14 items found
We estimate that importers avoided 13.1 percent ($6.5 billion) of new tariffs by accelerating purchases and changing their purchasing patterns in response to the new tariff regime. Importers especially stockpiled pharmaceuticals and precious metals during 2025 Q1.
Treasury debt held by the public is an explicit pay-as-you-go obligation. The government also runs implicit pay-as-you-go obligations, such as Social Security and Medicare Part A, which are twice as large. Both types of obligations require tax increases and spending cuts to balance the budget over time.
President Biden recently proposed that Medicare and Medicaid cover obesity medications starting in 2026. PWBM estimates a 10-year cost of $140 billion.
PWBM estimates that President Biden’s new Medicare proposal would increase the solvency of the Medicare trust fund from the year 2028 to 2053. However, a significant share of that increase comes from redirecting existing (current law) revenue to the trust fund. Another portion comes from unspecific expenditure reductions that lack the details required to score. Counting only new income without unspecified expenditure reductions, we project, as an illustrative alternative, that the HI trust fund would remain solvent until 2037.
PWBM estimates that the Inflation Reduction Act would reduce non-interest cumulative deficits by $248 billion over the budget window with no impact on GDP in 2031. The impact on inflation is statistically indistinguishable from zero. An illustrative scenario is also presented where Affordable Care Act subsidies are made permanent. Under this illustrative alternative, the 10-year deficit reduction estimate falls to $89 billion.
PWBM estimates that Medicaid’s inflation adjusted expenditures on Long Term Care services will increase from $130 billion in 2020 (0.62 percent of GDP) to $179 billion in 2030 (0.71 percent of GDP). We project that Medicaid expenditures on Nursing Home and Home Health will increase 4.7 percent and 6.9 percent per year above inflation through 2030, respectively.
PWBM estimates that auto-enrolling into a Medicare Advantage (MA) plan those who age into Medicare and fail to sign up for Medicare Fee-For-Service (FFS) or another MA plan would increase enrollment in the MA program by 1.4 million people in 2032 and increase federal outlays by $189 billion over the 2022-32 period. If we assume that in response to such a policy change people would lose the incentive to enroll in Medicare FFS and instead get automatically enrolled into a MA plan, enrollment would increase by 6.8 million people in 2032 and outlays would increase by $269 billion over the 2022-32 period.
This brief analyzes the impact on health insurance premiums, out-of-pocket spending, and the economy for the healthcare proposal from Daniel Evan McGary as part of the PWBM Democratizing the Budget Contest.
The Biden healthcare plan focuses on expanding access and affordability of insurance and decreasing prescription drug prices. We estimate that by 2030, relative to current law, the Biden plan would decrease the uninsurance rate from 10 percent to 6 percent, decrease private insurance premiums by 23 percent and out-of-pocket spending by 16 percent, and decrease the percent of the population that forgoes medical care from 7 percent to 4 percent. The Biden healthcare plan would increase net spending by $352 billion over ten years but would reduce debt by 4.5 percent over that period due to dynamic growth effects.
PWBM uses dynamic distributional analysis to evaluate the effects of the Biden platform on different age and income groups. We find that working-age individuals in the bottom 40 percent of taxable income benefit the most due to expanded health insurance, increases in housing subsidies, and lower cost of prescriptions in the Biden platform, while young, high-income individuals and wealthy retirees see net losses due to tax increases and lower returns on their savings.
We report results from a survey of Pennsylvania physicians, finding that more than half report large decreases in hours worked for staff in their workplaces and 44 percent anticipate their income to decrease by more than half. We estimate PA doctors could lose $6 billion in income during 2020 Q3, with 45 percent of those in private practice anticipating shutting down within the next six months.
Study finds that patient satisfaction scores are related to factors other than health. Linking these scores to physician pay could lead to lower compensation for young female doctors and incentivize doctors to prescribe controlled substances at higher rates.
Background: Assessing patient experiences with healthcare and publicly reporting this information is increasingly prevalent. Patients use this data when reviewing physicians and hospital systems. Measurements of patient satisfaction are increasingly integrated into payment policies from insurance companies. Objective: This study analyzes (1) the relationship of physician characteristics and treatment modalities to patient satisfaction scores among primary care physicians and (2) the relationship of higher patient satisfaction scores to compliance with health maintenance objectives like mammography and colonoscopy. Main Measures: CAHPS survey as administered by Press Ganey for Main Line Health Care physicians in suburban Philadelphia. Survey data obtained on 115 physicians over 345 "doctor-years." Patient data identified by ICD9/10 codes linked to chief complaints of (1) upper respiratory illness (2) back pain and (3) fatigue, depression and anxiety. Treatment modalities groupings include (a) prescriptions for antibiotics (b) prescriptions for narcotics, (c) prescriptions for stimulants, (d) prescriptions for benzodiazepines, and (e) orders for radiologic imaging. Rates of colonoscopies and mammograms per provider were obtained for the year 2017. Key Results: Providers in practice for longer periods of time received higher top box scores. There is a significant difference in top box scores for female physicians years 0-3 and 4-9 when compared to male physicians in practice more than 10 years. There is a significant relationship between top box scores and the physician's rate of writing prescriptions for benzodiazepines, narcotics and stimulants. There is a positive correlation between top box score and compliance with mammography and colonoscopy screenings. Conclusions: Press Ganey top box score correlates with physician gender, years of experience, and certain treatment modalities. There is a correlation between high patient satisfaction scores and rate of mammography and colonoscopy compliance. Our results do not imply a causative relationship but may be suggestive that one exists.
We document that states that experienced website glitches in the ACA's first year faced higher average costs that persisted into future years. These dynamics are inconsistent with the standard strategic-pricing model, which requires non-localized common knowledge about market conditions, but are consistent with price-taking. Initial conditions can have a permanent effect—including convergence to a Pareto-dominated, stable equilibrium—under conditions that we show are plausible in this setting. Changing the fine from a fixed amount to a fraction of equilibrium prices increases the likelihood of reaching a Pareto-efficient equilibrium without increasing the equilibrium fine collected.
