Overview of Health Care Changes in the FY2013 Budget Proposal Offered by House Budget Committee Chairman Ryan Page: 5 of 16
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Health Care Changes in the FY2013 Budget Proposal Offered by Chairman Ryan
term projections, which are based on an extension of CBO's baseline forecasts issued in March
In general, the budget proposal, as outlined in Chairman Ryan's "Path to Prosperity" report, in the
committee report, and in CBO's analysis, suggests a change in the structure of the Medicare and
Medicaid programs; the repeal of many of the provisions in the Patient Protection and Affordable
Care Act as amended by the Health Care and Education Reconciliation Act of 2010 (ACA, P.L.
111-148, P.L. 111-152), including those that establish insurance exchanges; and changes to tort
law governing medical malpractice.
This report provides a synopsis of the health care-related changes in Chairman Ryan's FY20 13
budget proposal. This summary is based on the text of the Concurrent Resolution, the committee
report, the FY20 13 "Path to Prosperity" report, and the CBO analysis of the proposal. The
collective details are referred to in this report as the "budget proposal" or Chairman Ryan's
proposal. CRS provided a similar summary of the proposed health care changes included in the
FY20 12 House Budget in CRS Report R41767, Overview of Health Care Changes in the FY2O]2
Budget Offered by House Budget Committee Chairman Ryan.
Medicare is the nation's federal insurance program that pays for covered health services for most
persons 65 years old and older and for most permanently disabled individuals under the age of 65.
Generally, individuals are eligible for Medicare if they or their spouse worked for at least 40
quarters in Medicare-covered employment, are 65 years old, and are a citizen or permanent
resident of the United States. Individuals under the age of 65 may also qualify for coverage if
they have a permanent disability, have End-Stage Renal disease, or have amyotrophic lateral
In FY20 12, the program will cover an estimated 50 million persons at an estimated total cost of
$576 billion, accounting for approximately 3.600 of GDP. CBO estimates that federal Medicare
spending (after deduction of beneficiary premiums and other offsetting receipts) will be about
$492 billion in FY2012, accounting for about 13.7%o of total federal spending." Medicare is an
more recent baseline projections made by CBO (rather than those provided by the Budget Committee).
8 For CBO's most recent baseline projections, see Congressional Budget Office, Updated Budget Projections: Fiscal
Years 2012 to 2022, March 2012.
9 Some of the Medicare reform assumptions underlying the FY20 13 budget resolution are similar to those in a
Medicare reform proposal issued jointly by Chairman Ryan and Senator Wyden in December 2011,
http://paulryan.house.gov/UploadedFiles/WydenRyan.pdf. However, the FY20 13 Ryan budget proposal is not the same
as the Ryan/Wyden proposal. For example, see Chairman Ryan's statements at http://www.aei.org/events/20 12/03/20/
a-blueprint-for- american-renewal-an-address-by-house-budget-committee-chairman-paul-ryan/ g 28.34 minutes.
Therefore, the sources used in this CRS paper were limited to documentation provided in connection with the proposed
FY20 13 House budget resolution.
10 ACA added an additional eligibility category; individuals with one or more specified lung diseases or types of cancer
who lived for six months during a specified period prior to diagnosis in an area subject to a public health emergency
declaration by the Environmental Protection Agency (EPA) as of June 17, 2009, are also entitled to Medicare benefits.
ii Congressional Budget Office, Medicare Baseline, March 2012, http://www.ebo.gov/sites/default/files/ebofiles/
Congressional Research Service2
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Overview of Health Care Changes in the FY2013 Budget Proposal Offered by House Budget Committee Chairman Ryan, report, March 29, 2012; Washington D.C.. (digital.library.unt.edu/ark:/67531/metadc807899/m1/5/: accessed January 20, 2019), University of North Texas Libraries, Digital Library, digital.library.unt.edu; crediting UNT Libraries Government Documents Department.