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The Case Against Premium Support
December 21, 2011
On December 16, 2011, the Brookings Institution's project on Budgeting for National Priorities hosted a discussion of the proposal for Medicare premium support developed by former Office of Management and Budget Director Alice Rivlin and former Senator Pete Domenici. [1] That proposal, and the markedly similar proposal advanced by House … -
Ryan-Wyden Premium Support Proposal Not What It May Seem
Revised December 21, 2011
The proposal for Medicare premium support by House Budget Committee Chairman Paul Ryan (R-WI) and Senator Ron Wyden (D-OR) differs in key respects from how many media reports are describing it.[1] Despite claims to the contrary, it likely would shift substantial costs to beneficiaries rather than protect them from such cost increases, could … -
Media Briefing: A Closer Look at the Ryan-Wyden Plan to Reform Medicare
December 20, 2011
The Center on Budget and Policy Priorities held a conference call briefing on Tuesday, December 20 at 12:30 pm (ET) to discuss the new Medicare reform framework put forth by Rep. Paul Ryan and Sen. Ron Wyden. Ezekiel Emanuel, a world-renowned bioethicist and health care expert, former Special Adviser for Health Policy to the Director of the Office of Management and Budget and Chair of the Department of Medical Ethics and Health Policy and Vice Provost for Global Initiatives at the University of Pennsylvania, and Senior Fellow, Center for American Progress joined CBPP's Senior Fellow Paul Van de Water, and CBPP President, Robert Greenstein to discuss the implications of the Ryan-Wyden plan on Medicare, its beneficiaries, and health care costs.
Duration: 18:27
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General Assistance Programs: Safety Net Weakening Despite Increased Need
Updated December 19, 2011
State General Assistance programs, which provide a safety net of last resort for those who are very poor and do not qualify for other public assistance, have weakened considerably in recent decades and are continuing to do so, despite the large increase in need resulting from the recession. This report discusses how General Assistance Programs … -
Senate’s Balanced Budget Amendment Could Force Deep Cuts in Aid to States
December 14, 2011
The Republican-sponsored version of a constitutional balanced budget amendment, which the Senate voted on today, would require enormous federal budget cuts, very likely resulting in dramatic reductions in federal grants to states and localities for services ranging from education to highway maintenance to public safety. The attached … -
Provision in House Republican Payroll Tax Bill Would Cause 170,000 People to Forgo Health Coverage and Could Jeopardize Health Reform
December 12, 2011
The House Republican payroll-tax bill unveiled December 9 includes a change in the Affordable Care Act’s subsidies that would cause 170,000 people to forgo coverage and make it more difficult for the health reform law’s insurance exchanges to function effectively. The provision in question would substantially increase the … -
Allowing Insurers to Withhold Data on Enrollees’ Health Status Could Undermine Key Part of Health Reform
December 12, 2011
Risk adjustment is one of the critical elements of health reform (i.e., the Affordable Care Act, or ACA) that’s designed to encourage insurers to compete based on price and quality — not on attracting the healthiest enrollees and deterring those in poorer health, as they typically do today in the individual and small-group … -
Program Cuts Under a Balanced Budget Amendment: How Severe Might They Be?
November 15, 2011
The constitutional balanced budget amendment that the House is expected to consider this week could force Congress to cut all programs by an average of 17.3 percent by 2018. If revenues are not raised (the House-passed budget resolution assumes no increase above current-policy levels) and all programs are cut by the same percentage, … -
Plan From Toomey, Other Republicans Not a First Step Toward Balanced Deficit Reduction
November 10, 2011
Senator Pat Toomey and other Republicans on the Joint Select Committee on Deficit Reduction (“Supercommittee”) portray their new offer to raise close to $300 billion in revenues (under a plan to reduce deficits by about $1.5 trillion over ten years) as a significant concession, and some observers have suggested it represents a … -
Democrats Offer Significant Concessions
Revised November 1, 2011
The new deficit-reduction plan from several Democrats on the congressional Joint Select Committee on Deficit Reduction (the "supercommittee") marks a dramatic departure from traditional Democratic positions — and actually stands well to the right of plans by the co-chairs of the bipartisan Bowles-Simpson commission and the … -
Republican Plan Contains Minuscule Revenue Increase Alongside Deep Cuts in Medicare and Medicaid
October 31, 2011
The latest proposal by Republicans on the congressional Joint Select Committee on Deficit Reduction (the "supercommittee") contains virtually no new revenue and deep cuts in Medicare and Medicaid. In those respects, it represents little change from earlier Republican budget proposals. It stands in contrast to last week's … -
Statement: Paul N. Van de Water, Senior Fellow, on the CLASS Act
October 14, 2011
Health and Human Services (HHS) Secretary Kathleen Sebelius’ announcement today that her department has not been able to design a financially self-sustaining CLASS program within the law’s boundaries is sad but not surprising. It does not, however, eliminate the need for new … -
Converting Medicare to Premium Support Would Likely Lead to Two-Tier Health Care System
September 26, 2011
Some policymakers and analysts have proposed to convert Medicare to a "premium support" system — that is, replace its guarantee of health coverage with a flat payment that beneficiaries could use to help them purchase private insurance or, in some versions, traditional Medicare. But proponents have crafted a … -
Statement: James R. Horney, Vice President Of Federal Fiscal Policy, on President Obama’s Budget Package
September 19, 2011
President Obama proposed a balanced and well-designed package today that would boost economic growth and jobs in the short run while stabilizing federal debt as a share of the economy after 2013. By keeping federal debt held by the public from growing as a share of the economy, the President's … -
Poverty Rate Second-Highest in 45 Years; Record Numbers Lacked Health Insurance, Lived in Deep Poverty
September 14, 2011
Driven by the persistent weakness in the economy, the poverty rate in 2010 reached its second-highest point since 1965, median income declined, and the number and percentage of Americans without health insurance stood at record highs, the Census Bureau said yesterday. The share of Americans in "deep poverty" — with incomes … -
Statement: Robert Greenstein, President, on Census’ 2010 Poverty, Income, and Health Insurance Data
September 13, 2011
Today's Census report shows that in 2010, the share of all Americans and the share of children living in poverty, the number and share of people living in "deep poverty," and the number without health insurance all reached their highest level in many years — in some cases, in … -
Media Briefing: Examining the New 2010 Census Data on Poverty, Health Insurance Coverage, and Income
September 13, 2011
The Center on Budget and Policy Priorities held a conference call briefing for journalists Tuesday, September 13, at 1:30 p.m. (ET) to examine the new Census Bureau data for 2010 on poverty, health insurance coverage, and income trends that will be released that morning.
Duration: 21:12
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Media Briefing: Raising the Medicare Eligibility Age: A Misguided Deficit-Reduction Proposal
September 12, 2011
The Center on Budget and Policy Priorities will hold a conference call briefing on Monday, September 12 at 11:00 a.m. (ET) to discuss the impact of raising the Medicare eligibility age from 65 to 67, a proposal that the Congressional Joint Select Committee on Deficit Reduction is expected to consider in its effort to reduce the nation's long-term deficit.
Duration: 15:11
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The Census Bureau’s Upcoming Report on Health Insurance
September 9, 2011
On September 13, the Census Bureau will release estimates of the number and percentage of Americans with, and without, health insurance coverage in 2010. Historical trends and other survey data suggest that: The number and share of Americans without health coverage are likely to … -
Raising Medicare’s Eligibility Age Would Increase Overall Health Spending and Shift Costs to Seniors, States, and Employers
August 23, 2011
Raising Medicare's eligibility age from 65 to 67, which the new Joint Select Committee will likely consider this fall as a deficit-reduction measure, would not only fail to constrain health care costs across the economy; it would increase them. While this proposal would save the federal government money, it would do so by shifting costs … -
Statement: Robert Greenstein, President, on New Debt Ceiling Agreement
Updated August 2, 2011
The new debt ceiling agreement will achieve the essential goal of avoiding a potentially catastrophic default in the days ahead. But to say that the deal is likely to lead to highly unbalanced results would be an understatement. The deal places the nation on a disturbing policy course and sets what may become important precedents that are cause … -
Statement: Robert Greenstein, President, on House Speaker Boehner’s New Budget Proposal
Updated July 27, 2011
House Speaker John Boehner’s new budget proposal would essentially require, as the price of raising the debt ceiling again early next year, a choice between deep cuts in the years immediately ahead in Social Security and Medicare benefits for current retirees, repeal of health reform’s coverage expansions, or wholesale … -
Testimony: Robert Greenstein, President, on “Deficit Reduction: A Review of Key Issues”
July 26, 2011
Mr. Chairman and members of the Committee, thank you for the invitation to testify here today. As you well know, the nation is on an unsustainable fiscal course, and substantial changes in policy will be needed to right the ship. As a number of bipartisan commission have recommended over the past year, policymakers should aim … -
Greenstein Statement on the “Cut, Cap, and Balance Act” That the House Will Consider on July 19
Updated July 16, 2011
The “Cut, Cap, and Balance Act” that the House of Representatives will vote on next week stands out as one of the most ideologically extreme pieces of major budget legislation to come before Congress in years, if not decades. It would go a substantial way toward enshrining Grover … -
TANF’s Inadequate Response to Recession Highlights Weakness of Block-Grant Structure
July 14, 2011
Leading conservatives in Congress – including House Budget Committee Chairman Paul Ryan – as well as some conservative activists and commentators [1] have recently cited welfare reform and the TANF block-grant structure as a model for reshaping the federal-state funding relationship in other programs for low-income … -
A Tempest in a Teapot
July 13, 2011
A few weeks ago, some news articles suggested that a large and costly “glitch” in the health reform law would allow several million middle-income people to receive Medicaid, which would greatly swell budget deficits. House Majority Leader Eric Cantor claimed that the provision in question, under which Medicaid … -
Testimony: Paul N. Van de Water, Senior Fellow, On the Financial Status of the Medicare Program
July 12, 2011
Mr. Chairman, Mr. Davis, and members of the subcommittee, I appreciate the invitation to appear before you today. Although Medicare faces significant financing challenges, claims that the program is nearing “bankruptcy” are highly misleading. The 2011 report of … -
CHIP's Success Not an Argument for Block-Granting Medicaid
June 29, 2011
Some proponents of converting Medicaid to a block grant have attributed the success of the Children’s Health Insurance Program (CHIP) in extending coverage to millions of low-income uninsured children to the program’s financing structure, which provides states with fixed allotments rather than open-ended federal financing.[1] … -
Health Care Providers Would Face Deep Cuts in Payments and Higher Uncompensated Care Costs Under Medicaid Block Grant
June 28, 2011
The proposal in the House-passed budget plan to convert Medicaid to a block grant would weaken the nation’s health care infrastructure by making it difficult for a multitude of providers — including hospitals, nursing homes, doctors, and pharmacies — to remain economically viable and to continue to deliver … -
States Should Take Additional Steps to Limit Adverse Selection Among Health Plans in an Exchange
June 28, 2011
Health insurance exchanges, as envisioned under the Affordable Care Act (ACA), are intended to make an array of different coverage options available to individuals and small businesses. Exchange plans will be offered at several coverage levels (Bronze, Silver, Gold and Platinum, plus a catastrophic plan open to certain … -
Medicaid and the Uninsured: Online Applications for Medicaid and/or CHIP
June 27, 2011
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Proposal to Establish Federal Medicaid “Blended Rate” Would Shift Significant Costs to States
June 24, 2011
An Obama Administration proposal that’s on the table for budget negotiators would reduce federal Medicaid expenditures by reducing the federal share of Medicaid and CHIP costs, shifting costs to states and likely prompting states to cut payments to health care providers and to scale back the health services that Medicaid covers for … -
Media Briefing: Strategies For Reining in Health Care Costs Beyond Measures in Health Reform
June 23, 2011
Peter Orszag, former Director of the White House Office of Management and Budget, now Vice Chair of Global Banking at Citigroup and Adjunct Senior Fellow at the Council on Foreign Relations, discusses and critiques various ideas and approaches for transforming the U.S. health care system in order to slow the rise in health care costs.
Duration: 16:24
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Under House Budget, “Tax Reform” Places Top Priority on High-Income Tax Cuts and Ignores Deficit Reduction
Updated May 26, 2011
The tax proposals in the budget that the House approved on April 15 place a top priority on cutting taxes for high-income people, while doing nothing to reduce budget deficits, themselves. [1] In addition to making the Bush tax cuts permanent and continuing to provide relief from the Alternative Minimum Tax … -
Toomey Budget Even More Radical, and Potentially More Damaging, Than Ryan Budget
May 25, 2011
The Senate will likely consider this week a budget proposal for fiscal year 2012 from Senator Patrick J. Toomey that, in several ways, is even more radical than the House-passed plan of House Budget Committee Chairman Paul Ryan.[1] At first blush, the Toomey plan may seem more moderate than the Ryan budget, which the Senate also will … -
Ensuring Effective Risk Adjustment
May 18, 2011
Risk adjustment is a critical element of the Affordable Care Act (ACA) that can help assure the long-term success of the law’s new health insurance exchanges and market reforms. Risk adjustment compensates insurers offering plans in the individual and small-group markets inside and outside the exchanges for the risks … -
Media Briefing: Understanding the Annual Reports of the Social Security and Medicare Trustees
May 13, 2011
Robert Greenstein, the Center’s President, and Paul Van de Water, Senior Fellow at the Center and one of Washington’s leading experts on social insurance programs, discuss what the reports say about the long-term financial status of Social Security and Medicare.
Duration: 11:17
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Statement: Robert Greenstein, President, on the 2011 Medicare Trustees' Report
May 13, 2011
The new report from Medicare’s trustees shows little change from last year’s report in the long-run outlook for the program, while indicating that the program continues to face significant financing challenges. Partly because the trustees now foresee a modestly slower economic … -
Statement: Robert Greenstein, President, on the 2011 Social Security Trustees' Report
May 13, 2011
The trustees’ report shows that Social Security faces no immediate crisis and will have substantial resources to pay benefits even over the long run, but it faces a long-term shortfall that Congress should address sooner rather than later so the program can meet its promises. … -
Lower-Than-Expected Medicare Drug Costs Reflect Decline in Overall Drug Spending and Lower Enrollment, Not Private Plans
May 6, 2011
Some supporters of the House budget plan’s proposal to replace Medicare with a voucher to purchase private health insurance claim that reliance on private insurers can lower costs.[1] They cite the fact that the costs of Medicare Part D, which took effect in 2006, have been lower than the Congressional Budget Office predicted … -
Testimony: Paul Van de Water, Senior Fellow, on Budget Enforcement Mechanisms
May 4, 2011
Mr. Chairman, Senator Hatch, and members of the committee, I appreciate the invitation to appear before you today. The federal budget is on an unsustainable path. If we continue current policies — including a further extension of the 2001 and 2003 tax cuts and AMT relief — deficits will remain high throughout the … -
Ryan Medicaid Block Grant Would Cause Severe Reductions in Health Care and Long-Term Care for Seniors, People with Disabilities, and Children
May 3, 2011
House Budget Committee Chairman Paul Ryan’s budget plan, which the House passed on April 15, would dramatically restructure Medicaid by converting it to a block grant and cutting the program’s funding sharply. According to the Congressional Budget Office, the Ryan budget would reduce federal funding by 35 percent in 2022 … -
Chairman Ryan Gets Nearly Two-Thirds of His Huge Budget Cuts From Programs for Lower-Income Americans
Updated April 20, 2011
House Budget Committee Chairman Paul Ryan’s budget plan would get nearly two-thirds of its $4.5 trillion in budget cuts over 10 years from programs that serve people of limited means, which violates basic principles of fairness and stands a core principle of President Obama’s fiscal commission on its head. The plan … -
Statement of Robert Greenstein, President, on Chairman Ryan’s Budget Plan
Updated April 20, 2011
Chairman Ryan’s sweeping budget plan has been labeled “courageous,” but it’s a cowardly budget in a crucial respect. It proposes a dramatic reverse-Robin-Hood approach that gets the lion’s share of its budget cuts from programs for low-income Americans — the politically and economically weakest group in … -
Understanding Health Reform’s Waivers for State Innovation
April 18, 2011
What are waivers for state innovation? Section 1332 of the Affordable Care Act (ACA) allows states to request five-year waivers of certain key provisions of health reform, including the individual mandate and the requirement to set up an exchange. To be approved, a “waiver for state innovation” must cover at least as many people as under the ACA and provide … -
Out-of-Pocket Medical Costs Would Skyrocket for Low-Income Seniors and People with Disabilities Under the Ryan Budget Plan
April 15, 2011
House Budget Committee Chairman Paul Ryan’s (R-WI) budget proposal to convert Medicare into a system of vouchers and to block-grant Medicaid would substantially increase out-of-pocket costs for millions of low-income seniors and people with disabilities who are “dually eligible” for both programs. Under current law, Medicaid pays the Medicare premiums — and in … -
Proposed Cap on Federal Spending Would Force Deep Cuts in Medicare, Medicaid, and Social Security
Revised April 15, 2011
A prominent proposal by Senators Bob Corker (R-TN) and Claire McCaskill (D-MO) to limit total federal spending to no more than 20.6 percent of the Gross Domestic Product (GDP), which is attracting increasing attention, may sound benign, but it would inevitably force enormous cuts in Medicare, Medicaid, and possibly Social Security. The … -
Statement: Robert Greenstein on President Obama's Deficit-Reduction Plan
April 13, 2011
President Obama made an important contribution today to efforts to address the nation’s long-term fiscal problems, proposing a plan to reduce deficits by about $4 trillion over the next 12 years and meet the essential goal of stabilizing the national debt so that it rises no faster than … -
What if Ryan's Medicaid Block Grant Had Taken Effect in 2000?
April 12, 2011
House Budget Committee Chairman Paul Ryan’s radical proposal to convert Medicaid to a block grant, which the House will consider this week as part of Ryan’s sweeping budget plan, would have cut federal Medicaid funds to most states by more than 25 percent by 2009 and to several of them by more than 40 percent if it … -
CBO Report: Ryan Plan Specifies Spending Path That Would Nearly End Most of Government Other Than Social Security, Health Care, and Defense by 2050
April 7, 2011
House Budget Committee Chairman Paul Ryan's budget plan specifies a long-term spending path that means that, by 2050, most of the federal government aside from Social Security, health care, and defense would literally cease to exist, according to figures in a Congressional Budget Office report[1] that was released on Tuesday. CBO's …




