Health Care

Research

Welfare Block Grants as a Guide for Medicaid Reform Daniel Sutter \| Mar 21, 2013 Driven by the need to reform unsustainable entitlement programs, policymakers today are looking to the successful example of welfare reform—specifically, to its block grants to states. To inform this discussion, a new Mercatus Center at George Mason University study by Daniel Sutter reviews arguments in the debate over block grants versus matching grants for joint federal-state programs, examines the effects of shifting control of welfare programs to the states, and considers how the lessons from welfare reform can inform the current debate about Medicaid block grants.	The Affordable Care Act's Optional Medicaid Expansion: Considerations Facing State Governments Charles Blahous \| Mar 05, 2013 In the wake of a 2012 Supreme Court ruling, states face complex decisions concerning whether to expand Medicaid coverage to the full extent envisioned in the Affordable Care Act (ACA, commonly referred to as Obamacare). With the federal government no longer able to coerce expansion, states must base their decisions on value judgments that incorporate each state’s unique budgetary circumstances, the needs of its uninsured population, and the incentives established by interactions among the ACA’s provisions.
Medicaid Reform and Emergency Room Visits: Evidence from West Virginia's Medicaid Redesign Tami Gurley-Calvez \| Dec 18, 2012 Federal and state governments are under increasing pressure to limit Medicaid spending without negative health consequences. We examine a unique policy effort in West Virginia aimed at reducing spending and improving health through personal responsibility and preventive care. These efforts show promise for reducing emergency-room (ER) visits among those who chose the personal-responsibility plan but had the unintended consequence, at least in the short run, of increasing visits for those who defaulted into the plan with reduced benefits.	The Fiscal Consequences of the Affordable Care Act Charles Blahous \| Apr 10, 2012 The Affordable Care Act (ACA) enacted in 2010 will significantly worsen the federal government’s fiscal position relative to previous law.
The Fiscal Health of the States Jeffrey Miron, Robert Sarvis \| Feb 13, 2012 This paper examines the fiscal health of the states, focusing on two worrisome characteristics: an understatement of unfunded pension liabilities and ever-increasing expenditures, driven primarily by health care costs.	Beware the Rush to Presumption, Part A Christopher J. Conover, Jerry Ellig \| Jan 09, 2012 Federal agencies issued eight major “interim final regulations” in 2010 to quickly implement major provisions of the ACA. This working paper demonstrates that analyses for these regulations were seriously incomplete, often omitting significant benefits, costs, or regulatory alternatives. Analysis of fairness was cursory at best.

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Testimony & Comments

The Department of Health and Human Services' Standards for Privacy of Individually Identifiable Health Information

| Feb 17, 2000

Standards for Privacy of Individually Identifiable Health Information…

Research Summaries & Toolkits

Haste Made Waste: The Health Care Law's Rushed Regulations

| Jan 09, 2012

This research summary discusses a new Mercatus Center study finding that in 2010, in the rush to implement key provisions of the the Patient Protection and Affordable Care Act (ACA), the federal government used a fast-track process of regulatory analysis that failed to comply with its own standards and produced poorly substantiated claims about the ACA’s benefits and costs.

Expert Commentary

To Fight Pandemics, Reward Research The New York Times By Tyler Cowen \| May 04, 2013 That frightening word “pandemic” is back in the news. A strain ofavian influenza has infected people in China, with a death toll of more than 25 as of late last week. The outbreak raises renewed questions about how to prepare for possible risks, should the strain become more easily communicable or should other deadly variations arise.	Expanding Medicaid: The Conflicting Incentives Facing States e21 By Charles Blahous \| Mar 05, 2013 Recent decisions by individual states concerning the Affordable Care Act (ACA)’s now-optional Medicaid expansion have been much in the news of late. Today the Mercatus Center is publishing my comprehensive study of the conflicting incentives facing states as they make their choices about expansion.
George Will Cites Blahous on Social Security in Fiscal Cliff Negotiations The Washington Post By Charles Blahous \| Dec 13, 2012 Within academia there has been some debate about the fiscal significance of cash payments of interest to Social Security, with the preponderance of evidence finding that they add to federal deficits. But about the payments financed by general revenue transfers there is not even an issue to debate; they are purely debt-financed. Altogether, Social Security is adding substantially to the deficit this year, to the extent of $165 billion.”…	Debate Over Medicare, Health Care Reform Forbes By Christopher J. Conover \| Oct 03, 2012 The universal nature of Medicare is another flaw that cannot be sustained over the long run. Given the enormous hidden costs of raising every dollar of taxes—roughly 40 cents on the dollar as best I have been able to estimate—it is neither efficient nor fair to transfer payroll taxes from low-paid workers to pay for Warren Buffett’s Medicare benefits.
Health Care Cronyism Forbes By Christopher J. Conover \| Aug 24, 2012 As the government intervenes more and more in our healthcare industry, the normal business model less frequently marks the path to success. Instead, connections are becoming more important than competence.	Blahous: Latest Score of the ACA Shows Worsened Finances By Charles Blahous \| Jul 25, 2012 From almost any vantage point, the updated CBO score is more bad news concerning the 2010 health care law’s fiscal impact.

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Charts

Social Security Trust Fund Exhausting Faster Than Expected

According to the latest Social Security Trustee Report released last week, the Social Security trust fund will likely be exhausted by 2033—that’s 3 years earlier than last year’s projection and more than 20 years earlier than projections made in 1990.

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Experts

Charles Blahous

Charles Blahous is a senior research fellow at the Mercatus Center and public trustee for Medicare and Social Security. His primary research interests include retirement security, with an emphasis on Social Security and employer-provided defined benefit pensions, as well as federal fiscal policy, entitlements, demographic change, economic stimulus, financial market regulation, and health care reform.

Christopher J. Conover

Christopher J. Conover is an affiliated senior scholar at the Mercatus Center at George Mason University and a research scholar at the Center for Health Policy & Inequalities Research at Duke University.

Jerry Ellig

Jerry Ellig is a senior research fellow at the Mercatus Center at George Mason University. His primary research interests include the federal regulatory process, economic regulation, and telecommunications regulation.

Michael L. Marlow

Michael L. Marlow is an affiliated senior scholar at the Mercatus Center at George Mason University and professor of economics and distinguished scholar at California Polytechnic State University, San Luis Obispo.

Videos

Optional Medicaid Expansion: Considerations Facing the States

Charles Blahous | May 14, 2013

Charles Blahous Discusses Medicaid Expansion and the Health Care Law on C-SPAN

Charles Blahous | March 08, 2013

Podcasts

Frakt on Medicaid and the Oregon Medicaid Study

Russell Roberts | May 13, 2013

Austin Frakt of Boston University and blogger at The Incidental Economist talks with EconTalk host Russ Roberts about Medicaid and the recent results released from the Oregon Medicaid study, a randomized experiment that looked at individuals with and without access to Medicaid.

Download the MP3

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Recent Events

The Fiscal Future of Medicare and Social Security

Panel Discussion with Public Trustees Charles Blahous and Robert Reischauer, and Mercatus Scholar Jason Fichtner.

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More Media Clippings

Welfare Block Grants as a Guide for Medicaid Reform Daniel Sutter \| Mar 21, 2013 Driven by the need to reform unsustainable entitlement programs, policymakers today are looking to the successful example of welfare reform—specifically, to its block grants to states. To inform this discussion, a new Mercatus Center at George Mason University study by Daniel Sutter reviews arguments in the debate over block grants versus matching grants for joint federal-state programs, examines the effects of shifting control of welfare programs to the states, and considers how the lessons from welfare reform can inform the current debate about Medicaid block grants.	The Affordable Care Act's Optional Medicaid Expansion: Considerations Facing State Governments Charles Blahous \| Mar 05, 2013 In the wake of a 2012 Supreme Court ruling, states face complex decisions concerning whether to expand Medicaid coverage to the full extent envisioned in the Affordable Care Act (ACA, commonly referred to as Obamacare). With the federal government no longer able to coerce expansion, states must base their decisions on value judgments that incorporate each state’s unique budgetary circumstances, the needs of its uninsured population, and the incentives established by interactions among the ACA’s provisions.
Medicaid Reform and Emergency Room Visits: Evidence from West Virginia's Medicaid Redesign Tami Gurley-Calvez \| Dec 18, 2012 Federal and state governments are under increasing pressure to limit Medicaid spending without negative health consequences. We examine a unique policy effort in West Virginia aimed at reducing spending and improving health through personal responsibility and preventive care. These efforts show promise for reducing emergency-room (ER) visits among those who chose the personal-responsibility plan but had the unintended consequence, at least in the short run, of increasing visits for those who defaulted into the plan with reduced benefits.	The Fiscal Consequences of the Affordable Care Act Charles Blahous \| Apr 10, 2012 The Affordable Care Act (ACA) enacted in 2010 will significantly worsen the federal government’s fiscal position relative to previous law.
The Fiscal Health of the States Jeffrey Miron, Robert Sarvis \| Feb 13, 2012 This paper examines the fiscal health of the states, focusing on two worrisome characteristics: an understatement of unfunded pension liabilities and ever-increasing expenditures, driven primarily by health care costs.	Beware the Rush to Presumption, Part A Christopher J. Conover, Jerry Ellig \| Jan 09, 2012 Federal agencies issued eight major “interim final regulations” in 2010 to quickly implement major provisions of the ACA. This working paper demonstrates that analyses for these regulations were seriously incomplete, often omitting significant benefits, costs, or regulatory alternatives. Analysis of fairness was cursory at best.

To Fight Pandemics, Reward Research The New York Times By Tyler Cowen \| May 04, 2013 That frightening word “pandemic” is back in the news. A strain ofavian influenza has infected people in China, with a death toll of more than 25 as of late last week. The outbreak raises renewed questions about how to prepare for possible risks, should the strain become more easily communicable or should other deadly variations arise.	Expanding Medicaid: The Conflicting Incentives Facing States e21 By Charles Blahous \| Mar 05, 2013 Recent decisions by individual states concerning the Affordable Care Act (ACA)’s now-optional Medicaid expansion have been much in the news of late. Today the Mercatus Center is publishing my comprehensive study of the conflicting incentives facing states as they make their choices about expansion.
George Will Cites Blahous on Social Security in Fiscal Cliff Negotiations The Washington Post By Charles Blahous \| Dec 13, 2012 Within academia there has been some debate about the fiscal significance of cash payments of interest to Social Security, with the preponderance of evidence finding that they add to federal deficits. But about the payments financed by general revenue transfers there is not even an issue to debate; they are purely debt-financed. Altogether, Social Security is adding substantially to the deficit this year, to the extent of $165 billion.”…	Debate Over Medicare, Health Care Reform Forbes By Christopher J. Conover \| Oct 03, 2012 The universal nature of Medicare is another flaw that cannot be sustained over the long run. Given the enormous hidden costs of raising every dollar of taxes—roughly 40 cents on the dollar as best I have been able to estimate—it is neither efficient nor fair to transfer payroll taxes from low-paid workers to pay for Warren Buffett’s Medicare benefits.
Health Care Cronyism Forbes By Christopher J. Conover \| Aug 24, 2012 As the government intervenes more and more in our healthcare industry, the normal business model less frequently marks the path to success. Instead, connections are becoming more important than competence.	Blahous: Latest Score of the ACA Shows Worsened Finances By Charles Blahous \| Jul 25, 2012 From almost any vantage point, the updated CBO score is more bad news concerning the 2010 health care law’s fiscal impact.