Show Summary Details

Page of

PRINTED FROM OXFORD HANDBOOKS ONLINE ( © Oxford University Press, 2018. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Handbooks Online for personal use (for details see Privacy Policy and Legal Notice).

date: 27 October 2020

Abstract and Keywords

This chapter examines how the congressional budget process influences health policy debates. It begins with an overview of the federal budgeting process and the role of health programs in the growth of federal spending over time. It considers three parts of the federal budget: discretionary spending, mandatory spending, and tax spending. It then describes the baseline used as a model to project the required spending of the federal government. It also discusses procedural and statutory limits to Congress’s ability to increase spending or cut taxes, including the “Pay-as-You-Go” (PAYGO) requirement and the use of scorekeeping to estimate the costs of new legislative proposals to make PAYGO limits workable. The chapter concludes with examples illustrating how the budget process influences legislative results, including the tobacco bill, the Sustainable Growth Rate in Medicare, and the Patient Protection and Affordable Care Act’s federal matching rates for its Medicaid expansion.

Keywords: budget process, health policy, federal spending, federal budget, baseline, scorekeeping, tobacco bill, Sustainable Growth Rate, Medicare, Patient Protection and Affordable Care Act

Access to the complete content on Oxford Handbooks Online requires a subscription or purchase. Public users are able to search the site and view the abstracts and keywords for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can''t find the answer there, please contact us.