Medicare, Medicaid, & Social Security

Medicare, Medicaid, & Social Security

Research

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.
Roger Feldman, Bryan Dowd, Robert Coulam | Oct 08, 2015
A new study published by the Mercatus Center at George Mason University assesses the numerous problems with Medicare’s price calculations and looks at how they affect prices in commercial insurance policies. The study proposes an arrangement of competitive bidding on bundles of services as a promising alternative to Medicare’s price-fixing regime.
David E. Bernstein | Sep 30, 2015
A new study published by the Mercatus Center at George Mason University describes how such an approach in Medicare Part B—which covers outpatient services such as office visits and preventive care—could enhance doctors’ participation in the program, expand choices for beneficiaries, boost innovation, and make prices more responsive to market forces. Below is a brief summary of this analysis. Please see “Restoring Freedom of Contract between Doctor and Patient in Medicare Part B” to read the entire study and to learn more about its author, David E. Bernstein, the George Mason University Foundation Professor at George Mason University School of Law.
Mark J. Warshawsky, Ross Marchand | Sep 10, 2015
A new study published by the Mercatus Center at George Mason University finds that part of the problem can be traced to a flaw in the SSDI program’s administrative structure: even if an applicant is twice denied disability benefits by the Disability Determination Service, he or she can often obtain benefits by appealing the rejection to an administrative law judge (ALJ). This study analyzes ALJ decisions using case studies, economic literature, descriptive statistics, and econometric analysis.
Mark J. Warshawsky | Jun 09, 2015
As the baby boom generation begins to retire, fewer and fewer private-sector workers have traditional defined benefit pension plans, which usually pay lifetime annuity benefits. Instead, they have accumulated considerable assets in 401(k) plans and individual retirement accounts (IRAs) that have no particular method of payout. Federal government policy, which has regulated defined benefit plans heavily and mandated plan designs for distributions, has tread more lightly on defined contribution plans because of their historical secondary nature.

Testimony & Comments

Research Summaries & Toolkits

Expert Commentary

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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.
Jan 26, 2016

Relative to its 2015 ACA projections, CBO now expects several million fewer enrollees, even including the fact that Medicaid enrollment is above previous projections. CBO also expects higher federal spending, largely because the ACA Medicaid expansion appears much more costly than CBO expected. The combination of lower enrollment and higher federal spending than expected provides additional evidence that the ACA’s benefits were not worth the corresponding costs.
Jan 19, 2016

The decision states face of whether to expand Medicaid to non-disabled, working-age, childless adults—the Affordable Care Act (ACA) primary expansion population— involves tradeoffs. These tradeoffs include higher taxes, reduced spending on items like education, transportation, or infrastructure, or reduced spending on other Medicaid populations such as the disabled, children, or the elderly. The ACA funding formula allows states to pass a much greater share of the costs of covering non-disabled childless adults to federal taxpayers, but the tradeoffs still exist.
Jan 18, 2016

No politician on either side of the aisle reaps a political windfall from proposing to slow Social Security benefit growth. Responsible stewardship nevertheless requires that public pension plans such as Social Security only promise benefits that can be securely funded. Those who step forward with credible plans for correcting Social Security’s untenable cost growth trend are obeying the demands of responsibility, not ideology.
Jan 13, 2016

From a fiscal and economic perspective, Washington’s failure to make structural program reforms to reduce the massive unfunded liabilities of entitlement programs during the last seven years—while adding to the problem with the ACA—will inevitably put increasing pressure on the next president and Congress to tackle these mounting problems. It is unlikely that the next Congress and president will be able to sweep these difficult challenges under the rug, as has been the case for far too long in both Republican and Democratic administrations.

Charts

The latest federal budget projections from the Congressional Budget Office (CBO) should set off alarm bells on Capitol Hill. According to CBO’s baseline, federal debt held by the public will climb from $14 trillion this year to almost $24 trillion in fiscal year 2026. Measured as a share of the economy, publicly held debt as a percentage of GDP is projected to jump substantially, from 75.6 percent to 86.1 percent in the next 11 years. As the following chart shows, current debt levels are already disconcertingly high.

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

Joseph Antos, Charles Blahous, James C. Capretta, Robert Graboyes, Jason J. Fichtner, June O’Neill , Nina Owcharenko , Thomas P. Miller, | Apr 08, 2014
Top experts explain everything you wanted to know about Medicaid—from federal-state financing to potential reforms.

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.
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