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 Decade: 2010-2019
 Collection: Congressional Research Service Reports
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). digital.library.unt.edu/ark:/67531/metadc503456/
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). digital.library.unt.edu/ark:/67531/metadc463057/
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. digital.library.unt.edu/ark:/67531/metadc86569/
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. digital.library.unt.edu/ark:/67531/metadc227797/
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. digital.library.unt.edu/ark:/67531/metadc743516/
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. digital.library.unt.edu/ark:/67531/metadc795587/
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. digital.library.unt.edu/ark:/67531/metadc491520/
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. digital.library.unt.edu/ark:/67531/metadc490863/
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. digital.library.unt.edu/ark:/67531/metadc462816/
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. digital.library.unt.edu/ark:/67531/metadc501495/
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. digital.library.unt.edu/ark:/67531/metadc503565/
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. digital.library.unt.edu/ark:/67531/metadc503374/
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. digital.library.unt.edu/ark:/67531/metadc503381/
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. digital.library.unt.edu/ark:/67531/metadc227685/
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). digital.library.unt.edu/ark:/67531/metadc824709/
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. digital.library.unt.edu/ark:/67531/metadc824419/
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. digital.library.unt.edu/ark:/67531/metadc822555/
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. digital.library.unt.edu/ark:/67531/metadc821668/
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. digital.library.unt.edu/ark:/67531/metadc812033/
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. digital.library.unt.edu/ark:/67531/metadc822356/
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. digital.library.unt.edu/ark:/67531/metadc822646/
The Affordable Care Act and Small Business: Economic Issues
This report explains how employer-sponsored insurance can be used to address concerns about health insurance coverage and cost. Then, it summarizes the three ACA provisions most relevant to small businesses. Also, it analyzes these provisions for their potential effects on small businesses. Last, this report presents several approaches that could address some concerns associated with these provisions (particularly the employer penalty). digital.library.unt.edu/ark:/67531/metadc282333/
Treating Ebola Patients in the United States: Health Care Delivery Implications
This report discusses the recent response to Ebola patients in the United States. While the U.S. health care system has the resources to effectively identify and treat Ebola cases, a situation that is novel, emergent, and resource-intensive may test the system's ability to effectively mobilize those resources. digital.library.unt.edu/ark:/67531/metadc491297/
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. digital.library.unt.edu/ark:/67531/metadc491389/
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. digital.library.unt.edu/ark:/67531/metadc491500/
Beverage Industry Pledges to Reduce Americans' Drink Calories
This report briefly covers recent initiatives by leading beverage companies to curb the obesity epidemic. digital.library.unt.edu/ark:/67531/metadc461921/
Ebola: Selected Legal Issues
Several West African countries are currently grappling with an unprecedented outbreak of Ebola virus disease (EVD). Here in the United States, where Ebola is not endemic, a handful of EVD cases have been diagnosed, and domestic transmission of the virus has occurred in only two cases to date. This report provides a brief overview of selected legal issues regarding measures to prevent transmission of Ebola virus and the civil rights of individuals affected by the disease. digital.library.unt.edu/ark:/67531/metadc501695/
The Affordable Care Act and Small Business: Economic Issues
This report explains how employer-sponsored insurance can be used to address concerns about health insurance coverage and cost. Then, it summarizes the three Affordable Care Act (ACA) provisions most relevant to small businesses. Also, it analyzes these provisions for their potential effects on small businesses. Last, this report presents several approaches that could address some concerns associated with these provisions (particularly the employer penalty). digital.library.unt.edu/ark:/67531/metadc501935/
Health Coverage Tax Credit
The report describes the expired eligibility criteria, as well as the types of health insurance to which the tax credit may have been applied. It discusses past federal and state roles in administering the HCTC program, and it summarizes analyses on the credit's effectiveness in reaching targeted populations and related equity and efficiency issues. In addition, the report includes a short discussion of relevant current law and summarizes statutory history of the HCTC program. digital.library.unt.edu/ark:/67531/metadc505481/
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. digital.library.unt.edu/ark:/67531/metadc503513/
Medicaid Financing and Expenditures
This report provides an overview of Medicaid’s financing structure, including both federal and state financing issues. The Medicaid expenditures section of the report discusses economic factors affecting Medicaid, state variability in spending, and projected program spending. Other issues that are examined include congressional proposals to turn Medicaid into a block grant program, federal deficit reduction proposals affecting Medicaid, and state fiscal conditions affecting Medicaid financing and services. digital.library.unt.edu/ark:/67531/metadc99074/
The Affordable Care Act and Small Business: Economic Issues
This report explains how employer-sponsored insurance can be used to address concerns about health insurance coverage and cost. Then, it summarizes the three ACA provisions most relevant to small businesses. Also, it analyzes these provisions for their potential effects on small businesses. Last, this report presents several approaches that could address some concerns associated with these provisions (particularly the employer penalty). digital.library.unt.edu/ark:/67531/metadc227906/
TRICARE and VA Health Care: Impact of the Patient Protection and Affordable Care Act (PPACA)
This report addresses key questions concerning how the Patient Protection and Affordable Care Act (PPACA) affects TRICARE and VA health care. digital.library.unt.edu/ark:/67531/metadc103091/
U.S. Response to the Global Threat of Malaria: Basic Facts
This report outlines basic facts related to global malaria, including characteristics of the epidemic and U.S. legislation, programs, funding, and partnerships related to the global response to malaria. digital.library.unt.edu/ark:/67531/metadc93862/
U.S. Response to the Global Threat of Malaria: Basic Facts
This report outlines basic facts related to global malaria, including characteristics of the epidemic and U.S. legislation, programs, funding, and partnerships related to the global response to malaria. digital.library.unt.edu/ark:/67531/metadc103130/
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. digital.library.unt.edu/ark:/67531/metadc103069/
Post-Traumatic Stress Disorder and Other Mental Health Problems in the Military: Oversight Issues for Congress
This report discusses the prevalence of different psychological health concerns within the Armed Forces, current mental health screening and treatments, and DOD responses. digital.library.unt.edu/ark:/67531/metadc227900/
The Affordable Care Act's (ACA) Employer Shared Responsibility Determination and the Potential ACA Employer Penalty
This report describes the potential employer penalties related to the Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) as well as regulations to implement the ACA employer provisions. The regulations address insurance coverage requirements, methodologies for determining whether a worker is considered full time, provisions relating to seasonal workers and corporate franchises, and other reporting requirements. digital.library.unt.edu/ark:/67531/metadc743623/
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. digital.library.unt.edu/ark:/67531/metadc824795/
The Health Coverage Tax Credit (HCTC): In Brief
This report describes the eligibility criteria for the Health Coverage Tax Credit (HCTC) and the types of health insurance to which the tax credit may be applied. The tax credit's purpose is to make the purchase of health insurance more affordable for eligible individuals. The HCTC has a sunset date of January 1, 2020. The report also briefly describes the administration of the HCTC program and receipt of the credit by eligible taxpayers; it concludes with a summary of the HCTC's statutory history. digital.library.unt.edu/ark:/67531/metadc824691/
The Use of Modified Adjusted Gross Income (MAGI) in Federal Health Programs
This report explores how modified adjusted gross income (MAGI) is defined differently across health programs such as Medicare, the health insurance exchanges under the Affordable Care Act (ACA), and Medicaid. It also discusses why MAGI is used, and how it is applied, specific to each program. The report covers that MAGI is used to determine (1) penalty amounts owed if a person does not comply with the individual mandate or whether an individual is exempt from the individual mandate; (2) eligibility for and the amount of a premium credit to purchase coverage through a health insurance exchange; and (3) Medicaid income eligibility for certain populations. digital.library.unt.edu/ark:/67531/metadc824590/
Requiring Individuals to Obtain Health Insurance: A Constitutional Analysis
This report discusses the Patient Protection and Affordable Care Act (ACA), P.L. 111-148, as amended, Congress enacted a “minimum coverage provision,” which compels certain individuals to have a minimum level of health insurance. This report provides an analysis of the constitutionality of this provision requiring individuals to obtain health insurance. digital.library.unt.edu/ark:/67531/metadc821696/
Public Health, Workforce, Quality, and Related Provisions in H.R. 3590, as Passed by the Senate
This report summarizes the workforce, prevention, quality, and related provisions in H.R. 3590, as passed by the Senate. It begins with some background on health care delivery reform, followed by an overview of the report’s content and organization digital.library.unt.edu/ark:/67531/metadc821682/
Centers for Medicare & Medicaid Services (CMS) Proposed Rule on Medicaid Managed Care: Frequently Asked Questions
This report responds to a series of frequently asked questions (FAQs) identified to address some of the major updates included in the proposed rule. The FAQs summarize provisions such as the introduction of a minimum medical loss ratio (MLR), guidance on enrolling the long-term services and supports (LTSS) population in managed care, and network adequacy. digital.library.unt.edu/ark:/67531/metadc822604/
Requiring Individuals to Obtain Health Insurance: A Constitutional Analysis
This report first analyzes the authority of Congress to enact the minimum essential coverage requirement contained in Patient Protection and Affordable Care Act (PPACA), as well as how a court might analyze this provision if challenged based on various provisions of the Fifth and Tenth Amendments. This report discusses whether there must be exceptions to a requirement to purchase health insurance based on First Amendment freedom of religion, and finally, discusses some of the legal challenges to this federal requirement. digital.library.unt.edu/ark:/67531/metadc806315/
Community Living Assistance Services and Supports (CLASS) Provisions in the Patient Protection and Affordable Care Act (PPACA)
This report first discusses the cost and financing for long-term care (LTC) services as well as the current market for private LTC insurance. It then details those CLASS program requirements for enrollment, premiums, eligibility, benefits, administration, and oversight. The report also discusses federal budget implications, as estimated by the Congressional Budget Office (CBO) and the Centers for Medicare and Medicaid Services (CMS). Finally, the report provides a timeline of the CLASS program provisions enacted under PPACA. digital.library.unt.edu/ark:/67531/metadc822373/
Requiring Individuals to Obtain Health Insurance: A Constitutional Analysis
This report first analyzes the authority of Congress to enact the minimum essential coverage requirement contained in the Patient Protection and Affordable Care Act (PPACA), as well as how a court might analyze this provision if challenged based on various provisions of the Fifth and Tenth Amendments. This report discusses whether there must be exceptions to a requirement to purchase health insurance based on First Amendment freedom of religion, and finally, discusses some of the legal challenges to this federal requirement. digital.library.unt.edu/ark:/67531/metadc815463/
Requiring Individuals to Obtain Health Insurance: A Constitutional Analysis
This report first analyzes the authority of Congress to pass a law of this nature, as well as how a court could analyze this provision in light of a constitutional challenge based on various provisions of the Fifth and Tenth Amendments. Finally, this report discusses whether the exceptions to the individual responsibility requirement to purchase health insurance satisfy First Amendment freedom of religion protections. digital.library.unt.edu/ark:/67531/metadc820533/
Medical Child Support: Background and Current Policy
This report describes current federal policy with respect to medical child support. It also examines the potential impact of the Affordable Care Act (ACA) on the Child Support Enforcement (CSE) program. It provides a legislative history of medical support provisions in the CSE program and state data on the medical support coverage of children in the CSE program. digital.library.unt.edu/ark:/67531/metadc272041/
Overview of Health Care Changes in the FY2015 House Budget
This report summarizes the proposed changes to Medicare, Medicaid, and private health insurance as described in H.Con.Res. 96 and accompanying documents, including the committee report and Chairman Ryan's Path to Prosperity report. digital.library.unt.edu/ark:/67531/metadc287964/
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