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June 11, 2001
Honorable Max Baucus
Committee on Finance
Chairman
United States Senate
Washington, DC 20510
Dear Mr. Chairman:
The Congressional Budget Office (CBO) has prepared the attached updated estimates of the effect on direct spending of four proposals made during the 106th Congress to establish an outpatient prescription drug benefit in Medicare. Those proposals are:
The updated estimates reflect CBO's current baseline for spending on outpatient prescription drugs by or for the Medicare population and revisions in CBO's estimating methods. Those revisions are based on updated data and intensive review of our methods to ensure the reasonableness and consistency of the estimates.
The original proposals all would have established a prescription drug benefit in 2003 or earlier. The updated estimates assume that the benefit would begin in 2004.
The original proposals specified dollar amounts for deductibles, benefit caps, and stop-loss thresholds for the first year of the benefit, and occasionally for subsequent years. The updated estimates assume the specified amounts apply beginning in 2004.
Table 1 summarizes the effect of each proposal on direct spending during the 2002-2011 period. Tables 2 through 5 provide year-by-year estimates and supplemental information for each of the estimates.
If you or your staff have any questions about these estimates, or if you need additional information, we would be happy to be of assistance. The CBO staff contact is Julia Christensen.
I hope this information is helpful to you.
Sincerely,
Dan L. Crippen
Director
Attachments
cc: | Honorable Charles E. Grassley
Ranking Member, Senate Committee on Finance |
Honorable Kent Conrad
Chairman, Senate Committee on the Budget |
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Honorable Pete V. Domenici
Ranking Member, Senate Committee on the Budget |
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Honorable John B. Breaux | |
Honorable Bill Frist | |
Identical letters sent to Honorable W. J. "Billy" Tauzin and Honorable William "Bill" M. Thomas |
Table 1. Estimated Effect on Direct Spending of Proposals Introduced During the 106th Congress to Establish a Prescription Drug Benefit in Medicare, Fiscal Years 2004-2011 |
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Clinton | Robb | Breaux- Frist |
H.R. 4680 | ||||
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Federal Spending on Prescription Drugs for Medicare Enrollees | |||||||
Medicare | 417 | 295 | 124 | 97 | |||
Spending by Other Federal Programs on Prescription Drugs for Medicare Enrollees | -113 | -111 | -64 | -68 | |||
Low-Income Subsidy | 100 | 111 | 104 | 109 | |||
Subtotal | 405 | 294 | 164 | 138 | |||
Other Direct Spending | 21 | 24 | 12 | 16 | |||
Total | 425 | 318 | 176 | 154 | |||
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SOURCE: Congressional Budget Office. | |||||||
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TABLE 2. CBO's Estimate of the Effect on Direct Spending of Establishing a Prescription Drug Benefit in Medicare: President Clinton's Proposal in the 2000 Mid-Session Review, Assuming Implementation in 2004 (Outlays in billions of dollars, by fiscal year) |
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2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | 2002- 2006 |
2002- 2011 |
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Federal Spending on Prescription Drugs for Medicare Enrollees | |||||||||||||||||
Medicare | |||||||||||||||||
Benefits | 0 | 0 | 28.2 | 44.3 | 54.1 | 63.3 | 75.0 | 86.4 | 100.4 | 116.4 | 126.6 | 568.0 | |||||
Premiums | 0 | 0 | -8.9 | -12.3 | -15.9 | -17.7 | -21.6 | -23.8 | -28.0 | -31.6 | -37.0 | -159.7 | |||||
Subsidy to ESI plans | 0 | 0 | 0.5 | 0.7 | 0.9 | 1.0 | 1.2 | 1.3 | 1.6 | 1.8 | 2.1 | 9.0 | |||||
Subtotal | 0 | 0 | 19.8 | 32.7 | 39.2 | 46.5 | 54.6 | 64.0 | 74.0 | 86.5 | 91.7 | 417.3 | |||||
Spending by Other Federal Programs on Drugs for Medicare Enrollees | |||||||||||||||||
Medicaid | 0 | 0 | -4.3 | -9.3 | -10.4 | -11.6 | -13.0 | -14.6 | -16.3 | -18.3 | -24.0 | -97.8 | |||||
FEHB (for annuitants, on-budget) | 0 | 0 | -0.3 | -0.4 | -0.4 | -0.5 | -0.5 | -0.5 | -0.6 | -0.6 | -1.1 | -3.7 | |||||
Tricare | 0 | 0 | -0.6 | -0.9 | -1.1 | -1.3 | -1.5 | -1.7 | -2.0 | -2.3 | -2.5 | -11.3 | |||||
Subtotal | 0 | 0 | -5.2 | -10.5 | -11.9 | -13.4 | -15.0 | -16.9 | -18.9 | -21.2 | -27.5 | -112.9 | |||||
Low-Income Subsidy | 0 | 0 | 4.3 | 9.1 | 10.8 | 12.2 | 13.6 | 15.0 | 16.7 | 18.6 | 24.1 | 100.2 | |||||
Subtotal, Federal Spending on Drugs for Medicare Enrollees | 0 | 0 | 18.9 | 31.2 | 38.1 | 45.4 | 53.2 | 62.2 | 71.8 | 83.9 | 88.2 | 404.7 | |||||
Other Direct Spending | |||||||||||||||||
Other Medicaid and Medicare effects | 0 | a | 0.6 | 1.4 | 2.2 | 2.4 | 2.6 | 2.8 | 3.0 | 3.2 | 4.3 | 18.3 | |||||
Effect of higher drug prices on federal programs (on-budget) | 0 | 0 | a | 0.1 | 0.1 | 0.2 | 0.3 | 0.4 | 0.5 | 0.7 | 0.2 | 2.2 | |||||
Effect of higher drug prices on FEHB (for postal workers and annuitants, off-budget) | 0 | 0 | a | a | a | a | a | a | a | a | 0 | 0 | |||||
Subtotal | 0 | a | 0.7 | 1.5 | 2.3 | 2.6 | 2.9 | 3.1 | 3.5 | 3.9 | 4.5 | 20.5 | |||||
Total | 0 | a | 19.6 | 32.7 | 40.4 | 48.0 | 56.1 | 65.3 | 75.3 | 87.8 | 92.8 | 425.2 | |||||
Memorandum: Change in Spending by States | 0 | a | -0.1 | -0.6 | -0.3 | -0.4 | -0.6 | -0.8 | -1.1 | -1.4 | -1.0 | -5.2 | |||||
Characteristics of the Proposed Benefit | |||||||||||||||||
Voluntary prescription drug benefit under new Part D; one-time only enrollment option; 50 percent subsidy of premium below the benefit cap, 100 percent subsidy of premium above the stop-loss amount. | |||||||||||||||||
Administered by single Pharmacy Benefit Manager (PBM) per region that does not assume insurance risk. | |||||||||||||||||
Premiums and cost-sharing subsidies for low-income people, including amounts above the benefit cap and below the stop-loss amount. | |||||||||||||||||
Monthly Premium for Prescription Drug Benefit | $27.50 | $28.40 | $38.40 | $39.90 | $49.50 | $51.40 | $61.10 | $65.50 | |||||||||
Deductible | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | |||||||||
Coinsurance Rate (Percent) | 50 | 50 | 50 | 50 | 50 | 50 | 50 | 50 | |||||||||
Benefit Cap | $1,000 | $1,000 | $1,500 | $1,500 | $2,000 | $2,000 | $2,500 | $2,638 | |||||||||
Total Spending on Drugs at the Benefit Cap | $2,000 | $2,000 | $3,000 | $3,000 | $4,000 | $4,000 | $5,000 | $5,276 | |||||||||
Stop-loss Amount | $4,000 | $4,220 | $4,452 | $4,697 | $4,955 | $5,228 | $5,515 | $5,819 | |||||||||
Total Spending on Drugs at the Stop-loss Amount | $5,000 | $5,220 | $5,952 | $6,197 | $6,955 | $7,228 | $8,015 | $8,457 | |||||||||
Participation Rate (as percentage of Part B enrollment) | 92% | 92% | 92% | 92% | 92% | 92% | 92% | 92% | |||||||||
Price Effect (in the 10th year) | 12.4% | ||||||||||||||||
Medicare Cost-Management Factor | 10.0% | ||||||||||||||||
SOURCE: Congressional Budget Office. | |||||||||||||||||
Notes: a = less than $50 million; ESI = employer-sponsored insurance; FEHB = Federal Employees Health Benefits program. | |||||||||||||||||
TABLE 3. CBO's Estimate of the Effect on Direct Spending of Establishing a Prescription Drug Benefit in Medicare: Senator Robb's Proposal in Amendment 3598 to H.R. 4577, Assuming Implementation in 2004 (Outlays in billions of dollars, by fiscal year) |
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2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | 2002- 2006 |
2002- 2011 |
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Federal Spending on Prescription Drugs for Medicare Enrollees | |||||||||||||||||
Medicare | |||||||||||||||||
Benefits | 0 | 0 | 31.6 | 50.3 | 57.6 | 65.1 | 73.9 | 84.0 | 95.0 | 108.5 | 139.5 | 565.9 | |||||
Premiums | 0 | 0 | -17.0 | -25.5 | -29.2 | -33.0 | -37.4 | -42.5 | -48.0 | -54.9 | -71.8 | -287.6 | |||||
Subsidy to ESI plans | 0 | 0 | 1.0 | 1.4 | 1.7 | 1.9 | 2.1 | 2.4 | 2.7 | 3.1 | 4.1 | 16.2 | |||||
Subtotal | 0 | 0 | 15.5 | 26.2 | 30.1 | 34.0 | 38.6 | 43.9 | 49.7 | 56.7 | 71.7 | 294.6 | |||||
Spending by Other Federal Programs on Drugs for Medicare Enrollees | |||||||||||||||||
Medicaid | 0 | 0 | -4.3 | -9.3 | -10.4 | -11.6 | -13.0 | -14.6 | -16.3 | -18.3 | -23.9 | -97.8 | |||||
FEHB (for annuitants, on-budget) | 0 | 0 | -0.2 | -0.3 | -0.3 | -0.3 | -0.4 | -0.4 | -0.4 | -0.4 | -0.7 | -2.6 | |||||
Tricare | 0 | 0 | -0.6 | -1.0 | -1.1 | -1.3 | -1.4 | -1.7 | -1.9 | -2.1 | -2.7 | -11.1 | |||||
Subtotal | 0 | 0 | -5.1 | -10.5 | -11.8 | -13.2 | -14.8 | -16.6 | -18.6 | -20.9 | -27.4 | -111.5 | |||||
Low-Income Subsidy | 0 | 0 | 4.5 | 9.3 | 11.3 | 13.2 | 15.0 | 17.0 | 19.2 | 21.8 | 25.2 | 111.2 | |||||
Subtotal, Federal Spending on Drugs for Medicare Enrollees | 0 | 0 | 14.9 | 25.0 | 29.6 | 33.9 | 38.7 | 44.2 | 50.3 | 57.7 | 69.5 | 294.3 | |||||
Other Direct Spending | |||||||||||||||||
Other Medicaid and Medicare effects | 0 | a | 0.7 | 1.7 | 2.5 | 2.9 | 3.0 | 3.2 | 3.5 | 3.7 | 5.0 | 21.3 | |||||
Effect of higher drug prices on federal programs (on-budget) | 0 | 0 | a | 0.1 | 0.1 | 0.2 | 0.3 | 0.4 | 0.6 | 0.8 | 0.3 | 2.6 | |||||
Effect of higher drug prices on FEHB (for postal workers and annuitants, off-budget) | 0 | 0 | a | a | a | a | a | a | a | a | 0 | 0 | |||||
Subtotal | 0 | a | 0.8 | 1.7 | 2.7 | 3.1 | 3.4 | 3.7 | 4.1 | 4.5 | 5.2 | 23.9 | |||||
Total | 0 | a | 15.7 | 26.7 | 32.3 | 37.0 | 42.1 | 47.9 | 54.3 | 62.2 | 74.8 | 318.2 | |||||
Memorandum: Change in Spending by States | 0 | a | 0.4 | 0.4 | 1.1 | 1.4 | 1.7 | 1.9 | 2.2 | 2.6 | 1.9 | 11.7 | |||||
Characteristics of the Proposed Benefit | |||||||||||||||||
Voluntary prescription drug benefit under new Part D; one-time only enrollment option; 50 percent subsidy of premium. | |||||||||||||||||
Administered by competing Pharmacy Benefit Managers (PBMs) that do not assume insurance risk. | |||||||||||||||||
Coinsurance rates below the stop-loss amount vary from 50 percent to 25 percent. | |||||||||||||||||
Premiums and cost-sharing subsidies for low-income people. | |||||||||||||||||
Monthly Premium for Prescription Drug Benefit | $52.80 | $60.70 | $68.10 | $75.20 | $83.80 | $93.20 | $103.30 | $114.70 | |||||||||
Deductible | $250 | $250 | $277 | $306 | $338 | $371 | $406 | $443 | |||||||||
Coinsurance Rate (Percent) | 25-50 | 25-50 | 25-50 | 25-50 | 25-50 | 25-50 | 25-50 | 25-50 | |||||||||
Benefit Cap | None | None | None | None | None | None | None | None | |||||||||
Total Spending on Drugs at the Benefit Cap | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | n.a. | |||||||||
Stop-loss Amount | $4,000 | $4,000 | $4,428 | $4,902 | $5,402 | $5,931 | $6,495 | $7,092 | |||||||||
Total Spending on Drugs at the Stop-loss Amount | $8,750 | $8,750 | $9,686 | $10,723 | $11,816 | $12,974 | $14,207 | $15,514 | |||||||||
Participation Rate (as percentage of Part B enrollment) | 92% | 92% | 92% | 92% | 92% | 92% | 92% | 92% | |||||||||
Price Effect (in the 10th year) | 17.9% | ||||||||||||||||
Medicare Cost-Management Factor | 17.5% | ||||||||||||||||
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SOURCE: Congressional Budget Office. | |||||||||||||||||
Notes: a = less than $50 million; ESI = employer-sponsored insurance; n.a. = not applicable; FEHB = Federal Employees Health Benefits program. | |||||||||||||||||
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TABLE 4. CBO's Estimate of the Effect on Direct Spending of Establishing a Prescription Drug Benefit in Medicare: S. 2807, as Introduced by Senators Breaux and Frist, and Modified in Discussions with Staff; Assuming Implementation in 2004 (Outlays in billions of dollars, by fiscal year) |
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2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | 2002- 2006 |
2002- 2011 |
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Federal Spending on Prescription Drugs for Medicare Enrollees | ||||||||||||||||||
Medicare | ||||||||||||||||||
Benefits | 0 | 0 | 21.5 | 32.8 | 36.5 | 40.1 | 44.4 | 49.4 | 54.8 | 61.4 | 90.9 | 341.0 | ||||||
Premiums | 0 | 0 | -14.5 | -20.9 | -23.2 | -25.4 | -28.1 | -31.3 | -34.7 | -38.8 | -58.6 | -216.8 | ||||||
Subtotal | 0 | 0 | 7.0 | 12.0 | 13.3 | 14.7 | 16.3 | 18.2 | 20.2 | 22.6 | 32.3 | 124.3 | ||||||
Spending by Other Federal Programs on Drugs for Medicare Enrollees | ||||||||||||||||||
Medicaid | 0 | 0 | -2.5 | -5.4 | -6.0 | -6.7 | -7.6 | -8.5 | -9.5 | -10.8 | -13.8 | -56.9 | ||||||
FEHB (for annuitants, on-budget) | 0 | 0 | -0.1 | -0.1 | -0.1 | -0.1 | -0.1 | -0.2 | -0.2 | -0.2 | -0.3 | -1.1 | ||||||
Tricare | 0 | 0 | -0.4 | -0.6 | -0.6 | -0.7 | -0.8 | -0.9 | -1.0 | -1.1 | -1.6 | -6.1 | ||||||
Subtotal | 0 | 0 | -3.0 | -6.0 | -6.7 | -7.6 | -8.5 | -9.6 | -10.7 | -12.1 | -15.7 | -64.2 | ||||||
Low-Income Subsidy | 0 | 0 | 4.6 | 9.2 | 11.0 | 12.6 | 14.1 | 15.7 | 17.5 | 19.6 | 24.8 | 104.2 | ||||||
Subtotal, Federal Spending on Drugs for Medicare Enrollees | 0 | 0 | 8.7 | 15.1 | 17.6 | 19.7 | 21.8 | 24.3 | 27.0 | 30.1 | 41.4 | 164.3 | ||||||
Other Direct Spending | ||||||||||||||||||
Other Medicaid and Medicare effects | 0 | a | 0.4 | 0.5 | 1.0 | 1.4 | 1.8 | 2.0 | 2.1 | 2.2 | 1.9 | 11.4 | ||||||
Effect of higher drug prices on federal programs (on-budget) | 0 | 0 | a | a | a | a | a | a | a | a | a | 0.1 | ||||||
Effect of higher drug prices on FEHB (for postal workers and annuitants, off-budget) | 0 | 0 | a | a | a | a | a | a | a | a | 0 | 0 | ||||||
Subtotal | 0 | a | 0.4 | 0.5 | 1.0 | 1.4 | 1.8 | 2.0 | 2.1 | 2.2 | 1.9 | 11.5 | ||||||
Total | 0 | a | 9.1 | 15.6 | 18.6 | 21.2 | 23.7 | 26.3 | 29.1 | 32.3 | 43.3 | 175.9 | ||||||
Memorandum: Change in Spending by States | 0 | a | -0.7 | -1.4 | -1.1 | -1.5 | -2.2 | -2.7 | -3.2 | -3.7 | -3.1 | -16.4 | ||||||
Characteristics of the Proposed Benefit | ||||||||||||||||||
Voluntary prescription drug benefit under new Part D; one-time only enrollment option; 25 percent subsidy of basic benefit. | ||||||||||||||||||
Administered by competing Pharmacy Benefit Managers (PBMs) with full risk, offset by 80 percent federal reinsurance on high-cost enrollees. | ||||||||||||||||||
Premiums and cost-sharing subsidies for low-income people, but no subsidy for amounts above the benefit cap and below the stop-loss amount. | ||||||||||||||||||
Monthly Premium for Prescription Drug Benefit | $46.40 | $50.70 | $55.60 | $59.50 | $64.90 | $70.70 | $76.80 | $83.50 | ||||||||||
Deductible | $250 | $277 | $306 | $338 | $371 | $406 | $443 | $484 | ||||||||||
Coinsurance Rate (Percent) | 50 | 50 | 50 | 50 | 50 | 50 | 50 | 50 | ||||||||||
Benefit Cap | $1,050 | $1,162 | $1,287 | $1,418 | $1,557 | $1,705 | $1,862 | $2,033 | ||||||||||
Total Spending on Drugs at the Benefit Cap | $2,350 | $2,601 | $2,880 | $3,174 | $3,485 | $3,816 | $4,167 | $4,550 | ||||||||||
Stop-loss Amount | $6,000 | $6,642 | $7,353 | $8,103 | $8,897 | $9,742 | $10,638 | $11,617 | ||||||||||
Total Spending on Drugs at the Stop-loss Amount | $7,050 | $7,804 | $8,639 | $9,521 | $10,454 | $11,447 | $12,500 | $13,650 | ||||||||||
Participation Rate (as percentage of Part B enrollment) | 89% | 89% | 89% | 89% | 89% | 89% | 89% | 89% | ||||||||||
Price Effect (in the 10th year) | 0.7% | |||||||||||||||||
Medicare Cost-Management Factor (Risk / Fallback) | 30.0% / 12.5% | |||||||||||||||||
SOURCE: Congressional Budget Office. | ||||||||||||||||||
Notes: a = less than $50 million; FEHB = Federal Employees Health Benefits program. | ||||||||||||||||||
TABLE 5. CBO's Estimate of the Effect on Direct Spending of Establishing a Prescription Drug Benefit in Medicare: H.R. 4680, the Medicare Rx 2000 Act, as passed by the House; Assuming Implementation in 2004 (corrected August 10, 2001) (Outlays in billions of dollars, by fiscal year) |
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2002 | 2003 | 2004 | 2005 | 2006 | 2007 | 2008 | 2009 | 2010 | 2011 | 2002- 2006 |
2002- 2011 |
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Federal Spending on Prescription Drugs for Medicare Enrollees | |||||||||||||||||
Medicare | |||||||||||||||||
Benefits | 0 | 0 | 20.2 | 30.7 | 34.1 | 37.2 | 41.1 | 45.7 | 50.6 | 56.5 | 85.0 | 316.0 | |||||
Premiums | 0 | 0 | -15.0 | -21.6 | -23.8 | -25.7 | -28.3 | -31.4 | -34.7 | -38.7 | -60.4 | -219.1 | |||||
Subtotal | 0 | 0 | 5.2 | 9.2 | 10.3 | 11.5 | 12.8 | 14.3 | 15.9 | 17.8 | 24.6 | 96.8 | |||||
Spending by Other Federal Programs on Drugs for Medicare Enrollees | |||||||||||||||||
Medicaid | 0 | 0 | -2.7 | -5.8 | -6.4 | -7.2 | -8.1 | -9.1 | -10.1 | -11.3 | -15.0 | -60.8 | |||||
FEHB (for annuitants, on-budget) | 0 | 0 | -0.1 | -0.1 | -0.1 | -0.1 | -0.1 | -0.1 | -0.1 | -0.1 | -0.3 | -0.9 | |||||
Tricare | 0 | 0 | -0.4 | -0.6 | -0.6 | -0.7 | -0.8 | -0.9 | -1.0 | -1.1 | -1.6 | -6.1 | |||||
Subtotal | 0 | 0 | -3.2 | -6.5 | -7.2 | -8.1 | -9.0 | -10.1 | -11.3 | -12.6 | -16.8 | -67.8 | |||||
Low-Income Subsidy | 0 | 0 | 5.1 | 9.9 | 11.7 | 13.2 | 14.6 | 16.3 | 18.2 | 20.3 | 26.6 | 109.2 | |||||
Subtotal, Federal Spending on Drugs for Medicare Enrollees | 0 | 0 | 7.1 | 12.6 | 14.7 | 16.6 | 18.4 | 20.5 | 22.8 | 25.5 | 34.4 | 138.2 | |||||
Other Direct Spending | |||||||||||||||||
Other Medicaid and Medicare effects | 0 | a | 0.2 | 0.3 | 0.9 | 1.7 | 2.5 | 3.1 | 3.3 | 3.6 | 1.5 | 15.6 | |||||
Effect of higher drug prices on federal programs (on-budget) | 0 | 0 | a | a | a | a | a | a | a | a | a | 0.1 | |||||
Effect of higher drug prices on FEHB (for postal workers and annuitants, off-budget) | 0 | 0 | a | a | a | a | a | a | a | a | 0 | 0 | |||||
Subtotal | 0 | a | 0.2 | 0.3 | 0.9 | 1.7 | 2.5 | 3.1 | 3.3 | 3.6 | 1.5 | 15.7 | |||||
Total | 0 | a | 7.3 | 12.8 | 15.7 | 18.3 | 20.9 | 23.6 | 26.1 | 29.1 | 35.9 | 153.9 | |||||
Memorandum: Change in Spending by States | 0.0 | 0.0 | -0.9 | -1.8 | -2.0 | -3.0 | -4.1 | -5.1 | -5.7 | -6.5 | -4.7 | -29.1 | |||||
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Characteristics of the Proposed Benefit | |||||||||||||||||
Voluntary prescription drug benefit under new Part D; one-time only enrollment option. | |||||||||||||||||
Administered by competing Pharmacy Benefit Managers (PBMs) with full risk,offset by 35 percent reinsurance subsidy on high-cost enrollees. | |||||||||||||||||
Premiums and cost-sharing subsidies for low-income people, but no subsidy for amounts above the benefit cap and below the stop-loss amount. | |||||||||||||||||
Monthly Premium for Prescription Drug Benefit | $54.60 | $59.40 | $64.80 | $68.20 | $74.10 | $80.50 | $87.30 | $94.60 | |||||||||
Deductible | $250 | $277 | $306 | $338 | $371 | $406 | $443 | $484 | |||||||||
Coinsurance Rate (Percent) | 50 | 50 | 50 | 50 | 50 | 50 | 50 | 50 | |||||||||
Benefit Cap | $1,050 | $1,162 | $1,287 | $1,418 | $1,557 | $1,705 | $1,862 | $2,033 | |||||||||
Total Spending on Drugs at the Benefit Cap | $2,350 | $2,601 | $2,880 | $3,174 | $3,485 | $3,816 | $4,167 | $4,550 | |||||||||
Stop-loss Amount | $6,000 | $6,642 | $7,353 | $8,103 | $8,897 | $9,742 | $10,638 | $11,617 | |||||||||
Total Spending on Drugs at the Stop-loss Amount | $7,050 | $7,804 | $8,639 | $9,521 | $10,454 | $11,447 | $12,500 | $13,650 | |||||||||
Participation Rate (as percent of Part B enrollment) | 79% | 79% | 78% | 78% | 78% | 78% | 78% | 78% | |||||||||
Price Effect (in the 10th year) | 0.5% | ||||||||||||||||
Medicare Cost-Management Factor (Risk / Fallback) | 30.0% / 12.5% | ||||||||||||||||
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SOURCE: Congressional Budget Office. | |||||||||||||||||
Notes: a = less than $50 million; FEHB = Federal Employees Health Benefits program. | |||||||||||||||||
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