Health Care Forecasting Conference James Baumgardner Deputy Assistant Director Congressional Budget Office February 25, 2010.

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Presentation transcript:

Health Care Forecasting Conference James Baumgardner Deputy Assistant Director Congressional Budget Office February 25, 2010

CBO Baseline Not a forecast of the future. Assumes that current law remains unchanged. Consistent with CBO’s job of scoring proposals relative to current law. Special treatment of discretionary spending.

CBO Baseline Assumptions Tax provisions expire as scheduled. No modification of the Alternative Minimum Tax. Discretionary spending grows with inflation. No fix of Medicare physician payment.

Budget Outlook Under Current Policies (In billions of dollars)

Budget Outlook Under Current Policies (As a percentage of GDP)

Annual Unemployment Rate, 1950 to 2020 Source: Congressional Budget Office; Department of Labor, Bureau of Labor Statistics Percent

Revenues and Outlays as a Share of GDP, 1970 to 2020 Percentage of GDP Source: Congressional Budget Office

The Total Deficit or Surplus as a Share of GDP, 1970 to 2020 Percentage of GDP Source: Congressional Budget Office

The Budgetary Effects of Policy Alternatives Not Included in CBO’s Baseline (January 2010) (Billions of Dollars) Note: Additional debt service included in alternatives. Source: Congressional Budget Office

Medicare Baselines: Net Outlays, Average Annual Increase: 7.0% (Billions of Dollars) Source: Congressional Budget Office

Medicaid Baselines: Mandatory Outlays, Average Annual Increase: 5.0% (Billions of Dollars) Source: Congressional Budget Office

H.R. 3962: Affordable Health Care for America Act Mandate on individuals to obtain insurance Medicaid expansion Subsidies for individual purchase through exchanges (includes DHHS public plan) Penalty payments on non-offering employers Reductions in the growth of Medicare payment rates Income tax surcharge on high-income people

H.R. 3962: Affordable Health Care for America Act (Billions of Dollars) Source: Congressional Budget Office

H.R. 3962: Affordable Health Care for America Act (Billions of Dollars) Source: Congressional Budget Office

H.R – Senate Amendment 2786: Patient Protection and Affordable Care Act Mandate on individuals to obtain insurance Medicaid expansion Subsidies for individual purchase through exchanges (OPM contracts with “multi- state” plans) Reductions in the growth of Medicare payment rates (and establish Independent Payment Advisory Board) Excise tax on high-premium health plans Payroll tax increase on high-income people

H.R – Senate Amendment 2786: Patient Protection and Affordable Care Act (Billions of Dollars) Source: Congressional Budget Office Note: Based on CBO analysis of December 19, 2009.

H.R – Senate Amendment 2786: Patient Protection and Affordable Care Act (Billions of Dollars) Source: Congressional Budget Office Note: Based on CBO analysis of December 19, 2009.