Key Points
We analyze a stylized mandatory single payer system (“Medicare for All” or “M4A”) system that provides the same benefits currently available under Medicare to the working-age population. This brief lays the foundation for future analysis of plans that expand Medicare benefits and coverage while also seeking additional cost savings.
We project that under current law, the percent of the population without medical insurance will more than double over the next 40 years, growing from around 10 percent today to over 27 percent by 2060.
We project that a shift to a mandatory single-payer system (Medicare for All) increases life expectancy by almost 2 years, grows the population size by 3 percent, and increases worker productivity through improved health, before macroeconomic feedback effects.
The choice of funding mechanism, however, is critical for macroeconomic performance. We project that financing M4A with a premium that is independent of a worker’s labor income would increase GDP by about 16 percent by 2060 through a combination of cost savings and productivity increases. In contrast, financing M4A with a new payroll tax that is proportional to a worker’s labor income would reduce GDP by roughly 3 percent, whereas deficit financing would reduce GDP by almost 15 percent by 2060.
Medicare for All: Comparison of Financing Options
Introduction
This brief presents a new model we use to estimate the impact of Medicare for All (“M4A”) on demographics and economic variables. The model is rich in detail while remaining internally consistent between micro-economic decisions, demographics and macroeconomic outcomes. These interactions allow the model to produce complex relationships found in the data, including mutually reinforcing health-income interactions that produce “health deserts” of uninsured people who do not qualify for Medicaid. Without reform, we project that the population without medical care will more than double by 2060.
In contrast to some existing policy proposals, we consider a “pure” M4A proposal, a stylized plan that simply extends existing Medicare benefits to workers as a mandatory replacement of the employer-based system. This model outlined herein lays the foundation for our follow-on analyses of specific plans that call for expanded benefits and other changes.
By 2060, we project that M4A improves life expectancy by 1.8 years, grows the population size by almost 3 percent. M4A also increases worker productivity through improved health, before macroeconomic feedback effects.
However, the macroeconomic performance depends critically on how M4A is financed. We project that financing M4A with a premium that is independent of a worker’s labor income would grow the economy by almost 16 percent by 2060 through a combination of cost savings and productivity increases. In contrast, financing M4A with a new payroll tax that is proportional to a worker’s labor income would shrink the economy by roughly 3 percent, whereas deficit financing would shrink the economy by almost 15 percent by 2060.
Model Overview
We briefly summarize the key elements of the model here. Additional details are available in our technical presentation.
The household sector in our model contains a wide range of various family units (single, married with zero or more children) that vary in ages, assets, income, “health state” (i.e., a health score) and insurance status. Each household faces uncertainty about their future health state, expenses within each health state, future wages and mortality. Under current law, households must make a decision each year over several variables: (i) how much to work (if at all); (ii) whether to purchase insurance (often subsidized by employer); (iii) whether to pay out-of-pocket expenses in response to a health cost in order to receive medical care (either at low values if covered by insurance or at higher values if uninsured); and, (iv) how much income to enjoy today on non-health consumption versus save toward future consumption and leisure.
A household’s productivity and health state interact. For the same level of intrinsic productivity (e.g., education), a healthier household will earn more in the labor market than a less healthy household. A household that does not receive medical care when needed increases its chance of being in a worse future health state (and potentially dying). This chance increases nonlinearly with the cost of foregone medical care. In other words, failing to receive costly medical care is substantially more risky than failing to receive less costly care.
The production sector is characterized by firms who sell into competitive product markets using inputs (workers and capital) that they must compensate facing competition from other firms for these factors of production. For workers, that compensation takes the form of wages and subsidized health insurance (with firms paying about 77.5 percent of the insurance premium on average).1 Health insurance premiums are fully tax exempt (through employer deduction and employee exclusion from taxable income), the value of which is generally captured by workers as lower taxable compensation due to competitive labor markets. However, firms face real wage rigidity: if a worker’s total value (“marginal product”) falls below approximately $13,000 (the minimum wage) the household is compensated only with wages. The worker can still purchase insurance but the value of the tax exemption is, therefore, lost.
The government sector collects revenue from an array of different tax instruments to finance its operations, provides Social Security benefits and two forms of medical care: Medicaid (based on income and assets) and Medicare (based on retirement). These programs are financed in a manner consistent with current law. Medicaid is cost-shared between federal and state governments.2 Medicare costs are financed by premiums on retirees as well as general revenue transfers. Minimum household consumption is guaranteed through SNAP (food stamps).
Private insurers are competitive. For workers, premiums are calculated to produce a competitive level of profits for the given risk pool based on workers who select insurance and their utilization. Insurers generally can’t perform individual-specific medical underwriting in employer-based plans, and so premium prices reflect this pooling. Overhead costs are about 6 percent per year higher for private payers than for Medicare.3 Private payers also face higher cost growth than Medicare, as shown in Figure 1 , which adopts Congressional Budget Office (CBO) assumptions.4
As discussed in our technical presentation, our model “calibrates” to numerous microeconomic and macroeconomic targets. Additional “overidentification” relationships are used to compare model outcomes with real-world data, and the model matches up very well without ad-hoc adjustments.
Complex Dynamics
Our integrated model produces realistic dynamics that have not been captured in existing models. Existing models usually take one of two forms. One set of existing models focus on a single sector such as healthcare but take premium values as given, thereby not including adverse selection and moral hazard effects. These models also often lack integration with other household-level decisions, macroeconomic variables and other government programs, like Medicaid, Social Security and SNAP, all of which impact the decision to buy insurance. Or, existing models are macroeconomic in nature and treat the healthcare sector as just another spending program--and thus cannot model actual policy changes to healthcare.
For example, the relationship between income and health is bi-directional in our model. Under current law, a household with low income (maybe from a non-health-related labor market shock) might lose health benefits if they do not qualify for Medicaid. Those households, therefore, are “caught in the middle” and lack affordable medical care, producing “healthcare deserts.” Low income and poor health mutually reinforce, at least, until the household becomes sufficiently poor in income and assets to qualify for Medicaid.
At the same time, healthier young households under current law might choose to “adversely select” themselves out of the pooled private insurance market that is expensive for their own individual health “type” (current health state and probability of moving to a bad state in the near future), even when premiums are heavily subsidized by their employer and are tax preferred.
Putting these pieces together, the uninsured can be bifurcated in costs. One group is younger and healthy; extending coverage to them is relatively cheap. Another group is sicker and lower income; extending coverage to them is not cheap, although some costs are recouped over many years after new coverage increases their productivity, adding to the tax base.
The availability of Medicaid and Medicare also materially impacts household decision-making, especially for asset accumulation. Medicare reduces saving for medical costs during retirement. Medicaid encourages households with low non-housing assets to further reduce their non-housing assets to qualify for Medicaid, even though this spend-down produces less smooth consumption over time.5
Powerful interactions also exist with the existing Social Security and tax systems. Given competitive labor markets, replacing employer-based health benefits with M4A raises worker wages by the pre-tax amount of employer-subsidized health benefits under current law. M4A also expands the tax base by removing the (employer and employee) exemption of health benefits. Income and payroll tax bases, therefore, are expanded, raising tax revenue by as much as 35 percent for income taxes by 2060 and by about 40 percent for payroll taxes, due to higher reported wages and larger macroeconomic effects. Social Security benefits also increase (by as much as 12 percent by 2060), which, in turn, impacts household saving for retirement.
Limitations
Our integrated model takes advantages of modern theoretical advances and computing methods to solve a complex, interactive system. Like all models, choices have to be made about what to include. We, therefore did not include some model complexities where their inclusion would not likely materially impact the comparison between different financing mechanisms to pay for M4A. We list these exclusions here:
First, the model does not include potential rigidities in the supply expansion of healthcare services, including short-term physical capital supply constraints (e.g., adding more hospital beds) as well as longer-term labor supply constraints on entry to medical schools and post-medical school residency programs and fellowships. Such supply constraints should produce similar “waiting times” for expanded care under any financing mechanism. However, in an analysis of a specific policy change relative to current law, our analysis, would, therefore, paint a slightly optimistic view of adoption of M4A. In that case, we would expect that any legislation would also work to address these constraints.
Second, the “health state” in our model is based on an overall health score that does not further differentiate by diagnosis. For example, two people could have equal health scores, where one is due to cardiovascular disease and another is due to compromised kidney functioning. The latter diagnosis might have more persistent costs over time than the former, and our health state probabilistic process captures only the average weighted score across all diagnoses within a health state and age. In practice, however, the combination of health state and age are generally good proxies for diagnosis heterogeneity. Moreover, our focus is not at the treatment level but at a level of health that is more aggregated. Any limitations from this aggregation would not be material across different funding mechanisms that expanded coverage.
Third, there is no distinction by race that is not already proxied by factors such as income and wealth. However, in reality, blacks are more likely to have a shorter life expectancy than whites, even controlling for income and wealth. Including racial differences would only affect our comparisons if the funding mechanisms were differentiated by factors that correlated with race, such as geography, which is not the case in the funding mechanisms we analyze.
Fourth, we do not differentiate our analysis by region. In reality, the healthcare and insurance industries are likely to be less competitive in some parts of the country than others. Different funding mechanisms that we consider herein do not differentiate by region. We suspect that actual legislation relative to current law might also address and increase provider competition.
Fifth, the empirical literature is unclear in terms of quality differences between traditional Medicare (fee-for-service) and Medicare Advantage (MA). As such, we do not model these differences under current law, instead assuming that Medicare overhead reflects a weighted (by usage) combination of these two programs. We also do not include some smaller government healthcare programs, including healthcare provided through Veterans Affairs ($73 billion in 2019)6 and healthcare for active-duty military families ($54 billion in 2019).7 While we do not break out subsidies for insurance purchased on the Affordable Care Act (ACA) exchanges ($62 billion in 2019),8 a large part of our population is on Medicaid. Moreover, most of the increase in the uninsurance rate reported later comes from working households who forgo a 77.5 percent employer match without any compensating increase in wages. We also do not model the “Cadillac tax” and other ACA taxes given their recent repeal.
Current Law (“Baseline”)
As shown in Figure 2, we project that the percent of the population without health insurance (either Medicaid, private, or Medicare) will increase from about 10 percent today to over 27 percent by 2060. Figure 2 (Percent of Population without Health Insurance), we project that the percent of the population without health insurance (either Medicaid, private, or Medicare) will increase from about 10 percent today to over 27 percent by 2060. Figure 2 (Population that foregoes medical treatment) shows that the share of the population that does not receive medical treatment (whether insured or paying out-of-pocket) will almost triple during this same time period, from around 4.5 percent today9 to 12.3 percent in 40 years. This strong increase is partly driven by increases in excess cost growth in the private system, as shown earlier.
At first glance, this increase under current law seems implausibly large, as it appears that the ACA exchanges have worked to stabilize the uninsured rate in recent years. Moreover, many employers have introduced ACA-compliant health benefit offerings that attempt to reduce moral hazard (over-utilization), such as through high-deductible plans. However, our view is that these changes constitute one-time “level” effects rather than “slope” effects. Our view is buttressed by the recent repeal of the ACA individual penalties for remaining uninsured, combined with recent steep premium increases and greater employer reluctance to offer high-deductible-only plans. Slope effects would require future excess cost growth rates to fall below CBO projections or legislative changes such as a mandate (or taxes) for non-participation.
In our model, adverse selection snowballs over time, with healthier workers dropping their coverage as prices increase. These drops occur despite (i) insurance being heavily subsidized by employers (by 77.5 percent on average); (ii) benefits being delivered pre-tax; and (iii) workers who selectively drop their coverage not receiving corresponding wage increases under current law.10 These drops by the healthier part of the pool, therefore, endogenously raise premiums faster than static excess cost growth projections shown in Figure 1, resulting in a mini “price spiral” over time. We project that health insurance premiums will increase by about 90 percent under current law over the next 40 years even after removing the effects of both inflation and real economic growth in order to hold fixed the real purchasing power of workers.
Stylized Policy Changes
This brief considers a stylized expansion of the existing Medicare system that replaces the current employer-based system for workers on a mandatory basis. We focus on differences in funding mechanisms in a new system that takes advantage of Medicare’s lower overhead costs and slower excess cost growth, while making the fewest number of other changes. Accordingly:
Firms: Employer-side health insurance is fully replaced with mandatory M4A. Because labor compensation is competitive, worker wages increase immediately by the pre-tax value of the employer-share of benefits previously provided. The tax exemption (employer deduction and employee exclusion) of employer-based insurance premiums is also removed, which expands the size of the payroll and income tax bases even more, as reviewed below.
Medicare: Medicare’s current benefits are not changed, and the Medicare Advantage (MA) option is maintained. Medicaid is also preserved in its current form. Physicians continue to be reimbursed at current Medicare rates for retirees; for workers, physician reimbursement rates are phased-down slowly over time, starting at current private-payer reimbursement rates but grown at only the lower Medicare cost growth rate over time. Relative to the dual physician payment system under current law, M4A reimbursements for the medical procedures on workers, therefore, become less generous over time.
Financing: This dual reimbursement is combined with dual financing: retirees continue to pay the same premium as under the current Medicare system, which is less than the value of the benefits they received, with the difference being financed with general revenue transfers. In all three funding scenarios we consider, workers pay the same premiums as retirees. However, barring additional deficits, workers also pay an additional premium or payroll taxes to fully cover their benefits. More specifically, we consider three funding options:
Premium financing: each worker pays the same amount regardless of age, health risk profile (existing medical condition) or income. Reductions in labor income do not reduce the premium owed, hence, making it more similar to an insurance premium rather than a tax on labor income. However, unlike retirees, these premiums are not subsidized by general revenue. As a result, the average worker pays about three times the amount as the average retiree. For workers who cannot afford the premium, the costs are absorbed by a combination of Medicaid and SNAP.11
Payroll tax financing: M4A is financed using a new proportional (linear) payroll tax. The tax rate does not depend on age or health risk profile; however, a worker with higher labor income pays a larger absolute amount, making the financing more progressive. Unlike the premium, that payment can be reduced by working less, discouraging work. The choice between premiums and payroll taxes, therefore, reflects the classic equity-efficiency tradeoff in public policy: more progressive policies are more likely to discourage economic activity.
Deficit financing: If worker M4A benefits are instead financed with deficits, then the costs of greater debt largely fall on current and future workers. Larger debt levels reduce private sector investment, as a larger portion of household savings and international capital flows are redirected to financing current consumption rather than investment for future returns.
In contrast to the stylized policy change design herein, Senate Bill S.1129 introduced by Senator Sanders would expand Medicare benefits and also reduce physician reimbursement payments for worker healthcare at a faster rate than we consider herein. We model those changes in our analysis of that bill.
Projections: Health and Demographic
As shown in Table 1, we project that a move to M4A would increase worker health, mostly by expanding coverage. By 2060, the percent of the population that is uninsured falls from 27.1 percent to zero. The percent of the population not receiving medical care falls from 12.3 percent under current law to less than 1 percent under the different policy runs. This latter share does not drop all the way to zero because some households will rationally choose to avoid paying Medicare out-of-pocket expenses even after they are insured under M4A.12
| Financing Option | Uninsured | Population not Receiving Medical Treatment | Population in the Sickest Health States | Increase in Productivity |
|---|---|---|---|---|
| Current Law | 27.1% | 12.3% | 14.5% | n/a |
| Premium | 0.0% | 0.5% | 13.3% | 3.6% |
| Payroll | 0.0% | 0.7% | 13.2% | 7.2% |
| Deficit | 0.0% | 0.6% | 13.3% | 7.6% |
Note: The effects of health on productivity are calculated as a percentage change from current law.
Moreover, the share of the sickest population drops from 14.5 percent to 13.3 percent.13 Even before the introduction M4A, the sickest share of the population tends to be older and already covered by Medicare under current law. The adoption of M4A, therefore, mainly impacts workers, including “moderately sick” workers under current law. Worker productivity (wages) increase before macroeconomic effects (discussed below), due to greater health-induced productivity. Table 2 shows that M4A increases life expectancy by almost 2 years while increasing the size of the population by almost 3 percent.
| Financing Option | Change in Life Expectancy (years) | Change in Population Size (%) |
|---|---|---|
| Premium | 1.8 | 2.9 |
| Payroll | 1.8 | 2.9 |
| Deficit | 1.8 | 2.9 |
Figure 3 shows the projected share of the population that do not receive medical treatment over time, in both current law (“baseline”) and under different M4A funding mechanisms. Households “forego” medical treatment usually because they are uninsured and do not want to pay out of pocket; in some cases, insured workers or retirees refuse to pay out-of-pocket costs despite their lower costs relative to those of the uninsured.
Figure 4 shows the change in insured health spending over time relative to current law. (To focus on the model dynamics, this figure does not include non-insured health spending, including over-the-counter medications and other spending categories not currently covered by employer-based insurance.) Spending increases in the very short run by adding uncovered workers but quickly falls due to cost advantages (lower overhead and excess cost growth rates) in Medicare relative to private payers. However, by around 2038, we project that total costs exceed current law due to three factors: First, as noted earlier, we project that a larger share of the population would otherwise forego medical treatment over time under current law. So, covering them again becomes more costly relative to current law. Second, consistent with Figure 1 shown above, the excess cost growth advantages begin to fall, with Medicare’s main remaining advantage being its lower overhead costs. Third, because the population is healthier and longevity is improved, the size of the population served by the M4A program expands over time.
Projections: Financing
Figure 5 shows the change in premiums paid by workers under three financing mechanisms: premium financing, payroll tax financing and deficit financing. Insurance premiums fall the most under payroll tax and deficit financing, since M4A is financed without additional premiums; however, the premiums are not completely eliminated because workers still pay the same premiums as retirees, which are lower than the actuarial value of the benefits.
Projections: The Federal Budget
Figure 6 presents the impact of M4A on key government budget variables, including income tax revenue, payroll tax revenue, Social Security (OASI) spending, and federal debt. Readers can select different variables from the pull-down menu. By 2060, income tax revenue increases by almost 35 percent for premium financing. For payroll tax financing, revenue increases by almost 8 percent by 2060, despite contracting GDP reported below, as the tax deductibility of private insurance is eliminated. With deficit financing, the negative impact on economic growth (reported below) eventually leads to an overall reduction in tax revenue, despite the statutory base expansion. Payroll tax revenue also increases, especially under payroll tax financing of M4A, as reported wages increase after employer-subsidized health benefits are removed. Social Security (OASI), therefore, receives more tax revenue immediately but also eventually owes more benefits over time. A future PWBM brief will examine the impact of M4A on Social Security in more detail.14
Projections: The Economy
As discussed in more detail in our technical presentation, the economy in the model is calibrated to various macroeconomic targets. In the near term, the economy is expected to grow faster than the government’s borrowing rate (near zero). But there is still no “free lunch” in government borrowing since additional debt reduces investments in private capital, which has a higher return. Specifically, the real (net of inflation) marginal product of capital after depreciation but before business and household taxes is 5 percent in the near term. Readers familiar with macroeconomic models will notice that the “crowd out” cost per dollar of additional debt, therefore, is lower in our model than in macroeconomic models commonly found in the literature about a decade or so ago.15 However, our model captures the significant growth in government debt under current law, which we have documented elsewhere. Adding additional deficits to this rising stock of debt further erodes private investment.
Figure 7 presents key macroeconomic variables, including changes in hours worked in the economy, changes in the size of the capital stock and changes in GDP. Readers can select different variables from the pull-down menu.
Hours Worked: Each financing mechanism lowers hours worked in the short run. With premium financing, workers enjoy an increase in lifetime resources through lower overhead costs and excess cost growth in M4A, producing an “income effect” that allows them to consume more leisure, either by reducing hours worked (the “intensive” margin) and participation (the “extensive” margin). Deficit financing produces an even larger income effect, as a large amount of the financing gets pushed forward to future generations. Payroll taxes introduce additional “substitution effects” that are common to distortionary taxes, lowering labor supply even more. Over time, premium financing expands labor supply, as capital and wages increase. However, hours worked continue to fall for deficit and payroll tax financing.
Capital supply: Premium financing increases capital accumulation by 33.1 percent by 2060, whereas payroll tax financing reduces it in the short run while recovering to roughly current law values by 2060. Deficit financing reduces capital formation, by over 27 percent by 2060, as a larger share of household savings and international capital flows are redirected away from productive investment toward financing immediate health care consumption today. Putting these numbers together, the capital stock in 2060 is 77 percent larger with premium financing relative to deficit financing.
Wages and Output per Hour: Changes in worker wages occur from four different sources, the first one being purely mechanical in nature, and the rest being “real” in nature:
Competitive labor markets: wages increase through competitive micro-economic labor markets, as employer-based health benefits are eliminated, forcing up wages. However, this effect is “mechanical” in nature and does not correspond to any improvement in the actual well-being (“welfare”) of workers.
“Fiscal externalities:” The first mechanical effect, though, produces indirect real effects though other tax channels, as more of a worker’s reported compensation is now subject to income and payroll taxation. Holding all other factors fixed, this additional revenue reduces deficits, increasing national saving and the capital stock, in turn boosting wages.
Improved health: As noted earlier, improvements in health effectively increase the productivity of workers, raising their wages.
Macroeconomics: Wages will rise if the capital stock grows faster than labor supply, as labor becomes a more scarce factor of production.
The three real effects are captured by the changes in “Output per Hour,” as shown in Figure 7.
Under premium financing, output per hour eventually increases by as much as 16 percent, reflecting all three effects noted above. Under payroll tax financing, output per hour increases by 11 percent, largely because hours worked falls more sharply than capital, thereby making labor scarcer over time. Under deficit financing, despite a 5 percent increase in output per hour in the short run, output per hour eventually decreases by over 4 percent.
Gross Domestic Product: GDP represents the nation’s production of goods and services. GDP can increase due to several factors that we capture:
Improvements in worker productivity due to better health
Changes the total number of workers due to population growth
Changes in hours worked per worker due to after-tax changes in hourly wages
Changes in capital stock due to changes in household saving and international capital flows
By 2060, GDP rises by 16 percent with premium financing, falls by 3 percent with payroll tax financing, and falls by 15 percent with deficit financing. Premium financing, therefore, produces a GDP that is over a third (36 percent) larger than deficit financing by 2060.
Felix Reichling and Kent Smetters produced the analysis and wrote this report, with research assistance from Minh Quach, Danni Chen and Ivan Li. Kody Carmody, Diane Lim and Sophia Seidenberg provided editorial assistance. Mariko Paulson prepared this report for the PWBM website. Additional technical support was provided by other PWBM team members.
Note: These readings will access websites not controlled by PWBM. PWBM does not advocate for any policy, and so any opinions that may be expressed in linked articles reflect the opinions of those authors.
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See Kaiser Family Foundation (2018), “2018 Employer Health Benefits Survey.” The 77.5 average value is the weighted average between individual and family coverage. ↩
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To properly account for economic feedback effects, we include the state-level cost share of Medicaid financing using a linear tax. ↩
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Under current law, we set overhead costs to 15 percent for Private health insurance, 9 percent for Medicare, and 7 percent for Medicaid. ↩
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See Congressional Budget Office (2018), “Appendix B: Changes in Long-Term Budget Projections Since March 2017,” updated for 2020. ↩
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Medicaid might also discourage the purchase of long-term care insurance, as shown by Brown, Jeffrey R., and Amy Finkelstein. “The interaction of public and private insurance: Medicaid and the long-term care insurance market.” American Economic Review 98, no. 3 (2008): 1083-1102. ↩
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Department of Veteran Affairs, “Department of Veterans Affairs - Budget in Brief (2020)”, 2019. ↩
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Defense Health Agency, “Evaluation of the TRICARE Program: Fiscal Year 2019 Report to Congress”, 2019. ↩
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Congressional Budget Office, “Federal Subsidies for Health Insurance Coverage for People Under Age 65: 2019 to 2029”, 2019. ↩
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Centers for Disease Control and Prevention, “Summary Health Statistics: National Health Interview Survey”, 2018. ↩
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If markets were competitive enough to identify healthier workers who drop their coverage and increase their wages, even more drops would occur. ↩
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Specifically, we calculate a household’s resources equal to assets + asset income + labor income + transfer income - tax payments - insurance premium - out-of-pocket (OOP) medical expenses. If resources fall below $5,000, the model checks whether the shortfall is due to medical expenses. The shortfall not due to medical expenses are picked up by SNAP and the shortfall due to medical expenses (OOP or premium) is picked up by Medicaid. ↩
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The projected outcomes vary by financing mechanism and macroeconomic variables that, for example, impact labor productivity and returns to saving. ↩
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This population is defined as being in health states 4 or 5 in our posted technical presentation. ↩
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Social Security benefits determined at the point of retirement are weighted upward by wage-indexed factors that account for the rise of wages over time. M4A would increase reported wages “mechanically” (rather than by growing the size of the economy) through competitive labor markets. As a result, initial benefits received by new retirees could be mechanically adjusted upward, despite new retirees not having paid more into the program. For these calculations, we assume that M4A would require a one-time adjustment to these factors to avoid this mechanical effect. ↩
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In particular, our calibration is very consistent with the argument in Blanchard, Olivier. "Public debt and low interest rates." American Economic Review 109, no. 4 (2019): 1197-1229. ↩
Year,Excess Cost Growth Private,Excess Cost Growth Medicare,Excess Cost Growth Medicaid
2020,2,0.972,1.328
2021,2,0.972,1.339
2022,2,0.972,1.35
2023,2,0.972,1.361
2024,2,0.972,1.373
2025,2,1.048,1.448
2026,2,1.124,1.524
2027,2,1.2,1.6
2028,2,1.276,1.676
2029,2,1.352,1.752
2030,2,1.2,1.6
2031,1.947,1.189,1.568
2032,1.895,1.179,1.537
2033,1.842,1.168,1.505
2034,1.79,1.158,1.474
2035,1.737,1.147,1.442
2036,1.684,1.137,1.41
2037,1.632,1.126,1.379
2038,1.579,1.116,1.347
2039,1.526,1.105,1.316
2040,1.474,1.095,1.284
2041,1.421,1.084,1.253
2042,1.368,1.074,1.221
2043,1.316,1.063,1.19
2044,1.263,1.053,1.158
2045,1.211,1.042,1.126
2046,1.158,1.032,1.095
2047,1.105,1.021,1.063
2048,1.053,1.01,1.032
2049,1,1,1
2050,1,1,1
2051,1,1,1
2052,1,1,1
2053,1,1,1
2054,1,1,1
2055,1,1,1
2056,1,1,1
2057,1,1,1
2058,1,1,1
2059,1,1,1
2060,1,1,1
Year,Current Law
2020,10.00739439
2021,9.834446062
2022,9.985020755
2023,10.3470526
2024,10.87031865
2025,11.50247198
2026,12.20338862
2027,13.14720249
2028,13.06307465
2029,13.89015105
2030,14.45506283
2031,15.14620272
2032,15.65360429
2033,16.18114546
2034,16.65807918
2035,17.20179593
2036,17.78873841
2037,18.4097551
2038,19.08069228
2039,19.53727974
2040,19.95962122
2041,20.24831848
2042,20.54838055
2043,20.93917761
2044,21.35303204
2045,21.6157799
2046,21.83433853
2047,22.17826035
2048,22.45271233
2049,22.85583851
2050,23.28618275
2051,23.63852615
2052,24.0164162
2053,24.41445613
2054,24.7736777
2055,25.16316278
2056,25.60377829
2057,26.00599174
2058,26.34057127
2059,27.05277707
2060,27.08482573
Year,Current Law
2020,4.516100473
2021,4.909452613
2022,5.226980537
2023,5.575948044
2024,6.033797378
2025,6.495081147
2026,6.763715672
2027,7.30323406
2028,7.378281168
2029,7.784781549
2030,8.150688164
2031,8.379914641
2032,8.743009878
2033,8.971794371
2034,9.265198593
2035,9.486995522
2036,9.689485028
2037,9.941240988
2038,10.19336094
2039,10.45549773
2040,10.75023993
2041,10.86476513
2042,10.95240342
2043,11.13746228
2044,11.23064104
2045,11.47681294
2046,11.53909726
2047,11.55696131
2048,11.65915429
2049,11.71884737
2050,11.8509087
2051,11.91029917
2052,11.94132193
2053,12.05908775
2054,12.11158753
2055,12.18741026
2056,12.20207246
2057,12.23099464
2058,12.23384432
2059,12.26571602
2060,12.20843275
Year,Current Law,Premium,Payroll,Deficit
2020,4.516100473,4.516100473,4.21487369,4.516100473
2021,4.909452613,0.371742523,0.566154304,0.551330812
2022,5.226980537,0.339758019,0.574303629,0.566388387
2023,5.575948044,0.331023826,0.578573721,0.585347428
2024,6.033797378,0.33723028,0.608594342,0.599819453
2025,6.495081147,0.342718934,0.628261889,0.616465586
2026,6.763715672,0.344427079,0.656162643,0.638822074
2027,7.30323406,0.367359032,0.679024067,0.664673296
2028,7.378281168,0.370053632,0.700013444,0.684926631
2029,7.784781549,0.374858465,0.698883159,0.681067528
2030,8.150688164,0.356428358,0.713015862,0.688879243
2031,8.379914641,0.38384464,0.722514254,0.697114109
2032,8.743009878,0.384853234,0.729447514,0.708163802
2033,8.971794371,0.388538171,0.724696919,0.714733317
2034,9.265198593,0.389051378,0.726208053,0.719313465
2035,9.486995522,0.387035551,0.722679817,0.72119774
2036,9.689485028,0.387861003,0.719798469,0.722115292
2037,9.941240988,0.386986661,0.719289523,0.724643846
2038,10.19336094,0.387013195,0.7195425,0.723466137
2039,10.45549773,0.390678683,0.719965271,0.710534642
2040,10.75023993,0.390968449,0.721077814,0.707602949
2041,10.86476513,0.383568987,0.720305406,0.710270037
2042,10.95240342,0.387710984,0.710852934,0.709850287
2043,11.13746228,0.389023323,0.709741576,0.712217633
2044,11.23064104,0.388546423,0.70766937,0.700024179
2045,11.47681294,0.385269303,0.704967446,0.698116212
2046,11.53909726,0.387084194,0.702932739,0.695225663
2047,11.55696131,0.391796267,0.699185222,0.691235995
2048,11.65915429,0.391189517,0.697730222,0.69038453
2049,11.71884737,0.390445254,0.696022751,0.681658159
2050,11.8509087,0.390363003,0.690133593,0.676752856
2051,11.91029917,0.394492341,0.688676753,0.665767347
2052,11.94132193,0.388774838,0.686097795,0.663560618
2053,12.05908775,0.392673755,0.682210022,0.660303748
2054,12.11158753,0.394506875,0.679552853,0.656537993
2055,12.18741026,0.394135101,0.677514224,0.649563201
2056,12.20207246,0.391278811,0.672782027,0.635861042
2057,12.23099464,0.396031564,0.666626594,0.633413736
2058,12.23384432,0.39750078,0.662030287,0.625858723
2059,12.26571602,0.398339743,0.660259246,0.614912526
2060,12.20843275,0.397423396,0.65690009,0.607237414
Year,Premium,Payroll,Deficit
2020,0,0,0
2021,2.447927131,2.45,2.525366687
2022,1.250530017,1.204892894,1.158281193
2023,0.148915163,0.14886511,0.045490522
2024,-0.651930632,-0.625456628,-0.75055552
2025,-1.179264972,-1.133216919,-1.264137067
2026,-1.386533568,-1.327759454,-1.455310034
2027,-1.400469868,-1.324379159,-1.451576233
2028,-1.730627264,-1.654928536,-1.770789903
2029,-1.679451253,-1.591355561,-1.699642409
2030,-1.664832141,-1.570006608,-1.659811986
2031,-1.5130674,-1.430182149,-1.503885052
2032,-1.40237579,-1.326320434,-1.386783764
2033,-1.242515185,-1.175411632,-1.21923705
2034,-1.270718232,-1.210027041,-1.237886784
2035,-1.137833081,-1.091387408,-1.103849706
2036,-0.731054188,-0.704374007,-0.698271489
2037,-0.353191533,-0.338818526,-0.321595579
2038,-0.002704256,-0.00208789,0.02822567
2039,0.323779388,0.312652702,0.357227672
2040,0.744070789,0.719324675,0.772395835
2041,1.055400754,1.020762285,1.085395837
2042,1.420331908,1.380091832,1.445161751
2043,1.892240575,1.843481166,1.912670274
2044,2.232177695,2.173565691,2.246351769
2045,2.845523313,2.783572972,2.860228451
2046,3.37847908,3.313780569,3.391657267
2047,3.959618865,3.893979764,3.973168536
2048,4.555640269,4.486076588,4.567702864
2049,5.172972616,5.102658088,5.183878931
2050,5.947266834,5.880717345,5.955519286
2051,6.61060248,6.544544845,6.620626599
2052,7.291647796,7.231052461,7.298743335
2053,8.154166447,8.094189291,8.161532044
2054,8.974675458,8.919251185,8.978415716
2055,9.661179788,9.609350654,9.667128699
2056,10.33187532,10.28279428,10.33704909
2057,11.01857934,10.97796446,11.02225318
2058,11.7145458,11.68244989,11.72550435
2059,12.49927303,12.47131578,12.51206774
2060,12.99946024,12.97811247,13.01562423
Year,Premium,Payroll,Deficit
2020,0,0,0
2021,0.485853101,-67.37636443,-67.37636443
2022,-0.294200056,-68.01622279,-68.01622279
2023,-1.249313564,-68.65730344,-68.65730344
2024,-2.166016413,-69.28559105,-69.28559105
2025,-3.136118066,-69.91695853,-69.91695853
2026,-3.91220142,-70.52289197,-70.52289197
2027,-4.766721457,-71.13412546,-71.13412546
2028,-5.491508615,-71.69949154,-71.69949154
2029,-6.446521792,-72.28357391,-72.28357391
2030,-7.097848056,-72.85694903,-72.85694903
2031,-7.863466915,-73.40398396,-73.40398396
2032,-8.595890411,-73.93833314,-73.93833314
2033,-9.257808127,-74.44305365,-74.44305365
2034,-9.968163355,-74.93685347,-74.93685347
2035,-10.54333765,-75.38807657,-75.38807657
2036,-11.11934766,-75.82333986,-75.82333986
2037,-11.57850895,-76.22863372,-76.22863372
2038,-12.02784318,-76.63013597,-76.63013597
2039,-12.44712991,-77.00904313,-77.00904313
2040,-12.85813423,-77.3668879,-77.3668879
2041,-13.23242188,-77.70505843,-77.70505843
2042,-13.44448728,-77.99728202,-77.99728202
2043,-13.70292887,-78.29020524,-78.29020524
2044,-13.83907614,-78.56537398,-78.56537398
2045,-14.1017326,-78.8473824,-78.8473824
2046,-14.25954758,-79.09147342,-79.09147342
2047,-14.34652658,-79.32250686,-79.32250686
2048,-14.36761018,-79.55032231,-79.55032231
2049,-14.35410941,-79.75882598,-79.75882598
2050,-14.29950843,-79.95960308,-79.95960308
2051,-14.25964546,-80.16160917,-80.16160917
2052,-14.12959298,-80.35451323,-80.35451323
2053,-14.06782549,-80.54701758,-80.54701758
2054,-13.98312236,-80.73416019,-80.73416019
2055,-13.89654884,-80.92252012,-80.92252012
2056,-13.77513031,-81.11192176,-81.11192176
2057,-13.72902169,-81.30984841,-81.30984841
2058,-13.57113904,-81.49167396,-81.49167396
2059,-13.52001926,-81.68176188,-81.68176188
2060,-13.32750536,-81.85645699,-81.85645699
Year,Premium,Payroll,Deficit
2020,0,0,0
2021,0,6.911,0
2022,0,6.971,0
2023,0,7.013,0
2024,0,7.076,0
2025,0,7.18,0
2026,0,7.306,0
2027,0,7.462,0
2028,0,7.632,0
2029,0,7.937,0
2030,0,8.166,0
2031,0,8.382,0
2032,0,8.603,0
2033,0,8.831,0
2034,0,9.059,0
2035,0,9.293,0
2036,0,9.527,0
2037,0,9.771,0
2038,0,10.015,0
2039,0,10.264,0
2040,0,10.514,0
2041,0,10.771,0
2042,0,11.03,0
2043,0,11.293,0
2044,0,11.564,0
2045,0,11.839,0
2046,0,12.116,0
2047,0,12.401,0
2048,0,12.686,0
2049,0,12.983,0
2050,0,13.287,0
2051,0,13.596,0
2052,0,13.912,0
2053,0,14.235,0
2054,0,14.568,0
2055,0,14.923,0
2056,0,15.279,0
2057,0,15.659,0
2058,0,16.047,0
2059,0,16.434,0
2060,0,16.818,0
Year,Premium,Payroll,Deficit
2020,0,0,0
2021,8.119669593,2.905379404,5.955289464
2022,8.641748759,3.099670138,5.960559825
2023,9.00134537,3.199187902,5.90943244
2024,9.353510917,3.334352403,5.877374876
2025,9.739012566,3.424273465,5.868795422
2026,10.10069004,3.504347979,5.872192297
2027,10.48359126,3.583360773,5.884096148
2028,10.89260024,3.662544862,5.88950177
2029,11.82877578,3.75494859,6.292533957
2030,12.29571674,3.802842202,6.308530598
2031,12.78219643,3.873030062,6.337921374
2032,13.27273892,3.956447262,6.356410441
2033,13.79937562,4.047019143,6.378903623
2034,14.34260621,4.164131902,6.398485184
2035,14.90644684,4.279632579,6.409644789
2036,15.47562534,4.406508023,6.402126063
2037,16.0539605,4.512726532,6.374872735
2038,16.66257794,4.648676275,6.346928345
2039,17.27764596,4.772001412,6.299107546
2040,17.92298433,4.926125636,6.241394379
2041,18.58069992,5.064019625,6.165964538
2042,19.24114903,5.209745428,6.060952587
2043,19.93583638,5.361170986,5.953723662
2044,20.63688574,5.4986791,5.808812575
2045,21.3614197,5.649179104,5.651919991
2046,22.0963857,5.802038382,5.470923077
2047,22.84866406,5.946443055,5.260110316
2048,23.62142559,6.107812617,5.014067632
2049,24.40081712,6.24470487,4.728523815
2050,25.19775916,6.389458032,4.401708293
2051,26.01922425,6.544458253,4.040395262
2052,26.84902664,6.686702384,3.631983471
2053,27.56980551,6.761590028,3.222248293
2054,28.46788744,6.908865528,2.719167839
2055,29.40775706,7.044910332,2.170396064
2056,30.38531889,7.219285374,1.556640961
2057,31.40109977,7.362720369,0.878553669
2058,32.44206047,7.488910013,0.117915988
2059,33.55104032,7.660550354,-0.713075869
2060,34.66987522,7.853236036,-1.666812093
Year,Premium,Payroll,Deficit
2020,0,0,0
2021,11.11273156,82.42122115,8.885677447
2022,11.65436266,84.31953646,9.06022207
2023,12.18686143,86.13506585,9.238066983
2024,12.73284658,88.01600674,9.432877335
2025,13.29399887,90.1038819,9.625763517
2026,13.86005001,92.12179748,9.812249074
2027,14.43748058,94.44369403,9.996893277
2028,15.00857168,96.60995128,10.15964331
2029,15.74714504,98.78537074,10.40422228
2030,16.3867072,101.5116774,10.59868787
2031,17.05603092,103.9831928,10.80303336
2032,17.73519419,106.6280016,11.00628162
2033,18.44173432,109.3954151,11.21983566
2034,19.16820038,112.1014999,11.43266132
2035,19.8860738,114.8026129,11.61437964
2036,20.59725821,117.4241238,11.77540358
2037,21.30654596,120.1366542,11.91344517
2038,22.03185848,122.8293983,12.04536637
2039,22.78849799,125.6596689,12.17964223
2040,23.56578121,128.4517948,12.31227527
2041,24.38341073,131.3903308,12.45472022
2042,25.17535851,134.2324009,12.54624588
2043,25.97285335,137.1351915,12.61327997
2044,26.81218759,140.1388019,12.68633212
2045,27.65573019,143.1663494,12.72925057
2046,28.49069535,146.1618549,12.73739125
2047,29.35227093,149.2845685,12.73129147
2048,30.21344418,152.33774,12.68929069
2049,31.07910602,155.5142805,12.60771268
2050,31.93818441,158.6723957,12.47675602
2051,32.81632276,161.8647002,12.31516103
2052,33.73876174,165.121938,12.13809325
2053,34.63875339,168.4182479,11.88764674
2054,35.61394584,171.8273595,11.64305838
2055,36.65605999,175.7151634,11.38944898
2056,37.66116443,179.2473314,11.02891648
2057,38.75132621,183.2853371,10.65516884
2058,39.82576928,187.3144784,10.18567213
2059,40.96079684,191.3278465,9.669412801
2060,42.06525543,195.0785783,9.018401413
Year,Premium,Payroll,Deficit
2020,0,0,0
2021,0,0,0
2022,0.015463494,0.026094646,0.016429962
2023,0.04735901,0.051225052,0.051225052
2024,0.095206797,0.086507699,0.100039629
2025,0.159496571,0.133880455,0.164813123
2026,0.23878577,0.190931941,0.244102862
2027,0.335990641,0.261057476,0.335507201
2028,0.448222341,0.33991403,0.440002514
2029,0.575988393,0.430903156,0.556160077
2030,0.719803795,0.530661803,0.68449084
2031,0.878237139,0.639685673,0.821139628
2032,1.053288865,0.758503517,0.970032576
2033,1.243057136,0.887136998,1.126838315
2034,1.447590256,1.023680794,1.293529446
2035,1.665971906,1.16865239,1.465783836
2036,1.898258394,1.322087987,1.645092609
2037,2.146018558,1.486003805,1.832996855
2038,2.406356082,1.657010485,2.024641475
2039,2.678875183,1.835651591,2.221541811
2040,2.96511034,2.021489268,2.423257827
2041,3.263684692,2.214086811,2.628376142
2042,3.575222446,2.41596741,2.836983111
2043,3.898815186,2.625712767,3.049104682
2044,4.23549633,2.840917414,3.264760026
2045,4.586362148,3.065070418,3.48401226
2046,4.951643533,3.298811645,3.709939505
2047,5.332902075,3.543669813,3.938663295
2048,5.728755171,3.794797305,4.171676179
2049,6.136850589,4.055687693,4.407052857
2050,6.560459084,4.326556325,4.646458681
2051,6.998536015,4.608347176,4.886849279
2052,7.449960008,4.901796206,5.129901549
2053,7.914416286,5.207529626,5.373711595
2054,8.388126112,5.521229208,5.615372038
2055,8.875275522,5.845529101,5.857443555
2056,9.382555143,6.182407896,6.105799365
2057,9.920231329,6.542526673,6.37102403
2058,10.48037335,6.916796578,6.646480393
2059,11.07271635,7.30869391,6.937099359
2060,11.66499347,7.707057524,7.216644915
Year,Premium,Payroll,Deficit
2020,0,0,0
2021,1.53301E-05,-0.077360017,1.88859E-05
2022,-4.884395762,-3.872594307,1.302352155
2023,-8.588904322,-6.619384804,3.41020219
2024,-12.1552227,-9.31037935,5.312860816
2025,-15.57071512,-11.86801712,7.047644179
2026,-18.8374781,-14.29712076,8.658111906
2027,-21.9320638,-16.57075043,10.18261
2028,-24.83474915,-18.6949442,11.67106237
2029,-27.57951043,-20.68344464,13.11674647
2030,-30.33366922,-22.51965581,14.46352356
2031,-32.95537017,-24.24124177,15.78976629
2032,-35.47238975,-25.86426679,17.0892135
2033,-37.91759227,-27.42730112,18.37999796
2034,-40.25451083,-28.90518284,19.69257733
2035,-42.49445496,-30.30688208,21.01882209
2036,-44.65875619,-31.64868428,22.34392009
2037,-46.70804574,-32.90612063,23.64254515
2038,-48.6697945,-34.09613469,24.94802342
2039,-50.58641243,-35.2429801,26.27793244
2040,-52.45098904,-36.34523615,27.62446051
2041,-54.2338521,-37.3808964,28.96655017
2042,-55.94302217,-38.35709755,30.2919421
2043,-57.62363113,-39.29678257,31.61955128
2044,-59.24641644,-40.18791836,32.93269157
2045,-60.82955022,-41.04905258,34.25770493
2046,-62.38857072,-41.89573669,35.57390111
2047,-63.90026907,-42.69840513,36.90263269
2048,-65.37725781,-43.46978176,38.24754687
2049,-66.8310522,-44.20721072,39.62369605
2050,-68.2474502,-44.9076651,41.02362053
2051,-69.63497844,-45.57425174,42.45419385
2052,-70.99251141,-46.20812013,43.92315295
2053,-72.32035882,-46.80825468,45.40809352
2054,-73.60933452,-47.37518238,46.89739434
2055,-74.86673303,-47.9128207,48.43480797
2056,-76.09508475,-48.42391275,50.01524695
2057,-77.31708421,-48.91843132,51.64113448
2058,-78.5286491,-49.40004052,53.30112659
2059,-79.71328141,-49.85853297,54.98467051
2060,-80.87913765,-50.29736296,56.70470381
Year,Premium,Payroll,Deficit
2020,0,0.000793017,0
2021,-0.886932888,-3.616037852,-2.226328627
2022,-0.427885232,-3.658055808,-2.447198828
2023,-0.125191621,-3.779890307,-2.776492087
2024,0.220896308,-3.828844865,-3.080630689
2025,0.592596923,-3.886228935,-3.392702495
2026,0.999172597,-3.911006795,-3.699057232
2027,1.431928249,-3.925764493,-4.008306336
2028,1.906397577,-3.913957132,-4.319346256
2029,2.308215439,-4.266530116,-4.762814456
2030,2.818203232,-4.288760269,-5.097207009
2031,3.351392437,-4.293690877,-5.444436069
2032,3.913787612,-4.274026214,-5.793867459
2033,4.509770014,-4.242036783,-6.143702198
2034,5.131034052,-4.18690498,-6.509778497
2035,5.783560823,-4.116159701,-6.886337822
2036,6.463162827,-4.027627219,-7.274427912
2037,7.169495059,-3.936107942,-7.683720941
2038,7.904460137,-3.819991722,-8.108258281
2039,8.671103202,-3.694288953,-8.54869287
2040,9.4674239,-3.54467086,-9.008561747
2041,10.29751104,-3.387612539,-9.49146411
2042,11.16105588,-3.208271344,-9.994122581
2043,12.05803267,-3.022300933,-10.51885027
2044,12.99046286,-2.826619663,-11.07269257
2045,13.95348076,-2.617742124,-11.65666675
2046,14.95471009,-2.389383781,-12.26702157
2047,15.99281244,-2.15229563,-12.90760521
2048,17.06465784,-1.898210453,-13.58728909
2049,18.17018425,-1.642730662,-14.30833373
2050,19.31424527,-1.373155947,-15.07265854
2051,20.4917324,-1.093862946,-15.88461231
2052,21.70938166,-0.807005967,-16.74846912
2053,22.96809255,-0.509327196,-17.66720059
2054,24.262191,-0.211910939,-18.63646695
2055,25.60426819,0.082372774,-19.66814942
2056,26.99415923,0.404343779,-20.77221469
2057,28.43324786,0.715970291,-21.95053621
2058,29.92896438,1.035806483,-23.20301314
2059,31.48332667,1.376109738,-24.54613788
2060,33.10963062,1.756805926,-25.98178246
Year,Premium,Payroll,Deficit
2020,0,0,0
2021,-4.808958772,-9.562341383,-7.990146402
2022,-4.675571851,-9.593074108,-8.032363513
2023,-4.538182839,-9.628043491,-8.084924418
2024,-4.407936013,-9.623074017,-8.120361286
2025,-4.299505005,-9.67105332,-8.175928304
2026,-4.184072364,-9.704136035,-8.231346975
2027,-4.066239687,-9.75506638,-8.280627867
2028,-3.933067244,-9.785974545,-8.320465922
2029,-4.079345216,-10.43526204,-8.673722618
2030,-3.962588694,-10.52471511,-8.722754187
2031,-3.857752606,-10.60782603,-8.785356181
2032,-3.750998468,-10.67975224,-8.834863928
2033,-3.647756113,-10.76404788,-8.879331112
2034,-3.526477943,-10.82231063,-8.923558933
2035,-3.388217221,-10.87781803,-8.951369118
2036,-3.253330245,-10.9273769,-8.97053137
2037,-3.129060366,-10.99575839,-9.002822795
2038,-3.002711485,-11.03968555,-9.025248311
2039,-2.869366467,-11.08904497,-9.045276182
2040,-2.732371923,-11.11809328,-9.062240134
2041,-2.596293281,-11.15677278,-9.081803954
2042,-2.461151242,-11.18822179,-9.092717856
2043,-2.325748612,-11.22988342,-9.109058843
2044,-2.188240252,-11.27590058,-9.132584462
2045,-2.068168287,-11.33495866,-9.172515395
2046,-1.956775506,-11.40090832,-9.215995339
2047,-1.835658364,-11.46929675,-9.255615912
2048,-1.72185419,-11.53194899,-9.307151781
2049,-1.609971413,-11.610605,-9.368755463
2050,-1.493269916,-11.68384572,-9.433166576
2051,-1.388831859,-11.76943118,-9.516862673
2052,-1.283737646,-11.86105822,-9.611583068
2053,-1.178503681,-11.95571088,-9.717553936
2054,-1.077001675,-12.0639156,-9.841080776
2055,-0.960989473,-12.19929891,-9.970435538
2056,-0.838458482,-12.31454473,-10.11151804
2057,-0.717123024,-12.46137785,-10.2749877
2058,-0.57971869,-12.61268213,-10.43369363
2059,-0.453386187,-12.76408018,-10.62041894
2060,-0.319916802,-12.88192924,-10.83535246
Year,Premium,Payroll,Deficit
2020,0,0,0
2021,-1.214477832,-4.915737941,-3.031732651
2022,-0.956525808,-4.907238112,-3.151647953
2023,-0.747238634,-4.926623532,-3.298061617
2024,-0.516652169,-4.88630457,-3.418176463
2025,-0.283580915,-4.884727954,-3.552608889
2026,-0.034582039,-4.864354489,-3.682102174
2027,0.22303711,-4.85142536,-3.815017328
2028,0.514005694,-4.820579196,-3.945611873
2029,0.686062465,-5.276148011,-4.240517311
2030,0.978324946,-5.295747552,-4.387370828
2031,1.275789625,-5.304451777,-4.543476856
2032,1.585914139,-5.294725457,-4.696708235
2033,1.914184074,-5.283521566,-4.844041879
2034,2.25458943,-5.251752259,-4.99971561
2035,2.612740756,-5.211813365,-5.156630011
2036,2.979636892,-5.162862478,-5.31886859
2037,3.35347476,-5.125832781,-5.496657793
2038,3.740446377,-5.068854392,-5.678957124
2039,4.143820655,-5.012110054,-5.866641309
2040,4.559352235,-4.936327072,-6.063053322
2041,4.989343362,-4.865014184,-6.271810749
2042,5.432333673,-4.777934376,-6.48945623
2043,5.889524553,-4.693945374,-6.716973244
2044,6.358113449,-4.612791646,-6.965048153
2045,6.835285777,-4.528964628,-7.229994141
2046,7.32487591,-4.438693932,-7.511726608
2047,7.830125265,-4.349250162,-7.807535764
2048,8.345666908,-4.250566779,-8.129005938
2049,8.871361377,-4.162019292,-8.476577444
2050,9.413584564,-4.065149156,-8.849392171
2051,9.965948093,-3.965542591,-9.250682303
2052,10.53498452,-3.867169046,-9.684713757
2053,11.11677195,-3.768171781,-10.15572357
2054,11.71138217,-3.678181955,-10.65979777
2055,12.32973409,-3.602844094,-11.19933827
2056,12.96823581,-3.501235392,-11.78604706
2057,13.62398173,-3.427471077,-12.42229013
2058,14.30280248,-3.355707067,-13.10620967
2059,14.99974836,-3.272289006,-13.85588501
2060,15.72917435,-3.152372742,-14.66749441
Year,Premium,Payroll,Deficit
2020,0,0,0
2021,3.776070619,5.137907718,5.389002979
2022,3.901461688,5.183049805,5.306992488
2023,3.971162835,5.202299631,5.207919127
2024,4.070718511,5.241126975,5.117765904
2025,4.196346205,5.298772477,5.034975394
2026,4.330689509,5.359914988,4.957297127
2027,4.471081696,5.433702285,4.868775739
2028,4.629140132,5.504017057,4.771898213
2029,4.968072509,5.760206696,4.854249439
2030,5.144780116,5.844035666,4.749686869
2031,5.339528011,5.932705314,4.650436759
2032,5.544901788,6.02889817,4.539186657
2033,5.77250717,6.141612414,4.428511427
2034,5.992387599,6.246582987,4.30829672
2035,6.211414181,6.357569508,4.167815671
2036,6.442565055,6.471701649,4.011517187
2037,6.691929645,6.595107724,3.853048094
2038,6.951903466,6.711791872,3.678263611
2039,7.220365879,6.834855067,3.494744131
2040,7.496558004,6.955033295,3.29806542
2041,7.787831591,7.081866329,3.090682974
2042,8.092657455,7.217834776,2.863644764
2043,8.410889307,7.36276835,2.631819594
2044,8.737552338,7.509920048,2.385383469
2045,9.091481195,7.676073832,2.138693219
2046,9.466897345,7.858110346,1.877278643
2047,9.846532323,8.042460213,1.595779356
2048,10.24390623,8.230521789,1.299050439
2049,10.65284048,8.427012886,0.984404465
2050,11.07219219,8.626617204,0.644578576
2051,11.51469977,8.844880745,0.294176769
2052,11.97241659,9.069645059,-0.080907146
2053,12.44190392,9.299341474,-0.485332038
2054,12.92761447,9.536169033,-0.908082082
2055,13.41968533,9.790872639,-1.364999087
2056,13.92343653,10.05105044,-1.862896092
2057,14.44469096,10.31990971,-2.393203827
2058,14.96930101,10.59304175,-2.983840851
2059,15.52351602,10.88059964,-3.619916353
2060,16.10059968,11.16824146,-4.297826618