How Much of the 医疗保险 Spending Slowdown Can be Explained? Insights and Analysis from 2014

多年来,分析人士一直警告联邦决策者,医疗保健支出的长期增长可能会威胁联邦预算并消耗该国经济的不可持续份额。1 医疗保险 is by far the largest federal health program in terms of spending,2 从历史上看,该计划的支出增长是由注册人数和每名注册人数的持续增长推动的。因为医疗保险在联邦预算和国家中所占的份额不断增加’经济形势下,对医疗保险支出增长的担忧促使人们不断提出有关计划重大改革的建议,例如增加资格年龄,调整医疗保险结构等’福利设计,或将计划转移到定义的供款安排。3

Against this backdrop, a seemingly incongruous storyline has emerged in recent years: 医疗保险 spending growth of late has been remarkably low relative to historical norms. Annual growth in aggregate spending has averaged just over 3 percent since 2009, despite rapid enrollment growth due to the aging of the “baby boom” generation. On a per enrollee basis, 医疗保险 spending has been growing more slowly than GDP per capita,4 并且自2009年以来一直相对平稳-自2011年以来,以名义美元计算甚至下降幅度很小 (图1). Both the magnitude and the duration of the slowdown in 医疗保险 spending growth have no precedent in 医疗保险’已有近50年的历史。

Exhibit 1: 医疗保险 spending per beneficiary has been relatively flat in recent years

Exhibit 1: 医疗保险 spending per beneficiary has been relatively flat in recent years

医疗保险’s recent slow spending growth has manifested itself in several ways. Between 2009 and 2014, the 医疗保险 Trustees extended by more than 10 years their projections of the solvency of the 医疗保险 Hospital Insurance trust fund, from 2017 (2009 projection) to 2030 (2014 projection)—which is also related to growth in revenues from a payroll tax increase included in the Affordable Care Act (ACA) and to a stronger economy.5 医疗保险支出的缓慢增长也导致Medicare保费和费用分担的增长相对适度,而随着计划成本的增加,该指数会上升。例如,与B部分支出增长挂钩的Medicare B部分保费在2013年至2014年之间没有变化,2015年将与前两年相同。而且,Medicare受托人预计,到2022年,独立支付顾问委员会(IPAB)(一个有争议但尚未任命或召集的独立实体,由ACA授权作为支出支持)将不会在2022年之前发布有关Medicare储蓄的建议。相对较低的预计支出趋势。6

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