Budget Options, Volume I: Health Care

This volume—which expands on one of the Congressional Budget Office’s (CBO’s) regular reports to the House and Senate Committees on the Budget—presents 115 options for reducing (or, in some cases, increasing) federal spending on health care, altering federal health care programs, and making substantive changes to the nation’s health insurance system. An introductory chapter provides an overview of the volume and offers some important context for understanding the options. Chapters 2 through 12 present those options, organized by broad themes (for example, payment for Medicare services, cost sharing in federal programs, and long-term care). Each chapter is introduced with a page of background information about the theme. 

The options compiled for this volume stem from a variety of sources, including extensive discussions with Congressional staff; reviews of legislative proposals, the President’s budget, and academic literature; and analyses conducted by CBO staff, other government agencies, and private groups. Although the number of health-related policy options shown here is significantly greater than in previous Budget Options volumes, it is not an exhaustive list: Some options could not be included because of time constraints or analytical complexity. The inclusion or exclusion of a particular policy change does not represent an endorsement or rejection by CBO; to ensure impartiality, the discussion of each option summarizes arguments for and against it. In keeping with CBO’s mandate to provide objective analysis, the report makes no recommendations.

This report is the product of an enormous effort involving more than three dozen members of the CBO staff over a period of many months. That effort was skillfully coordinated by Lara Robillard (of the Budget Analysis Division) and Lyle Nelson (of the Health and Human Resources Division). The volume was edited by Loretta Lettner and Leah Mazade. Appendix A lists the many CBO staff members who contributed to the report.

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Table of Contents:
Introduction
The Private Health Insurance Market
The Tax Treatment of Health Insurance
Changing the Availability of Health Insurance Through Existing Federal Programs
The Quality and Efficiency of Health Care
Geographic Variation in Spending for Medicare
Paying for Medicare Service
Financing and Paying for Services in Medicaid and the State Children’s Health Insurance Program
Premiums and Cost Sharing in Federal Health Programs
Long-Term Care
Health Behavior and Health Promotion
Closing the Gap Between Medicare’s Spending and Receipts
Contributors to this Volume
Options by Major Program, Provider of Services, or Category

Those interested in Medicare or healthcare insurance, including business owners, policymakers and the general public, would find this information useful.