Medicare, Medicaid, & Social Security

Medicare, Medicaid, & Social Security

Research

Brian Blase, Doug Badger, Edmund F. Haislmaier | Apr 22, 2016
This is the first in a series of papers in which we provide the most comprehensive analysis to date of the impact of the ACA on the individual and small group insurance market in 2014. In this overview, we provide information on how insurers fared in their first year selling QHPs—plans that satisfy all of the ACA’s requirements and are certified to be sold on exchanges—using a data set compiled from medical loss ratio form that insurers are required to file with the Department of Health and Human Services.
James C. Capretta | Mar 08, 2016
The Affordable Care Act (ACA) is known primarily for its provisions that subsidize and regulate health insurance for the working-age population and their families, but it also made many important changes to the Medicare program. Perhaps the most important of those changes is a new upper limit on Medicare spending, enforced by the Independent Payment Advisory Board, or IPAB.
James C. Capretta | Feb 23, 2016
Advances in information technology and knowledge of human health have the potential to revolutionize the way medical care is delivered to patients over the coming decade. Americans could get better health care, at less cost, if those delivering services to patients have the freedom to take full advantage of what these advances make possible.
Brian Blase | Feb 16, 2016
Medicaid’s complex federal-state financing structure has long created perverse incentives that discourage efficient care. Key to the problem is the federal government’s uncapped reimbursement of state Medicaid expenditures, which encourages states to artificially inflate their Medicaid spending. Such schemes have significantly increased over the past several years and they likely add tens of billions in generally low-value Medicaid spending each year.
Mark J. Warshawsky | Dec 10, 2015
A new study published by the Mercatus Center at George Mason University investigates more efficient partial annuitization strategies and the rule changes necessary to set these strategies on an equal tax basis with those favored by the Obama administration. The study uses historical simulations to demonstrate the efficiency of combining systematic withdrawals from a dynamically changing asset portfolio with the laddered purchase of immediate life annuities over an extended period of time. The study proposes steps regulators can take to make this genus of retirement strategy more attractive.
James C. Capretta, Joseph Antos | Oct 27, 2015
Proponents of the Affordable Care Act (ACA) have frequently pointed to official cost estimates projecting that the law will reduce federal budget deficits. Much less attention has been paid to the primary reason for this favorable outlook: the law’s heavy reliance on indexing important provisions to restrain spending and increase revenue. These components of the ACA will automatically impose perpetual, across-the-board cuts on payments to certain institutional medical providers; increase premiums for lower-income households; and raise taxes on an ever-expanding segment of taxpayers.

Testimony & Comments

Research Summaries & Toolkits

Expert Commentary

Apr 05, 2016

While the WEP is intended to ensure that Social Security beneficiaries are treated fairly and that benefits are provided only for years in which people paid into the Social Security system, the result is that the replacement rate for some people with high lifetime combined earnings is higher than those with low lifetime earnings.
Apr 04, 2016

Despite substantial and growing federal deficits, largely driven by unsustainable healthcare commitments, the Obama Administration is proposing more than $100 billion in new Medicaid spending over the next decade. No major area of federal spending has increased more dramatically since President Barack Obama took office than Medicaid, and recent evidence indicates that the program is failing both enrollees and taxpayers. Instead of spending more on the program, Congress should reject the president’s new Medicaid proposals, particularly the three I discuss below, and focus on structural reforms to the program.
e21
Mar 14, 2016

Social Security is a terrific topic for testing whether presidential candidates are willing to "tell it like it is" -- and whether voters are willing to listen -- when uncomfortable truths are involved.
Feb 16, 2016

Provider taxes demonstrate the worst aspect of our nation’s health care entitlement programs—complicated rules and subsidies that profit special interest groups and empower government bureaucracies with too little benefit for patients most in need and taxpayers.
e21
Feb 02, 2016

Our best information remains that the ACA, by expanding Medicaid as well as other subsidized insurance, didn’t merely shift more of the burden of funding existing health care costs to taxpayers– it actually increased those costs.
Feb 02, 2016

Six years after enactment, the ACA remains a law very much in turmoil. Beyond the widely reported website problems, many of the law's fundamental institutions — individual exchanges, SHOP exchanges, co-ops, mandates — are failing to perform as expected.

Charts

According to the federal government’s latest estimates, government programs for fiscal year 2015 paid out $137 billion “improperly”—meaning that these payments violated guidelines or rules in some way. Fraud is not the only reason, as the federal government reports. Rather, an improper payment can also result from simple clerical error or failure to confirm that a recipient was eligible to receive the amount of money that was disbursed. Whether due to fraud, the complexity of program rules, or bureaucracy, $137 billion is a significant amount of taxpayer funds. Federal spending has grown too massive for the government to provide adequate oversight.

Experts

Charles Blahous is the director of the Spending and Budget Initiative, a senior research fellow at the Mercatus Center at George Mason University and has served as a public trustee for Social Security and Medicare. He specializes in domestic economic policy and retirement security (with an emphasis on Social Security), as well as federal fiscal policy, entitlements, demographic change, and health-care reform.
Brian Blase is a Senior Research Fellow with the Spending and Budget Initiative at the Mercatus Center at George Mason University.
Veronique de Rugy is a senior research fellow at the Mercatus Center at George Mason University and a nationally syndicated columnist. Her primary research interests include the U.S. economy, the federal budget, homeland security, taxation, tax competition, and financial privacy. Her popular weekly charts, published by the Mercatus Center, address economic issues ranging from lessons on creating sustainable economic growth to the implications of government tax and fiscal policies. She has testified numerous times in front of Congress on the effects of fiscal stimulus, debt and deficits, and regulation on the economy.
Jason J. Fichtner is a senior research fellow at the Mercatus Center at George Mason University. His research focuses on Social Security, federal tax policy, federal budget policy, retirement security, and policy proposals to increase saving and investment.
Matthew Mitchell is a senior research fellow at the Mercatus Center at George Mason University, where he is the director of the Project for the Study of American Capitalism. He is also an adjunct professor of economics at Mason. In his writing and research, he specializes in economic freedom and economic growth, public-choice economics, and the economics of government favoritism toward particular businesses.

Podcasts

Robert Graboyes | October 15, 2015
Mercatus scholars Bob Graboyes, Darcy Nikol Bryan and Brian Blase discuss various aspects of healthcare policy on America’s Web Radio.

Recent Events

Please join us for a lunch discussion centered on reform options for the Social Security Disability Insurance program and a path forward to make real change.

Books

Jason J. Fichtner, Jason S. Seligman | Mar 2016
This book was published by The McCrery-Pomeroy SSDI Solutions Initiative, and includes a chapter by Mercatus scholars Jason Fichtner and Jason Seligman.

Media Clippings

Charles Blahous | Jun 04, 2014
This excerpt originally appeared in CQ and also appeared Roll Call.
Jason J. Fichtner | Feb 18, 2014
This excerpt originally appeared in MarketWatch.
Jason J. Fichtner | Oct 17, 2013
This excerpt originally appeared in NBC News.
Charles Blahous | Jul 18, 2013
VHHA tried to drive home the point in January with an economic report that projected Virginia would receive $3.9 billion in annual economic benefits and 30,000 jobs, but Charles Blahous, a senior research fellow at George Mason University’s Mercatus Center, said the benefits wouldn’t outweigh the expansion in costs.
Charles Blahous | Jun 14, 2013
Although the continuing increase in medical costs plays a role in the growth of Social Security and health care programs, “demographics is the bigger factor, hands down,” said Charles Blahous, a public trustee for the Social Security and Medicare Boards of Trustees.
' '