Congressional Research Service Reports - 199 Matching Results
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- Medicare Advantage (MA)--Proposed Benchmark Update and Other Adjustments for CY2016: In Brief
- This report provides a brief background on how Medicare Advantage (Part C or MA) payments are determined through a comparison of a plan's estimated cost (bid) and the maximum amount Medicare will pay a plan (benchmark).
- NFIB v. Sebelius: Constitutionality of the Individual Mandate
- Report that provides an overview of the Court's holding with respect to the individual mandate of the Patient Protection and Affordable Care Act (ACA) under the Commerce Clause and the Taxing Power. It also addresses possible implications of the decision on existing federal law and future legislation.
- Medicare Trigger
- This report analyzes the financing of Medicare and its impact on the federal budget. It includes a discussion of the Medicare "trigger," which requires certain actions to be taken should general revenue funding be expected to exceed a certain proportion of total Medicare outlays within a certain number of years.
- The ACA Medicaid Expansion
- This report provides an overview of the ACA Medicaid expansion, and the impact of the Supreme Court decision on the ACA Medicaid expansion. Then, the report describes who is covered under the expansion, the expansion rules, and how the expansion is financed. In addition, enrollment and expenditure estimates for the ACA Medicaid expansion are provided. Finally, the report reviews state decisions whether or not to implement the ACA Medicaid expansion, and the implications of those decisions on certain individuals, employers, and hospitals.
- Medicare Primer
- This report provides a general overview of the Medicare program including descriptions of the program's history, eligibility criteria, covered services, provider payment systems, and program administration and financing.
- The Independent Payment Advisory Board
- This report, which provides an overview of the Payment Advisory Board, begins with a discussion of the rationale behind the creation of an independent Medicare board and briefly reviews prior proposals for similar boards and commissions. The report then describes the structure of the Board, the calculations and determinations required to be made by the Office of the Chief Actuary (the Chief Actuary) in the Centers for Medicare & Medicaid Services (CMS) that trigger a Board proposal, and the content of and constraints on Board proposals--including the Medicare productivity exemptions under Section 3401 of the The Patient Protection and Affordable Care Act (PPACA).
- The Affordable Care Act’s Contraceptive Coverage Requirement: History of Regulations for Religious Objections
- This report summarizes the issues involved with the Affordable Care Act's (ACA) requirement in group health plans for contraceptive coverage. Moreover, the report covers the history of how religious objections to this provision of the ACA have been handled. Specifically, the report discuses this topic in relation to employers providing health insurance for employees.
- Addressing Medicare Hospital Readmissions
- This report highlights the issue of one-fifth of medicare patients in 2005 being readmitted to a hospital within thirty days time. These readmissions put a strain on the budget, the majority of which it is estimated may be avoidable. The report notes that Medicare as a program is working on moving around those difficulties, without reducing the quality of care.
- The Independent Payment Advisory Board
- In response, in part, to overall growth in Medicare program expenditures and growth in expenditures per Medicare beneficiary, the Patient Protection and Affordable Care Act created the Independent Payment Advisory Board (IPAB, or the Board) and charged the Board with developing proposals to "reduce the per capita rate of growth in Medicare spending." This report discusses the responsibilities and duties.
- The Independent Payment Advisory Board (IPAB): Frequently Asked Questions
- This report responds to frequently asked questions about the Independent Payment Advisory Board (IPAB), including the board's background, current status, controversial issues including legal challenges, and recent legislative efforts to repeal the IPAB.
- Health Insurance: Small is the New Large
- This report discusses aspects of the Patient Protection and Affordable Care Act that expand the definition of small employer to include employers with 100 or fewer employees. States must implement the expanded definition for plan years beginning in 2016, but have the option of implementing the expanded definition prior to the deadline.
- Medicare Financing
- This report provides an overview of how the Medicare program is financed, including a description of the Medicare trust funds and a summary of key findings and estimates from the 2013 Report of the Medicare Board of Trustees regarding 2012 program operations and future financial soundness.
- Military Medical Care: Frequently Asked Questions
- This report answers selected frequently-asked questions about military health care, including: 1) How is the Military Health System structured?, 2) What is TRICARE?, 3) What are the different TRICARE plans and who is eligible?, 4) What are the costs of military health care to beneficiaries?, 5) What is the relationship of TRICARE to Medicare?, 6) How does the Affordable Care Act affect TRICARE?, 7) When can beneficiaries change their TRICARE plan?, and 8) What is the Medicare Eligible Retiree Health Care fund, which funds TRICARE for Life?
- Medicare Physician Payment Updates and the Sustainable Growth Rate (SGR) System
- This report provides a background on the Medicare fee schedule, the Sustainable Growth Rate (SGR) system and the annual updates, and discusses recent proposal to address this issue.
- Abortion: Judicial History and Legislative Response
- This report discusses the judicial history of abortion and how legislatures respond to those decisions made by the court. The report tackles landmark cases such as Roe v. Wade as well as companion decisions such as Doe v. Bolton. The report highlights specifically how Congress has attempted to enact legislation that limits abortion practices.
- Medicare Primer
- This report provides an overview of Medicare, the nation's federal insurance program, which pays for covered health care services of qualified beneficiaries.
- Bipartisan Budget Act of 2018 (P.L. 115-23): Brief Summary of Division E-The Advancing Chronic Care, Extenders, and Social Services (ACCESS) Act
- This report provides a brief summary of each of the provisions included in Division E (the ACCESS Act) of the Bipartisan Budget Act of 2018, along with the contact information for the CRS expert who can answer questions about each provision. Division E consists of 12 titles. Each title is addressed in a separate table, and the provisions are discussed in the order they appear in the law. Topics discussed in this report include Medicare, Medicaid, the State Children's Health Insurance Program (CHIP), public health, child and family services, foster care, social impact partnerships, child support enforcement, and prison data reporting. Subsequent CRS reports examining selected subsets of these provisions will be linked to this report as they become available.
- The Individual Mandate for Health Insurance Coverage: In Brief
- This report provides an overview of the individual mandate for health insurance, its associated penalty, and the exemptions from the mandate.
- Tax Options for Financing Health Care Reform
- This report reviews the revenue raisers proposed to fund health care reform. Other financing proposals are presented including those made by the Obama Administration and those introduced in earlier congressional work. The final sections discuss other proposals suggested by the round-table discussion participants.
- The Community Health Center Fund: In Brief
- This report provides information on the Community Health Center Fund (CHCF) that may be useful for discussions about the fund's future. Specifically, it includes information on: the types of grants awarded, total funds disbursed, and the amount of CHCF funds that facilities in each state and territory received.
- Appropriations and Fund Transfers in the Affordable Care Act (ACA)
- This report summarizes all the mandatory appropriations and Medicare trust fund transfers in the ACA and provides details on the status of obligation of these funds. The information is presented in two tables. The report also includes a brief discussion of the impact that sequestration is having on ACA mandatory spending. This report is periodically revised and updated to reflect important legislative and other developments.
- Centers for Disease Control and Prevention Global Health Programs: FY2001-FY2011
- This report explains the role the Centers for Disease Control and Prevention (CDC) plays in U.S. global health assistance, highlights how much the agency has spent on global health efforts from FY2001 to FY2010, and discusses how funding to each of its programs has changed during this period.
- Appropriations and Fund Transfers in the Affordable Care Act (ACA)
- This report summarizes all the mandatory appropriations and Medicare trust fund transfers in the Affordable Care Act (ACA) and provides details on the status of obligation of these funds. The information is presented in two tables. The report also includes a brief discussion of the impact that sequestration is having on ACA mandatory spending.
- Self-Insured Health Insurance Coverage
- This report provides background information on private health insurance coverage, state and federal regulation of private coverage, and self-insured health plans. It includes data on the prevalence of self-insurance and discusses the employer decision to self-insure. Lastly, it describes selected private health insurance provisions under federal health reform, and application of such provisions on self-insured plans.
- Centers for Medicare & Medicaid Services: President’s FY2013 Budget
- This report summarizes the President's budget estimates for each section of the CMS budget. Then, for each legislative proposal included in the President's budget, this report provides a description of current law and the President's proposal. The explanations of the President's legislative proposals are grouped by the following program areas: Medicare, Medicaid, program integrity, and health insurance programs.
- Health Savings Accounts: Overview of Rules for 2012
- This report provides a summary of the principal rules governing Health Savings Accounts (HSAs), covering such matters as eligibility, qualifying health insurance, contributions, and withdrawals.
- Discretionary Spending Under the Affordable Care Act (ACA)
- This report examines the Affordable Care Act's (ACA's) effects on discretionary spending. It first discusses all the ACA authorizations (and reauthorizations) of appropriations for grant and other programs; this information, along with actual funding amounts, is summarized in a series of tables. The report then reviews the ACA administrative costs borne by CMS and the IRS.
- Medicare Physician Payment Updates and the Sustainable Growth Rate (SGR) System
- This report discusses the Sustainable Growth Rate (SGR), which is the statutory method for determining the annual updates to the Medicare physician fee schedule. The SGR system was established because of the concern that the Medicare fee schedule itself would not adequately constrain overall increases in spending for physicians’ services.
- Medicare Physician Payment Updates and the Sustainable Growth Rate (SGR) System
- This report provides a background on the Medicare fee schedule, the Sustainable Growth Rate (SGR) system, and the annual updates and discusses recent proposals to address this issue.
- Health-Related Tax Expenditures: Overview and Analysis
- This report analyzes health-related tax expenditures together at the budget function level, rather than focusing on the size of any single provision. To provide some insights into common questions about health-related expenditures, this report analyzes historical data on health-related tax expenditure estimates published by the Joint Committee on Taxation (JCT).
- Self-Insured Health Insurance Coverage
- This report provides background information on private health insurance coverage, state and federal regulation of private coverage, and self-insured health plans. It includes data on the prevalence of self-insurance and discusses the employer decision to self-insure. Lastly, it describes selected private health insurance provisions under federal health reform, and application of such provisions on self-insured plans.
- Discretionary Spending Under the Affordable Care Act (ACA)
- This report examines the Affordable Care Act's (ACA's) effects on discretionary spending. It first discusses all the ACA authorizations (and reauthorizations) of appropriations for grant and other programs; this information, along with actual funding amounts, is summarized in a series of tables. The report then reviews the ACA administrative costs borne by CMS and the IRS.
- Finding Medicare Enrollment Statistics
- This report presents basic categories and definitions for terms related to Medicare enrollment data, a quick reference table that summarizes key data available in selected resources, and a more detailed overview of core resources.
- A Federal Pause in Potentially Risky Influenza Research
- This report briefly discusses a recently implemented federal research moratorium that has highlighted concerns about the general appropriateness of research on biological pathogens and the sufficiency of certain biosecurity efforts.
- Discretionary Spending Under the Affordable Care Act (ACA)
- The Patient Protection and Affordable Care Act (Affordable Care Act, or ACA) reauthorized funding for numerous existing discretionary grant programs administered by the Department of Health and Human Services (HHS). The ACA also created many new discretionary grant programs and provided for each an authorization of appropriations. Generally, the law authorized (or reauthorized) appropriations through FY2014 or FY2015. This report summarizes all the discretionary spending provisions in the ACA.
- Medicaid Coverage of Long-Term Services and Supports
- This report provides a description of the various statutory authorities that either require or otherwise allow states to cover LTSS under Medicaid. The Appendix provides a brief legislative history of Medicaid LTSS from Medicaid’s enactment and initial coverage requirements for institutional care through the evolution of HCBS options available to states.
- Eligibility and Determination of Health Insurance Premium Tax Credits and Cost-Sharing Subsidies: In Brief
- Certain individuals without access to subsidized health insurance coverage may be eligible for premium tax credits, as established under the Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended). This report examines these tax credits and their eligibility requirements, as well as cost-sharing subsidies.
- Abortion at or Over 20 Weeks' Gestation: Frequently Asked Questions
- This report provides answers to frequently asked questions concerning abortions that are performed in the second trimester of a woman's pregnancy because Congress and many state legislatures are considering legislation that would limit or ban abortions in midpregnancy. This report does not discuss constitutional or legal questions nor does it discusses differing state regulations regarding such abortions.
- Division A of H.R. 3922: The CHAMPIONING HEALTHY KIDS Act
- This report summarizes provisions in Division A of the CHAMPIONING HEALTHY KIDS Act that would extend funding for certain public health programs and provide offsets for these funding extensions. CRS Report R44989, Comparison of the Bills to Extend State Children's Health Insurance Program (CHIP) Funding, summarizes provisions in Division B.
- Bipartisan Budget Act of 2018 (P.L. 115-123): CHIP, Public Health, Home Visiting, and Medicaid Provisions in Division E
- This report provides information about the provisions from Division E of the Bipartisan Budget Act of 2018 (BBA 2018) related to CHIP, certain public health programs, the MIECHV program, and the Medicaid program.
- Health Insurance Premium Credits in the Patient Protection and Affordable Care Act (ACA) in 2015
- This report describes the eligibility criteria applicable to the premium tax credits and cost-sharing subsidies, and the calculation method for the credit and subsidy amounts. It also highlights selected issues addressed in the final regulation and guidance on premium credits and indicates the status of implementation, where relevant data is available.
- Contractors and HealthCare.gov: Answers to Frequently Asked Questions
- This report provides answers to 20 frequently asked questions regarding contractors and HealthCare.gov, the federal online health insurance portal called for by the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148, as amended). Over 50 contractors, including CGI Federal and Quality Software Services, Inc. (QSSI), helped in building the site, which was reportedly largely unusable when it first became available to the public on October 1, 2013.
- Provisions of the Senate Amendment to H.R. 3762
- This report includes a table listing all provisions in H.R. 3762 and the Senate amendment to H.R. 3762 that would amend or repeal Affordable Care Act (ACA) provisions. It also provides a brief explanation of the provisions included in the Senate Amendment to H.R. 3762.
- Health Benefits for Members of Congress and Designated Congressional Staff: In Brief
- This report discusses the health benefits for federal employees through the Federal Employees Health Benefits (FEHB) Program.
- Legislative Actions to Repeal, Defund, or Delay the Affordable Care Act
- This report a brief overview of the Affordable Care Act (ACA) and discusses the legislative process known as budget reconciliation in an effort to repeal parts of the ACA.
- Medicaid Financial Eligibility for Long-Term Services and Supports
- This report provides an overview of the financial requirements used for determining eligibility for Medicaid long-term services and supports (LTSS). It first provides background information on the Medicaid program, including general eligibility requirements. Then it describes federal statutes as well as selected regulations and guidance regarding these financial eligibility requirements, including rules related to spousal impoverishment, asset transfers, treatment of certain assets, post-eligibility treatment of income, and estate recovery.
- Legislative Actions in the 112th, 113th, and 114th Congresses to Repeal, Defund, or Delay the Affordable Care Act
- This report a brief overview of the Affordable Care Act (ACA), and discusses the legislative process known as budget reconciliation in an effort to repeal parts of the ACA.
- Public Health and Emergency Preparedness: CRS Experts
- This table provides access to names and contact information for CRS experts on policy concerns relating to public health and emergency preparedness.
- Congress Faces Calls to Address Expiring ACA Appropriations
- This report discusses the Affordable Care Act (ACA), enacted in March 2010, which appropriated billions of dollars of mandatory funds to support grant programs and other activities authorized by the law.
- Extensively Drug-Resistant Tuberculosis (XDR-TB): Emerging Public Health Threats and Quarantine and Isolation
- This report the international saga of Andrew Speaker, a traveler thought to have XDR-TB, a drug-resistant form of tuberculosis, placed a spotlight on existing mechanisms to contain contagious disease threats and raised numerous legal and public health issues. It also discusses the application of various public health measures available to contain an emerging public health threat posed by an individual who ignores medical advice and attempts to board an airplane or take other forms of public transportation.