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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.
Health Insurance Exchanges Under the Patient Protection and Affordable Care Act (ACA)
This report outlines the required minimum functions of state health insurance exchanges and explains how exchanges are expected to be established and administered under the Patient Protection and Affordable Care Act (ACA). The coverage offered through exchanges is discussed, and the report concludes with a discussion of how exchanges will interact with selected other ACA provisions.
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.
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.
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.
U.S. Response to the Global Threat of Tuberculosis: Basic Facts
Tuberculosis (TB) is one of the most widespread infectious diseases in the world, infecting an average of 9 million people annually. Although TB is curable, more than 1 million TB-related deaths occur each year. Due in part to a growing global response to TB, progress has been made in combating the disease. Globally, new TB infection rates have begun to slowly decline and TB mortality rates have decreased significantly since 1990. At the same time, absolute numbers of people infected with TB, particularly in Asia and Africa, continue to rise. Congress has recognized TB as an important humanitarian issue and increasingly as a potential threat to global security. In its second session, the 112th Congress will likely debate the appropriate funding levels and optimum strategy for addressing the continued challenge of global TB.
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.
U.S. Response to the Global Threat of Tuberculosis: Basic Facts
This report outlines basic facts related to global tuberculosis (TB), including characteristics of the epidemic and U.S. legislation, programs, funding, and partnerships related to the global response to TB.
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.
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.
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 Care Flexible Spending Accounts
Health care Flexible Spending Accounts (FSAs) are benefit plans established by employers to reimburse employees for health care expenses such as deductibles and copayments. FSAs are usually funded by employees through salary reduction agreements, although employers are permitted to contribute as well. The contributions to and withdrawals from FSAs are tax-exempt. This report discusses two recent bills, the Patient Protection and Affordable Care Act (ACA) and the Health Care Cost Reduction Act of 2012, both of which limits contributions to FSAs and redefines over the counter (OTC) drugs,
Health Care Flexible Spending Accounts
Health care Flexible Spending Accounts (FSAs) are benefit plans established by employers to reimburse employees for health care expenses such as deductibles and copayments. The contributions to and withdrawals from FSAs are tax-exempt. On June 7, 2012, the House passed H.R. 436, the Health Care Cost Reduction Act of 2012, which would allow up to $500 of unused balances in health FSAs to be distributed back to the account holder after the plan year ends and to allow over-the-counter prescriptions to be a qualified medical expense. The bill has been sent to the Senate for its consideration. Similar bills in the Senate have been referred to the Senate Finance Committee (S. 1368 and S. 1404). This report discusses these bills in greater detail.
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.
TRICARE and VA Health Care: Impact of the Patient Protection and Affordable Care Act (ACA)
This report addresses key questions concerning the impact of enactment of the Affordable Care Act (ACA) on the TRICARE and VA health care programs. To provide some context to this discussion, the report begins with a brief overview of the two health systems and eligibility for care under each system.
ACA: A Brief Overview of the Law, Implementation, and Legal Challenges
This report summarizes the Affordable Care Act (ACA) and the legal challenges it has faced. The report contains information on various lawsuits due to the ACA and provides the reasoning behind them as Congress violating its enumerated powers in the constitution. Moreover, the report covers the challenges of implementing the law.
ACA: A Brief Overview of the Law, Implementation, and Legal Challenges
This report summarizes the Affordable Care Act (ACA) and the legal challenges it has faced. The report contains information on various lawsuits due to the ACA and provides the reasoning behind them as Congress violating its enumerated powers in the constitution. Moreover, the report covers the challenges of implementing the law.
The Global Fund to Fight AIDS, Tuberculosis, and Malaria: Issues for Congress and U.S. Contributions from FY2001 to FY2013
The Global Fund to Fight AIDS, Tuberculosis, and Malaria (Global Fund, or the Fund) was established in 2002 as a public-private partnership that could provide significant financial support for global responses to HIV/AIDS, tuberculosis (TB), and malaria. In November 2011, the Global Fund Board announced that due to inadequate resources from donors, it would cancel its 11th round of funding, but would maintain support for existing activities to avoid disruptions in ongoing services. Global health advocates urge Congress to meet the President's FY2013 request for the Fund in order to support the sustainability of its activities and to encourage continued contributions from other donors. Although Congress has traditionally been a strong supporter of the Fund, several issues may affect congressional views about the Fund in the future, which are discussed in this report.
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.
Health Care: Constitutional Rights and Legislative Powers
The health care reform debate raises many complex issues including those of coverage, accessibility, cost, accountability, and quality of health care. Underlying these policy considerations are issues regarding the status of health care as a constitutional or legal right. This report analyzes constitutional and legal issues pertaining to a right to health care, as well as the power of Congress to enact and fund health care programs. Following the passage of the Patient Protection and Affordable Care Act, P.L. 111-148, legal issues have been raised regarding the power of Congress to mandate that individuals purchase health insurance, and the ability of states to "nullify" or "opt out" of such a requirement. These issues are also discussed.
Health Care: Constitutional Rights and Legislative Powers
This report analyzes constitutional and legal issues pertaining to a right to health care, as well as the power of Congress to enact and fund health care programs. The report also discusses legal issues that have been raised regarding the power of Congress to mandate that individuals purchase health insurance, and the ability of states to "nullify" or "opt out" of such a requirement, following the passage of the Patient Protection and Affordable Care Act (P.L. 111-148).
Affordable Care Act: Litigation Resources
This report discusses the lawsuits challenging the Patient Protection and Affordable Care Act (PPACA). Moreover, the report also discusses how the Supreme Court granted three petitions of certiorari and scheduled oral arguments in 2012.
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.
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