1
Transitioning to Bundled Payments in Medicare
Michael Chernew and Dana Goldman
Proposal
Proposes a global payment system, where provider systems are paid a fixed fee per beneficiary to cover all spending.
Broader benefits to U.S. economy
Promotes efficiency in the Medicare program by providing incentives to treat disease rather than paying for individual services; continues to
encourage improvements in the quality of care,
but at lower costs.
Deficit reduction as estimated by authors (10-year)
$100 billion
2
Reforming Federal Support for Risky Development
David R. Conrad and Edward A. Thomas
Proposal
Proposes to reform federal disaster programs to prioritize hazard mitigation, and change incentives to encourage risk reduction in local public- and private-sector investments.
Broader benefits to U.S. economy
Reduces budget costs of natural disasters; reduces risks to life and property of Americans living in
disaster-prone areas.
Deficit reduction as estimated by authors (10-year)
$40 billion
3
Restructuring Cost Sharing and Supplemental Insurance for Medicare
Jonathan Gruber
Proposal
Proposes an integrated, progressive
Medicare cost-sharing structure with new
limits on out-of-pocket expenses; imposes
a tax on supplemental insurance policies to
reflect costs shifted to Medicare.
Broader benefits to U.S. economy
Insures consumers against high out-of-pocket
costs; aligns the costs faced by
consumers with the actual cost of care;
discourages incentives in private plans
that encourage excess use of Medicare
benefits.
Deficit reduction as estimated by author (10-year)
$125 billion
4
An Evidence-Based
Path to Disability
Insurance Reform
Jeffrey B. Liebman and
Jack A. Smalligan
Proposal
Proposes three early intervention
demonstration projects to help people
with disabilities stay at or return to
work. Also proposes mandatory funding
for initial eligibility determinations and
redeterminations so that the Social
Security Administration can perform more
timely and thorough eligibility reviews,
thereby improving accuracy and reducing
program costs.
Broader benefits to U.S. economy
Potential to increase employment and
economic engagement of workers with
disabilities and provide more rapid and
reliable resolution of disability insurance
claims for those who cannot work. Results
of the pilots would inform broader reforms
of the disability insurance system, leading
to additional longer-term benefits.
Deficit reduction as estimated by authors (10-year)
$10 - 20 billion
5
Eliminating Fossil Fuel
Subsidies
Joseph E. Aldy
Proposal
Proposes to eliminate twelve tax provisions
that subsidize the production of fossil fuels
in the United States.
Broader benefits to U.S. economy
Levels the playing field among fossil fuel
producers and relative to other business
investments; leads to potentially lower
global fuel prices by providing the
United States with increased leverage in
negotiations over eliminating fossil fuel
subsidies in the developing world.
Deficit reduction as estimated by author (10-year)
$41 billion
6
Better Ways to Promote
Saving through the Tax
System
Karen Dynan
Proposal
Proposes improving incentives for saving by
low-income households by expanding use
of behavioral approaches and incentives;
reduces inefficient tax expenditures for
higher-income households.
Broader benefits to U.S. economy
Improves saving and economic security
for low-income households; reduces
expensive and ineffective federal
subsidies for high-income households.
Deficit reduction as estimated by author (10-year)
$40 billion
7
Limiting Individual
Income Tax Expenditures
Diane M. Lim
Proposal
Proposes limiting itemized deductions to 15
percent, with special provisions to maintain
incentives for charitable giving.
Broader benefits to U.S. economy
Raises revenue more efficiently by
reducing tax expenditures; limits
potential negative impacts on subsidized
sectors by preserving certain tax
incentives; equalizes implicit subsidies
across middle- and higher-income
taxpayers.
Deficit reduction as estimated by authors (10-year)
$1 trillion
8
Replacing the Home
Mortgage Interest
Deduction
Alan D. Viard
Proposal
Proposes replacing the mortgage interest
deduction with a 15 percent refundable
credit based on up to $300,000 of
mortgage principal.
Broader benefits to U.S. economy
Reduces the artificial incentive for the
construction of high-end homes by
reducing and better targeting the tax
breaks for housing.
Deficit reduction as estimated by authors (10-year)
$300 billion
9
Funding Transportation
Infrastructure with User
Fees
Jack Basso and Tyler Duvall
Proposal
Proposes expanding the use of user fees
and tolls to fund ground transportation.
Broader benefits to U.S. economy
Raises revenues, reduces congestion
on major roadways, reduces pollution;
promotes wiser infrastructure investments.
Deficit reduction as estimated by authors (10-year)
$312 billion
10
Creating an American
Value-Added Tax
William G. Gale and
Benjamin H. Harris
Proposal
Proposes a 5-percent value-added tax on
consumption starting in 2017, and offsets
regressive impacts through refundable
cash payments.
Broader benefits to U.S. economy
Raises revenue in a manner that does not
distort saving and investment choices.
Deficit reduction as estimated by authors (10-year)
$1.6 trillion
11
The Many Benefits of a
Carbon Tax
Adele C. Morris
Proposal
Proposes a $16 per ton carbon dioxide
tax, consolidates and rolls back redundant
climate-change regulations, reduces
corporate income tax rates, and offsets tax
burden on the poorest households.
Broader benefits to U.S. economy
Reduces the buildup of greenhouse
gas emissions; replaces commandand-
control regulations and expensive
subsidies with transparent and powerful
market-based incentives; promotes
economic activity through reduced
regulatory burden and lower marginal tax
rates.
Deficit reduction as estimated by author (10-year)
$199 billion
12
Overhauling the
Temporary Work Visa
System
Pia M. Orrenius, Giovanni
Peri, and Madeline Zavodny
Proposal
Proposes replacing the current system
for allocating temporary worker visas with
permit auctions for employers.
Broader benefits to U.S. economy
Maximizes the economic benefits of workoriented
visas by allocating visas to firms
(and immigrants) based on market needs;
raises revenue through auctions.
Deficit reduction as estimated by authors (10-year)
$7 - 12 billion
13
Increasing the Role
of the Private Sector in
Housing Finance
Phillip Swagel
Proposal
Proposes to increase private participation in
mortgage securitization markets, privatize
the mortgage finance firms of Fannie Mae
and Freddie Mac, and provide secondary
government insurance on housing securities.
Broader benefits to U.S. economy
Improves incentives for risk taking and
investment in the mortgage market and
market for homes; reduces taxpayer
exposure to risk; fosters competition and
innovation in housing finance.
Deficit reduction as estimated by authors (10-year)
$134 billion
14
National Defense in a
Time of Change
Gary Roughead and Kori
Schake
Proposal
Proposes restructuring and restrategizing
the military force structure by scaling back
ground combat troops, altering acquisition
practices, and reforming compensation
packages.
Broader benefits to U.S. economy
Improves the military's ability to respond
to modern challenges, particularly in
Asia and the Middle East; makes military
procurement of assets more efficient and
competitive; designs benefit packages
more in line with troops' preferences.
Deficit reduction as estimated by authors (10-year)
$500 billion
15
Making Defense
Affordable
Cindy Williams
Proposal
Proposes changes to slow the growth of
costs for military health care, pay, weapons
acquisition, and operation and maintenance;
offers one option to downsize the military
consistent with the Budget Control Act and
another to reduce and reshape the forces
strategically, consistent with rebalancing
toward Asia and the Pacific.
Broader benefits to U.S. economy
Addresses growing internal costs in
the defense budget to preserve military
capabilities; reshapes military forces in
a way that reduces future budgets while
keeping a strong and ready military.
Deficit reduction as estimated by authors (10-year)
$540 - 770 billion