the administration have restricted access to health insurance subsidies, but at the same granted exemptions to the penalty for more categories of people who cannot qualify for those subsidies.

For example, an IRS regulation clarified that employers are obligated to offer coverage only to their employees, but not to their employees’ families. However, the language of the health reform law makes it clear that if the employee has the ability to get employer-sponsored coverage for himself or herself only, the rest of the family is not eligible for subsidized exchange coverage, and may end up being uninsured because they are unable to afford the full, unsubsidized premium. In this case, the IRS exempts the rest of a family in this situation from having to pay the penalty for not having insurance. The CBO also forecasts a further decrease in the number of people obtaining health care through their employers.

Six months ago, they projected that 4 million people would lose employer-based coverage, and now the projection is 7 million. This reflects, in part, an extension of the slightly lower income tax rates beyond 2012, which slightly reduces the tax advantage of employment- based insurance. Of course, many health reform watchers (including this author) think this estimate is wildly optimistic, since it doesn’t take into account the either the incentives for employers to drop their health plans, or the survey data indicating that a large number of employers plan to consider doing just that. Of course, it remains to be seen if these projections will be close to reality. Many factors could affect the accuracy of these projections, mostly by altering the underlying assumptions.

For example, people might realize that with the absence of exclusions for pre-existing conditions, it might make financial sense for healthy people to wait to enroll in health coverage until they “need” it. For most people, paying the penalty will be cheaper than paying the premium, and staying healthy for just a few years could be enough to come out ahead (even if one has to pay out of pocket for care until the next enrollment period). Also, employers might realize that in some circumstances, it will be to their mutual benefit to drop their employer-sponsored plan. If the premium subsidies – which depend on income and family size – are higher than the employer penalty (fixed at $2,000 per full-time employee) plus the tax advantage of employer-sponsored coverage, then it will be to their mutual advantage for the employer to drop coverage, pay the penalty, and split the difference with the employees.

For employers with a large proportion of medium- and low-income, low-tax-bracket employees, this is quite likely to be the case. This article is available online at: Video Reflection Analysis Overview The objective of these videos is to share with you some reflections and insights as they pertain to the participants’ identity, advocacy, leadership, and motivation. Watching the video and reflecting on the content will contribute to the creation of your own social change identity. Note: As you progress through the video series and the subsequent module reflections, you will synthesize information provided from various concepts discussed within the context of the videos. Pay particular attention to specific conceptual themes that emerge from the video.

You will use the knowledge acquired in all the videos that you’ve viewed so far to complete each module reflection assignment. Prompt: For this assignment, you will watch the, and answer the following in 2 to 4 sentences per question. · Describe which aspects of psychology the interview participants highlighted when discussing their ability to develop and adhere to goals. · Describe how your understanding of motivation can promote the drive and determination required to achieve your goals. All sources and ideas requiring attribution must be cited according to APA style.

1. SOURCE: TAX POLICY CENTER The Federal Budget: The CBO Baseline Underlying data: download In an update to its FY Budget and Economic Outlook, the Congressional Budget Office (CBO) forecasts a $357 billion deficit for baseline FY2008. It projects that the deficit will decline steadily over the next few years, become a surplus of $105 billion in 2012, and improve further to a $202 billion surplus in 2018. These projected surpluses, if they materialize, will combine with economic growth to shrink federal debt held by the public from 37 percent of GDP in 2007 to 24 percent by 2018. CBO’s baseline is not a projection of what spending and revenue will actually be. Rather, under congressional budget rules, the baseline assumes no change in tax law and limits the projected growth of discretionary spending. As a result, it omits many budget items Congress will likely enact: supplemental appropriations to pay for the war in Iraq, the War on Terror, and disaster relief, continued relief from the alternative minimum tax, extension of the tax cuts beyond their current expiration after 2010, and renewal of expiring provisions of the tax code.

CBO’s projections also constrain the growth of discretionary spending (spending authorized by annual legislation) to the rate of inflation. Under that limitation, discretionary spending would decline from 7.6 percent of GDP in 2007 to 6.1 percent of GDP by 2018. CBO does provide estimates of how its baseline would change if it relaxed the strict assumptions used for the official baseline. Alternative assumptions include 1) discretionary spending grows at the same rate as nominal GDP, and 2) 2003 tax cuts are extended beyond 2010, 3) expiring tax provisions are extended indefinitely, and 4) relief from the alternative minimum tax (AMT) is provided. Under those assumptions, which some people view as more likely to occur, the federal budget remains in deficit throughout the ten-year budget window and grows to nearly 4 percent of GDP in 2018.

Even with the unrealistic assumptions underlying its baseline, CBO forcefully warns that rapidly growing entitlement spending will consume an ever-larger share of the federal budget. In particular, it projects annual spending growth rates over the period of 6 percent for Social Security and between 7 and 8 percent for Medicare and Medicaid, both more than double the growth rates of federal revenue the economy as a whole. The different growth rates mean that, over time, an ever-rising share of the budget will go to pay for health and retirement benefits. Congressional Budget Office THE ECONOMIC AND BUDGET OUTLOOK: AN UPDATE AUGUST 1998 Summary Table 4. CBO Baseline Budget Projections, Assuming Compliance with Discretionary Spending Caps (By fiscal year) Actual Deficit (-) or Surplus - On-budget deficit (-) or surplus - a Off-budget surplus Cernik notes here The TOTAL deficit in ACTUAL 1997 was -$22 billion (the -$103 billion and the +$81 billion come to -$22 billion). The -$22 billion is known as the UNIFIED BUDGET. The ON-BUDGET is all expenses WITHOUT Social Security. The OFF-BUDGET is the Social Security Trust Fund. So, the Social Security Trust Fund money helped to bring down the UNIFIED BUDGET’S deficit. There was a surplus (not a deficit) in the Social Security Trust Fund, which means that through your withholding taxes being taken out of your paycheck going into the Social Security Trust Fund, the Federal Government had money left over after sending your grandmother her monthly Social Security check.

That leftover money was used toward helping to reduce the overall Federal Government’s budgetary deficit (the UNIFIED BUDGET). Why break down the Federal Government budget this way? Because by seeing the UNIFIED BUDGET, OFF- BUDGET, ON-BUDGET you can get a sense of the importance of the Social Security Trust Fund. Where did I get the following actual deficit or surplus amounts for each of the Fiscal Years? From the annual reports titled, “The Budget and Economic Outlook: An Update,” put out by the CBO. 1998 $69 Billion 1999 $124 Billion 2000 $236 Billion 2001 $127 Billion 2002 -$158 Billion 2003 -$375 Billion 2004 -$412 Billion 2005 -$318 Billion 2006 -$248 Billion 2007 -$161 Billion 2008 -$459 Billion