Medicare, Medicaid, & Social Security

Medicare, Medicaid, & Social Security


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.
Mark J. Warshawsky, Ross Marchand | Apr 28, 2015
We explain that the medical-vocational grid guidelines that are used to determine whether someone is disabled are an important part of the explanation for increased disability awards. The grid applies much looser standards for applicants as young as 45 and 50. We propose that age be eliminated as a deciding criterion, as well as language ability and education level. We also note that the guideline’s list of impairments is outdated and needs to reflect a modern workforce that has access to remedying medical technologies.

Testimony & Comments

Research Summaries & Toolkits

Expert Commentary

Nov 04, 2015

ACA proponents, often pointing to Congressional Budget Office (CBO) estimates, argued that the law would reduce the number of uninsured people by about 30 million while producing federal budget savings. Five years later, low exchange enrollment suggests that far more people than projected will remain uninsured. New Mercatus research by James Capretta and Joe Antos shows that the projected federal budgetary savings result from provisions that are unlikely to be economically or politically sustainable.
Nov 02, 2015

The bottom line, based on the facts, is that Social Security is facing impending insolvency; raising taxes on the “rich” won’t solve the problem; and the sooner and more responsibly we work together on a realistic reform package, the easier and less painful the inevitable changes will be.
Nov 02, 2015

The bipartisan budget bill just passed by Congress contains several provisions affecting Social Security disability insurance (DI) operations as well as Social Security finances generally. The purpose of this piece is to explain key effects of the disability provisions. I will not speak to the merits of the budget deal as a whole, which is already the subject of many others’ analysis and commentary.
Oct 26, 2015

In Part I, I showed that the administration’s new estimate of next year’s exchange enrollment is only about half of what prominent groups projected in 2010, and I discussed evidence that exchange plans are not attracting many young, healthy people. This piece shows that the groups also projected far too many unsubsidized enrollees and discusses reasons to be skeptical that the individual mandate will lead as many people to purchase coverage as assumed.
Oct 13, 2015

In a bold effort "to protect individual liberty and personal control over Health Care decisions," nine states have approved a Health Care Compact to claim some autonomy from the Affordable Care Act, Medicare and Medicaid; two other states are considering joining them. The problem, however, is that in health care, most of the compact's signatory states have poor records with respect to individual liberty and personal control over care.
Oct 08, 2015

Traditional "fee-for-service" (FFS) Medicare — which pays providers a fee for each service delivered — is the nation's largest health-insurance program, enrolling 38.1 million aged and disabled beneficiaries in 2014. The program pays more than 200 million claims for inpatient hospital admissions and home-health-care visits each year, and 1 billion claims for doctors' services. There are about 10,000 different services for doctors alone, and each of these fees is set through an administrative process that attempts to discern the cost of producing that service — called the "relative value" — in terms of the costs of physician work, practice expenses, and liability insurance.


As I underscored in two recent charts, the Social Security Disability Insurance (SSDI) program is financially unsustainable, and to save it, policymakers need to rein in benefits, which have exploded in recent years. This week’s charts add two important points: first, that SSDI has turned into a quasi-unemployment program, and second, that the good intentions that prompt the creation of federal programs are not enough to prevent poor and costly outcomes.


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.


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.

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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.


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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