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 Collection: Congressional Research Service Reports
Health Care Spending: Past Trends and Projections

Health Care Spending: Past Trends and Projections

Date: April 8, 2004
Creator: Morgan, Paulette C.
Description: 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.
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Provisions of the Senate Amendment to H.R. 3762

Provisions of the Senate Amendment to H.R. 3762

Date: February 1, 2016
Creator: Mach, Annie L.
Description: 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.
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The Health Coverage Tax Credit (HCTC): In Brief

The Health Coverage Tax Credit (HCTC): In Brief

Date: February 18, 2016
Creator: Fernandez, Bernadette
Description: 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.
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Health-Related Tax Expenditures: Overview and Analysis

Health-Related Tax Expenditures: Overview and Analysis

Date: January 8, 2016
Creator: Lowry, Sean
Description: 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).
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Medicare Structural Reform: Background and Options

Medicare Structural Reform: Background and Options

Date: January 28, 2003
Creator: Chaikind, Hinda R.; O'Sullivan, Jennifer & Boulanger, Jennifer
Description: 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.
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Implications of the Medicare Prescription Drug Benefit for Dual Eligibles and State Medicaid Programs

Implications of the Medicare Prescription Drug Benefit for Dual Eligibles and State Medicaid Programs

Date: January 19, 2006
Creator: Tritz, Karen
Description: 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.
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Use of the Annual Appropriations Process to Block Implementation of the Affordable Care Act (FY2011-FY2016)

Use of the Annual Appropriations Process to Block Implementation of the Affordable Care Act (FY2011-FY2016)

Date: January 5, 2016
Creator: Redhead, C. S. & Cornell, Ada S.
Description: 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.
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The Use of Modified Adjusted Gross Income (MAGI) in Federal Health Programs

The Use of Modified Adjusted Gross Income (MAGI) in Federal Health Programs

Date: February 25, 2016
Creator: Baumrucker, Evelyne P.; Davis, Patricia A.; Fernandez, Bernadette; Mach, Annie L. & Pettit, Carol A.
Description: 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.
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Tax Benefits for Health Insurance: Current Legislation

Tax Benefits for Health Insurance: Current Legislation

Date: February 6, 2006
Creator: Lyke, Bob
Description: 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.
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Discretionary Spending Under the Affordable Care Act (ACA)

Discretionary Spending Under the Affordable Care Act (ACA)

Date: January 13, 2016
Creator: Redhead, C. Stephen; Colello, Kirsten J.; Heisler, Elayne J.; Lister, Sarah A. & Sarata, Amanda K.
Description: 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.
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The Ebola Outbreak: Quarantine and Isolation Authority

The Ebola Outbreak: Quarantine and Isolation Authority

Date: October 28, 2014
Creator: unknown
Description: 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.
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Military Medical Care Services: Questions and Answers

Military Medical Care Services: Questions and Answers

Date: January 26, 2005
Creator: Best, Richard A., Jr.
Description: 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.
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Puerto Rico and Health Care Finance: Frequently Asked Questions

Puerto Rico and Health Care Finance: Frequently Asked Questions

Date: February 3, 2016
Creator: Mach, Annie L.
Description: 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.
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Requiring Individuals to Obtain Health Insurance: A Constitutional Analysis

Requiring Individuals to Obtain Health Insurance: A Constitutional Analysis

Date: April 6, 2012
Creator: Staman, Jennifer; Brougher, Cynthia; Liu, Edward C.; Lunder, Erika K. & Thomas, Kenneth R.
Description: 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.
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Medicare Physician Payment Updates and the Sustainable Growth Rate (SGR) System

Medicare Physician Payment Updates and the Sustainable Growth Rate (SGR) System

Date: February 15, 2013
Creator: Hahn, Jim & Janemarie Mulvey
Description: 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.
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Medicare Physician Payment Updates and the Sustainable Growth Rate (SGR) System

Medicare Physician Payment Updates and the Sustainable Growth Rate (SGR) System

Date: December 27, 2011
Creator: Hahn, Jim & Mulvey, Janemarie
Description: 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.
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Public Health, Workforce, Quality, and Related Provisions in H.R. 3590, as Passed by the Senate

Public Health, Workforce, Quality, and Related Provisions in H.R. 3590, as Passed by the Senate

Date: March 1, 2010
Creator: Redhead, C. Stephen & Williams, Erin D.
Description: 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
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Medicaid Expenditures, FY2003 and FY2004

Medicaid Expenditures, FY2003 and FY2004

Date: January 17, 2006
Creator: Tritz, Karen
Description: This report discusses the federal medical assistance percentage (FMAP), which is the percentage of Medicaid benefit costs paid for by the federal government.
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Medicaid and CHIP Maintenance of Effort (MOE): Requirements and Responses

Medicaid and CHIP Maintenance of Effort (MOE): Requirements and Responses

Date: May 25, 2011
Creator: Baumrucker, Evelyne P.
Description: 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.
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Self-Insured Health Insurance Coverage

Self-Insured Health Insurance Coverage

Date: June 25, 2010
Creator: Fernandez, Bernadette
Description: 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.
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Self-Insured Health Insurance Coverage

Self-Insured Health Insurance Coverage

Date: May 12, 2010
Creator: Fernandez, Bernadette
Description: 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.
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Transitional Medical Assistance (TMA) Under Medicaid

Transitional Medical Assistance (TMA) Under Medicaid

Date: July 24, 2008
Creator: Grady, April
Description: 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.
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Hurricane Katrina: Medicaid Issues

Hurricane Katrina: Medicaid Issues

Date: November 18, 2005
Creator: Baumrucker, Evelyne P; Grady, April; Hearne, Jean P & Herz, Elicia J
Description: 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.
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Centers for Medicare & Medicaid Services (CMS) Proposed Rule on Medicaid Managed Care: Frequently Asked Questions

Centers for Medicare & Medicaid Services (CMS) Proposed Rule on Medicaid Managed Care: Frequently Asked Questions

Date: July 15, 2015
Creator: Blom, Kirstin B.
Description: 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.
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