Deficit Soars 25% Over First Four Months of Fiscal 2020

Deficit Soars 25% Over First Four Months of Fiscal 2020

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Plus: Americans struggling to pay medical bills
Wednesday, February 12, 2020

Deficit Soars 25% Over First Four Months of Fiscal 2020

The federal budget deficit over the first four months of fiscal year 2020 totaled $389 billion, up more than 25% from the same period last year, according to data released Wednesday by the Treasury Department. Spending has risen by 10% while revenues have grown by 6.1%.

The deficit over the past 12 months reached $1.06 trillion. The Treasury estimates that the deficit will top $1 trillion this year for the first time since 2012, when the economy was still recovering from the Great Recession.

Surprise Medical Bills Hit 1 in 5 After Surgery: Study

Even patients who plan their elective surgeries ahead of time — using in-network surgeons at in-network facilities — can receive unforeseen bills from out-of-network providers, according to a new study published Tuesday in JAMA.

Reviewing the files on nearly 350,000 patients with commercial insurance who underwent common elective surgeries such as hysterectomies and coronary artery bypass grafts, researchers found that about 20% were hit with out-of-network charges. The average outstanding balance on these so-called surprise medical bills was $2,011.

Why the bills occur: Surprise bills came most frequently from surgical assistants and anesthesiologists, who are typically not selected by the patient. Patients with insurance plans purchased on the health insurance exchanges also had an increased risk of receiving out-of-network bills.

What it means for patients: “The study highlights how common surprise billing is, even in a context where consumers may have an illusion of control over what they will have to pay,” says NPR’s Elena Renken. “For elective surgeries, patients often have time to select in-network providers, but it didn't appear to make a difference.”

A call to act: In an editorial published in JAMA Tuesday, Drs. Karen Joynt Maddox and Edward Livingston called on doctors and lawmakers to address the problem, citing the ethical obligations of the medical profession. “Patients generally select surgeons because they have faith that the surgeon they choose will provide them with the best possible care,” they wrote. “This crucial trust between patient and physician will be eroded if patients discover after an operation that they must pay large sums of money to other clinicians the surgeon has involved in their care. When feasible, surgeons should ensure that all the personnel involved in the care team that they are leading accept the same insurance plans and should consider refusing to work in facilities that allow surprise billing.”

Congress may – or may not – act: Legislation that would regulate surprise bills was under consideration last year and lawmakers from both parties say they want to do something about the problem. But powerful lobbying groups representing the divergent interests of insurers, hospitals and physicians have pushed for different kinds of solutions, and no compromise has yet been reached.

Jean Fuglesten Biniek, a senior researcher at the Health Care Cost Institute, told NPR that Congress could make a deal this year. "It's a rare case where both parties in Congress want to get something done, and we have examples of what a bipartisan agreement might look like," she said. "Just getting that far can often be difficult in health policy. I'm hopeful that they will take action."

More Than 14% of Americans Struggled to Pay Medical Bills in 2018

About one in seven Americans reported belonging to a family that struggled to pay medical bills in 2018, according to a new report from the Centers for Disease Control and Prevention.

The percentage of people in families having problems paying their medical bills over the past 12 months has dropped by 5.5 percentage points from 2011 to 2018, falling from 19.7% to 14.2%.

"Significant expenses for one family member may adversely affect the whole family," researchers from the CDC's National Center for Health Statistics wrote. "People who are in families with problems paying medical bills may experience serious financial consequences, such as having problems with paying for food, clothing, or housing, and filing for bankruptcy."

Quotes of the Day

“I stand by our comments that the tax cuts will pay for themselves. This will be simple math.”

– Treasury Secretary Steven Mnuchin, in testimony before Congress on Wednesday. Wall Street Journal tax reporter Richard Rubin notes that, “Every independent analyst has said that the tax cuts absolutely will not pay for themselves. Maybe more like it pays for 25% or 30% of itself.”


“I don’t think there’s anybody focused on the deficit, concerned about the deficit right now. We’re taking the perspective that there are other deficits in the country right now that are every bit as important to our future — deficits in infrastructure, in education and in health care — and we have to work on those as well.”

– House Budget Committee Chairman John Yarmuth (D-KY), in a Roll Call article looking at Democrats’ fiscal priorities and how the party will signal those priorities to voters without drafting a budget resolution this year. Roll Call’s Lindsey McPherson notes that some moderate Democrats have expressed concerns about the deficit but that members of the party thus far “have largely opted against offering their own solutions,” instead pointing the finger at the 2017 GOP tax law.

Map of the Day

About 23% of total state revenues came from federal grants in the 2017 fiscal year, contributing to programs that touch on a range of issues including health care, education and infrastructure. This map from the Tax Foundation shows how the individual states rank with respect to federal aid as a share of general revenue. The states with the greatest reliance on federal funds were Montana (46.1%), Wyoming (44.5%), Louisiana (43.7%), Mississippi (43.3%) and Arizona (43.1%). The states with the smallest share of federal funds relative to general revenue were Hawaii (20.7%), Virginia (21.1%), Kansas (23.3%), Utah (24.2%) and Minnesota (26.0%).


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