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Estimate of the Effects of Medicare, Medicaid, and Other Mandatory Health Provisions included in the President's Budget Request for Fiscal Year 2013 - March 2012 Baseline 1 (March 16, 2012)

handle is hein.congrec/cbo10688 and id is 1 raw text is: CBO Estimate of the Effects of Medicare, Medicaid, and Other Mandatory Health Provisions Included in the President's Budget Request for Fiscal Year 2013 (Billions of dollars, by fiscal year) Total 2013- 2013- 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2017 2022 CHANGES IN DIRECT SPENDING Current-Policy Adjustment, Medicare Freeze payment rates for physicians' services (includes Medicare Advantage and Part B Premium interactions) Provider Provisions, Medicare Adjust payment updates for certain post-acute care providers Reduce Medicare coverage of patients' bad debts Reduce indirect medical education payments Use of Inpatient Rehabilitation Facility (IRF) payment rates limited to facilities in which 75 percent of patients have a qualifying condition Equalize payments for certain conditions treated in Skilled Nursing Facilities (SNFs) and IRFs Adjust SNF payments to reduce hospital readmissions Critical Access Hospitals: Reduce payments to 100 percent of reasonable costs Critical Access Hospitals: Prohibit designation for facilities less than 10 miles from nearest hospital Update payment rates to account for utilization of advanced imaging Require prior authorization for advanced imaging Beneficiary Provisions, Medicare Increase income-related premiums under Medicare Parts B and D Increase Part B deductible for new enrollees Introduce a Part B premium surcharge for near first-dollar Medigap coverage Introduce home health co-payments for new beneficiaries Other Medicare Provisions Align Medicare drug payment policies with Medicaid for low-income beneficiaries Medicare Improvement Fund Reduce threshold for action by the Independent Payment Advisory Board (IPAB) Medicaid Provisions Phase down provider tax threshold beginning in 2015 Limit Medicaid payment for durable medical equipment to Medicare rates Apply single blended matching rate to Medicaid and the Children's Health Insurance Program (CHIP) Rebase Disproportionate Share Hospital allotments in 2022 Expand state flexibility to provide benchmark benefit packages Extend Transitional Medical Assistance Extend subsidies for Qualifying Individuals Establish hold-harmless for federal poverty guidelines Extend Supplemental Security Income time limits for qualified refugees (Medicaid effect) Increase in TRICARE out-of-pocket costs (Medicaid effect) 11.0 18.4 20.9 23.6 25.8 28.1 31.1 34.3 37.2 40.6 0 -0.7 -1.5 -2.4 -3.4 -4.6 -5.9 -7.3 -8.8 -10.5 -0.3 -1.0 -1.8 -2.3 -2.5 -2.7 -2.9 -3.1 -3.3 -3.6 0 -0.5 -0.6 -0.6 -0.6 -0.7 -0.7 -0.8 -0.8 -0.8 -0.1 -0.1 -0.1 -0.1 -0.1 -0.1 -0.1 -0.1 -0.1 0 -0.1 -0.1 -0.1 -0.2 -0.2 -0.2 -0.2 -0.2 -0.2 0 0 0 -0.2 -0.2 -0.2 -0.2 -0.2 -0.2 -0.2 -0.1 -0.1 -0.1 -0.1 -0.1 -0.1 -0.1 -0.2 -0.2 -0.2 0 -0.1 -0.1 -0.1 -0.1 -0.1 -0.1 -0.1 -0.1 -0.1 -0.1 -0.1 -0.1 -0.1 -0.1 -0.1 -0.1 -0.1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -1.6 -2.3 -2.7 -5.9 -8.0 -9.7 0 -0.1 -0.2 -0.4 -0.6 -0.9 0 0 -0.2 -0.3 -0.5 -0.7 -0.8 -0.1 -0.1 0 -5.1 -12.5 -14.7 -15.5 -16.4 -16.6 -17.4 -18.7 -20.5 0 0 0 0 0 0 0 -0.5 -0.5 -0.5 99.7 271.0 -8.0 -45.1 -7.9 -23.6 -2.3 -6.1 -0.3 -0.8 -0.5 -1.4 -0.3 -1.4 -0.5 -1.3 -0.2 -0.7 -0.4 -0.9 0 0 -1.6 -30.2 -2.3 -2.6 -0.3 -47.8 -137.4 0 -1.4 Included in estimate of IPAB interaction (below) 0 0 -2.9 -4.3 -5.8 -6.2 -6.6 -6.9 -7.4 -7.9 -0.1 -0.1 -0.2 -0.3 -0.3 -0.4 -0.4 -0.4 -0.5 0 0 0 0 0 0 0 0 0 0.2 1.1 0.2 0.7 0.9 0.2 0 0 0 0 -3.4 -3.1 -3.1 -2.5 -2.8 -3.0 0 0 0 0 0 0 -4.2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 -13.0 -47.8 -0.8 -2.8 -3.4 -17.9 0 -4.2 0 0 1.5 1.5 1.8 1.8 0 0 0 0 0 0 0 0 0 0 * * * * * * * * * 0.1 Continued March 16, 2012 Page 1 of 3

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