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HOUSE_OVERSIGHT_021003

House Oversight Committee
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Restructure Medicare & Medicaid: Policy Option #5

Consider / Implement CBO’s 26 policy options that could reduce annual budget deficit by up to 38% over the next 10 years

KP www.kpcb.com USA Inc. | What Might a Turnaround Expert Consider? 323

Restructure Medicare & Medicaid: CBO Policy Options— Regulate Private Health Insurance Market; Modify Tax Code; Modify Insurance Eligibility; Improve Efficiency

Policy Options Gov. Future Deficit yp Reduction (%)'

Require large employers to either pay government for providing insurance or offer employees basic insurance coverage

Replace the income tax and payroll tax exclusion with a refundable credit

Replace the income tax exclusion for employment-based health insurance with a deduction

Reduce the tax exclusion for employment-based health insurance and the health insurance deduction for self-employed individuals

Raise the age of eligibility for Medicare to 67 Convert Medicare and Medicaid “Disproportionate Share Hospital Payments” into a block grant

Consolidate Medicare and Federal Medicaid payments for graduate medical education costs at teaching hospitals; set consolidated payment equal to:

* Adjusted IME? payments using a 2.2% adjustment factor + DGME* and Medicaid GME? funding inflated by the CPI-U5 minus 1 percentage point

* 90% total mandatory GME? funding inflated by the CPI-U minus 1 percentage point

Note: 1) As % of Cumulative Total Government Deficit from 2010 to 2019 2) Graduate Medical Education 3) Indirect Medical P Education 4) Direct Graduate Medical Education 5) Consumer price index for all urban consumers Source: CBO www.kpcb.com

USA Inc. | What Might a Turnaround Expert Consider? 324

HOUSE_OVERSIGHT_021003