Congressional Research Service Reports - 556 Matching Results

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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.
Medicare Financial Status: In Brief: This report provides an overview on Medicare, discussing its various components and sources of funding. It also examines projections for spending within the program.
The Affordable Care Act's (ACA) Employer Shared Responsibility Determination and the Potential Employer Penalty: This report describes potential employer penalties 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.
Private Health Insurance Market Reforms in the Patient Protection and Affordable Care Act (ACA): This report provides background information about the private health insurance market, including market segments and regulation. It then describes each ACA market reform, grouped under the following categories: obtaining coverage, keeping coverage, cost of purchasing coverage, covered services, cost-sharing limits, consumer assistance and other health care protections, and plan requirements related to health care providers.
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.
Consumer Operated and Oriented Plan (CO-OP) Program: Frequently Asked Questions: This report addresses frequently asked questions regarding the Consumer Operated and Oriented Plan (CO-OP) program, which was established under the Patient Protection and Affordable Care Act and aims to foster the creation of CO-OPs--nonprofit, member-run health insurance issuers that sell health plans in states in which they are licensed.
Health Care Spending: Context and Policy: This report seeks to put health spending in context. Health care costs and spending are persistent concerns for the Congress. On one hand, policymakers worry about access to care and the burden of health costs on household and employer budgets. On the other hand, rising costs put growing pressure on the federal budget from Medicare, Medicaid, and tax expenditures for private health insurance.
Excise Tax on High-Cost Employer-Sponsored Health Coverage: In Brief: This report provides an overview of the excise tax. The report includes cost estimates for the excise tax and explores the excise tax's relationship with the tax advantages for employer-sponsored health coverage. The information in this report is based on statute and two notices issued by the Department of the Treasury (Treasury) and the Internal Revenue Service (IRS).
Medicare: Enrollment in Medicare Drug Plans: This report discusses the enrollment process for private prescription drug plans (PDPs) or Medicare Advantage prescription drug (MA-PD) plans. At a minimum, these plans offer "standard coverage" or alternative coverage with actuarially equivalent benefits. Beneficiaries are required to enroll in one of these private plans in order to obtain coverage.
Medicare Prescription Drug Proposals: Estimates of Aged Beneficiaries Who Fall Below Income Criteria, by State: This report discusses bills related to Medicare benefits, which include additional assistance for low-income beneficiaries. The assistance would have been in the form of reduced, subsidized or eliminated premiums, deductibles and other cost-sharing. Proposals in the 108th Congress will probably also include some of these features for low-income beneficiaries.
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.
U.S. and International Responses to the Global Spread of Avian Flu: Issues for Congress: This report will provide an account of global H5N1-related human infections and deaths, outline U.S. government and international responses to the global spread of H5N1, discuss situations in various countries affected by H5N1, and present some foreign policy issues for Congress.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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).
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.
The Health Insurance Portability and Accountability Act (HIPAA) of 1996: Overview and Guidance on Frequently Asked Questions: The Health Insurance Portability and Accountability Act of 1996 guarantees the availability and renewability of health insurance coverage for certain individuals. It permits a limited number of small businesses and self-employment individuals to establish tax-favored medical savings accounts, increases the tax deduction for health insurance for the self-employed, and amends the Internal Revenue Code to treat private long-term care policies the way health insurance policies and health care expenses are currently treated.
AIDS: Ryan White CARE Act: This report discusses the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, which makes federal funds available to metropolitan areas and states to assist in health care costs and support services for individuals and families affected by the human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS). This report discusses related legislation and appropriations.
Prescription Drug Coverage Under Medicaid: Medicaid is a joint federal-state entitlement program that pays for medical services on behalf of certain groups of low-income persons. It is the third largest social program in the federal budget, exceeded only by Social Security and Medicare and is typically the second largest spending item for states. This report discusses prescription drug policies under the program.
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.
AIDS: The Ryan White CARE Act: This report discusses the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, which makes federal funds available to metropolitan areas and states to assist in health care costs and support services for individuals and families affected by the human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS). This report discusses related legislation and appropriations.
AIDS: The Ryan White CARE Act: This report discusses the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, which makes federal funds available to metropolitan areas and states to assist in health care costs and support services for individuals and families affected by the human immunodeficiency virus (HIV) or acquired immune deficiency syndrome (AIDS). This report discusses related legislation and appropriations.
Medicare: Enrollment in Medicare Drug Plans: This report discusses the enrollment process for private prescription drug plans (PDPs) or Medicare Advantage prescription drug (MA-PD) plans. At a minimum, these plans offer "standard coverage" or alternative coverage with actuarially equivalent benefits. Beneficiaries are required to enroll in one of these private plans in order to obtain coverage.
Medicaid Citizenship Documentation: Due to recent changes in federal law, individuals who declare that they are citizens for Medicaid eligibility purposes must present documentation that proves citizenship and documents personal identity. This report discusses issues related to Medicaid citizenship documentation that have received considerable media and interest group attention, as well as proposed legislation that would affect the requirement.
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
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.
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.
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.
Health Insurance Coverage for Retirees: With the retirement of the baby boom generation looming ahead, employers offering coverage to their retired workers will face a huge future financial commitment. Some employers have already reduced or eliminated their commitment to insure their retirees. Recent trends indicate that retiree health benefits are increasingly subject to higher beneficiary cost-sharing. Further, among employers who provide health insurance for current retirees, their current workers are less likely to be guaranteed these benefits upon retirement. This report discusses issues regarding health insurance coverage for retirees.
Medicaid and SCHIP: The President’s FY2006 Budget Proposals: This report describes the proposal and provides an estimate of the cost or savings based on publicly available information. The report provides a brief background for the proposal and provides a listing of current Congressional Research Service (CRS) reports related to the proposal.
Prescription Drug Coverage Under Medicaid: Medicaid is a joint federal-state entitlement program that pays for medical services on behalf of certain groups of low-income persons. It is the third largest social program in the federal budget, exceeded only by Social Security and Medicare and is typically the second largest spending item for states. This report discusses prescription drug policies under the program.
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.
Tax Benefits for Health Insurance and Expenses: Overview of Current Law and Legislation: This report discusses how tax policy affects health insurance and health care spending.
Medicare Home Health Benefit Primer: Benefit Basics and Issues: This report describes home health eligibility criteria, home health services, characteristics of Medicare beneficiaries who use home health services, and home health providers. Further, this report describes in detail the Medicare home health prospective payment system (HH PPS), provides an overview of Medicare home health payments, and discusses issues for Congress related to the Medicare home health benefit.
Medicaid Issues for the 109th Congress: Medicaid is jointly financed by the federal and state governments, but each state designs and administers its own state program under broad federal guidelines. Accordingly, state variation in eligibility, covered services, and the delivery of, and reimbursement for, services is the rule rather than the exception. How is Congress to respond to the numerous proposals to move Medicaid forward into the near and long term? This report lays out some of these issues, explains the factors underlying them, and provides links to CRS products that can help Members of Congress and their staff prepare to discuss Medicaid’s role today and into the future.
Medicare: Selected Prescription Drug Proposals in the 107th Congress: Medicare, the nationwide health insurance program for the aged and disabled, does not cover most outpatient prescription drugs. On several occasions, the Congress has considered providing coverage for at least a portion of beneficiaries’ drug costs. The issue received renewed attention in the 106th Congress. However, there was no consensus on how the coverage should be structured. This report provides a side-by-side comparison of bills introduced in the 107th Congress that have received the most attention.
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.
Health Professions Programs in Title VII and Title VIII of the Public Health Service Act: Appropriations History (FY2002-FY2009): The health professions programs in Titles VII and VIII of the Public Health Service Act provides grants, scholarships, and loans to support institutions and individuals in the education and training of health professional and the nursing workforce. This report contains information on Title VII Health Professional Education Appropriations, Title VIII Nursing Workforce Development Appropriations, and related information.
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.
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.
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.

Congressional Research Service Reports - 556 Matching Results

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