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Thursday, March 28, 2013

Overview of Health Care Changes in the FY2014 Budget Proposal Offered by House Budget Committee Chairman Ryan

Patricia A. Davis
Specialist in Health Care Financing

Alison Mitchell
Analyst in Health Care Financing

Bernadette Fernandez
Specialist in Health Care Financing

On March 12, 2013, House Budget Committee Chairman Paul Ryan released the chairman’s mark of the FY2014 House budget resolution together with his report entitled The Path to Prosperity: A Responsible Balanced Budget, which outlines his budgetary objectives. The House Budget Committee considered and amended the chairman’s mark on March 13, 2013, and voted to report the budget resolution to the full House. H.Con.Res. 25 was introduced in the House March 15, 2013, and was accompanied by the committee report (H.Rept. 113-17). H.Con.Res. 25 was agreed to by the House on March 21, 2013.

A budget resolution provides general budgetary parameters; however, it is not a law. Changes to programs that are assumed or suggested by the budget resolution would still need to be enacted in separate legislation. Chairman Ryan’s budget proposal, as outlined in his report and in the committee report, suggests short-term and long-term changes to federal health care programs including to Medicare, Medicaid, and the health insurance exchanges established by the Patient Protection and Affordable Care Act as amended (ACA, P.L. 111-148, P.L. 111-152).

Within the 10-year budget window (FY2014-FY2023), the budget proposal assumes that certain ACA provisions would be repealed, including those that expand Medicaid coverage to the nonelderly with incomes up to 133% of the federal poverty level, and those provisions that establish health insurance exchanges. The proposal also suggests restructuring Medicaid from an individual entitlement program to a block grant program. Beyond the 10-year budget window, beginning in 2024, the budget proposal assumes an increase in the age of eligibility for Medicare and the conversion of Medicare to a fixed federal contribution program.

This report summarizes the proposed changes to Medicare, Medicaid, and private health insurance as described in H.Con.Res. 25, the accompanying committee report, and Chairman Ryan’s Path to Prosperity report. Additionally, it briefly examines the potential impact of the proposed changes on health care spending and coverage.

Date of Report: March 22, 2013
Number of Pages: 15
Order Number: R43017
Price: $29.95

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