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OverlappingPoliciesandSavingsEstimates_0

OverlappingPoliciesandSavingsEstimates_0

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Published by: Committee For a Responsible Federal Budget on Oct 12, 2011
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10/15/2013

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 _________________________________________________________________________________________________________________________________________________ Committee for a Responsible Federal Budget 
1
 
Overlapping Policies and Estimated Savings Across Fiscal Plans
Deficit-ReducingPoliciesPresident’s SuperCommitteeSubmissionHouseRepublicanBudgetBowles-SimpsonFiscalCommissionDomenici-Rivlin(BPC)*UnderConsiderationin Debt LimitDiscussions
+
Lieberman-Coburn HealthProposal
Government-Wide
 
Use Chained CPIfor All Inflation-IndexedPrograms**$232 billion
fromimplementingchained CPI
$232 billion
fromimplementingchained CPIUnder discussionby Obama andBoehner
 
Health Care
 
Reform MedicaidFormula$15 billion
fromintroducing areduced blendedMedicaid rate in2017
$770 billion
fromblock grantingMedicaid andindexing to CPI +population
 
Recommendsconsideration ofblock granting tomeet long-termhealth cap
 
Replacesmatching rateswith reallocation offederal/stateresponsibilitiesbeginning in 2018
 $100 billion
fromunspecified FMAPchanges (withpossible increasedstate flexibility)
 Reduce StateMedicaid Gaming$26 billion
fromreducing Medicaidprovider taxthreshold
$51 billion
fromphasing outMedicaid providertax threshold
 
Under discussionas part ofMedicaid reform
 Improve DualEligible Care$15 billion
frommandating dualeligibles be placedin Medicaidmanaged care(with Medicarecapitatedpayments)
 $8 billion
fromremoving barriersfor states to placedual eligibles inmanaged care
 $0-$5 billion
frombetter carecoordination
 
 
 
 _________________________________________________________________________________________________________________________________________________ Committee for a Responsible Federal Budget 
2
 
Deficit-ReducingPoliciesPresident’s SuperCommitteeSubmissionHouseRepublicanBudgetBowles-SimpsonFiscalCommissionDomenici-Rivlin(BPC)*UnderConsiderationin Debt LimitDiscussions
+
Lieberman-Coburn HealthProposalEnact TortReform$62 billion
fromaggressivereforms, includingcaps to non-economic andpunitive damages
 $20 billion
fromreforms such ascollateral sourcerule changes andconsideration ofaggressive reforms
 $62 billion
fromrequiring states tocap non-economicand punitivedamages
 Reduce MedicarePayments forPharmaceuticalDrugs$142 billion
fromprohibiting pay fordelay for genericdrugs ($3b),shorteningexclusivity forgenerics ($4b),and drug rebates($135b)
$55 billion
byapplying Medicaiddrug rebates tolow income seniorscovered byMedicaid andMedicare Part D
 
About
$160billion
byexpandingMedicaid drugrebates toMedicare Part D
 
Part D rebatesproposed byDems; otherreforms, such asaveragewholesale price(AWP) rules forPart D drugs anddrugreclassificationsalso considered
IncreaseMedicare Cost-Sharing
More than
$1billion
fromincreasing thePart B deductibleand introducing ahome health co-payment for newbeneficiaries in2017
$65 to $75 billion
 from a $550deductible, 20%co-insurance up to$5,500, 5% co-insurance up to$7,500, andcatastrophic capabove that
 
About
$30 billion
 from a $560deductible, 20%co-insurance up to$5,250 andcatastrophic capabove that
 
Up to
$66 billion
from clinical laband skilled nursingfacilities (SNF) / Home Health co-pays (thoughmoney could alsocome frompaymentreduction)
 $65 to $75billion
from a$550 deductible,20% co-insurance up to$5,500, 5% co-insurance up to$7,500, andcatastrophic capabove that
 
 
 
 _________________________________________________________________________________________________________________________________________________ Committee for a Responsible Federal Budget 
3
 
Deficit-ReducingPoliciesPresident’s SuperCommitteeSubmissionHouseRepublicanBudgetBowles-SimpsonFiscalCommissionDomenici-Rivlin(BPC)*UnderConsiderationin Debt LimitDiscussions
+
Lieberman-Coburn HealthProposalIncrease BasicMedicarePremium
About
$240billion
fromraising basic PartB premiums from25% to 35% ofcosts (5-yearphase-in)
 
About
$240billion
fromraising basicPart B premiumsfrom 25% to35% of costs (5-year phase-in)
IncreaseMedicare Means-Testing$20 billion
fromincreasing means-testing premiumsand freezingbracketsbeginning in 2017
$38 billion
fromfreezing premiumbrackets after2019 andincreasing costsfor high-earners
 
Increasescatastrophic capfor high-earnersand requireshigh-earners topay 100% ofpremiums
Restrict MedigapCoverage
Over
$2 billion
 from a MedicarePart B surchargeon beneficiarieswho purchaseMedigap policieswith low cost-sharingrequirements fornew beneficiariesbeginning in 2017
$53 billion
fromrestricting first-dollar coverage ofMedigap plans
 
Up to
$53 billion
from restrictingfirst-dollarcoverage ofMedigap plans
 $53 billion
fromrestricting first-dollar coverageof Medigap plans
Strengthen theIndependentPaymentAdvisory Board(IPAB)
Lowers IPAB’starget rate forMedicarespending perbeneficiary fromGDP+1% toGDP+0.5%Broadens IPAB’sauthority byeliminatingexemptions from itsrecommendations,including hospitalsand other providersRequires IPAB toreview Medicarebenefit structureevery two yearsand recommendchanges in privatemarket

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