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Status of the Social Security and Medicare Programs">
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<h2>Status of the Social Security and Medicare Programs</h2><!-- #EndEditable -->
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<p> <a href="../../index.html">Office of the Chief Actuary </a> </p>
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<p> <a href="../../TR/2012/index.html">2012 Trustees Report </a> </p>
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<p> <a href="../../pubs.html">Actuarial Publications</a> </p>
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<h2 >A SUMMARY OF THE 2012 ANNUAL REPORTS</h2>
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Social Security and Medicare Boards of Trustees
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<br />
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<h3 class="center">A MESSAGE TO THE PUBLIC:</h3>
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<p>
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Each year the Trustees of the Social Security and Medicare trust funds
|
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report on the current and projected financial status of the two programs. This message summarizes our 2012 Annual Reports.
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</p>
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<p>
|
||
The long-run actuarial deficits of the Social Security and Medicare programs worsened in 2012, though in each case for
|
||
different reasons. The actuarial deficit in the Medicare Hospital Insurance program increased primarily because the
|
||
Trustees incorporated recommendations of the 2010-11 Medicare Technical Panel that long-run health cost growth rate
|
||
assumptions be somewhat increased. The actuarial deficit in Social Security increased largely because of the
|
||
incorporation of updated economic data and assumptions. Both Medicare and Social Security cannot sustain projected
|
||
long-run program costs under currently scheduled
|
||
financing, and legislative modifications are necessary to avoid disruptive consequences for beneficiaries and taxpayers.
|
||
</p>
|
||
<p>
|
||
Lawmakers should not delay addressing the long-run financial challenges facing Social Security and Medicare. If they take
|
||
action sooner rather than later, more options and more time will be available to phase in changes so that the public has
|
||
adequate time to prepare. Earlier action will also help elected officials minimize
|
||
adverse impacts on vulnerable populations, including lower-income workers and people already dependent on program benefits.
|
||
</p>
|
||
<p>
|
||
Social Security and Medicare are the two largest federal programs, accounting for 36 percent of federal expenditures in
|
||
fiscal year 2011. Both programs will experience cost growth substantially in excess of GDP growth in the coming decades
|
||
due to aging of the population and, in the case of Medicare, growth in expenditures per beneficiary exceeding growth in
|
||
per capita GDP. Through the mid-2030s, population aging caused by the large baby-boom generation entering retirement
|
||
and lower-birth-rate generations entering employment will be the largest single factor causing costs to grow more
|
||
rapidly than GDP. Thereafter, the primary factors
|
||
will be population aging caused by increasing longevity and health care cost growth somewhat more rapid than GDP growth.
|
||
</p>
|
||
<p>
|
||
<b><u>Social Security</u></b>
|
||
<p>
|
||
Social Security’s expenditures exceeded non-interest income in 2010 and 2011, the first such occurrences since 1983,
|
||
and the Trustees estimate that these expenditures will remain greater than non-interest income throughout the 75-year
|
||
projection period. The deficit of non-interest income relative to expenditures was about $49 billion in 2010 and $45
|
||
billion in 2011, and the Trustees project that it will average about $66 billion between 2012 and 2018 before rising
|
||
steeply as the economy slows after the recovery is complete and the number of beneficiaries continues to grow at a
|
||
substantially faster rate than the number of covered workers. Redemption of trust fund assets from the General Fund
|
||
of the Treasury will provide the resources needed to offset the annual cash-flow deficits. Since these redemptions
|
||
will be less than interest earnings through 2020, nominal trust fund balances will continue to grow. The trust fund
|
||
ratio, which indicates the number of years of program cost that could be financed solely with current trust fund
|
||
reserves, peaked in 2008, declined through 2011, and is expected to decline further in future years. After 2020,
|
||
Treasury will redeem trust fund assets in amounts that exceed interest earnings until exhaustion of trust fund
|
||
reserves in 2033, three years earlier than projected last year.
|
||
Thereafter, tax income would be sufficient to pay only about three-quarters of scheduled benefits through 2086.
|
||
</p>
|
||
<p>
|
||
A temporary reduction in the Social Security payroll tax rate reduced payroll tax revenues by $103 billion in 2011 and
|
||
by a projected $112 billion in 2012. The legislation establishing the payroll tax reduction also provided for transfers
|
||
of revenues from the general fund to the trust funds in order to "replicate to the extent possible" payments that
|
||
would have occurred if the payroll tax reduction had not been enacted.
|
||
Those general fund reimbursements comprise about 15 percent of the program's non-interest income in 2011 and 2012.
|
||
</p>
|
||
<p>
|
||
Under current projections, the annual cost of Social Security benefits expressed as a share of workers’ taxable earnings
|
||
will grow rapidly from 11.3 percent in 2007, the last pre-recession year, to roughly 17.4 percent in 2035, and will
|
||
then decline slightly before slowly increasing after 2050. Costs display a slightly different pattern when expressed
|
||
as a share of GDP. Program costs equaled 4.2 percent of GDP in 2007, and the Trustees project these costs will increase
|
||
gradually to
|
||
6.4 percent of GDP in 2035 before declining to about 6.1 percent of GDP by 2050 and then remaining at about that level.
|
||
</p>
|
||
<p>
|
||
The projected 75-year actuarial deficit for the combined Old-Age and Survivors Insurance and Disability Insurance (OASDI)
|
||
Trust Funds is 2.67 percent of taxable payroll, up from 2.22 percent projected in last year's report. This is the largest
|
||
actuarial deficit reported since prior to the 1983 Social Security amendments, and the largest single-year deterioration
|
||
in the actuarial deficit since the 1994 Trustees Report. This deficit amounts to 20 percent of program non-interest
|
||
income or 16 percent of program cost. The 0.44 percentage point increase in the OASDI actuarial deficit and the
|
||
three-year advance in the exhaustion date for the combined trust funds reflect many factors. The most significant
|
||
factor is lower average real earnings levels over the next 75 years than were projected last year, principally due
|
||
to: 1) a surge in energy prices in 2011 that lowered real earnings in 2011 and is expected to be sustained, and 2)
|
||
slower assumed growth in average hours worked per week after the economy
|
||
has recovered. An additional significant factor is the one-year advance of the valuation period from 2011-85 to 2012-86.
|
||
</p>
|
||
<p>
|
||
While the combined OASDI program continues to fail the long-range test of close actuarial balance, it does satisfy the
|
||
test for short-range financial adequacy. The Trustees
|
||
project that the combined trust fund assets will exceed one year’s projected cost for more than ten years, through 2027.
|
||
</p>
|
||
<p>
|
||
However, the Disability Insurance (DI) program satisfies neither the long-range test nor the short-range test. DI costs
|
||
have exceeded non-interest income since 2005, and the Trustees project trust fund exhaustion in 2016, two years earlier
|
||
than projected last year. The DI program faces the most immediate financing shortfall of any of the
|
||
separate trust funds; thus lawmakers need to act soon to avoid reduced payments to DI beneficiaries four years from now.
|
||
</p>
|
||
<p>
|
||
|
||
<b><u>Medicare</u></b></p>
|
||
The Medicare HI Trust Fund faces depletion earlier than the combined Social Security Trust Funds, though not as soon
|
||
as the Disability Insurance Trust Fund when separately considered. The projected HI Trust Fund's long-term actuarial
|
||
imbalance is smaller than that of the combined Social Security Trust Funds under the assumptions employed in this report.
|
||
</p>
|
||
<p>
|
||
The Trustees project that Medicare costs (including both HI and SMI expenditures) will grow substantially
|
||
from approximately 3.7 percent
|
||
of GDP in 2011 to 5.7 percent of GDP by 2035, and will increase gradually thereafter to about 6.7 percent of GDP by 2086.
|
||
|
||
</p>
|
||
<p>
|
||
The projected 75-year actuarial deficit in the HI Trust Fund is 1.35 percent of taxable payroll, up from 0.79 percent
|
||
projected in last year’s report. The HI fund again fails the test of short-range financial adequacy, as projected
|
||
assets are already below one year's projected expenditures and are expected to continue declining. The fund also
|
||
continues to fail the long-range test of close actuarial balance. The Trustees project that the HI Trust Fund
|
||
will pay out more in hospital benefits and other expenditures than it receives in income in all future years, as
|
||
it has since 2008. The projected date of HI Trust Fund exhaustion is 2024, the same date projected in last year's
|
||
report, at which time dedicated revenues would be sufficient to pay 87 percent of HI costs. The Trustees project
|
||
that the share of HI expenditures that can be financed with HI dedicated revenues will decline slowly to 67 percent
|
||
in 2045, and then rise slowly until it reaches 69
|
||
percent in 2086. The HI 75-year actuarial imbalance amounts to 36 percent of tax receipts or 26 percent of program cost.
|
||
</p>
|
||
<p>
|
||
The worsening of HI long-term finances is principally due to the adoption of short-range assumptions and long-range
|
||
cost projection methods recommended by the 2010-11 Medicare Technical Review Panel. Use of those methods increases the
|
||
projected long-range annual growth rate for Medicare's costs by 0.3 percentage points. The new assumptions increased
|
||
projected short-range costs, but those increases are about offset,
|
||
temporarily, by a roughly 2 percent reduction in 2013-21 Medicare outlays required by the Budget Control Act of 2011.
|
||
</p>
|
||
<p>
|
||
The Trustees project that Part B of Supplementary Medical Insurance (SMI), which pays doctors’ bills and other
|
||
outpatient expenses, and Part D, which provides access to prescription drug coverage, will remain adequately financed
|
||
into the indefinite future because current law automatically provides financing each year to meet the next year’s
|
||
expected costs. However, the aging population and rising health care costs cause SMI projected costs to grow rapidly
|
||
from 2.0 percent of GDP in 2011 to approximately 3.4 percent of GDP in 2035, and then more slowly to 4.0 percent of
|
||
GDP by 2086. General revenues will finance roughly three quarters of these costs, and premiums paid by beneficiaries
|
||
almost all of the remaining quarter. SMI also receives a small amount of
|
||
financing from special payments by States and from fees on manufacturers and importers of brand-name prescription drugs.
|
||
</p>
|
||
<p>
|
||
Projected Medicare costs over 75 years are substantially lower than they otherwise would be because of provisions in
|
||
the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of
|
||
2010 (the "Affordable Care Act" or ACA). Most of the ACA-related cost saving is attributable to a reduction in the
|
||
annual payment updates for most Medicare services (other than physicians’ services and drugs) by total economy
|
||
multifactor productivity growth, which the Trustees project will average 1.1 percent per year. The report notes that
|
||
sustaining these payment reductions indefinitely will require unprecedented efficiency-enhancing innovations in health
|
||
care payment and delivery systems that are by no means certain. In addition, the Trustees assume an almost 31-percent
|
||
reduction in Medicare payment
|
||
rates for physician services will be implemented in 2013 as required by current law, which is also highly uncertain.
|
||
</p>
|
||
<p>
|
||
The drawdown of Social Security and HI trust fund reserves and the general revenue transfers into SMI will result in
|
||
mounting pressure on the Federal budget. In fact, pressure is already evident. For the sixth consecutive year, the
|
||
Social Security Act requires that the Trustees issue a "Medicare funding warning" because projected non-dedicated
|
||
sources of revenues—primarily general revenues—are expected to continue
|
||
to account for more than 45 percent of Medicare's outlays, a threshold breached for the first time in fiscal year 2010.
|
||
</p>
|
||
<p>
|
||
<b><u>Conclusion</u></b>
|
||
</p>
|
||
<p>
|
||
Lawmakers should address the financial challenges facing Social Security and Medicare as soon as possible.
|
||
Taking action sooner rather than
|
||
later will leave more options and more time available to phase in changes so that the public has adequate time to prepare.
|
||
</p>
|
||
|
||
By the Trustees:
|
||
<br /> <br />
|
||
<br /> <br />
|
||
<div class="grid_6 left" >
|
||
Timothy F. Geithner,<br />
|
||
Secretary of the Treasury,<br />
|
||
and Managing Trustee <br /> <br />
|
||
<br /> <br />
|
||
|
||
Kathleen Sebelius,<br />
|
||
Secretary of Health<br />
|
||
and Human Services,<br />
|
||
and Trustee <br /><br />
|
||
<br /> <br />
|
||
Charles P. Blahous III,<br />
|
||
Trustee<br /><br />
|
||
|
||
|
||
</div><!-- end .grid_6 -->
|
||
|
||
<div class="grid_6" >
|
||
Hilda L. Solis,<br />
|
||
Secretary of Labor,<br />
|
||
and Trustee<br /><br />
|
||
|
||
<br /> <br />
|
||
Michael J. Astrue,<br />
|
||
Commissioner of<br />
|
||
Social Security,<br />
|
||
and Trustee<br /><br />
|
||
|
||
<br /> <br />
|
||
|
||
Robert D. Reischauer,<br />Trustee
|
||
|
||
<br /> <br />
|
||
|
||
</div><!-- end .grid_6 -->
|
||
<div class="grid_12" >
|
||
|
||
<hr />
|
||
</div><!-- end .grid_12 -->
|
||
|
||
<h3 align="center" class="newpage">A SUMMARY OF THE 2012 ANNUAL SOCIAL SECURITY<br />
|
||
AND MEDICARE TRUST FUND REPORTS</h3>
|
||
<p>
|
||
|
||
Projected long-range costs for both Medicare and Social Security are not sustainable under currently scheduled financing
|
||
and will require legislative action to avoid disruptive consequences for beneficiaries and taxpayers. If lawmakers act
|
||
sooner rather than later, they can consider more options and more time will be available to phase in the changes, giving
|
||
the public adequate time to prepare. Earlier action would also help
|
||
avoid adverse impacts on vulnerable populations, including lower-income workers and people dependent on program benefits.
|
||
<p>
|
||
<span class="bluebold">What Are the Trust Funds? </span>
|
||
Congress established trust funds managed by the Department of the Treasury to account for Social Security and Medicare
|
||
income and disbursements. The Treasury credits Social Security and Medicare taxes, premiums, and other income to the
|
||
funds. There are four separate trust funds. For Social Security, the Old-Age and Survivors Insurance (OASI) Trust Fund
|
||
pays retirement and survivors benefits and the Disability Insurance (DI) Trust Fund pays disability benefits. (OASDI
|
||
is the designation for the two trust funds when they are considered on a combined basis.) For Medicare, the Hospital
|
||
Insurance (HI) Trust Fund pays for inpatient hospital and related care. The Supplementary Medical Insurance (SMI) Trust
|
||
Fund comprises two separate accounts: Part B, which pays for physician and outpatient services, and Part D, which covers
|
||
the prescription drug benefit. In 2011, 44.8
|
||
million people received OASI benefits, 10.6 million received DI benefits, and 48.7 million were covered under Medicare. </p>
|
||
<p>
|
||
The only disbursements permitted from the funds are administrative costs and benefit payments. Federal law requires that
|
||
all excess funds be invested in interest-bearing securities backed by the full faith and credit of the United States.
|
||
The Department of the Treasury currently invests all program revenues in special non-marketable securities of the U.S.
|
||
Government which earn a market rate of interest. The balances in the trust funds represent the accumulated value,
|
||
including interest, of all prior program annual surpluses and deficits, and provide automatic authority to pay benefits.
|
||
</p>
|
||
|
||
<p>
|
||
<span class="bluebold">What Were the Trust Fund Results in 2011?</span>
|
||
Trust fund operations, in billions of dollars, are shown below. (Totals may not add due to rounding.)
|
||
The OASI and SMI Trust Funds each showed a net increase in assets in 2011; DI and HI Trust Fund assets declined.
|
||
</p>
|
||
<blockquote>
|
||
<table cellpadding="2" cellspacing="0" class="border" bordercolor="#cccccc" width="100%"
|
||
summary="trust fund operations in 2009, in billions of dollars, for OASI, DI and Medicare">
|
||
<tr class="align-right">
|
||
<td> </td> <th class="right" scope="col">OASI</th> <th class=" right" scope="col">DI</th>
|
||
<th class="right" scope="col">HI</th> <th class=" right" scope="col">SMI</th>
|
||
</tr>
|
||
<tr align="right">
|
||
<td align="left">Assets (end of 2010)</td>
|
||
<td>$2,429.0</td>
|
||
<td>$179.9</td>
|
||
<td>$271.9</td>
|
||
<td>$72.1</td>
|
||
</tr>
|
||
<tr align="right">
|
||
<td align="left">Income during 2011</td>
|
||
<td>698.8</td>
|
||
<td>106.3</td>
|
||
<td>228.9</td>
|
||
<td>301.0</td>
|
||
</tr>
|
||
<tr align="right">
|
||
<td align="left">Outgo during 2011</td>
|
||
<td>603.8</td>
|
||
<td>132.3</td>
|
||
<td>256.7</td>
|
||
<td>292.5</td>
|
||
</tr>
|
||
<tr align="right">
|
||
<td align="left"> Net increase in assets</td>
|
||
<td>95.0</td>
|
||
<td>-26.1</td>
|
||
<td>-27.7</td>
|
||
<td>8.6</td>
|
||
</tr>
|
||
<tr align="right">
|
||
<td align="left">Assets (end of 2011)</td>
|
||
<td>2,524.1</td>
|
||
<td>153.9</td>
|
||
<td>244.2</td>
|
||
<td>80.7</td>
|
||
</tr>
|
||
</table></blockquote>
|
||
|
||
<p>
|
||
<span class="bluebold">
|
||
What Were the Components of Trust Funds Outlays in 2011?</span>
|
||
The following table shows payments, by category, from each trust fund in 2011 (totals may not add due to rounding).
|
||
|
||
<blockquote>
|
||
<table class="border" bordercolor="#cccccc" width="100%" cellspacing="0" cellpadding="2">
|
||
<tr class="align-right valign="bottom">
|
||
<td align="left" scope="col"><b>Category</b> (<i>in billions</i>)</td>
|
||
<th class=" right" scope="col">OASI</th>
|
||
<th class=" right" scope="col">DI</th>
|
||
<th class=" right" scope="col">HI</th>
|
||
<th class=" right" scope="col">SMI</th>
|
||
</tr>
|
||
<tr valign="bottom" align="right">
|
||
<td align="left">Benefit payments</td>
|
||
<td>$596.2</td>
|
||
<td>$128.9</td>
|
||
<td>$252.9</td>
|
||
<td>$288.5</td>
|
||
</tr>
|
||
<tr valign="bottom" align="right">
|
||
<td align="left">Railroad Retirement financial interchange</td>
|
||
<td>4.1</td>
|
||
<td>0.5</td>
|
||
<td>—</td>
|
||
<td>—</td>
|
||
</tr>
|
||
<tr valign="bottom" align="right">
|
||
<td align="left">Administrative expenses</td>
|
||
<td>3.5</td>
|
||
<td>2.9</td>
|
||
<td>3.8</td>
|
||
<td>4.0</td>
|
||
</tr>
|
||
<tr valign="bottom" align="right">
|
||
<td align="left">Total</td>
|
||
<td>603.8</td>
|
||
<td>132.3</td>
|
||
<td>256.7</td>
|
||
<td>292.5</td>
|
||
</tr>
|
||
|
||
</table>
|
||
|
||
</blockquote>
|
||
|
||
|
||
<span class="bluebold">What Were the Sources of Income to the Trust Funds in 2011?</span>
|
||
The following table shows income, by source, to each trust fund in 2011 (totals may not add due to rounding)
|
||
<blockquote>
|
||
<table class="border" bordercolor="#cccccc" width="100%" cellspacing="0" cellpadding="2">
|
||
<tr class="align-right valign="bottom">
|
||
<td class="align-left scope="col"><b>Source</b> <i>(in billions)</i></td>
|
||
<th class=" right" scope="col">OASI</th>
|
||
<th class=" right" scope="col">DI</th>
|
||
<th class=" right" scope="col">HI</th>
|
||
<th class=" right" scope="col">SMI</th>
|
||
</tr>
|
||
<tr valign="bottom" align="right">
|
||
<td align="left">Payroll taxes</td>
|
||
<td>$482.4</td>
|
||
<td>$81.9</td>
|
||
<td>$195.6</td>
|
||
<td>—</td>
|
||
</tr>
|
||
<tr valign="bottom" align="right">
|
||
<td align="left">Taxes on benefits</td>
|
||
<td>22.2</td>
|
||
<td>1.6</td>
|
||
<td>15.1</td>
|
||
<td>—</td>
|
||
</tr>
|
||
<tr valign="bottom" align="right">
|
||
<td align="left">Beneficiary premiums</td>
|
||
<td>—</td>
|
||
<td>—</td>
|
||
<td>3.5</td>
|
||
<td>65.4</td>
|
||
</tr>
|
||
<tr valign="bottom" align="right">
|
||
<td align="left">Transfers from States</td>
|
||
<td>—</td>
|
||
<td>—</td>
|
||
<td>—</td>
|
||
<td>7.1</td>
|
||
</tr>
|
||
<tr valign="bottom" align="right">
|
||
<td align="left">General Fund reimbursements</td>
|
||
<td>87.8</td>
|
||
<td>14.9</td>
|
||
<td>0.5</td>
|
||
<td>—</td>
|
||
</tr>
|
||
<tr valign="bottom" align="right">
|
||
<td align="left">General revenues</td>
|
||
<td>—</td>
|
||
<td>—</td>
|
||
<td>—</td>
|
||
<td>$222.8</td>
|
||
</tr>
|
||
|
||
<tr valign="bottom" align="right">
|
||
<td align="left">Interest earnings</td>
|
||
<td>106.5</td>
|
||
<td>7.9</td>
|
||
<td>12.0</td>
|
||
<td>3.2</td>
|
||
</tr>
|
||
|
||
|
||
<tr valign="bottom" align="right">
|
||
<td align="left">Other</td>
|
||
<td ><sup>a</sup></td>
|
||
<td >—</td>
|
||
<td >2.2</td>
|
||
<td >2.5</td>
|
||
</tr>
|
||
<tr valign="bottom" align="right">
|
||
<td align="left">Total</td>
|
||
<td >698.8</td>
|
||
<td>106.3</td>
|
||
<td>228.9</td>
|
||
<td>301.0</td>
|
||
</tr>
|
||
</table>
|
||
<small><sup>a</sup> Less than $50 million.</small>
|
||
</blockquote>
|
||
<span class="bluebold">What is the Outlook for Future Social Security and Medicare Costs in Relation to GDP?</span>
|
||
One instructive way to view the projected cost of Social Security and Medicare is to compare the cost of scheduled
|
||
benefits for the two programs with the gross domestic product (GDP), the most frequently used measure of the total
|
||
output of the U.S. economy (Chart A). Measured this way, costs for both programs increase substantially through 2035
|
||
because: (1) the number of beneficiaries rises rapidly as the baby-boom generation retires; and (2) the lower birth
|
||
rates that have persisted since the baby boom cause slower growth of the labor force and GDP. Social Security?s
|
||
projected annual cost increases to about 6.4 percent of GDP in 2035, declines to 6.1 percent by 2055, and remains
|
||
at about that level through 2086. Under current law, projected Medicare cost rises to 5.7 percent of GDP by 2035,
|
||
largely due to the growth in the number of beneficiaries, and then to 6.7
|
||
percent in 2086, with growth in health care cost per beneficiary becoming the larger factor later in the valuation period.
|
||
</p>
|
||
<p>
|
||
In 2011, the combined cost of the Social Security and Medicare programs equaled 8.5 percent of GDP. The Trustees project
|
||
an increase to 12.1 percent of GDP in 2035, which then reaches 12.8 percent of GDP in 2086. Although Medicare cost
|
||
(3.7 percent of GDP) was smaller than Social Security cost (4.9 percent of GDP) in 2011, the projected gap closes
|
||
gradually until 2049, when Medicare becomes the more costly program. During the final 10 years of the long-range
|
||
projection period, Medicare cost is about 10 percent larger than Social Security cost.
|
||
|
||
</p>
|
||
<p>
|
||
The projected costs for OASDI and HI depicted in Chart A and elsewhere in this document reflect the full cost of scheduled
|
||
current-law benefits without regard to whether the trust funds will have sufficient resources to meet these obligations.
|
||
Current law precludes payment of any benefits beyond the amount that can be financed by the trust funds, so the amount of
|
||
benefits that would be payable in years after trust fund exhaustion is lower than shown, as described later in this
|
||
summary. In addition, the projected costs assume realization of the full estimated savings of the Affordable Care Act
|
||
as well as adherence to Medicare’s sustainable growth rate limits. In practice, lawmakers are likely to prevent a large
|
||
reduction in payment rates for physician services that will otherwise take effect for 2013. Also, as described in the
|
||
Medicare Trustees Report, the projections for HI and SMI Part B depend significantly on the long-range feasibility of
|
||
the various cost-saving measures in the Affordable Care Act<63>in particular, the lower increases in Medicare payment rates to most categories of health care providers. For such efforts to be successful in the long range,
|
||
providers will have to generate and sustain unprecedented levels of productivity gains or other improvements in efficiency.
|
||
</p>
|
||
<p><center><a name="A"></a>
|
||
<table>
|
||
<caption><span class="bluebold">
|
||
Chart A—Social Security and Medicare Cost as a Percentage of GDP</span>
|
||
</caption>
|
||
<tr>
|
||
<td><a href="images/LD_ChartA.html" title="click on graph for underlying data">
|
||
<img src="images/chartA.jpg" width="600" height="500" border="0" alt="click on graph for underlying data"></a>
|
||
</td></tr></table>
|
||
</center></p>
|
||
|
||
|
||
<p>
|
||
|
||
<span class="bluebold">What is the Outlook for Future Social Security and Medicare HI Costs and Income in Relation to Taxable Earnings?</span>
|
||
Since the primary source of income for OASDI and HI is the payroll tax, it is informative to express the programs’
|
||
income and costs as percentages of taxable payroll—that is, of the base of worker earnings taxed to support
|
||
each program (Chart B).<sup><a name="fn" href="#fntext">1</a></sup> Both the OASDI and HI annual cost rates rise over the long run from their 2011 levels
|
||
(13.52 and 3.75 percent). Projected Social Security cost grows to 17.41 percent of taxable payroll by 2035,
|
||
declines to 17.07 percent in 2052, and then rises gradually to 17.83 percent in 2086. The projected Medicare
|
||
HI cost rate rises to 5.82 percent of taxable payroll in
|
||
2050 under the intermediate assumptions employed in this report, and thereafter gradually increases to 6.28 percent in 2086.
|
||
|
||
</p>
|
||
|
||
<p><center><a name="B"></a>
|
||
<table>
|
||
<caption><span class="bluebold">
|
||
Chart B—OASDI and HI Income and Cost as a Percentage
|
||
of Taxable Payroll</span><br /></caption>
|
||
<tr>
|
||
<td><a href="images/LD_ChartB.html" title="click on graph for underlying data">
|
||
<img src="images/chartB.jpg" width="600" height="500" border="0" alt="click on graph for underlying data"></a>
|
||
</td></tr></table>
|
||
</center></p>
|
||
<p>
|
||
The OASDI income rate—which includes payroll taxes, taxes on benefits, and any other transfers of revenues to the
|
||
trust funds excepting payments of interest—is 12.89 percent in 2012 and increases little over time, until it
|
||
reaches 13.33 percent in 2086. Scheduled payroll tax rates remain unchanged from their 1990 levels with the
|
||
exception of temporary reductions in the tax rates for 2010, 2011, and 2012 that are offset by reimbursements
|
||
from the General Fund of the Treasury. Annual income from the other tax source, the taxation of OASDI benefits,
|
||
will increase gradually relative to taxable payroll as a greater proportion of Social Security
|
||
benefits is subject to taxation in future years, but will continue to be a relatively small component of program income.
|
||
</p>
|
||
<p>
|
||
The projected HI income rate rises gradually from 3.20 in 2012 to 4.32 in 2086 due to the Affordable Care Act’s scheduled
|
||
increase in payroll tax rates for high earners starting in 2013. Individual tax return filers with earnings above
|
||
$200,000, and joint return filers with earnings above $250,000, will pay an additional 0.9 percent tax on earnings
|
||
above these earnings thresholds. An increasing fraction
|
||
of all earnings will be subject to the higher tax rate over time because the new law does not index the thresholds.
|
||
</p>
|
||
<p>
|
||
<span class="bluebold">How Will Cost Growth in the Different Parts of Medicare Change the Sources of Program Financing?</span>
|
||
As Medicare costs grow over time, general revenue and beneficiary premiums will play an increasing role in financing
|
||
the program. Chart C shows scheduled cost and non-interest revenue sources under current law for HI and SMI combined
|
||
as a percentage of GDP.
|
||
The total cost line is the same as displayed in Chart A and shows Medicare cost rising to 6.7 percent of GDP by 2086
|
||
</p>
|
||
|
||
<p><center><a name="C"></a>
|
||
<table>
|
||
<caption><span class="bluebold">
|
||
Chart C—Medicare Cost and Non-Interest Income by Source as a Percentage of GDP
|
||
</span></caption>
|
||
<tr>
|
||
<td><a href="images/LD_ChartC.html" title="click on graph for underlying data">
|
||
<img src="images/chartC.jpg" width="600" height="500" border="0" alt="click on graph for underlying data"></a>
|
||
</td></tr></table>
|
||
</center></p>
|
||
<p>
|
||
Projected revenue from payroll taxes and taxes on OASDI benefits credited to the HI Trust Fund increases from 1.4
|
||
percent of GDP in 2012 to 1.8 percent in 2086 under current law, while projected general revenue transfers to the
|
||
SMI Trust Fund increase from 1.4 percent of GDP in 2012 to 3.0 percent in 2086, and beneficiary premiums increase
|
||
from 0.5 to 1.0 percent of GDP. The share of total non-interest Medicare income from taxes would fall substantially
|
||
(from 43 percent to 31 percent) while general revenue transfers would rise (from 42 to 50 percent), as would
|
||
premiums (from 14 percent to 17 percent). The distribution of financing changes in part because Part B and D
|
||
costs increase at a faster rate than Part A cost under the Trustees" projections. By 2086, the Medicare SMI
|
||
program will require general revenue transfers equal to 3.0 percent of GDP. Moreover, the HI deficit represents
|
||
a further 0.8 percent of GDP in 2086. There
|
||
is no provision under current law to finance this deficit through general revenue transfers or any other revenue source.
|
||
</p>
|
||
<p>
|
||
The Medicare Modernization Act (2003) requires that the Board of Trustees determine each year whether the annual
|
||
difference between program outlays and dedicated revenues (the bottom four layers of Chart C) exceeds 45 percent
|
||
of total Medicare outlays in any of the first seven fiscal years of the 75-year projection period. In effect, the
|
||
law sets a threshold condition that signals that general revenue financing of Medicare is becoming excessive. In
|
||
that case, the annual Trustees Report must include a determination of "excess general revenue Medicare funding."
|
||
Two consecutive reports with such a determination triggers a "Medicare funding warning." The warning directs the
|
||
President to submit proposed legislation within 15 days of the next budget submission to respond to the warning
|
||
and requires Congress to consider the proposal on an expedited basis. To date, elected officials
|
||
have not enacted legislation responding to these funding warnings which have been included in the five previous reports.
|
||
</p>
|
||
<p>
|
||
This year"s report projects the difference between outlays and dedicated financing revenues to exceed 45 percent of
|
||
total Medicare outlays during fiscal year 2012, prompting a determination of "excess
|
||
general revenue Medicare funding" for the seventh consecutive report, triggering another "Medicare funding warning."
|
||
</p>
|
||
|
||
|
||
<p>
|
||
<span class="bluebold">What are the Budgetary Implications of Rising Social Security and Medicare Costs?</span>
|
||
Concern about the long-range financial outlook for Medicare and Social Security often focuses on the exhaustion dates
|
||
for the HI and OASDI trust funds—the time when projected trust fund balances under current law would be insufficient
|
||
to pay the full amounts of scheduled benefits. A more immediate
|
||
issue is the growing burden that the programs will place on the Federal budget well before exhaustion of the trust funds.
|
||
</p>
|
||
<p>
|
||
Chart D shows the excess of scheduled outgo over dedicated tax and premium income for the OASDI, HI, and SMI trust funds
|
||
expressed as percentages of GDP. Each of these trust funds’ operations will exert rapidly rising pressure on the
|
||
Federal budget in future years. General revenues pay for roughly 75 percent of all SMI costs. From now through 2024,
|
||
interest earnings and asset redemptions, financed from general revenues, will cover the shortfall of HI tax and premium
|
||
revenues relative to
|
||
expenditures. In addition, general revenues must cover similar payments as a result of growing OASDI
|
||
deficits through 2033.<sup><a name="fn2" href="#fntext2">2</a></sup>
|
||
</p>
|
||
|
||
<p><center><a name="D"></a>
|
||
<table>
|
||
<caption><span class="bluebold">
|
||
Chart D—Projected SMI General Revenue Funding <br /> plus OASDI and HI Tax Shorfalls<br /><i>[Percentage of GDP]</i>
|
||
</span></caption>
|
||
<tr>
|
||
<td><a href="images/LD_ChartD.html" title="click on graph for underlying data">
|
||
<img src="images/chartD.jpg" width="600" height="500" border="0" alt="click on graph for underlying data"></a>
|
||
</td></tr></table>
|
||
</center></p>
|
||
|
||
<p>
|
||
In 2012, the projected difference between Social Security’s dedicated tax income and expenditures is $165 billion.
|
||
For HI, the projected difference between dedicated tax and premium income and expenditures is $38 billion. The
|
||
projected general revenue demands of SMI are $217 billion. Thus, the total general funds for Social Security
|
||
and Medicare in 2012 are $420 billion, or 2.7 percent of GDP. Redemption of trust fund bonds, interest paid on
|
||
those bonds, and transfers from the general funds provide no new net income to the Treasury, which must finance
|
||
these payments through
|
||
some combination of increased taxation, reductions in other government spending, or additional borrowing from the public.
|
||
</p>
|
||
<p>
|
||
Chart D shows that the difference between cost and revenue from dedicated payroll taxes, income taxation of
|
||
benefits, and premiums will grow rapidly through the 2030s as the baby-boom generation reaches retirement age.
|
||
This imbalance would result in vastly increased pressure on the Federal budget if the law were changed to
|
||
maintain scheduled benefits in the
|
||
absence of an increase in dedicated tax revenues, with such financing requirements equaling 4.8 percent of GDP by 2040.
|
||
</p>
|
||
|
||
<p>
|
||
<span class="bluebold">What Is the Outlook for Short-Term Trust Fund Adequacy?</span>
|
||
The reports measure the short-range adequacy of the OASI, DI, and HI Trust Funds by comparing fund assets to projected
|
||
costs for the ensuing year (the "trust fund ratio"). A trust fund ratio of 100 percent or more—that is, assets at
|
||
least equal to projected costs for a year—is a good indicator of a fund’s short-range adequacy. That level of
|
||
projected assets for any year suggests that even if cost exceeds income,
|
||
the trust fund reserves, combined with annual tax revenues, would be sufficient to pay full benefits for several years.
|
||
</p>
|
||
|
||
<p>
|
||
By this measure, the OASI Trust Fund is financially adequate throughout the 2012-21 period, but the DI Trust Fund
|
||
fails the short-range test because
|
||
its projected trust fund ratio falls to 83 percent by the beginning of 2013, followed by exhaustion of assets in 2016.
|
||
</p>
|
||
<p>
|
||
The HI Trust Fund also does not meet the short-range test of financial adequacy; its trust fund ratio was 90 percent
|
||
at the beginning of 2012 based on the year’s anticipated expenditures, and the projected ratio does not rise to
|
||
100 percent within five years. Projected HI Trust Fund
|
||
assets are fully depleted in 2024. Chart E shows the trust fund ratios through 2040 under the intermediate assumptions.
|
||
</p>
|
||
|
||
<p>
|
||
The Trustees apply a less stringent annual "contingency reserve" test to SMI Part B assets since the overwhelming portion
|
||
of the financing for that account consists of beneficiary premiums and general revenue contributions that are set
|
||
each year to meet expected costs. Part D financing is also set on an annual basis. Moreover, the operation of Part D
|
||
through private insurance plans, together with a flexible appropriation for Federal costs, eliminates the need for
|
||
a contingency reserve in that account. Note, however, that estimated Part B costs are improbably low for 2013 and
|
||
beyond because the projections assume that current law, which substantially reduces physician payments per service under
|
||
the sustainable growth rate system, will not change. The estimated physician fee reduction for 2013 is 30.9 percent. A
|
||
reduction in fees of this magnitude is highly unlikely; lawmakers have acted to prevent smaller reductions in every year
|
||
since 2003. Underestimated payments to physicians would affect projected costs for Part B, total SMI, and total Medicare.
|
||
</p>
|
||
|
||
<p><center><a name="E"></a>
|
||
<table>
|
||
<caption><span class="bluebold">
|
||
Chart E—OASI, DI, and HI Trust Fund Ratios<br /> <i>[Assets as a percentage of annual cost] </i></span>
|
||
|
||
|
||
</caption>
|
||
<tr>
|
||
<td><a href="images/LD_ChartE.html" title="click on graph for underlying data">
|
||
<img src="images/chartE.jpg" width="600" height="500" border="0" alt="click on graph for underlying data"></a>
|
||
</td></tr></table>
|
||
</center></p>
|
||
|
||
|
||
|
||
<p>
|
||
<span class="bluebold">What Are Key Dates in Long-Range OASI, DI, and HI Financing?</span>
|
||
In 2011, the HI fund used interest income ($12 billion) and assets ($28 billion) to help finance expenditures. This
|
||
report anticipates a $38 billion deficit in non-interest income for 2012,
|
||
followed by a period of declining deficits (2013-18) as the growth in taxable earnings accelerates. The projected
|
||
trust fund exhaustion date is 2024 (unchanged from last year). Under current law, scheduled HI tax and premium income
|
||
would be sufficient to pay 87 percent of estimated HI costs in 2024 and 69 percent by 2086.
|
||
</p>
|
||
<p>
|
||
In 2011, Social Security’s cost continued to exceed both the program’s tax income and its non-interest income, a trend
|
||
that the Trustees project to continue throughout the short-range period and beyond. The 2011 deficit of tax income
|
||
relative to cost was $148 billion and the projected 2012 deficit is $165 billion. The sizes of these deficits are
|
||
largely due to a temporary reduction in the Social Security payroll tax for 2011 and 2012. The legislation
|
||
establishing the payroll tax reduction also provided for transfers of revenues from the General Fund of the
|
||
Treasury to the trust funds to "replicate to the extent possible" revenues that would have occurred in the
|
||
absence of the payroll tax reduction. Including these general revenue reimbursements,
|
||
the 2011 deficit of non-interest income relative to cost was $45 billion and the projected 2012 deficit is $53 billion.
|
||
</p>
|
||
<p>
|
||
The combined Social Security trust funds continue to grow because projected interest earnings ($110 billion in 2012) still
|
||
substantially exceed the non-interest income deficit. The report indicates that annual OASDI income, including payments
|
||
of interest to the trust funds from the General Fund, will exceed annual cost every year until 2021, increasing the
|
||
nominal value of combined OASDI trust fund assets. As noted earlier, however, the trust fund ratio (the
|
||
ratio of projected assets to costs) will gradually decline despite this nominal balance increase, as it has since 2008.
|
||
</p>
|
||
<p>
|
||
Beginning in 2021, net redemptions of trust fund assets with General Fund payments will be required until exhaustion of
|
||
these assets in 2033. After OASDI trust fund exhaustion, continuing tax income would be sufficient to pay 75 percent
|
||
of scheduled benefits in 2033 and 73 percent in 2086. When the programs are considered separately, the projected
|
||
exhaustion dates are 2035 for the OASI Trust Fund and 2016 for the DI Trust Fund. Payment of full DI benefits
|
||
beyond 2016, when tax income would cover only 79 percent of scheduled benefits, will require legislation
|
||
to address the financial imbalance, possibly including a reallocation of the OASDI payroll tax rate between OASI and DI.
|
||
</p>
|
||
<p>
|
||
The following table shows key dates for the respective trust funds.
|
||
<p>
|
||
<table class="border" bordercolor="#cccccc" width="100%" cellspacing="0" cellpadding="2">
|
||
<caption><span class="bluebold">KEY DATES FOR THE TRUST FUNDS</span></caption>
|
||
|
||
<tr valign="bottom" >
|
||
<td> </td>
|
||
<th class="right " width="13%" scope="col">OASI</th>
|
||
<th class="right " width="13%" scope="col">DI</th>
|
||
<th class="right " width="13%" scope="col">OASDI</th>
|
||
<th class="right " width="13%" scope="col">HI</th>
|
||
</tr>
|
||
<tr valign="bottom" align="right">
|
||
<td align="left">Year of peak trust fund ratio<sup>a</sup></td>
|
||
<td>2011</td>
|
||
<td>2003</td>
|
||
<td>2011</td>
|
||
<td>2003</td>
|
||
</tr>
|
||
<tr valign="bottom" align="right">
|
||
<td align="left">First year outgo exceeds income excluding interest<sup>b</sup></td>
|
||
<td>2010</td>
|
||
<td>2005</td>
|
||
<td>2010</td>
|
||
<td>2008</td>
|
||
</tr>
|
||
<tr valign="bottom" align="right">
|
||
<td align="left">First year outgo exceeds income including interest<sup>b</sup></td>
|
||
<td>2023</td>
|
||
<td>2009</td>
|
||
<td>2021</td>
|
||
<td>2008</td>
|
||
</tr>
|
||
<tr valign="bottom" align="right">
|
||
<td align="left">Year trust funds are exhausted</td>
|
||
<td>2035</td>
|
||
<td>2016</td>
|
||
<td>2033</td>
|
||
<td>2024</td>
|
||
</tr>
|
||
</table>
|
||
|
||
<p class="seventypercent">
|
||
<sup>a</sup> Dates pertain to the post-2000 period. <br />
|
||
<sup>b</sup> Dates indicate the first year that a condition is projected to occur and to
|
||
persist annually thereafter through 2086
|
||
</p>
|
||
|
||
|
||
|
||
<p>
|
||
<span class="bluebold">What is the Long-Range Actuarial Balance of the OASI, DI, and HI Trust Funds?</span>
|
||
Another way to view the outlook for payroll tax-financed trust funds is to consider their actuarial balances for
|
||
the 75-year valuation period. The actuarial balance of a fund is essentially the difference between annual income
|
||
and costs, expressed as a percentage of taxable payroll, summarized over the 75-year projection period. Premium
|
||
increases and general revenue transfers necessary to bring SMI into
|
||
annual balance occur as a requirement of Federal law so actuarial balance is not an informative concept for that program.
|
||
</p>
|
||
<p>
|
||
The OASI, DI, and HI Trust Funds all have long-range actuarial deficits under the intermediate assumptions, as shown in the
|
||
following table.
|
||
<blockquote>
|
||
<table class="border" bordercolor="#cccccc" width="100%" cellspacing="0" cellpadding="2">
|
||
<caption><span class="bluebold">LONG-RANGE ACTUARIAL DEFICIT OF THE OASI, DI, AND HI TRUST FUNDS</span>
|
||
<br /><small>(As a percentage of taxable payroll)</small>
|
||
</caption>
|
||
|
||
<tr valign="bottom" align="right">
|
||
<td> </td>
|
||
<th class="right " width="18%" scope="col">OASI</th>
|
||
<th class="right " width="18%" scope="col">DI</th>
|
||
<th class="right " width="18%" scope="col">OASDI</th>
|
||
<th class="right " width="18%" scope="col">HI</th>
|
||
</tr>
|
||
<tr valign="bottom" align="right">
|
||
<td align="left">Actuarial deficit</td>
|
||
<td>2.30</td>
|
||
<td>0.37</td>
|
||
<td>2.67</td>
|
||
<td>1.35</td>
|
||
</tr>
|
||
</table></blockquote>
|
||
|
||
A useful interpretation of the actuarial deficit is that it represents the percentage points that would have to be either
|
||
added to the current-law income rate or subtracted from the cost rate for each of the next 75 years to bring the
|
||
funds into actuarial balance. The actuarial balance equals zero if trust fund assets at the end of the period are
|
||
equal to the following year’s cost. Note that the Trustees project that Social Security’s annual deficits, expressed
|
||
as the difference between the cost rate and income rate, will increase gradually from 2017 to 2037, decline slightly
|
||
during 2038-52, and then resume increasing through 2086 (Chart B). Increasing annual deficits during the final three
|
||
decades of the projection indicate that a single tax rate increase for all years starting in 2012 sufficient to achieve
|
||
actuarial balance would result in large annual surpluses early in the period followed by increasing deficits in later
|
||
years. The relatively large deficits at the end of the 75-year projection period—equal to 4.50 percent of taxable
|
||
payroll in 2086 (see Chart B discussion)—indicate that sustained solvency would require payroll tax rate increases
|
||
or benefit reductions (or a combination thereof) by the
|
||
end of the period that are substantially larger than those needed on average for this report’s long-range period (2012-86).
|
||
</p>
|
||
<p>
|
||
Projected HI Trust Fund annual deficits gradually decline to 0.08 percent of taxable payroll in 2018, then
|
||
increase to 1.93 percent in 2050 and remain at about that level through 2086.
|
||
</p>
|
||
|
||
<p>
|
||
The financial outlooks for both OASDI and HI depend critically on a number of demographic and economic assumptions.
|
||
Nevertheless, the projected actuarial deficit in each of these programs is large enough that continued solvency under
|
||
current-law financing is extremely unlikely. An analysis that allows plausible random variations around the intermediate
|
||
assumptions employed in the report indicates that OASDI trust fund exhaustion is highly probable by mid-century.
|
||
</p>
|
||
<p>
|
||
|
||
|
||
<p>
|
||
<span class="bluebold">How Has the Financial Outlook for Social Security and Medicare Changed Since Last Year?</span>
|
||
Under the intermediate assumptions, the combined OASDI Trust Funds have a projected 75-year actuarial deficit equal
|
||
to 2.67 percent of taxable payroll, 0.44 percentage point larger than last year’s estimate. The anticipated asset
|
||
exhaustion date moves closer by three years to 2033. The increased OASDI shortfall is due chiefly to changes in
|
||
economic projections which incorporate new starting values and revised assumptions. Had assumptions, methods, and
|
||
starting values remained unchanged from last year’s report, the projected change in the actuarial deficit would
|
||
have been 0.05 percent of
|
||
taxable payroll, caused by the inclusion of 2086 (a year with a large negative balance) in the 75-year projection period.
|
||
</p>
|
||
<p>
|
||
Medicare’s HI Trust Fund has a long-range actuarial deficit equal to 1.35 percent of taxable payroll under the
|
||
intermediate assumptions, larger than the 0.79 percent figure reported last year. Medicare cost projections are
|
||
higher principally because the Trustees adopted the 2010-11 Medicare Technical Review Panel’s recommended changes
|
||
in projection assumptions that raised near-term costs and the long-range rate of increase in average HI and SMI
|
||
Part B costs per beneficiary. Nevertheless, the projected date of exhaustion for the HI Trust Fund remains 2024
|
||
because the higher
|
||
costs were offset during 2013-21 by a 2-percent reduction in expenditures expected under the Budget Control Act of 2011.
|
||
</p>
|
||
<p>
|
||
<span class="bluebold">Who Are the Trustees?</span>
|
||
There are six Trustees, four of whom serve by virtue of their positions in the Federal Government: the Secretary
|
||
of the Treasury, the Secretary of Labor, the Secretary of Health and Human Services, and the Commissioner of
|
||
Social Security. The other two Trustees are public representatives appointed by the President and confirmed by the
|
||
Senate: Charles P. Blahous III,
|
||
Research Fellow at the Hoover Institution, and Robert D. Reischauer, President Emeritus of the Urban Institute.
|
||
</p>
|
||
<p>
|
||
<span class="bluebold">How Are Social Security and Medicare Financed?</span>
|
||
For OASDI and HI, the major source of financing is payroll taxes on earnings paid by employees and their employers.
|
||
Self-employed workers pay the equivalent of the combined employer and employee tax rates. During 2011, an
|
||
estimated 158 million people had earnings covered by Social Security and paid payroll taxes; for Medicare the
|
||
corresponding figure was 162 million. Current law establishes payroll tax rates for OASDI and apply to earnings
|
||
up to an annual maximum ($110,100 in 2012) that ordinarily increases with the growth in the nationwide average
|
||
wage. In contrast
|
||
to OASDI, covered workers pay HI taxes on total earnings. The scheduled payroll tax rates (in percent) for 2012 are:
|
||
<blockquote>
|
||
<table class="border" bordercolor="#cccccc" width="100%" cellspacing="0" cellpadding="2"
|
||
summary="payroll tax rates by trust fund">
|
||
<tr valign="bottom" align="right">
|
||
<td> </td>
|
||
<th class="right " width="15%" scope="col">OASI</th>
|
||
<th class="right " width="15%" scope="col">DI</th>
|
||
<th class="right " width="15%" scope="col">OASDI</th>
|
||
<th class="right " width="15%" scope="col">HI</th>
|
||
<th class="right " width="15%" scope="col">Total</th>
|
||
</tr>
|
||
<tr valign="bottom" align="right">
|
||
<td align="left">Employees</td>
|
||
<td>5.30</td>
|
||
<td>0.90</td>
|
||
<td>6.20</td>
|
||
<td>1.45</td>
|
||
<td>7.65</td>
|
||
</tr>
|
||
<tr valign="bottom" align="right">
|
||
<td align="left">Employers</td>
|
||
<td class=" ">5.30</td>
|
||
<td class=" ">0.90</td>
|
||
<td class=" ">6.20</td>
|
||
<td class=" ">1.45</td>
|
||
<td class=" ">7.65</td>
|
||
</tr>
|
||
<tr valign="bottom" align="right">
|
||
<td align="left">Combined total</td>
|
||
<td>10.60</td>
|
||
<td>1.80</td>
|
||
<td>12.40</td>
|
||
<td>2.90</td>
|
||
<td>15.30</td>
|
||
</tr>
|
||
</table>
|
||
</blockquote>
|
||
<p>
|
||
Note two caveats concerning these rates. The Temporary Payroll Tax Cut Continuation Act of 2011 (Public Law 112-78)
|
||
and the Middle Class Tax Relief and Job Creation Act of 2012 (Public Law 112-96) reduced the OASDI tax rate for 2012
|
||
by 2 percentage points for employees and for self-employed workers. Under current law, the employee tax rate reverts
|
||
to the employer rate in 2013. Transfers from the General Fund of the Treasury to the OASI and DI Trust Funds compensate
|
||
for the loss of payroll tax revenue due to the temporary reduction and have no financial impact on either trust
|
||
fund. Furthermore, starting in 2013, the Affordable Care Act imposes an additional HI tax equal to 0.9 percent
|
||
of earnings over $200,000 for individual tax return filers, and on earnings over $250,000 for joint return filers.
|
||
</p>
|
||
<p>
|
||
Payments from the General Fund finance about 76 percent of SMI Part B and Part D costs, with most of the remaining
|
||
costs covered by monthly premiums charged to enrollees or in the case of low-income beneficiaries, paid on their
|
||
behalf by the Medicare or Medicaid. Part B
|
||
and Part D premium amounts rely on methods defined in law and increase as the estimated costs of those programs rise.
|
||
</p>
|
||
<p>
|
||
In 2012, the Part B standard monthly premium is $99.90. There are also income-related premium surcharges for Part B
|
||
beneficiaries whose modified adjusted gross income exceeds a specified threshold. In 2012 through 2019, the
|
||
threshold is $85,000 for individual tax return
|
||
filers and $170,000 for joint return filers. Income-related premiums range from $139.90 to $319.70 per month in 2012.
|
||
</p>
|
||
<p>
|
||
In 2012, the Part D "base monthly premium" is $31.08. Actual premium amounts charged to Part D beneficiaries depend on
|
||
the specific plan they have selected and should average around $30 for standard coverage. Beginning in 2012, Part D
|
||
enrollees with incomes exceeding the thresholds listed above must pay income-related monthly adjustment amounts in
|
||
addition to their normal plan premium. For 2012, the adjustments range from $11.60 to $66.40 per month. Part D also
|
||
receives payments from States that partially compensate for the Federal assumption of Medicaid responsibilities for
|
||
prescription drug costs for
|
||
individuals eligible for both Medicare and Medicaid. In 2012, State payments should cover about 12 percent of Part D costs.
|
||
</p>
|
||
<hr class="fn" />
|
||
|
||
<div class="footnote">
|
||
<sup><a name="fntext" href="#fn">1</a></sup>
|
||
Taxable payroll is larger for HI than for OASDI. See page 12 for further details.
|
||
</div>
|
||
<div class="footnote">
|
||
<sup><a name="fntext2" href="#fn2">2</a></sup>
|
||
As noted earlier in this summary, if trust fund exhaustion actually occurred as projected for HI in 2024 and for OASDI in
|
||
2033, each program could pay benefits thereafter only up to the amount of continuing dedicated revenues. Chart D, by
|
||
contrast,
|
||
compares dedicated sources of tax and premium income with the full cost of paying scheduled benefits under each program.
|
||
</div>
|
||
|
||
|
||
<hr />
|
||
<h3 align="center" class="newpage">A MESSAGE FROM THE PUBLIC TRUSTEES</h3>
|
||
<p>
|
||
|
||
The 1983 Social Security amendments established the public trustee position pursuant to the recommendation of the
|
||
National Commission on Social Security Reform (also known as the "Greenspan Commission"), which concluded that
|
||
the "presence of such public members" would, among other things, "help to assure that the demographic and economic
|
||
assumptions for the cost estimates" are developed "in an objective manner." While the production of the Trustees
|
||
reports inevitably involves the blending of diverse analytical viewpoints, we have found that the differing
|
||
perspectives are consistently offered in ways that fulfill the Commission's stated goal. Once again we have been
|
||
impressed, in this our second year as Public Trustees, by the professionalism
|
||
and objectivity of the ex officio Trustees, the Social Security and CMS actuaries, and the supporting staffs.
|
||
</p>
|
||
<p>
|
||
The formal Social Security and Medicare Trustees Reports have always been long and complex. This year the Trustees, led
|
||
by the Commissioner of Social Security, together with their dedicated staffs put a great deal of effort into making
|
||
them more understandable. We believe the language of this year’s reports is much
|
||
clearer than that of previous years; nevertheless we recognize that there remains room for further future improvement.
|
||
</p>
|
||
<p>
|
||
This year the Trustees benefited from the analysis and recommendations of the Medicare Technical Panel convened by the
|
||
Department of Health and Human Services and the Social Security Technical Panel convened by the Social Security
|
||
Advisory Board. These panels, whose members are expert economists, actuaries, and demographers, reviewed the
|
||
assumptions and methods used by the Trustees. We thank them for their diligent and useful work. Our current
|
||
reports incorporate some, but not all, of their recommendations.
|
||
We intend to continue to draw from their insights to inform refinements of our methods for future reports.
|
||
</p>
|
||
<p>
|
||
In our joint message last year, we warned that both Social Security and Medicare face substantial challenges, and opined
|
||
that elected officials will best serve the interests of the public if changes are enacted at the earliest possible time.
|
||
This year we sound the same warning but with greater urgency. The reasons for the increased urgency are somewhat
|
||
different, however, for each program..
|
||
</p>
|
||
<p>
|
||
The Medicare program’s near-term finances remain qualitatively similar to those described in last year's report, while
|
||
the reported long-term financial outlook has grown worse. For example, the Trustees᾿ new projection for the date of
|
||
Hospital Insurance (HI) Trust Fund depletion remains 2024 as was projected last year, while the HI program's long-term
|
||
actuarial deficit has grown significantly—from 0.79 percent of taxable payroll to 1.35 percent (an increase of over 70
|
||
percent). Similarly, this year's projection for overall Medicare costs in 2035—5.7 percent of GDP—is very close to last
|
||
year's projection of 5.6 percent of GDP, while our projection for 2085 has grown from 6.2 percent of GDP to 6.7 percent.
|
||
The reason for the deterioration in the long-term is primarily methodological, reflecting the incorporation
|
||
of the recommendation by the Medicare Technical Panel that we increase our estimate of long-term Medicare cost growth rates.
|
||
</p>
|
||
<p>
|
||
We do not regard the updated projection as a qualitatively significant further deterioration in the long-term outlook
|
||
for Medicare, as much as it is a methodological refinement that better reflects Medicare cost growth factors relative
|
||
to those for health care generally. We expect to incorporate further methodological improvements to the projections
|
||
next year, in particular a method for basing future health care cost growth projections on a new model of factors
|
||
contributing to growth. We do not currently have reason to believe this will cause a qualitative change in our projections.
|
||
</p>
|
||
<p>
|
||
Although Medicare's near-term outlook has not qualitatively changed over the last year, pressure on HI financing is
|
||
nevertheless increasing. The passage of time has brought us one year closer to the program's projected date of
|
||
trust fund exhaustion, even with the
|
||
program cost reductions recently enacted in the 2011 Budget Control Act which were not part of last year's projections.
|
||
</p>
|
||
<p>
|
||
This year's report, like previous reports, contains warnings that future Medicare costs are likely to be underestimated
|
||
in the report's intermediate projections. The primary reason for this is not methodological but rather is due to likely
|
||
changes to current law. The most immediate among these is the near-certainty that lawmakers will override the nearly 31
|
||
percent cut
|
||
in physician fee-schedule payments that the current-law Sustainable Growth Rate (SGR) formula requires in January 2013.
|
||
</p>
|
||
<p>
|
||
The Social Security outlook has worsened significantly relative to last year's report. The actuarial deficit in its
|
||
combined trust funds is now 2.67 percent of taxable payroll, the highest recorded since the last major Social Security
|
||
financing reforms roughly three decades ago. The single-year deterioration in the 2012 report is the largest recorded
|
||
since the 1994 report. While the projected depletion date (2033) for the combined trust funds is not the earliest
|
||
recorded since the 1983 reforms, we are nevertheless now closer to the point of projected depletion than we have
|
||
been since enactment of those reforms. The combined Social Security trust funds' balance continues to grow in nominal
|
||
terms, but has been declining generally relative to the total cost of paying benefits since 2008, and will be shrinking
|
||
after 2012 in real (inflation adjusted) terms.
|
||
Thus by almost any objective measure, the financial health of the Social Security system has entered a concerning decline.
|
||
</p>
|
||
<p>
|
||
While there is no way for us to know what mixture of additional tax revenues and restraints on benefit growth will prove
|
||
to be the most palatable means of strengthening Social Security's financial position, lawmakers should be aware that
|
||
it will become increasingly difficult to avoid adverse effects on current beneficiaries, those
|
||
close to retirement, and low-income beneficiaries in all birth cohorts if legislative changes are delayed much further.
|
||
</p>
|
||
<p>
|
||
The weak economy of recent years has placed both direct and indirect pressure on Social Security. It has placed direct
|
||
pressure on program finances by depressing payroll tax income. Much of the financial deterioration in this year’s
|
||
Social Security report reflects updated economic data and assumptions, including weaker-than-expected economic
|
||
performance and unexpectedly high inflation in 2011. But the weak economy has placed indirect pressure on the
|
||
program as well, in that lawmakers have relieved workers of part of the tax burden of financing Social Security
|
||
benefits so as to bolster near-term economic growth. Under this policy, over $200 billion will be transferred from
|
||
the General Fund of the Treasury to replace foregone Social Security tax collections. In 2011, due in large part to
|
||
this change in program financing, payroll tax revenue represented only 70 percent of total Social Security income.
|
||
Lawmakers should carefully consider whether continued significant General Fund financing for Social Security could
|
||
threaten to undermine long-standing public
|
||
perceptions of the program as an earned benefit financed by workers according to contributory social insurance principles.
|
||
</p>
|
||
<p>
|
||
The legislative achievement in creating the Social Security and Medicare programs remains a remarkable one, in that the
|
||
two programs have provided critical social insurance protections for hundreds of millions of Americans, at
|
||
exceptionally low administrative cost, with financing methods that have been accepted historically as generally
|
||
equitable. We believe that with responsible bipartisan action, Social Security and Medicare can continue to
|
||
fulfill these vital roles’but we stress that such action must be prompt and
|
||
sufficiently decisive if these programs are to serve future generations as well as they have served earlier ones.
|
||
|
||
</p>
|
||
|
||
<br /><br /><br />
|
||
|
||
<div class="grid_6">
|
||
|
||
Charles P. Blahous III,<br />Trustee
|
||
</div><!-- end .grid_6 -->
|
||
|
||
<div class="grid_6">
|
||
Robert D. Reischauer,<br />Trustee
|
||
</div><!-- end .grid_6 -->
|
||
|
||
|
||
|
||
</div>
|
||
|
||
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