Archive
New From the GAO
New GAO Reports
Source: Government Accountability Office
1. Batteries and Energy Storage: Federal Initiatives Supported Similar Technologies and Goals but Had Key Differences. GAO-12-842, August 30.
http://www.gao.gov/products/GAO-12-842
Highlights – http://www.gao.gov/assets/650/647743.pdf
2. Solar Energy: Federal Initiatives Overlap but Take Measures to Avoid Duplication. GAO-12-843, August 30.
http://www.gao.gov/products/GAO-12-843
Highlights – http://www.gao.gov/assets/650/647733.pdf
3. Ambulance Providers: Costs and Medicare Margins Varied Widely; Transports of Beneficiaries Have Increased. GAO-13-6, October 1.
http://www.gao.gov/products/GAO-13-6
Highlights – http://www.gao.gov/assets/650/649019.pdf
CBO Releases a Report on the Taxation of Capital and Labor Through the Self-Employment Tax
CBO Releases a Report on the Taxation of Capital and Labor Through the Self-Employment Tax
Source: Congressional Budget Office
Today CBO released a report, The Taxation of Capital and Labor Through the Self-Employment Tax.
The Self-Employment Contributions Act (SECA) tax is paid mainly by certain small business owners. That tax on sole proprietors and owners of partnerships is often characterized as one that parallels the Federal Insurance Contributions Act (FICA) tax that employers and employees pay to fund Social Security and Medicare. The two taxes, CBO concludes, are not really parallel in the way that they tax capital income and labor income. (For people who are not self-employed, interest, dividends, rents, and capital gains are capital income, and wages and benefits are labor income.) The differences in the treatment of capital and labor income may prompt people to make choices that they would not otherwise make about self-employment or the organizational form of a business, thereby reducing the efficient allocation of resources.
CBO finds that:
- Approximately 40 percent of the SECA tax base derives from capital income and 60 percent from labor income. The FICA tax base, in contrast, derives entirely from labor income.
- More than half of the labor income of self-employed people is not included in the SECA tax base. In contrast, virtually all of the labor income of employees is taxable under FICA.
CBO analyzed three options that would modify the SECA tax base by either reducing the share of capital income or increasing the share of labor income it includes. No option by itself would accomplish both of those objectives when applied to both sole proprietorships and partnerships, but one option would do so if applied only to partnerships.
Excluded Individuals Employed by Providers Enrolled in Medicaid Managed Care Entities
Excluded Individuals Employed by Providers Enrolled in Medicaid Managed Care Entities (PDF)
Source: U.S. Department of Health and Human Services, Office of Inspector General
WHY WE DID THIS STUDY
OIG is authorized to exclude certain individuals and entities (providers) from participating in federally funded health care programs, such as Medicaid managed care. These programs are generally prohibited from paying for any items or services furnished, ordered, or prescribed by an excluded provider or paying anyone who contracts with an excluded provider. In Medicaid managed care, States contract with managed care entities (MCE) to provide healthcare services to enrolled beneficiaries. The managed care entities create and manage networks of providers who deliver healthcare services to the enrolled beneficiaries. Since the providers in the Medicaid managed care networks are not under direct oversight by the States, we wanted to determine if the provider networks are vulnerable to excluded providers.
HOW WE DID THIS STUDY
This is the second of two evaluations related to excluded providers in Medicaid managed care. In the prior study, entitled Excluded Providers in Medicaid Managed Care Entities (OEI‑07‑09‑00630), we compared the provider networks of 12 selected MCEs to the List of Excluded Individuals and Entities (LEIE) to identify excluded providers. In the current study, we selected a stratified random sample of 500 hospitals, nursing facilities, home health agencies, and pharmacies from the population of providers enrolled in the 12 MCEs. From each of the 500 sampled providers, we collected rosters of employees in 2011, and responses to a survey on the safeguards they used to ensure that excluded individuals are not employed. We compared the employee rosters to the LEIE to identify excluded individuals.
WHAT WE FOUND
Of the 248,869 individuals listed on the employee rosters requested from sampled providers, we identified 16 individuals who were excluded among the employees of 14 sampled providers. Incorrect names and failure of contractors to follow procedures contributed to the employment of the excluded individuals. Most providers reported using a variety of safeguards to ensure they do not employ excluded individuals, but identified costs and resource burdens as challenges in executing those safeguards. Seven percent of providers in the 12 selected MCEs do not check the exclusions status of their employees; most of these providers lacked knowledge regarding exclusions.
This report does not contain recommendations.
Population Aging Will Have Long-Term Implications for Economy; Major Policy Changes Needed
Population Aging Will Have Long-Term Implications for Economy; Major Policy Changes Needed
Source: National Research Council
The aging of the U.S. population will have broad economic consequences for the country, particularly for federal programs that support the elderly, and its long-term effects on all generations will be mediated by how — and how quickly — the nation responds, says a new congressionally mandated report from the National Research Council. The unprecedented demographic shift in which people over age 65 make up an increasingly large percentage of the population is not a temporary phenomenon associated with the aging of the baby boom generation, but a pervasive trend that is here to stay.
…Social Security, Medicare, and Medicaid are on unsustainable paths, and the failure to remedy the situation raises a number of economic risks, the report says. Together, the cost of the three programs currently amounts to roughly 40 percent of all federal spending and 10 percent of the nation’s gross domestic product. Because of overall longer life expectancy and lower birth rates, these programs will have more beneficiaries with relatively fewer workers contributing to support them in the coming decades. Combined with soaring health care costs, population aging will drive up public health care expenditures and demand an ever-larger fraction of national resources.
Population aging is also occurring in other industrialized nations, so any consequences for the U.S. must be considered in the broader context of a global economy. Adapting to this new economic landscape entails costs and policy options with different implications for which generations will bear the costs or receive the benefits. Recent policy actions have attempted to address health care costs, but their effects are as yet unclear. According to the report, the ultimate national response will likely be some combination of major structural changes to public support programs, more savings during people’s working years, and longer working lives.
New From the GAO
New GAO Reports and Testimonies
Source: Government Accountability Office
+ Reports
1. Driver’s License Security: Federal Leadership Needed to Address Remaining Vulnerabilities. GAO-12-893, September 21.
http://www.gao.gov/products/GAO-12-893
Highlights – http://www.gao.gov/assets/650/648692.pdf
2. Military Readiness: Navy Needs to Assess Risks to Its Strategy to Improve Ship Readiness. GAO-12-887, September 21.
http://www.gao.gov/products/GAO-12-887
Highlights – http://www.gao.gov/assets/650/648683.pdf
Podcast – http://www.gao.gov/multimedia/podcasts/648595
3. Status of Open World Exchange Program’s Efforts to Strengthen Financial Management and Performance Measurement. GAO-12-1004R, September 21.
http://www.gao.gov/products/GAO-12-1004R
+ Testimonies
1. Homeland Security: DHS Requires More Disciplined Investment Management to Help Meet Mission Needs, by John Hutton, director, acquisition and sourcing management, before the Subcommittee on Oversight, Investigations, and Management, House Committee on Homeland Security. GAO-12-1029T, September 21.
http://www.gao.gov/products/GAO-12-1029T
2. Medicare Private Health Plans: Selected Current Issues, by James Cosgrove, director, health care, before the Subcommittee on Health, House Committee on Ways and Means. GAO-12-1045T, September 21.
http://www.gao.gov/products/GAO-12-1045T
Highlights – http://www.gao.gov/assets/650/648678.pdf
New From the GAO
New GAO Reports and Testimony
Source: Government Accountability Office
+ Reports
1. Military Disability System: Improved Monitoring Needed to Better Track and Manage Performance. GAO-12-676, August 28.
http://www.gao.gov/products/GAO-12-676
Highlights – http://www.gao.gov/assets/650/647592.pdf
2. Medicare Special Needs Plans: CMS Should Improve Information Available about Dual-Eligible Plans’ Performance. GAO-12-864, September 13.
http://www.gao.gov/products/GAO-12-864
Highlights – http://www.gao.gov/assets/650/648292.pdf
3. Waivers Related to the Temporary Assistance for Needy Families Block Grant. GAO-12-1028R, September 19.
http://www.gao.gov/products/GAO-12-1028R
4. Homeland Security: DHS Requires More Disciplined Investment Management to Help Meet Mission Needs. GAO-12-833, September 18.
http://www.gao.gov/products/GAO-12-833
Highlights – http://www.gao.gov/assets/650/648489.pdf
5. Human Capital: Complete Information and More Analyses Needed to Enhance DOD’s Civilian Senior Leader Strategic Workforce Plan. GAO-12-990R, September 19.
http://www.gao.gov/products/GAO-12-990R
6. Next Generation Enterprise Network: Navy Implementing Revised Approach, but Improvement Needed in Mitigating Risks. GAO-12-956, September 19.
http://www.gao.gov/products/GAO-12-956
Highlights – http://www.gao.gov/assets/650/648567.pdf
7. Suspension and Debarment: DOD Has Active Referral Processes, but Action Needed to Promote Transparency. GAO-12-932, September 19.
http://www.gao.gov/products/GAO-12-932
Highlights – http://www.gao.gov/assets/650/648578.pdf
+ Testimony
1. Human Capital Management: Effectively Implementing Reforms and Closing Critical Skills Gaps Are Key to Addressing Federal Workforce Challenges, by Gene L. Dodaro, Comptroller General of the United States, before the Subcommittee on Oversight of Government Management, the Federal Workforce, and the District of Columbia, House Committee on Homeland Security and Governmental Affairs. GAO-12-1023T, September 19.
http://www.gao.gov/products/GAO-12-1023T
Highlights – http://www.gao.gov/assets/650/648593.pdf
New From the GAO
New GAO Reports
Source: Government Accountability Office
+ Reports
1. Housing Assistance: Opportunities Exist to Increase Collaboration and Consider Consolidation. GAO-12-554, August 16.
http://www.gao.gov/products/GAO-12-554
Highlights – http://www.gao.gov/assets/600/593766.pdf
+ Related Product
Housing Assistance: An Inventory of Fiscal Year 2010 Programs, Tax Expenditures, and Other Activities, an E-supplement to GAO-12-554. GAO-12-555SP, August 16.
http://www.gao.gov/products/GAO-12-55sp
2. Medicaid: States’ Use of Managed Care. GAO-12-872R, August 17.
http://www.gao.gov/products/GAO-12-872R
3. Federal Training Investments: Office of Personnel Management and Agencies Can Do More to Ensure Cost-Effective Decisions. GAO-12-878, September 17.
http://www.gao.gov/products/GAO-12-878
Highlights – http://www.gao.gov/assets/650/648401.pdf
New From the GAO
New GAO Reports and Testimonies
Source: Government Accountability Office
+ Reports
1. Spent Nuclear Fuel: Accumulating Quantities at Commercial Reactors Present Storage and Other Challenges. GAO-12-797, August 15.
http://www.gao.gov/products/GAO-12-797
Highlights – http://www.gao.gov/assets/600/593746.pdf
2. Federal Real Property: Strategic Partnerships and Local Coordination Could Help Agencies Better Utilize Space. GAO-12-779, July 25.
http://www.gao.gov/products/GAO-12-779
Highlights – http://www.gao.gov/assets/600/593002.pdf
3. Electronic Government Act: Agencies Have Implemented Most Provisions, but Key Areas of Attention Remain. GAO-12-782, September 12.
http://www.gao.gov/products/GAO-12-782
Highlights – http://www.gao.gov/assets/650/648181.pdf
4. Recovery Act: Broadband Programs Are Ongoing, and Agencies’ Efforts Would Benefit from Improved Data Quality. GAO-12-937, September 14.
http://www.gao.gov/products/GAO-12-937
Highlights – http://www.gao.gov/assets/650/648356.pdf
5. The Distribution of Federal Economic Development Grants to Communities with High Rates of Poverty and Unemployment. GAO-12-938R, September 14.
http://www.gao.gov/products/GAO-12-938R
6. Unmanned Aircraft Systems: Measuring Progress and Addressing Potential Privacy Concerns Would Facilitate Integration into the National Airspace System. GAO-12-981, September 14.
http://www.gao.gov/products/GAO-12-981
Highlights – http://www.gao.gov/assets/650/648349.pdf
7. Medicare Savings Programs: Implementation of Requirements Aimed at Increasing Enrollment. GAO-12-871, September 14.
http://www.gao.gov/products/GAO-12-871
Highlights – http://www.gao.gov/assets/650/648369.pdf
8. Disaster Relief: Reimbursements to the American Red Cross for Certain 2008 Disaster Assistance. GAO-12-877, September 14.
http://www.gao.gov/products/GAO-12-877
Highlights – http://www.gao.gov/assets/650/648340.pdf
9. Disaster Assistance: USDA and SBA Could Do More to Help Aquaculture and Nursery Producers. GAO-12-844, September 11.
http://www.gao.gov/products/GAO-12-844
Highlights – http://www.gao.gov/assets/650/648075.pdf
+ Testimonies
1. SSA Disability Programs: Progress and Challenges Related to Modernizing, by Dan Bertoni, director, education, workforce, and income security issues, before the Subcommittee on Social Security, House Ways and Means Committee. GAO-12-891T, September 14.
http://www.gao.gov/products/GAO-12-891T
2. Human Capital: The Department of Health and Human Service’s and Environmental Protection Agency’s Use of Special Pay Rates for Consultants and Scientists, by Robert Goldenkoff, director, strategic issues, and Robert Cramer, managing associate general counsel, before the Subcommittee on Health, House Committee on Energy and Commerce. GAO-12-1035T, September 14.
http://www.gao.gov/products/GAO-12-1035T
Highlights – http://www.gao.gov/assets/650/648328.pdf
Plan Participation in Health Insurance Exchanges: Implications for Competition and Choice
Plan Participation in Health Insurance Exchanges: Implications for Competition and Choice
Source: Urban Institute
This brief examines the conditions under which competition in health insurance exchanges is likely to be effective in placing downward pressure on insurance premiums. We conclude that areas with a single dominant insurer or a dominant hospital system are less likely to experience effective competition. In markets in which there are several insurers with significant market share and no dominant hospital system, the result could be limited or tiered network products that could successfully constrain the cost of premiums. Participation of existing Medicaid plans may also increase effective competition in health insurance exchanges.
States Collection of Medicaid Rebates for Drugs Paid Through Medicaid Managed Care Organizations
States Collection of Medicaid Rebates for Drugs Paid Through Medicaid Managed Care Organizations (PDF)
Source: U.S. Department of Health and Human Services, Office of Inspector General
WHY WE DID THIS STUDY
In general, drug manufacturers must pay rebates for covered outpatient drugs reimbursed under Medicaid for States to receive Federal matching funds. Drugs dispensed by Medicaid Managed Care Organizations (MCO) were excluded from this requirement until March 23, 2010, when section 2501(c) of the Patient Protection and Affordable Care Act expanded the rebate requirement to include these drugs. To realize the full savings under this expansion, it is important that States collect accurate drug utilization data from MCOs and that States invoice and collect rebate payments from manufacturers.
HOW WE DID THIS STUDY
In October 2011, we sent surveys about rebate collections involving MCOs to all 50 States and the District of Columbia (hereinafter referred to as States) and received responses from all but 1 State. States that paid for drugs through their MCOs (the carve-in approach) were asked about the drug utilization data collected from MCOs, their processes for invoicing and collecting rebates from manufacturers using these data, and the amounts of rebates collected between the second quarter of 2010 and the second quarter of 2011. We asked States that did not pay for drugs through their MCOs (the carve-out approach) or did not contract with MCOs about potential changes to their drug programs’ structures as a result of the rebate expansion.
WHAT WE FOUND
Between April 1, 2010, and June 30, 2011, 18 of the 22 States using a carve-in approach collected all the data needed to invoice manufacturers for rebates from their MCOs, 3 collected data from a portion of their MCOs, and 1 never collected any drug utilization data. All but one State that used a carve-in approach performed some type of data verification check. Twelve of the twenty-two States using a carve-in approach invoiced manufacturers and collected $1.6 billion in rebates for utilization in the second quarter of 2010 through the second quarter of 2011. However, 10 of the 22 States did not invoice manufacturers and collect rebates because, for example, they had to complete programming changes to the systems that process MCO claims. Additionally, the rebate expansion has prompted five States that used the carve-out approach to change to a carve-in approach.
WHAT WE RECOMMEND
We recommend that CMS follow up with the 10 States that had not collected rebates for drugs dispensed to Medicaid MCO beneficiaries and take action to enforce rebate collection if necessary. CMS concurred.
New From the GAO
New GAO Report
Source: Government Accountability Office
Medicaid Long-Term Care: Information Obtained by States about Applicants’ Assets Varies and May Be Insufficient. GAO-12-749, July 26.
http://www.gao.gov/products/GAO-12-749
Highlights – http://www.gao.gov/assets/600/593054.pdf
Top Ten Myths of Medicare
Top Ten Myths of Medicare
Source: Social Science Research Network
In the context of changing demographics, the increasing cost of health care services, and continuing federal budgetary pressures, Medicare has become one of the most controversial federal programs. To facilitate an informed debate about the future of this important public initiative, this article examines and debunks the following ten myths surrounding Medicare: (1) there is one Medicare program, (2) Medicare is going bankrupt, (3) Medicare is government health care, (4) Medicare covers all medical cost for its beneficiaries, (5) Medicare pays for long-term care expenses, (6) the program is immune to budgetary reduction, (7) it wastes much of its money on futile care, (8) Medicare is less efficient than private health insurance, (9) Medicare is not means-tested, and (10) increased longevity will sink Medicare.
New From the GAO
New GAO Report
Source: Government Accountability Office
Medicaid: States Reported Billions More in Supplemental Payments in Recent Years. GAO-12-694, July 20.
http://www.gao.gov/products/GAO-12-694
Highlights – http://www.gao.gov/assets/600/592784.pdf
Opting in to the Medicaid Expansion under the ACA; Who are the Uninsured Adults Who Could Gain Health Insurance Coverage
Opting in to the Medicaid Expansion under the ACA; Who are the Uninsured Adults Who Could Gain Health Insurance Coverage
Source: Urban Institute
This brief provides new national and state-level information about the uninsured adults with incomes below 138 percent of FPL who could become eligible for Medicaid if states decide to expand Medicaid under the Affordable Care Act (ACA). At present, few states cover non-disabled, non-pregnant parents with incomes up to 138 percent of the Federal Poverty Level (FPL) and even fewer cover such adults without dependent children. This analysis shows that the approximately 15 million uninsured adults who could gain coverage under the ACA Medicaid expansion are a diverse group in terms of their age, gender and race/ethnicity.
CBO — Medicare’s Payments to Physicians: The Budgetary Impact of Alternative Policies Relative to CBO’s March 2012 Baseline
Medicare’s Payments to Physicians: The Budgetary Impact of Alternative Policies Relative to CBO’s March 2012 Baseline
Source: Congressional Budget Office
Medicare’s payment rates for physicians’ services are scheduled to be reduced by 27 percent in 2013, CBO estimates, under the provisions of law known as Medicare’s Sustainable Growth Rate (SGR) mechanism. The SGR mechanism consists of expenditure targets, which are established by applying a growth rate (calculated by formula) to spending for physicians’ services and certain related services in a base period, and annual adjustments to the payment rates, which are designed to bring spending in line with the expenditure targets over time. (For further discussion of the SGR, see the appendix of Changes in Payments to Physicians.) In each of the past several years, legislation has been enacted to override the SGR and to either maintain or increase those payment rates when they were otherwise scheduled to decrease.
The attached tables show CBO’s estimates of the budgetary impact over the 2013–2022 period of various alternative policies for modifying the payment rates that are scheduled to take effect under the SGR mechanism. The options in the tables are listed in three categories: “cliff” options, “clawback” options, and others. (See the descriptions of those terms in the attached document; both “cliff” and “clawback” approaches have been adopted since the Congress began overriding scheduled reductions in physician payment updates in 2003.)
The estimates in the tables are relative to CBO’s March 2012 baseline, which is used for Congressional scorekeeping purposes. Both the scorekeeping baseline and the estimates of the impact of the policy options are likely to change when the final rule setting the physician fee schedule for 2013 is issued by the Administration in early November.
Inappropriate and Questionable Billing by Medicare Home Health Agencies
Inappropriate and Questionable Billing by Medicare Home Health Agencies (PDF)
Source: U.S. Office of Health and Human Services, Office of Inspector General
WHY WE DID THIS STUDY
In 2010, Medicare paid $19.5 billion to 11,203 home health agencies (HHA) for services provided to 3.4 million beneficiaries. Recent investigations and prior Office of Inspector General studies have found that home health services are vulnerable to fraud, waste, and abuse.HOW WE DID THIS STUDY
We analyzed data from home health, inpatient hospital, and skilled nursing facility claims from 2010 to identify inappropriate home health payments. In addition, we identified HHAs that billed unusually high amounts according to at least one of our six measures of questionable billing. Although these six measures indicate potential fraud, there may be legitimate reasons for an HHA to exceed the threshold for unusually high billing on any of the six measures. We also determined the geographic locations of HHAs that had questionable billing.
WHAT WE FOUND
In 2010, Medicare inappropriately paid $5 million for home health claims with three specific errors: overlapping with claims for inpatient hospital stays, overlapping with claims for skilled nursing facility stays, or billing for services on dates after beneficiaries’ deaths. Further, we found that approximately one in every four HHAs exceeded the threshold that indicated unusually high billing for at least one of our six measures of questionable billing. Overall, HHAs with questionable billing were located mostly in Texas, Florida, California, and Michigan.
WHAT WE RECOMMEND
We recommend that CMS:
(1) Implement claims processing edits or improve existing edits to prevent inappropriate payments for the three specific errors we reviewed,
(2) Increase monitoring of billing for home health services,
(3) Enforce and consider lowering the 10‑percent cap on the total outlier payments an HHA may receive annually,
(4) Consider imposing a temporary moratorium on new HHA enrollments in Florida and Texas, and
(5) Take appropriate action regarding the inappropriate payments we identified and HHAs with questionable billing.
CMS concurred with all five recommendations; however, it disagreed with our estimate of the inappropriate payments for home health claims overlapping with claims for inpatient hospital stays and skilled nursing facility stays.
New From the GAO
New GAO Reports and Testimony
Source: Government Accountability Office
+ Reports
1. Influenza Pandemic: Agencies Report Progress in Plans to Protect Federal Workers but Oversight Could Be Improved. GAO-12-748, July 25.
http://www.gao.gov/products/GAO-12-748
Highlights – http://www.gao.gov/assets/600/592990.pdf
2. Medicare: CMS Needs an Approach and a Reliable Cost Estimate for Removing Social Security Numbers from Medicare Cards. GAO-12-831, August 1.
http://www.gao.gov/products/GAO-12-831
Highlights – http://www.gao.gov/assets/600/593216.pdf
3. Medicaid Expansion: States’ Implementation of the Patient Protection and Affordable Care Act. GAO-12-821, August 1.
http://www.gao.gov/products/GAO-12-821
4. Counter-Improvised Explosive Devices: Multiple DOD Organizations are Developing Numerous Initiatives. GAO-12-861R, August 1.
http://www.gao.gov/products/GAO-12-861R
5. Service-Disabled Veteran-Owned Small Business Program: Vulnerability to Fraud and Abuse Remains. GAO-12-697, August 1.
http://www.gao.gov/products/GAO-12-697
Highlights – http://www.gao.gov/assets/600/593237.pdf
6. Contingency Contracting: Agency Actions to Address Recommendations by the Commission on Wartime Contracting in Iraq and Afghanistan. GAO-12-854R, August 1.
http://www.gao.gov/products/GAO-12-854R
7. Ensuring Drug Quality in Global Health Programs. GAO-12-897R, August 1.
http://www.gao.gov/products/GAO-12-897R
+ Related Product
Survey on States’ Implementation of the Patient Protection and Affordable Care Act (GAO-12-944SP, August 2012), an E-supplement to GAO-12-821. GAO-12-944SP, August 1.
http://www.gao.gov/products/GAO-12-944SP
+ Testimony
1. Medicare: Action Needed to Remove Social Security Numbers from Medicare Cards, by Kathleen M. King, director, health care, and Daniel Bertoni, director, education, workforce, and income security issues, before the Subcommittees on Social Security and Health, House Committee on Ways and Means GAO-12-949T, August 1.
http://www.gao.gov/products/GAO-12-949T
The Book of the States 2012
Source: Council of State Governments
State revenue collections in the 2011 fiscal year grew by 6.4 percent and state general fund spending increased by 4 percent following two straight years of decline. The 2011 tax revenues are just $26.6 billion under the peak reached in 2008 and are just shy of the 2007 collections. Meanwhile, the challenges facing states in many programs continue to grow. State spending on Medicaid programs, for instance, is expected to increase nearly 50 percent from 2010 to 2012. Those are just a few examples of information and data found in the 2012 edition of The Book of the States, The Council of State Governments’ annual almanac of information about the states.
New From the GAO
New GAO Reports and Testimonies
Source: Government Accountability Office
+ Reports
1. Bus Rapid Transit: Projects Improve Transit Service and Can Contribute to Economic Development. GAO-12-811, July 25.
http://www.gao.gov/products/GAO-12-811
Highlights – http://www.gao.gov/assets/600/592974.pdf
2. Information Technology: DHS Needs to Further Define and Implement Its New Governance Process. GAO-12-818, July 25.
http://www.gao.gov/products/GAO-12-818
Highlights – http://www.gao.gov/assets/600/592930.pdf
3. Overseas Rightsizing: State Has Improved the Consistency of Its Approach, but Does Not Follow Up on Its Recommendations. GAO-12-799, July 25.
http://www.gao.gov/products/GAO-12-799
Highlights – http://www.gao.gov/assets/600/592966.pdf
4. Retirement Security: Women Still Face Challenges. GAO-12-699, July 19.
http://www.gao.gov/products/GAO-12-699
Highlights – http://www.gao.gov/assets/600/592727.pdf
5. Telecommunications: FCC Has Reformed the High-Cost Program, but Oversight and Management Could be Improved. GAO-12-738, July 25.
http://www.gao.gov/products/GAO-12-738
Highlights – http://www.gao.gov/assets/600/592958.pdf
6. United Nations Renovations: Best Practices Could Enhance Future Cost Estimates. GAO-12-795, July 25.
http://www.gao.gov/products/GAO-12-795
Highlights – http://www.gao.gov/assets/600/592922.pdf
+ Testimonies
1. Grants Management: Improving the Timeliness of Grant Closeouts by Federal Agencies and Other Grants Management Challenges, by Stanley J. Czerwinski, director, strategic issues, before the Subcommittee on Federal Financial Management, Government Information, Federal Services, and International Security, Senate Committee on Homeland Security and Governmental Affairs. GAO-12-704T, July 25.
http://www.gao.gov/products/GAO-12-704T
Highlights – http://www.gao.gov/assets/600/592996.pdf
2. Higher Education: Improved Tax Information Could Help Pay for College, by James R. White, director, strategic issues, and George A. Scott, director, education, workforce, and income security issues, before the Senate Committee on Finance. GAO-12-863T, July 25.
http://www.gao.gov/products/GAO-12-863T
3. Retirement Security: Older Women Remain at Risk, by Barbara D. Bovbjerg, managing director, education, workforce, and income security, before the Senate Special Committee on Aging. GAO-12-825T, July 25.
http://www.gao.gov/products/GAO-12-825T
4. Medicare Advantage: Quality Bonus Payment Demonstration Has Design Flaws and Raises Legal Concerns, by James Cosgrove, director, health care, and Edda Emmanuelli-Perez, managing associate general counsel, before the House Committee on Oversight and Government Reform. GAO-12-964T, July 25.
http://www.gao.gov/products/GAO-12-964T
Kids’ Share 2012: Report on Federal Expenditures on Children Through 2011
Kids’ Share 2012: Report on Federal Expenditures on Children Through 2011
Source: Urban Institute
From press release:
Federal spending on children declined in 2011 for the first time since the early 1980s, the Urban Institute’s sixth annual “Kids’ Share” study estimates. The children’s slice of the federal budget and gross domestic product also shrank.
The decline in spending on kids will continue in the fiscal year that ends September 30, as the economic stimulus funds from the American Recovery and Reinvestment Act of 2009 (ARRA) are nearly exhausted. Assuming no changes in federal policies or law, the children’s share of federal program outlays and of GDP will drop through at least 2022, the Urban Institute researchers forecast.
“In 2012, federal funding on children is projected to decline significantly. State funding is uncertain, but with states still recovering from the recession, it will be challenging for them to fill the gap caused by the drop in federal funding. As a result, there may be cutbacks in services and benefits for children in 2012,” the Kids’ Share research team concludes.
The researchers analyzed dozens of programs and tax expenditures (which reduce tax liabilities) affecting children. Their analysis of fiscal 2011 data, the most recent year for which complete federal data are available, reveals the following:
- Program outlays fell from $378 billion in 2010 to $376 billion in 2011 (figures are in inflation-adjusted 2011 dollars). Tax expenditures, such as the child tax credit, declined from $72 to $69 billion. Combined, total expenditures fell from $450 to $445 billion.
- While the federal government spent less on children in 2011, its total spending increased from $3.52 to $3.60 trillion. As a result, the share of the budget allocated to children fell from 10.7 to 10.4 percent. Programmatic spending on children slipped as a share of GDP from 2.6 to 2.5 percent, and total expenditures on children, including tax expenditures, dropped from 3.1 to 3.0 percent of GDP.
- Children’s 10 percent share in 2011 compares to the 41 percent spent on the elderly and disabled via Social Security, Medicare, and Medicaid; 20 percent on defense; 6 percent on interest payments on the debt; and 23 percent on everything else.
- Ten programs and tax provisions accounted for 75 percent of the $445 billion in expenditures on children, led by Medicaid at $74 billion.
- Federal spending on education was $5 billion lower in 2011 than in 2010. Expenditures also fell in the areas of health, social services, training, and tax provisions, but they rose in nutrition and income security.
- Overall federal-state-local spending per child was generally flat between 2008 and 2011. Education spending declined somewhat, while child health spending increased modestly.
