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Code · BILL · 113th Congress · H. Con. Res. 96 (Reported in House) — Establishing the budget for the United States Government for fiscal year 2015 and setting forth appropriate budgetary... · Sec. 401

Sec. 401. Direct spending

563 words·~3 min read·/bill/113/hconres/96/rh/section-401·

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For means-tested direct spending, the average rate of growth in the total level of outlays during the 10-year period preceding fiscal year 2015 is 6.8 percent. For means-tested direct spending, the estimated average rate of growth in the total level of outlays during the 10-year period beginning with fiscal year 2015 is 5.4 percent under current law. The following reforms are proposed in this concurrent resolution for means-tested direct spending: In 1996, a Republican Congress and a Democratic president reformed welfare by limiting the duration of benefits, giving States more control over the program, and helping recipients find work.
In the five years following passage, child-poverty rates fell, welfare caseloads fell, and workers’ wages increased. This budget applies the lessons of welfare reform to both the Supplemental Nutrition Assistance Program and Medicaid. For Medicaid, this budget assumes the conversion of the Federal share of Medicaid spending into a flexible State allotment tailored to meet each State’s needs, indexed for inflation and population growth. Such a reform would end the misguided one-size-fits-all approach that has tied the hands of State governments.
Instead, each State would have the freedom and flexibility to tailor a Medicaid program that fits the needs of its unique population. Moreover, this budget assumes the repeal of the Medicaid expansions in the President’s health care law, relieving State governments of its crippling one-size-fits-all enrollment mandates. For the Supplemental Nutrition Assistance Program, this budget assumes the conversion of the program into a flexible State allotment tailored to meet each State’s needs.
The allotment would increase based on the Department of Agriculture Thrifty Food Plan index and beneficiary growth. Such a reform would provide incentives for States to ensure dollars will go towards those who need them most. Additionally, it requires that more stringent work requirements and time limits apply under the program. For nonmeans-tested direct spending, the average rate of growth in the total level of outlays during the 10-year period preceding fiscal year 2015 is 5.7 percent.
For nonmeans-tested direct spending, the estimated average rate of growth in the total level of outlays during the 10-year period beginning with fiscal year 2015 is 5.4 percent under current law. The following reforms are proposed in this concurrent resolution for nonmeans-tested direct spending: For Medicare, this budget advances policies to put seniors, not the Federal Government, in control of their health care decisions. Those in or near retirement will see no changes, while future retirees would be given a choice of private plans competing alongside the traditional fee-for-service Medicare program.
Medicare would provide a premium-support payment either to pay for or offset the premium of the plan chosen by the senior, depending on the plan’s cost. The Medicare premium-support payment would be adjusted so that the sick would receive higher payments if their conditions worsened; lower-income seniors would receive additional assistance to help cover out-of-pocket costs; and wealthier seniors would assume responsibility for a greater share of their premiums. Putting seniors in charge of how their health care dollars are spent will force providers to compete against each other on price and quality.
This market competition will act as a real check on widespread waste and skyrocketing health care costs. In keeping with a recommendation from the National Commission on Fiscal Responsibility and Reform, this budget calls for Federal employees—including Members of Congress and congressional staff—to make greater contributions toward their own retirement.
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