Medicare, Medicaid, & Social Security

Medicare, Medicaid, & Social Security

Research

Daniel Sutter | Jun 21, 2016
Medicaid was established in 1965 as a joint state and federal program to provide medical insurance to Americans who are poor and have disabilities, and it has grown from 1 percent to 3 percent of GDP. The source of Medicaid’s growth over the past 50 years must inform efforts to reform the program and slow spending. The literature on the political economy of Medicaid provides strong evidence of interest group and political ideological influence, enabled by the open-ended federal match for state spending.
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.

Testimony & Comments

Research Summaries & Toolkits

Speeches & Presentations

Expert Commentary

Jul 20, 2016

As a start, HHS should make all the data available, including the average costs of expansion enrollees by state. In addition, Congress should closely scrutinize managed care contracts that states are making with insurers as well as any actions that HHS is taking to guard against outrageously high federal payments for the expansion population.
Jul 11, 2016

In fact, the Social Security crisis is not only real; it is already upon us. The trustees now estimate that the 75-year financial shortfall for the combined trust funds is $11.4 trillion in present-value terms. If we indefinitely extend past the 75-year period, the so-called "infinite horizon," the shortfall is a whopping $32.1 trillion. For comparison, our nation's gross domestic product is slightly over $18 trillion – and our gross national debt (not including unfunded liabilities) at the end of June is $19.3 trillion.
Jul 08, 2016

But if the structure of Medicaid produces unintended growth and wasteful spending, a design flaw so to speak, real reform might be accomplished without harming the people who rely on it.
Jul 06, 2016

Risk adjustment, therefore, introduces a trap economists refer to as a “collective action problem.” Because of risk adjustment, insurers individually lack an incentive to enroll relatively young and healthy people, but in the aggregate the ACA’s success is largely dependent on enough relatively young and healthy people purchasing coverage to both lower overall premiums and ensure insurer profitability.
Jun 29, 2016

Putting Medicare on a sustainable trajectory will involve tradeoffs, but the earlier policymakers act the better the likely outcome for taxpayers, workers, beneficiaries, and providers.
Jun 29, 2016

Spend but don’t tax politicians want to spend and keep taxes low to score points with fiscal conservatives ... Politicians take credit for providing health insurance for the poor; we constantly hear that Alabama Medicaid serves one million Alabamians. Most voters are too busy with their lives to take the time to learn how Medicaid fails to deliver its promise.

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

Brian Blase | July 26, 2016
Brian Blase appeared on the John Batchelor Show to discuss the much higher than anticipated costs of ACA Medicaid enrollees.

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.
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