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 Country: United States
 Collection: Congressional Research Service Reports
Health Care Spending: Past Trends and Projections
This report focuses on trends in personal health care spending, which includes spending on health care goods and services provided to individuals and excludes expenditures for administrative costs, research, and public health activities. Personal health care expenditures have grown considerably over the past 40 years. It is estimated that personal health spending will exceed $2.9 trillion in 2013. digital.library.unt.edu/ark:/67531/metadc824772/
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/
Puerto Rico and Health Care Finance: Frequently Asked Questions
This report provides answers to frequently asked questions (FAQs) about how federal health care programs and requirements are implemented in Puerto Rico, including information about eligibility, coverage, program requirements, and payment rules. Examples provided in the FAQs illustrate that in many circumstances, some health programs in Puerto Rico differ from programs in the US, while in other circumstances, Puerto Rico is treated the same as the states. As such, these questions and answers should be viewed as a discussion of the complexity of health care financing as it relates to Puerto Rico under current law. digital.library.unt.edu/ark:/67531/metadc824672/
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/
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/
Medicare Structural Reform: Background and Options
THis report provides a brief overview of major issues underlying the debate about possible structural reforms or improvements to the current Medicare system. Medicare is a nationwide health insurance program for the aged and certain disabled persons. digital.library.unt.edu/ark:/67531/metadc824714/
Implications of the Medicare Prescription Drug Benefit for Dual Eligibles and State Medicaid Programs
This report discusses the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA, P.L. 108-173), which added a new Medicare prescription drug benefit, implemented in January 2006. This report focuses on MMA provisions that added a voluntary prescription drug benefit under a new Medicare Part D, and the effect of this new benefit both on individuals who are dually eligible for Medicaid and Medicare, and on state Medicaid programs. digital.library.unt.edu/ark:/67531/metadc824753/
Use of the Annual Appropriations Process to Block Implementation of the Affordable Care Act (FY2011-FY2016)
This report summarizes the language related to the Affordable Care (ACA) that was added to annual appropriations legislation by congressional appropriators since the ACA was signed into law. The information is presented in a table. While a detailed examination of the ACA itself is beyond the scope of this report, a brief overview of the ACA's core provisions and its impact on federal spending is provided as context for the material in the table. Congress remains deeply divided over implementation of the Affordable Care Act (ACA), which President Obama signed into law in March 2010. digital.library.unt.edu/ark:/67531/metadc824565/
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/
Tax Benefits for Health Insurance: Current Legislation
This report discusses a variety of potential proposals to change the tax benefits for health insurance and medical expenses, including measures that would expand the availability and attractiveness of health savings accounts (HSAs), or employer tax credits. digital.library.unt.edu/ark:/67531/metadc824518/
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/
The Ebola Outbreak: Quarantine and Isolation Authority
This legal sidebar discusses recent quarantine policies announced by several states, including New York and New Jersey, for travelers arriving from areas affected by the outbreak of Ebola Virus Disease, which have raised legal and constitutional questions about federal and state authority to order quarantine and isolation measures. digital.library.unt.edu/ark:/67531/metadc824427/
Military Medical Care Services: Questions and Answers
This report attempts to answer basic questions about the Military Health Services System (MHSS), its beneficiary population, the medical services it provides, its costs, and major changes that are underway or have been proposed. Citations are made to more detailed CRS studies where appropriate. digital.library.unt.edu/ark:/67531/metadc824459/
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/
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/
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/
Medicaid Expenditures, FY2003 and FY2004
This report discusses the federal medical assistance percentage (FMAP), which is the percentage of Medicaid benefit costs paid for by the federal government. digital.library.unt.edu/ark:/67531/metadc822569/
Medicaid and CHIP Maintenance of Effort (MOE): Requirements and Responses
This report summarizes the MOE requirements enacted under American Recovery and Reinvestment Act of 2009 and the Patient Protection and Affordable Care Act as modified by the Health Care and Education Reconciliation Act of 2010 and what these requirements have meant for states in terms of their actions to restrict Medicaid and/or CHIP eligibility. It also summarizes recent legislative activity to repeal the MOE requirements. digital.library.unt.edu/ark:/67531/metadc822572/
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/
Transitional Medical Assistance (TMA) Under Medicaid
This report provides an overview of transitional medical assistance (TMA). While Section 1925 of the Social Security Act outlines the provisions requiring states to provide TMA for up to 12 months, states have considerable flexibility in designing and implementing their TMA programs. digital.library.unt.edu/ark:/67531/metadc822344/
Hurricane Katrina: Medicaid Issues
This report discusses the following: Medicaid’s rules on eligibility, benefits, and financing in the context of current questions and issues raised by Hurricane Katrina. Recent state actions in response to Medicaid issues raised by the hurricane. Federal Medicaid waiver authority, including information on current activity in this area and the New York Disaster Relief Medicaid waiver granted in response to the September 11 terrorist attacks. Current federal legislation related to Medicaid and Hurricane Katrina relief efforts. digital.library.unt.edu/ark:/67531/metadc822601/
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/
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/
Mental Health Parity and the Patient Protection and Affordable Care Act of 2010
This report provides a brief background on mental health parity and the policy discussion around parity in health insurance coverage; an overview of federal mental health parity law prior to the enactment of the ACA; and an analysis of the impact of the ACA. digital.library.unt.edu/ark:/67531/metadc810015/
Mental Health Parity and the Patient Protection and Affordable Care Act of 2010
This report provides a brief background on mental health parity and the policy discussion around parity in health insurance coverage; an overview of federal mental health parity law prior to the enactment of the ACA; and an analysis of the impact of the ACA. digital.library.unt.edu/ark:/67531/metadc822647/
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/
Requiring Individuals to Obtain Health Insurance: A Constitutional Analysis
This report first analyzes the authority of Congress to pass a proposal of this nature, as well as how a court could analyze this type of proposal if there were to be a constitutional challenge based on various provisions of the Fifth Amendment. Finally, this report discusses whether there must be exceptions to a requirement to purchase health insurance based on First Amendment freedom of religion. digital.library.unt.edu/ark:/67531/metadc822651/
Long-Term Care (LTC): Financing Overview and Issues for Congress
This report provides an overview of long-term care (LTC) and an explanation of the nation’s complex financing system of public and private payers. It also describes some of the major challenges facing Congress as it contemplates LTC reform and whether and how to include LTC in health reform legislation. digital.library.unt.edu/ark:/67531/metadc820874/
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. digital.library.unt.edu/ark:/67531/metadc820963/
Military Medical Care: Questions and Answers
This report answers several frequently-asked questions about military health care, particularly related to TRICARE and its various aspects. digital.library.unt.edu/ark:/67531/metadc795652/
Medicaid and Schools
This report discusses the recent history and current issues facing Medicaid funding for certain health related costs under the Individuals with Disabilities Education Act (IDEA). digital.library.unt.edu/ark:/67531/metadc795504/
Puerto Rico and Health Care Finance: Frequently Asked Questions
This report provides answers to frequently asked questions (FAQs) about Puerto Rico's health care system, including how federal health care programs (Medicare, Medicaid, and the State Children's Health Insurance Program [CHIP]) and private health insurance requirements apply to Puerto Rico. digital.library.unt.edu/ark:/67531/metadc795577/
Medicaid: The Federal Medical Assistance Percentage (FMAP)
This report examines the formula that determines the federal government's share of Medicaid costs for most services, which is established in statute; states must contribute the remaining portion of costs in order to qualify for federal funds. digital.library.unt.edu/ark:/67531/metadc795540/
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/
Medicare Advantage
This report is an overview of the Medicare Advantage (MA) program, an alternative way for Medicare beneficiaries to receive covered benefits, and includes legislative history and analysis of recent trends. digital.library.unt.edu/ark:/67531/metadc795844/
Use of the Annual Appropriations Process to Block Implementation of the Affordable Care Act (FY2011-FY2016)
This report summarizes the Patient Protection and Affordable Care act (ACA)-related language added to annual appropriations legislation by congressional appropriators since the ACA was signed into law. digital.library.unt.edu/ark:/67531/metadc795341/
Medicaid and Graduate Medical Education
This report discusses Medicaid coverage of graduate medical education (GME) costs. GME costs are difficult to determine because teaching occurs in the context of patient care and research. There are direct GME (DGME) costs, which include residents' stipends, payments to supervising physicians, and direct program administration costs. digital.library.unt.edu/ark:/67531/metadc795441/
Potential Impact of No Social Security COLA on Medicare Part B Premiums in 2016
This report provides an overview of Medicare Part B premiums, the relationship between the Social Security cost-of-living increase (COLA) and Part B premiums, and the potential impact of a projected 0% Social Security COLA in 2016 on Medicare premiums, based on recent projections by the Medicare Trustees. digital.library.unt.edu/ark:/67531/metadc795920/
The Ryan White HIV/AIDS Program: Overview and Impact of the Affordable Care Act
This report discusses the impact of the Affordable Care Act on the Ryan White HIV/AIDS Program, which makes federal funds available to metropolitan areas and states to that provide a number of health care services for HIV/AIDS patients. digital.library.unt.edu/ark:/67531/metadc795903/
Public Health Service Agencies: Overview and Funding (FY2010-FY2016)
This report gives a brief overview of the eight agencies within the Department of Health and Human Services (HHS) which are designated components of the U.S. Public Health Services (PHS), and summarizes its funding for FY2010 through FY2016. digital.library.unt.edu/ark:/67531/metadc795421/
Potential Policy Implications of the House Reconciliation Bill (H.R. 3762)
This report provides background on the reconciliation process and summarizes the provisions in the Restoring Americans' Healthcare Freedom Reconciliation Act of 2015 (H.R. 3762), including their projected budgetary impact. It then briefly examines some of the bill's policy implications. digital.library.unt.edu/ark:/67531/metadc795707/
Title X (Public Health Service Act) Family Planning Program
This report looks at several bills addressing the Family Planning Program (Title X of the Public Health Service Act) which have been introduced in the 112th Congress, including: funding for abortion-providing entities, elimination of the program, and prohibitions on government spending for the program. digital.library.unt.edu/ark:/67531/metadc770560/
The Patient Protection and Affordable Care Act's Essential Health Benefits (EHB)
This report provides an overview of the first component of the essential health benefits (EHB) package--a core package of health care services required by the Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) for non-group and small-group private health insurance markets. The report examines how the EHB are defined, regulations related to the EHB, state variation in the EHB, applicability of the EHB to health plans, and how the EHB interact with other ACA provisions. digital.library.unt.edu/ark:/67531/metadc770537/
Military Medical Care: Questions and Answers
This report answers several frequently-asked questions about military health care, including: how the system is structured, a TRICARE summary, TRICARE eligibility and plan options, cost of military health care to beneficiaries, relationship of TRICARE to MEDICARE, how the Affordable Care Act affects TRICARE, long-term trends of defense health care costs, and a summary of the fund which funds TRICARE (the Medicare Eligible Retiree Health Care fund). digital.library.unt.edu/ark:/67531/metadc770600/
The Health Information Technology for Economic and Clinical Health (HITECH) Act
This report provides a summary and explanation of the provisions in the HITECH Act, which is intended to promote the widespread adoption of health information technology (HIT) for the electronic sharing of clinical data among hospitals, physicians, and other health care stakeholders. It gives an overview of prior actions taken by Congress and the Administrations to promote HIT, and briefly describes efforts by the 109th and 110th Congresses to enact comprehensive HIT legislation. digital.library.unt.edu/ark:/67531/metadc743451/
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