Accounting for the Changing Impact of the Federal Government Including the Affordable Care Act Benjamin A. Mandel BEA Advisory Committee Meeting Washington,

Slides:



Advertisements
Similar presentations
Mission: To promote responsible and equitable fiscal policies through research and education Joy Smolnisky, Director 808 N. West Ave., Sioux Falls, SD.
Advertisements

Medicaid expansion in sc. today’s talk  Background  Politics of expansion  Impact on People  Impact on Business  Impact on the Economy  Final Thoughts.
Medicaid Opportunities & Challenges Task Force June 26, 2013 Jeff Bechtel, Senior Consultant Summary of Congressional Budget Office Reports and Analysis.
Lame Duck Session. ISSUES BEFORE CONGRESS DURING THE LAME DUCK SESSION Allowing current law to stand * results in deficit reduction of: – $ 7.8 T over.
 Medicare Drug Rebates  Medicare patients who face a gap in prescription drug coverage would received a one-year, $250 rebate to help pay for medication.
Robert Ricketts Frank M. Burke Chair in Taxation October 2010.
Affordable Care Act (ACA) Where Are We and Where Are We Headed Locey & Cahill, LLC Presentation to: New York State Association of Management Advocates.
Health Care Forecasting Conference James Baumgardner Deputy Assistant Director Congressional Budget Office February 25, 2010.
The Economics of Health Care Reform Allen C. Goodman Wayne State University Presented to Adult Learning Institute October 25, 2011
HEALTH INSURANCE REFORM: HIGHLIGHTS OF MERGED SENATE DEMOCRATIC BILL.
Major Health Issues The Affordable Healthcare Act.
Experience, Commitment, Results. Federal Health Care Reform The impact on individuals, employers, and our health insurance coverage… National Worksite.
What Does Health Care Reform Mean for You? Presented by Alliance 360° Insurance Solutions © 2013 Zywave, Inc. All rights reserved.
The Hilltop Health Care Reform Simulation Model Hamid Fakhraei, Ph.D. July 2012.
National Health Expenditure Accounts (NHEA) Stephen Heffler Director, National Health Statistics Group Office of the Actuary National Economic Accounts.
Patient Protection and Affordable Care Act (PPACA) – signed on March 23, 2010 Health Care and Education Reconciliation Act (Reconciliation Act) – signed.
Affordable Care Act (ACA) The Affordable Care Act
Proprietary and Confidential Health Care Reform Update What you need to know 02/13/2014 Health Care Reform AWI Presentation.
What Wonders Have They Wrought? The Patient Protection and Affordable Care Act.
Health Reform: What It Means to Our Community. Health Reform: Key Provisions o Provides coverage to 32 million uninsured people by o Changes insurance.
PATIENT PROTECTION AND AFFORDABLE CARE ACT (AKA HEALTH CARE REFORM)
Health Care Costs and the Long-Term Fiscal Imbalance Colorado Human Services Directors Association June 6, 2012.
Patient Protection and Affordable Care Act: Overview for Connecticut Financing Coverage expansions individual mandate employer responsibility insurance.
Health Care Reform Did Congress cure our system’s ailments? Debbie Carrothers, SE Regional Manager, U.S. Chamber of Commerce And Frederick C. Dawkins Freeman,
Health Care Reform and its Impact on Michigan Janet Olszewski, Director Michigan Department of Community Health Senate Health Policy Committee May 5, 2010.
HEALTH IN COLORADO GOVERNOR HICKENLOOPER’S VISION.
Spotlight on the Federal Health Care Reform Law. 2. The Health Care and Education Affordability Reconciliation Act of 2010 was signed March 30, 2010.
Healthcare Reform MDI Rotary September, Mount Desert Island Hospital Agenda The Problem Health Reform Bill Outstanding Issues / Challenges Questions.
1 ©2011 Foley & Lardner LLP Attorney Advertising Prior results do not guarantee a similar outcome Models used are not clients but may be representative.
Monetary Policy Monetary Policy – the process by which the government controls the supply of money in circulation and the supply of credit through the.
Medicare, Medicaid, and Health Care Reform Todd Gilmer, PhD Professor of Health Policy and Economics Department of Family and Preventive Medicine 1.
A non-profit corporation and independent licensee of the Blue Cross Blue Shield Association 1 Health Reform: The Impact on Michigan Michigan Purchasers.
Overview of the Bureau of Economic Analysis Regional Accounts at the BEA Robert L. Brown Monitoring Mississippi: Data & Tools for Understanding Our State.
Comparison of Health Care Reform Bills 2010 Contemporary Problems in Economics Professor Steve Cunningham 1.
THE COMMONWEALTH FUND The 2009 Congressional Health Reform Bills: Insurance Coverage Sara R. Collins, Ph.D., Vice President Rachel Nuzum, M.P.H., Senior.
Patient Protection and Affordable Care Act of 2010.
THE COMMONWEALTH FUND Figure 1. Insurance Reform Proposals as of December 2009 Senate (H.R. 3590) 12/24/09 House of Representatives (H.R. 3962) 11/7/09.
Taxes and Social Security. Understanding Taxes  Taxes are a form of payment to the government to support government services.  There are three types.
Why reform? Actual Projection 2.5 Percentage Points 1 Percentage Point Zero.
Government and Taxes Chapter 14. Funding Government Programs Citizens of the United States authorize the government, through the Constitution and elected.
GDP Using the Income Approach: the U.S. Experience Brian C. Moyer International Workshop on Household Income, Consumption, and Full Accounting.
Health Reform 2014 Bill Graham VP, Policy & Government Affairs August 17, 2010.
AFFORDABLE CARE ACT. March 23, 2010 President Obama signed the Patient Protection and Affordable Care Act into law.
 Chapter 16 Government Spending. Growth of Government In 1929 only 3 million governme nt workers at all levels Depression causes greater demand for government.
Paying Taxes Chapter 6.
S OCIAL S ECURITY AND H EALTH C ARE LECTURE – ISSUES In the U.S., persons 65 years or older number more than 12% of the population—that is close to one.
The Excise Tax on High-Cost Employer-Sponsored Health Coverage: Background and Economic Analysis Written By: Sean Lowry Published Online By: Congressional.
Taxes: Understanding Your Paycheck Economics 2015.
THE BUDGET… Every year, the President and Congress must appropriate funds Budget – a policy document allocating burdens (taxes) and benefits (expenditures)
1 U.S. Health Care Expenditures in the NHEA and in GDP Robert Kornfeld U.S. Bureau of Economic Analysis Pan American Health Organization Washington,
Health Reform: An Overview Unit 4 Seminar. The Decision The opinions spanned 193 pages, upholding the individual insurance mandate while reflecting a.
Federal Government Finances Fiscal Year- A 12-month financial planning period that may or may not coincide with the calendar year. The government’s fiscal.
January Delaware Ave Wilmington, DE Affordable Care.
1 Law and Economic Justice Jon Forman Alfred P. Murrah Professor of Law University of Oklahoma Central Oklahoma Association of Legal Assistants Oklahoma.
Chapter 5 Healthcare Reform. Objectives After studying this chapter the student should be able to: Describe the expansion of healthcare insurance under.
AFFORDABLE CARE ACT: OVERVIEW, STUDY OF THE GENERAL EFFECTS ON RADIOLOGY, HOW FAR HAVE WE COME AND THE FUTURE Bhavya Rehani, MD, Lindsay P. Busby, MD,
“In this world, nothing is certain but death and taxes”
“In this world, nothing is certain but death and taxes”
Individual Income Tax – Key Concepts
TAXES.
Federal Expenditures The programs & services the federal government funds are divided into two categories. Mandatory spending—or spending that is required.
The Great American Health Care Debate Continues…
National Income Accounts
“In this world, nothing is certain but death and taxes”
Bell Activity Write an journal entry giving your opinion of user fees charged for things such as entry into national parks. Include whether you think.
Taxes and Social Security
“In this world, nothing is certain but death and taxes”
CBO estimate of Affordable Care Act of 2010
Major Sources of Savings and Revenues Compared with Projected Spending, Net Cumulative Effect on Federal Deficit, 2010–2019 Dollars in billions CBO estimate.
CBO estimate of Affordable Care Act of 2010
Presentation transcript:

Accounting for the Changing Impact of the Federal Government Including the Affordable Care Act Benjamin A. Mandel BEA Advisory Committee Meeting Washington, DC May 10, 2013

bea.gov Sources of Change  Defense Spending  Military buildups and drawdowns  Historic Transformative Legislation  Creation of large-scale social programs  Temporary Programs  American Recovery and Reinvestment Act  Disaster Assistance

bea.gov Federal Defense Spending

bea.gov Derivation of NIPA Defense Estimates  Control total (top down) based on outlays data from the Monthly Treasury Statement.  DOD Military  OPM and DOD Civilian (retirement benefits)  Energy and a few other small programs  Allows the NIPAs to capture changes in defense spending  Sequester impacts embedded in MTS data  Individual methodologies for component series (bottom up)  Compensation (possible furlough adjustments)

bea.gov Adjustments to Defense Outlays National Accounting differs from Budget Accounting  Timing  Personnel  Procurement of Equipment  Coverage  Consumption of Fixed Capital  Other smaller adjustments

bea.gov Historic Social Program Legislation  Old-Age (Retirement), Survivors, and Disability Insurance  Unemployment benefits  Medicare - Health insurance for aged and disabled  Medicaid - Federal grants to states for medical assistance programs  Supplemental Security Income - Payments to low- income people who are either 65 or older, blind, or disabled

bea.gov Patient Protection and Affordable Care Act  Ensure health insurance coverage for most U.S citizens  Individual Mandate  Employer  Medicare or Medicaid  Individual direct purchase  Health insurance exchanges  Prohibits exclusions for pre-existing conditions  Improve healthcare treatments and delivery

bea.gov Government Services and Funding  Government Support  Health Exchanges  Insurance subsidies  Expansion of existing programs – Medicaid and CHIP  Government Revenue  Increase existing taxes and reduce certain tax credits  New excise taxes  Penalties and fees

bea.gov  Several ACA provisions have already begun and related transactions are included in the NIPAs  Transactions are included in our normal source data (Budget, MTS, etc.)  Provisions continue to begin each year 2014 through 2020 BEA’s Analysis of ACA Impact on the Federal Sector of the NIPAs

bea.gov BEA’s Analysis of ACA Impact on the Federal Sector of the NIPAs  Classify estimates of ACA spending and revenues into a national accounts framework  Focus on which NIPA transactions are impacted, not estimated values  Source data (fiscal years)  CBO & Joint Committee on Taxation : 2010 – 2012 reports  Estimates a bit outdated, but still useful for analysis  Consistent impacts  OMB outlays and receipts through 2018 (used for allocations)  Lacking detailed data, BEA split estimates of the new Medicare surtaxes 50/50 between contributions for social insurance and personal current taxes  Federal sector perspective  Direct impacts of law changes  Changes to existing programs  New transactions  Not multiplier effects

bea.gov Impact of ACA on NIPA Federal Sector Illustration of the estimated ACA impact on federal NIPA transactions based on CBO, JCT, and OMB data.

bea.gov Federal Total Expenditures - ACA Illustration of the estimated ACA impact on federal NIPA transactions based on CBO, JCT, and OMB data.

bea.gov Federal Grants to S&L Governments - ACA Illustration of the estimated ACA impact on federal NIPA transactions based on CBO, JCT, and OMB data.

bea.gov Grants – Gross ACA Impacts

bea.gov Federal Social Benefits to Persons - ACA Illustration of the estimated ACA impact on federal NIPA transactions based on CBO, JCT, and OMB data.

bea.gov Federal Social Benefits – Gross ACA Impacts Illustration of the estimated ACA impact on federal NIPA transactions based on CBO, JCT, and OMB data.

bea.gov Health Insurance Subsidies  Subsidized purchase of insurance from government-run exchanges  Beginning in 2014  Eligibility: income that does not exceed 400% of the poverty level  Social Benefit to Persons  Prepaid refundable tax credit most likely paid directly to the insurer, not the individual  Personal Current Taxes  Tax filing: reconciliation of prepaid credit with allowable credit  Either a tax reduction (entitled to more of a subsidy) or tax increase (received too much of a subsidy)

bea.gov Federal CE & GI (GDP) - ACA Illustration of the estimated ACA impact on federal NIPA transactions based on CBO, JCT, and OMB data.

bea.gov Federal Subsidies - ACA Illustration of the estimated ACA impact on federal NIPA transactions based on CBO, JCT, and OMB data.

bea.gov Federal Capital Transfers to Persons - ACA Illustration of the estimated ACA impact on federal NIPA transactions based on CBO, JCT, and OMB data.

bea.gov Federal Total Receipts - ACA Illustration of the estimated ACA impact on federal NIPA transactions based on CBO, JCT, and OMB data.

bea.gov Federal Receipts of Contributions for Social Insurance - ACA  Additional Medicare hospital insurance surtax of 0.9% on earned income in excess of $200,000/$250,000 (unindexed) Note: BEA used a 50/50 split of an estimate of the total new Medicare HI surtaxes to allocate the surtaxes between contributions and personal current taxes to illustrate the impact on the component series.

bea.gov Federal Excise Taxes - ACA  2011: Annual fee on manufacturers and importers of branded drugs  2013: 2.3% excise tax on importers and manufacturers of certain medical devices  2014: Annual fee on health insurance providers  2018: 40% excise tax on high cost health “Cadillac” plans

bea.gov Current Transfer Receipts - ACA  Business Mandate: Insurance coverage for employees of businesses with more than fifty full-time workers.  Individual Mandate: Most U.S. citizens and legal residents required to have “minimal essential coverage” for themselves and their dependents.

bea.gov Federal Personal Current Taxes - ACA  2013: new 3.8% surtax on investment income for taxpayers with AGI in excess of $200,000/$250,000 (unindexed). Note: BEA used a 50/50 split of an estimate of the total new Medicare HI surtaxes to allocate the surtaxes between contributions and personal current taxes to illustrate the impact on the component series.

bea.gov Federal Taxes on Corporate Income – ACA Illustration of the estimated ACA impact on federal NIPA transactions based on CBO, JCT, and OMB data.

bea.gov ACA Analysis – Future Considerations  The implementation of the ACA will lead to changes in the current estimates of impacts  Some programs may be modified or eliminated  Unclear exactly what actions individuals and employers will take regarding health insurance.  Impacts on other sectors of the NIPAs?  State and Local Governments  Personal Consumption Expenditures (Current dollars and Prices)  Corporate Profits

bea.gov 2013 Comprehensive Revision - NIPAs  Changes in economic accounting definitions and classifications  Capitalization of research and development  Accrual treatment of defined benefit pension plan transactions