- #CONGRESSIONAL BUDGET OFFICE SOCIAL SECURITY REPORT FULL#
- #CONGRESSIONAL BUDGET OFFICE SOCIAL SECURITY REPORT PLUS#
This happened under the Balanced Budget Act in 1997 and again as part of the ACA legislation in 2010. One remedy in the past has been to reduce pressure on the Part A Trust Fund by reducing reimbursement to some or all providers paid by Medicare from Part A.
#CONGRESSIONAL BUDGET OFFICE SOCIAL SECURITY REPORT PLUS#
2 The threat of depletion has happened before and is an event‐forcing occurrence since payments from Part A cannot be made for Medicare inpatient hospital stays or other Part A benefits if the revenue plus any residual balances is less than the projected Part A costs. This is in contrast to the last 2 years of unusually slow Medicare spending growth per enrollee of 1.7% and 1.6%, respectively, but not as rapidly as it grew a decade ago, when it grew by 6.8% in 2007.įirst, the Part A Trust Fund is projected to be depleted by 2028. The growth in enrollment would be enough to stress Medicare financing even without a growth in spending per enrollee, but that, too, is expected to grow-3% this year and by 4.7% in 2025. According to the actuaries, in the decade after 2030, Medicare will grow at a much slower pace of slightly under 1% per year. The annual growth in Medicare enrollment in 2017 is expected to be 2.8% and CMS is projecting the same growth for 2025. Some of the growth in Medicare spending is because of enrollment growth. Such growth is more rapid than Medicare spending has been increasing in past years and more rapidly than private sector spending is projected to rise. Medicare spending is currently projected to grow at 5.9% in 2017 and by 7.6% in 2025. While projected spending levels for 1 to 2 decades are always subject to change and frequently wrong, the directional challenges awaiting Medicare are indisputable, even if the precise year when some of the event‐forcing changes-like which year the Part A: Hospital Insurance Trust Fund becomes insolvent-may not be certain. Changes may well be introduced in response to unanticipated outcomes associated with MACRA, but that will probably not happen until at least several years from now. But this law is only now beginning to go into effect. And, of course, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) will change how physicians are reimbursed under Medicare. This is so for two reasons: (1) President Trump has said he does not intend to change Medicare or Social Security, and (2) Medicare payments to the provider community were already substantially reduced when the ACA was adopted. What is unlikely to be affected is Medicare. Of course, this number is extremely sensitive to the types of changes that may occur under any health care reform revisions. Under current law, the insured rate is expected to remain at about 91% and should increase slightly to 91.5% by 2025. What is done, how it is done, and how soon the changes occur will obviously affect projections about health care spending and coverage. For the private sector of health care and for Medicaid, this is a more precarious assumption than usual since Congress and the Trump administration are in the throes of making decisions about the next round of health care reform. The projections, like all government projections, assume current law continues.
The early waves of baby boomers who began to retire in 2011 will reach the age of 70 or older during this next decade, which will also increase the amount of health care they are expected to use. By 2030, all of the baby boomers will have reached retirement age. This will continue until the end of the next decade. Medicare enrollment will only grow as the baby boomers (people born between 19) continue to age into Medicare. Individuals on Medicaid will become older over the decade and are more likely to be sicker and more costly. The higher growth in the previous year (2014‐2015) was attributed primarily to the expansion in coverage from the ACA while the slower growth for 2016 is because coverage had generally stabilized for 2016.ĬMS expects that this acceleration in health care spending during the decade after 2017 will be particularly sharp for Medicare and Medicaid. 1 Centers for Medicare and Medicaid Services (CMS) projections for the next decade indicate that 20 are expected to have the slowest periods of growth-5.4% growth between 20-and will then accelerate.
#CONGRESSIONAL BUDGET OFFICE SOCIAL SECURITY REPORT FULL#
Indeed, health care spending for 2016 grew at a rate of only 4.8%, a reduction of a full percentage point over the spending growth of 5.8% from 2015. The slowdown in health care spending recently reported for 2016 may also make it even easier to put aside concerns over Medicare. W ith so much attention focused on the Affordable Care Act (ACA) and its potential replacements or reforms, it is easy to forget about other looming health care challenges-but Medicare is the most serious among them.
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