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1 Answers to Questions for the Record following a Hearing Conducted by the House Committee on the Budget: Key Design Components and Considerations for Establishing a Single-Payer Health Care System 1 (December 20, 2019)

handle is hein.congrec/cbokydsn0001 and id is 1 raw text is: ;,' DECEMBER 20, 2019 Answers to Questions for the Record Following a Hearing Conducted by the House Committee on the Budget: Key Design Components and Considerations for Establishing a Single-Payer Health Care System On May 22, 2019, the House Committee on the Budget convened a hearing at which Mark Hadley, the Congressional Budget Offices Deputy Director, Jeffrey Kling, CBO's Associate Director for Economic Analysis, andJessica Banthin, CBO'former Deputy Assistant Director in the Health, Retirement, and Long- Term Analysis Division testified about the agency' report Key Design Components and Considerations for Establishing a Single-Payer Health Care System.1 After the hearing, Ranking Member Womack and Congressman Roy of the Committee submitted questions for the record. This document provides CBO's answers. It is available at www. cbo.gov/Publication/55951. Ranking Member Womack Question. The CBO report states: Government spending on health care would increase substantially under a single-payer system because the government (federal or state) would pay a large share of all national health care costs directly. How much of the spending on federal health programs is funded by: Taxes collected through the Treasury? Direct payments by beneficiaries in the form of premiums and out-of-pocket spending? Tax deductions for employer-sponsored health insurance? Other? What percentage of total health expenditures is NOT paid for by the federal government, which would likely be shifted to the federal government under a single-payer system? Answer. In fiscal year 2018, federal spending on major health care programs totaled $1.2 tril- lion, which consisted of spending on Medicare (excluding the effects of premiums and other offsetting receipts), Medicaid, and the Children's Health Insurance Program (CHIP), as well as subsidies for plans purchased thorough the marketplaces established by the Affordable Care Act (ACA).2 Virtually all of the financing for the programs other than Medicare comes from the general fund of the Treasury. In 2018, combined funding for those programs amounted to $456 billion. In 2018, transfers from the general fund of the Treasury accounted for $312 billion of the total funding for Medicare, revenues from payroll taxes accounted for $265 billion, and 1. See Congressional Budget Office, Key Design Components and Considerations for Establishing a Single-Payer Health Care System (May 2019), www.cbo.gov/publication/55150. 2. See Congressional Budget Office, 10-Year Budget Projections (August 2019), Table 1-4, www.cbo.gov/ about/products/budget-economic-data#3. That estimate does not include other federal spending for health care, such as health insurance costs for federal employees, veterans' health care, and the military health care system.

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