Masters level forumEconomic policy is a complex but vital part of the United States.  To start this forum, take a look at CNBCs explanation of who the Federal Reserve is and what they do.Now, look th

Introduction

Topics to be covered include:

• Basics of U.S. economic policy

• The federal budget process

• The budget deficit

• The national debt

• The basics of U.S. healthcare policy

• Medicare

• Medicaid

• The State Children’s Health Insurance Program (SCHIP)

• The Patient Protection and Affordable Care Act (ACA)

• Reducing healthcare costs

The focus of this lesson will be on two major policy issues that have been in the forefront of discussion over the past few years, economic and health care policy. Economic policy governs the largest economy in the world, one with a gross domestic product (GDP) of over $18 trillion and several of the world’s most important financial markets. Healthcare policy in the United States affects the health and well-being of hundreds of millions of people. Equity issues are rife in both policy fields; the question of who pays for what, and who benefits the most and least, pervade the nation’s economy and health industry alike.

The Basics of U.S. Economic Policy

Since at least the beginning of the twentieth century, the United States has the world’s largest national economy. Its gross domestic product (GDP) was estimated to be over $19 trillion and growing (as of November 2017). Its currency, the U.S. dollar, stands as the world’s foremost reserve currency and the currency most widely used in international transactions. Ecuador, El Salvador, and Panama are a few of many countries throughout the world that use the U.S. dollar as their own official currency.

Let’s discuss some basic qualities of U.S. Economic Policy. 

• Financial Markets-The United States has one of the world’s largest financial markets worldwide. This includes the New York and Chicago Stock Exchanges. The United States has the largest consumer market in the world, but only a quarter as many people of the world’s most populous country, China.

• Goals of U.S. Economic Policy-The goals of U.S. economic policy include sustaining economic growth, keeping unemployment levels down, keeping the level of inflation low, seeking a positive balance of trade every year, and managing the deficit and the national debt. The amount of goods and services the economy produces (output) and the number of jobs it generates (employment) can be affected by policy, but also depend on the technology available and the preferences people have for saving money and taking risks in investing.

• The Federal Reserve System-The Federal Reserve System (also known as “the Fed”) is the central banking system of the United States. With the Federal Reserve Act, which created the Fed on December 13, 1913, Congress established three key objectives: maximum employment, stable prices, and moderate long-term interest rates. The Fed’s duties have expanded over the years, and now include maintaining the stability of the financial system, supervising and regulating banks, and providing financial services. When a decrease in consumer demand prompts a recession, the Fed can stimulate the economy by lowering interest rates.

• Policy Tools-The U.S. government has a variety of policy tools to deal with economic issues. Along with the Fed, the government establishes fiscal policies, monetary policies, and tax policies, and also offers incentives and subsidies to businesses to facilitate government policy. The Fed cannot control inflation or influence output and employment directly, but can affect them indirectly by raising or lowering a short-term interest rate called the “federal funds” rate. Banks and other financial institutions keep a certain amount of funds in reserve to meet unexpected outflows, either as cash in their vaults or as deposits with the Fed.

• Economic Relationships-A few specific relationships within the U.S. economy merit attention. The trade-off between seeking full employment (somewhere around 5 percent) and keeping inflation low (below 5 percent) is always a matter of contention. And while economic growth is considered favorable, it can also result in rises in inflation—which is not favorable. High inflation can hinder economic growth by making it harder for consumers to evaluate changes in the prices of products and services. It also leads consumers to spend their time and resources hedging against inflation instead of investing in the economy more productively.

The Federal Budget

Process

The United States budget process begins when the President submits a budget request to Congress early in the calendar year (usually in February) for the coming fiscal year (which begins on October 1). The Office of Management and Budget (OMB) assists the President in formulating this budget, which includes funding requests from all executive branch organizations. This budget request is usually thousands of pages long, and it is often declared “dead on arrival” by congressional leadership. Click on the following link to review the current administration’s submission for 2018.

• THE PRESIDENT’S BUDGET

The President’s budget plays three major roles: It tells Congress what the President recommends for overall federal fiscal policy; it lays out the president’s relative priorities for federal programs (how much he supports spending on defense, agriculture, education, health, etc.); and it signals to Congress the President’s recommendations for spending and tax policy changes. The President’s recommendations are generally established by his views on how much money the federal government should spend on public purposes, how much it should take in as tax revenues, and how much of a deficit (or surplus) the federal government should run. The deficit (or surplus) is simply the difference between what the government spends and the revenues it takes in.

• CONGRESSIONAL COMMITTEES

The President’s budget submission is assigned to the House and Senate budget committees and the Congressional Budget Office (CBO) for review. In March, the CBO publishes an analysis of the President’s budget proposal for the various budget committees to consider. Each committee submits a budget resolution to its chamber by April for a floor vote, which usually occurs by mid-April. There is no obligation for either chamber of Congress to pass a budget resolution; the House and Senate may propose their own federal budget instead, and if no budget at all is passed the previous year’s resolution remains in force. In years where there is no budget resolution, the House, the Senate, or both can and typically do, adopt special procedures to set spending levels.

• FEDERAL BUDGET PROCESS

There is a two-step process regarding the federal budget. First, the budget must be approved.  For money to be disseminated, an appropriations bill must be passed and signed into law. Thus, after both chambers of Congress pass their own budget resolutions, selected representatives and senators negotiate a conference committee budget report to reconcile differences between the two versions. The conference budget report must be approved by both the House and Senate, and this budget resolution serves as a blueprint for the actual appropriations bill.

Once both chambers pass their own appropriations bills (much like the budget resolutions), which provide details about where the money in the federal budget goes, a conference committee is again required to resolve any differences between them. Once the appropriations conference bill has passed another vote by both chambers of Congress, it is sent to the President, who may sign the bill or veto it. If the President signs it, the bill becomes law and the fiscal budget for the country is set. Otherwise, Congress can try to override the veto or it can pass a continuing resolution bill to avoid a federal government shutdown.

Please take some time to review the federal budget process.

The Budget Deficit

A budget deficit refers to government spending that exceeds tax collections over a fiscal year.  When this happens, the government is required to borrow money to fund the difference. The U.S. federal government has run annual budget deficits in 36 of the past 40 fiscal years. The deficit for fiscal year 2018 was approximately $440 billion. The deficit as percentage of the size of the U.S. economy before 2008 was about three percent of the GDP. However, in 2009 the deficit rose to 10 percent of the GDP due to the Great Recession before falling back to around three percent by 2014.

• Reasons for Larger Deficits-There are a number of reasons why deficits have been larger than typical in the last decade. The terrorist attacks that occurred on September 11, 2001 led to wars that nearly doubled annual military spending. Between 2003 and 2011, the military budget alone rose from $437.4 billion to a peak of $855.1 billion (Amadeo, 2017, May 25). Mandatory spending, which includes funds spent on programs such as Social Security and Medicare, has exceeded $2 trillion a year since 2011, a marked increase (Amadeo, 2017, May 25). Changing these expenditures would require an Act of Congress that would involve a majority vote in both houses. Current beneficiaries of these programs, who have shown to be a powerful voting demographic, would be the ones to suffer and would also be likely to show their disapproval at the polling station.

• The Great Recession-Early efforts to curb the Great Recession included a $787 billion economic stimulus package, an expenditure that greatly added to the 2009 deficit by cutting taxes and extending unemployment benefits as well as funding public works projects to create jobs (Amadeo, 2017, Aug. 30). (With all fairness, this stimulus did play a substantial role in ending the Great Recession.) Federal revenue and taxes also experienced a decline during this time; government income fell from its record of $2.57 trillion in 2007 to only $2.1 trillion in FY 2009, not recovering until 2013 when it reached $2.78 trillion (Amadeo, 2017, Aug 30).

• Importance of Government and Consumer Spending-Oddly enough, the government’s inability to keep its spending levels within the prescribed annual budget is usually intentional. The government stimulates the economy through its spending; government spending is itself a component of GDP. Borrowing money is rarely a problem, with countries such as China more than willing to loan money to the United States. Furthermore, when jobs are created and the economy grows under an elected official’s term, he or she is likely to get re-elected; the same cannot be said for a politician whose term is marked by high taxes and unemployment.

• Moderate Deficits-When a moderate deficit in the budget is experienced, it increases economic growth and is not an immediate crisis. It gives businesses and families the means to spend more money, and in turn help create a stronger economy. Under these circumstances, the United States always pays back the debt that it incurs, giving its lenders no reason to worry. But when the debt-to-GDP ratio approaches or exceeds 100 percent, lenders develop cause for concern.

The National Debt

As deficits accumulate over time, the national debt of the United States grows. The amount owed to others by the U.S. federal government has two primary components: Debt held by the public and debt held by government accounts (intra-governmental debt). Two-thirds of the U.S. debt is in the form of treasury bills, notes, and bonds owned by the public, which includes investors, the Federal Reserve, and foreign governments. The other third is in the form of government account securities owned by federal agencies, including the Social Security Trust Fund, federal public employee retirement funds, and military retirement funds.

The U.S. national debt has risen each year since 1972, and the debt held by the public ranged between 23 percent of the GDP and 50 percent between 1971 and 2007, then rose considerably as a result of the Great Recession. Intra-governmental debt was at $5 trillion at the end of 2014. This placed the combined public and government debt close to $18 trillion, or about 105 percent of the GDP. To see the current national debt, check out the US Debt Clock.

REDUCING THE NATIONAL DEBT AND THE DEBT-TO-GDP RATIO

There are two ways to reduce the national debt: by raising taxes, or by cutting spending. Both of these practices have the potential to be controversial and unpopular because they slow economic growth. The debt-to-GDP ratio divides the debt by the nation’s gross domestic product to determine the nation’s ability to pay the debt off. Default becomes a concern to investors when the debt-to-GDP ratio rises above 77 percent. Foreign investors like China and Japan have confidence in the U.S. economy, and their continued investments help keep interest rates low. But these rates would skyrocket if those investments did very poorly.

The debt-to-GDP ratio rose above 77 percent until World War II, when the nation had to borrow money for wartime expenditures (Amadeo, 2017, Jul. 1). The fiscal policy assumed by the Roosevelt administration helped bring the Great Depression to an end. Not until 2009, when the Great Recession lowered tax receipts, did the ratio rise to that point again. At this time, Congress increased spending for the Economic Stimulus Act, the Troubled Asset Relief Program (TARP), and two wars.

High levels of spending, such as that on programs like Medicare, Medicaid, and Social Security, usually gives the GDP enough of a boost to reduce the debt-to-GDP ratio, but since the end of the Great Recession that has not happened. In spite of the economic recovery, the end of the Afghanistan and Iraq Wars, and sequestration, the ratio has remained above 100 percent ever since. Debt ceiling crises, the fiscal cliff, and one government shutdown drastically injured business and consumer confidence.

PAYING OFF THE NATIONAL DEBT

At over $20 trillion (as of November, 2017), paying off the national debt would require almost $60,000 for every man, woman, and child in the United States, and amount double the U.S. per capita income of $28,757. It stands as the largest national debt of any nation in the world by a large margin, greater even than that of the European Union, which includes 28 countries. In fact, the current debt is more than the country produces in a year. Even if everything the nation produced in an entire year went towards paying it, it would not be paid off. The federal government already pays over $250 billion a year on interest payments on the debt alone (Amadeo, 2017, Jul. 1).

Please take some time to explore the national debt and deficit by using the Economic Research capabilities of the Federal Reserve.

The Basics of U.S. Health Care Policy

At the federal level, the key organization regarding health care policy in the United States is the Department of Health and Human Services (DHHS). There are a number of organizations within DHHS that deal with various aspects of health care.

Food and Drug Administration (FDA)-One of them is the Food and Drug Administration (FDA), which regulates and supervises over-the-counter pharmaceutical drugs, dietary supplements, tobacco and marijuana products, food safety, and prescriptions and vaccines. The main role of the FDA is to protect the public health by assuring that foods (with the exception of meat and eggs) are safe, wholesome, sanitary and properly labeled and that human and veterinary drugs, vaccines, and other biological products and medical devices intended for human use are safe and effective (U.S. Food and Drug Administration (FDA), 2017).

Centers for Disease Control (CDC)-Another organization, the Centers for Disease Control (CDC), works to protect public health and safety by preventing disease, disability, and injury. The CDC is recognized around the world as a global leader in public health, remaining at the forefront of efforts to prevent and control infectious and chronic diseases, injuries, workplace hazards, disabilities, and environmental health threats. It applies research and findings to improve daily life and to respond to health emergencies, working with states and other partners to provide a system of health surveillance to monitor and prevent disease outbreaks (including bioterrorism), implement disease prevention strategies, and maintain national health statistics (Centers for Disease Control, 2017).

Health Resources and Service Administration (HRSA)-The Health Resources and Service Administration (HRSA) improves access to health care services for people who are medically vulnerable, geographically isolated, or without health insurance. Tens of millions of Americans receive quality, affordable health care through programs and grantees of the HRSA each year. Among those groups serviced by the HRSA include people living with HIV/AIDS, pregnant women and mothers, health professionals in training, and people receiving organ, bone marrow, and cord blood donations. The HRSA also maintains databases that protect against health care malpractice, waste, fraud, and abuse (Health Resources and Service Information, 2017).

National Institutes of Health (NIH)-Lastly, the National Institutes of Health (NIH) focuses on biomedical and health-related research for the country. Comprising 27 separate institutes and centers, the NIH is one of eight health agencies of the Public Health Service of the DHHS. The goal of NIH’s research is to acquire new knowledge to help prevent, detect, diagnose, and treat disease and disability in all forms. The organization’s mission is to uncover new knowledge that will lead to better health for all citizens, a mission that it pursues through research conducted in its own laboratories, support for scientists in universities, medical schools, hospitals, and research institutions throughout the country and abroad and the communication of medical and health sciences information (National Institutes of Health, 2017).

Medicare

Established in 1966, Medicare provides health insurance for citizens aged 65 or older. It also provides health insurance to younger people with physical disabilities or other medical issues, such as end-stage kidney disease or Lou Gehrig’s disease. People under 65 are eligible for the program after being on disability for a specific amount of time, usually 24 months. As a federal health insurance program, Medicare pays for a variety of health care expenses for those eligible. The Centers for Medicare & Medicaid Services (CMS), a division of the DHHS, administers this program. Similar to Social Security, Medicare is an entitlement program that most U.S. citizens earn the right to enroll in by working and paying specific taxes for a minimum required period. Citizens who do not work the requisite number of years may still qualify but may also have to pay more towards their care under the plan.

There are four different parts to the Medicare program. Medicare Parts A and B are often referred to as Original Medicare.

PART A

Part A covers hospital charges and most of the services a covered patient receives while in the hospital, but not the fees charged by doctors who treat them.

PART B

Part B covers doctor visits, most routine and emergency medical services, and some preventive care (such as an annual flu shot).

PART C

Part C, also known as Medicare Advantage, describes plans offered by private health insurers that combine coverage for hospital care, doctor visits and other medical services all in one plan. In order to offer Part C, an insurance company must be approved by Medicare.

PART D

Another part of Medicare, Part D, is also offered by private insurers and covers prescription drugs.

To find out more about these different parts, spend some time exploring this link.

In 2015, 55.3 million Americans received Medicare benefits; 46.3 million of these people were 65 or older and 9 million were disabled people under this age (National Committee to Preserve Social Security and Medicare, 2017). The average Medicare beneficiary received $12,559 in benefits from the program that year (National Committee to Preserve Social Security and Medicare, 2017).

Medicaid

Medicaid is a federal and state program that provides funding for medical and health-related services for Americans with low income. It is a means-tested program that is funded by both federal and state governments. In 2017, 69 million people were covered under Medicaid in the United States (National Committee to Preserve Social Security and Medicare, 2017).

QUALIFICATIONS

Poverty alone does not necessarily qualify someone for Medicaid. The program is administered by the states, with each state determining who is eligible for services. Federal law requires states to cover certain groups of individuals, and the mandatory eligibility groups include low-income families, qualified pregnant women and children, and individuals receiving Supplemental Security Income (SSI). States have additional options for coverage and may choose to cover other groups, as well. Examples may include people receiving home- and community-based services or children in foster care who are not otherwise eligible. In addition to being financially indigent, Medicaid beneficiaries must be residents of the state in which they are receiving Medicaid as well as either U.S. citizens or qualified non-citizens. Read more about eligibility here.

States may establish a “medically needy program” to assist residents who have significant health needs but cannot qualify for Medicaid due to income. These individuals can become eligible by “spending down” the amount of income that is above a particular state’s medically needy income standard by first paying expenses for medical care for which they do not have health insurance. Once the healthcare expenses they have incurred exceed the difference between the individual’s income and the income level required to qualify for Medicaid, the person can be eligible. The Medicaid program then pays the cost of services that exceed what the individual had to incur in the way of expenses in order to become eligible.

MEMBER PROGRAMS

Medicaid provides a number of programs that support access to care in several ways. It allows individuals to access health care services that may not be affordable otherwise. Some programs and benefits under Medicaid include special protections to ensure that the beneficiaries can access the programs. Examples include provider network standards and payment methodologies.  In order to save money in the long run and preserve the health of the people covered by the program, Medicaid encourages preventative care and has developed resources and materials to help beneficiaries understand the importance of preventing sickness and disease before it occurs.

The State Children’s Health Insurance Program (SCHIP)

It is very important to healthcare policymakers in the United States that as many children as possible receive the care that they need. Many families with children have difficulty obtaining health insurance even if their incomes are too high to qualify for Medicaid. Through the State Children’s Health Insurance Program (SCHIP), the federal government provides matching funds to participating states to pay for health insurance for low-income families with children.

Unlike Medicaid, funding for SCHIP is capped. Both spending for health care expenses and the number of children eligible for coverage under the program are far less than Medicaid allows. But like Medicaid, each state is given the freedom to determine the design of its SCHIP program, including the groups that are eligible, the benefit packages available, payment levels for coverage, and administrative and operating procedures.

Eligibility rules for the SCHIP program vary by state, but generally speaking, uninsured children under the age of nineteen whose families earn up to $36,200 a year (for a family of four) are eligible. SCHIP provides coverage for doctor visits, immunization, hospitalizations, and emergency care.

The Patient Protection and Affordable Care Act (ACA)

ACA BASICS

On, March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act into law. The purpose of this legislation, commonly called the Affordable Care Act (ACA) or simply “Obamacare,” was to increase the quality and affordability of health insurance, lower the uninsured rate by expanding both public and private insurance coverage, and reduce the costs of health care for individuals and the government. Most of the significant reforms associated with this law took effect on January 1, 2014. They include:

• Prohibiting insurers from denying coverage to individuals due to medical pre-existing conditions;

• Setting minimum standards for what health insurance policies are required to cover;

• Instituting an individual mandate requiring all Americans not covered by health insurance to get an approved private-insurance policy or pay a tax penalty to the Internal Revenue Service (IRS);

• Establishing state health insurance exchanges to operate as a new avenue by which individuals and small businesses can compare policies and buy insurance; and

• Offering subsidies to low-income individuals and families whose incomes are between 100 and 400 percent of the federal poverty level (if they purchase insurance via a state health insurance exchange).

However, President Trump issued an Executive Order in October of 2017 which may have a decided impact on the ACA. What impact has it had so far? What do you think will be the consequences in the future? Remember the types of consequences we examined earlier!

COURT CHALLENGES

The ACA was challenged before it was even passed, and it has continued to face challenges in Congress and in the federal courts. In 2012, the Supreme Court upheld the ACA’s individual mandate in National Federation of Independent Business v. Sebelius, determining that the required expense qualified as a tax that Congress had the power to levy. The Court upheld the right of the federal government to impose a tax penalty on those Americans who did not acquire health insurance of some kind.  In 2015, in the case King v. Burwell, the Supreme Court affirmed that the ACA’s federal subsidies program should be available in all states, not just in those that have established state health insurance exchanges.

RAND HEALTH REFORM OPINION STUDY

The RAND Health Reform Opinion Study, conducted in May 2014, surveyed over five thousand Americans and found that 49 percent of respondents held an unfavorable view of the ACA, while only 38 percent held a favorable view. In a separate 2014 poll by RealClearPolitics, it was shown that public approval of the ACA was at 52 percent with 39 percent opposed to the law (poll averages from February 27 to March 25, 2014). Public opinion of the ACA remains mixed. In March 2015, the CDC reported that the number of uninsured Americans was 11.4 million people fewer than it was in 2010 before the law was implemented; this finding suggests that regardless of what Americans think of the law, it has been effective in meeting its purpose.

Take a look at the latest Kaiser poll results. Does this square with Executive and Congressional moves currently?

Reducing Healthcare Costs

Even with the ACA making health insurance more available to millions of uninsured Americans, healthcare costs remain high. And while the program affords subsidies to help lower-income Americans pay for their health insurance, many in the middle class have seen higher premiums—sometimes considerably higher. The question of how to make healthcare not only accessible but also affordable to all Americans remains.

Managed healthcare plans use a variety of mechanisms to reduce inflated healthcare costs. These include granting economic incentives for physicians and patients who choose less costly forms of care, reviews of the medical necessity of specific services, increased beneficiary cost sharing, controls on inpatient admissions, cost-sharing incentives for outpatient surgery, and selective contracting with health care providers. Managed health care plans depend upon a network of health care providers, doctors, and facilities that establish a contract with the provider of those plans. A group or company provides an individual with the coverage and acts as the plan sponsor, and members receive assistance in locating the most affordable means of insurance services based on the healthcare providers who are in their network. All partners share the medical cost risks of individual members, and in the end the costs of healthcare are lower.

The three main types of managed healthcare plans are health maintenance organizations (HMO), preferred provider organizations (PPO), and point-of-service (POS) insurance plans.

HMO-An HMO supplies a list of healthcare providers to an employer’s personnel, which they may use at a reduced rate. The HMO model places its focus on preventative measures to reduce the chance of disease and healthcare expenses in the long run. A team of doctors, hospitals, health care providers, and the insurer work together to provide treatment under a HMO.

PPO-A PPO is similar to an HMO in that it provides discounted health services to its members. But under a PPO, members have the option to choose their own physician rather than one from a limited list of providers. However, the member may pay a little more towards their healthcare bill if they use a provider from outside of the PPO’s network. Members are required to pay for services at the time they are provided, and they are reimbursed for these services at a later date. The cost is arranged ahead of time, so patients know what they will be expected to pay. Healthcare costs under a PPO are typically capped at specific price points for individuals and families.

POS-The POS model shares many characteristics of both HMOs and PPOs. A primary care physician must work in and have the ability to make referrals among the network providers in order to be eligible for inclusion. Members who choose outside providers will be billed a deductible and higher co-payment than they would with one who is inside the network. If a member uses more than one doctor or specialist, they can come from both inside and outside of the network and the member is free to choose without permission from his or her primary care physician.

Conclusion

The United States has the world’s largest economy and one of its largest human populations, so issues of economic and healthcare policy are extremely important. Each year, the U.S. government passes a budget, which it typically manages to exceed, resulting in a deficit. A budget deficit can be good as well as bad, but if allowed to grow out of control it can substantially add to the country’s national debt. To take care of the health of the nation’s 340 million citizens, the Department of Health and Human Services (DHHS) contains several agencies that serve different health-related purposes. Programs such as Medicare, Medicaid, and most recently the Affordable Care Act (ACA) have helped millions of uninsured Americans receive the healthcare they need.

References

About the Federal Reserve System. (n.d.). Retrieved November 22, 2017, from https://www.federalreserve.gov/aboutthefed/structure-federal-reserve-system.htm

Affordable Care Act (ACA) - HealthCare.gov Glossary. (n.d.). Retrieved November 22, 2017, from https://www.healthcare.gov/glossary/affordable-care-act/

Amadeo, K. (2017, May 25). Current U.S. Federal Budget Deficit: 4 Reasons the U.S. Deficit Is Out of Control. The Balance. Retrieved from https://www.thebalance.com/current-u-s-federal-budget-deficit-3305783.

Amadeo, K. (2017, July 1). What Is the National Debt? 3 Ways to Visualize the National Debt. The Balance. Retrieved from https://www.thebalance.com/what-is-the-national-debt-4031393.

Amadeo, K. (2017, August 30). What Was Obama’s Stimulus Package? Retrieved from https://www.thebalance.com/what-was-obama-s-stimulus-package-3305625.

Centers for Disease Control (CDC). (2017). Our History - Our Story, 2017. Retrieved from https://www.cdc.gov/about/history/index.html.

Centers for Disease Control and Prevention. (2017, April 26). Retrieved November 22, 2017, from https://www.cdc.gov/

Centers for Medicare and Medicaid Services. (2017, November 02). Retrieved November 22, 2017, from https://www.cms.gov/

Exec. Order No. Presidential Executive Order Promoting Healthcare Choice and Competition Across the United States, 3 C.F.R. (2017). https://www.whitehouse.gov/the-press-office/2017/10/12/presidential-executive-order-promoting-healthcare-choice-and-competition

Federal Reserve Act. (n.d.). Retrieved November 22, 2017, from https://www.federalreserve.gov/aboutthefed/fract.htm

FRED Data Practice: “ U.S. deficit and debt ” Objectives. (n.d.). Retrieved November 22, 2017, from https://files.stlouisfed.org/files/htdocs/pageone-economics/uploads/Lessons/DataPracticeFRED_Debt_deficit.pdf

Health Resources and Service Information. (2017). About HRSA. Retrieved from https://www.hrsa.gov/about/index.html.

Kaiser Health Tracking Poll – August 2017: The Politics of ACA Repeal and Replace Efforts. (2017, September 18). Retrieved November 22, 2017, from https://www.kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-august-2017-the-politics-of-aca-repeal-and-replace-efforts/

King v. Burwell. (n.d.). Oyez. Retrieved November 22, 2017, from https://www.oyez.org/cases/2014/14-114

Medicaid Home. (2017, November 21). Retrieved November 22, 2017, from https://www.medicaid.gov/

Medicaid.gov. (n.d.). Affordable Care Act. Retrieved from https://www.medicaid.gov/affordable-care-act/index.html.

Medicaid.gov. (n.d.). Eligibility. Retrieved from https://www.medicaid.gov/medicaid/eligibility.

National Committee to Preserve Social Security and Medicare. (2017). Fast Facts About Medicare. Retrieved from http://www.ncpssm.org/Medicare/MedicareFastFacts.

National Federation of Independent Businesses v. Sebelius. (n.d.). Oyez. Retrieved November 22, 2017, from https://www.oyez.org/cases/2011/11-393

National Institutes of Health. (2017). Frequently Asked Questions: About NIH. Retrieved from https://www.nih.gov/about-nih/frequently-asked-questions.

National Institutes of Health. (n.d.). Retrieved November 22, 2017, from https://www.nih.gov/

News and Announcements. (n.d.). Retrieved November 22, 2017, from https://www.hrsa.gov/

Office of Management and Budget. (2017, September 30). Retrieved November 22, 2017, from https://www.whitehouse.gov/omb

Patient Protection and Affordable Care Act, 42 U.S.C. § 18001 (2010).

Policy Basics: Introduction to the Federal Budget Process. (2017, October 10). Retrieved November 22, 2017, from https://www.cbpp.org/research/policy-basics-introduction-to-the-federal-budget-process

State Children's Health Insurance Program. (n.d.). Retrieved November 22, 2017, from https://www.benefits.gov/benefits/benefit-details/607

The Presidents. (2017, March 08). Retrieved November 22, 2017, from https://www.whitehouse.gov/1600/Presidents

U.S. Department of Health and Human Services. (n.d.). HHS.gov. Retrieved November 22, 2017, from https://www.hhs.gov/

U.S. Food and Drug Administration (FDA). (2017). What does FDA do? Retrieved from https://www.fda.gov/AboutFDA/Transparency/Basics/ucm194877.htm.

U.S. National Debt Clock : Real Time. (n.d.). Retrieved November 22, 2017, from http://www.usdebtclock.org/

What's Medicare? (n.d.). Retrieved November 22, 2017, from https://www.medicare.gov/sign-up-change-plans/decide-how-to-get-medicare/whats-medicare/what-is-medicare.html