Restructure Medicare & Medicaid: Policy Option #5 * J * - Consider / Implement CBO’s 26 policy options that Vali 0 could reduce annual budget deficit by up to 38% over the next 10 years (@)) www.kpcb.com USA Inc. | What Might a Turnaround Expert Consider? 323 Restructure Medicare & Medicaid: CBO Policy Options— Regulate Private Health Insurance Market; Modify Tax Code; Modify Insurance Eligibility; Improve Efficiency : : Gov. Future Deficit Policy Options Reduction (%)' Require large employers to either pay government for providing insurance or offer employees 0.7% basic insurance coverage at) Replace the income tax and payroll tax exclusion with a refundable credit 8.8% Replace the income tax exclusion for employment-based health insurance with a deduction 8.0% Reduce the tax exclusion for employment-based health insurance and the health insurance 6.6% deduction for self-employed individuals ue Raise the age of eligibility for Medicare to 67 1.2% Convert Medicare and Medicaid “Disproportionate Share Hospital Payments” into a block grant 1.2% Consolidate Medicare and Federal Medicaid payments for graduate medical education costs at teaching hospitals; set consolidated payment equal to: * Adjusted IME? payments using a 2.2% adjustment factor + DGME‘4 and Medicaid GME? funding 0.8% inflated by the CPI-U5 minus 1 percentage point ot a * 90% total mandatory GME? funding inflated by the CPI-U minus 1 percentage point 0.4% Note: 1) As % of Cumulative Total Government Deficit from 2010 to 2019 2) Graduate Medical Education 3) Indirect Medical KP Education 4) Direct Graduate Medical Education 5) Consumer price index for all urban consumers Source: CBO Ce USA Inc. | What Might a Turnaround Expert Consider? 324 HOUSE_OVERSIGHT_021003