dcsimg


stock business photo

2016 Financial Report of the United States Government


United States Government Required Supplementary Information (Unaudited) For the Years Ended September 30, 2016, and 2015

Social Security and Medicare

Social Security

The Federal Old Age and Survivors Insurance (OASI) Trust Fund was established on January 1, 1940, as a separate account in the Treasury. The Federal Disability Insurance (DI) Trust Fund, another separate account in the Treasury, was established on August 1, 1956. The OASI fund pays cash retirement benefits to eligible retirees and their eligible dependents and survivors, and the much smaller DI fund pays cash benefits to eligible individuals who are unable to work because of medical conditions and certain family members of such eligible individuals. Though the events that trigger benefit payments are quite different, both trust funds have the same dedicated financing structure: primarily payroll taxes and income taxes on benefits. All financial operations of the OASI and DI Programs are handled through these respective funds. The two funds are often referred to as the combined OASDI Trust Funds. At the end of calendar year 2015, OASDI benefits were paid to approximately 60 million beneficiaries.

The primary financing source for these two funds are taxes paid by workers, their employers, and individuals with self-employment income, based on work covered by the OASDI Program. Since 1990, with the exception of calendar years 2011 and 2012, employers and employees have each paid 6.2 percent of taxable earnings, and the self-employed have paid 12.4 percent of taxable earnings. In 2011 and 2012, payroll tax rates paid by employees and the self-employed were each reduced by 2 percentage points and the General Fund reimbursed the OASDI Trust Fund for the resulting reduction in payroll tax revenues. Payroll taxes are levied on wages and net earnings from self-employment up to a specified maximum annual amount, referred to as maximum taxable earnings ($118,500 in 2016), that increases each year with economy-wide average wages.

Legislation passed in 1984 subjected up to half of OASDI benefits to income tax and allocated the revenue to the OASDI Trust Funds. In 1993 legislation increased the potentially taxed portion of benefits to 85 percent and allocated the additional revenue to the Medicare’s Hospital Insurance Trust Fund.

Medicare

The Medicare Program, created in 1965, has two separate trust funds: the Hospital Insurance (HI) Trust Fund (otherwise known as Medicare Part A) and the Supplementary Medical Insurance (SMI) Trust Funds (which consists of the Medicare Part B and Part D6 accounts). HI pays for acute inpatient hospital services, hospice, and major alternatives to hospitals (skilled nursing services, for example). SMI pays for hospital outpatient services, physician services, and assorted other services and products through the Part B account and for prescription drugs through the Part D account.

Though the events that trigger benefit payments are similar, HI and SMI have different dedicated financing structures. Similar to OASDI, HI is financed primarily by payroll contributions. Currently, employers and employees each pay 1.45 percent of earnings, while self-employed workers pay 2.9 percent of their net earnings. Beginning in 2013, employees and self-employed individuals with earnings above certain thresholds pay an additional HI tax of 0.9 percent on earnings above those thresholds. Other income to the HI Trust Fund includes a small amount of premium income from voluntary enrollees, a portion of the federal income taxes that beneficiaries pay on Social Security benefits (as explained above), and interest credited on Treasury securities held in the HI Trust Fund. As is explained in the next section, these Treasury securities and related interest have no effect on the consolidated statement of governmentwide finances.

For SMI, direct transfers from the General Fund financed 76 percent and 78 percent of 2016 program costs for Parts B and D, respectively. Premiums paid by beneficiaries and, for Part D state transfers, generally financed the remainder of expenditures. For beneficiaries dually eligible for Medicare and Medicaid, states must pay the Part D account a portion of their estimated foregone drug costs for this population (referred to as state transfers). As with HI, interest received on Treasury securities held in the SMI Trust Fund is credited to the fund. These Treasury securities and related interest have no effect on the consolidated statement of governmentwide finances. See Note 22—Social Insurance, for additional information on Medicare program financing.

Figure 1
Social Security, Medicare, and Governmentwide Finances

Figure 1 - Social Security, Medicare, and Governmentwide Finances

Social Security, Medicare, and Governmentwide Finances

The current and future financial status of the separate OASDI, HI, and SMI Trust Funds is the focus of the Social Security and Medicare Trustees’ Reports, a focus that may appropriately be referred to as the “trust fund perspective.” In contrast, the Government primarily uses the unified budget concept as the framework for budgetary analysis and presentation. It represents a comprehensive display of all federal activities, regardless of fund type or on- and off-budget status, and has a broader focus than the trust fund perspective that may appropriately be referred to as the “budget perspective” or the “governmentwide perspective.” Social Security and Medicare are among the largest expenditure categories of the U.S. federal budget. Together, they now account for more than a third of all federal spending and the percentage is projected to rise dramatically for the reasons discussed below. This section describes in detail the important relationship between the trust fund perspective and the governmentwide perspective.

Figure 1 is a simplified depiction of the interaction of the Social Security and Medicare Trust Funds with the rest of the federal budget.7 The boxes on the left show sources of funding, those in the middle represent the trust funds and other Government accounts, which include the General Fund into which that funding flows, and the boxes on the right show simplified expenditure categories. The figure is intended to illustrate how the various sources of program revenue flow through the budget to beneficiaries. The general approach is to group revenues and expenditures that are linked specifically to Social Security and/or Medicare separately from those for other government programs.

Each of the trust funds has its own sources and types of revenue. With the exception of General Fund transfers to SMI, each of these revenue sources represents revenue from the public that is dedicated specifically for the respective trust fund and cannot be used for other purposes. In contrast, personal and corporate income taxes as well as other revenue go into the General Fund and are drawn down for any Government program for which Congress has approved spending.8 The arrows from the boxes on the left represent the flow of the revenues into the trust funds and other Government accounts.

The heavy line between the top two boxes in the middle of Figure 1 represents intragovernmental transfers to the SMI Trust Fund from other Government accounts. The Medicare SMI Trust Fund is shown separately from the two Social Security Trust Funds (OASI and DI) and the Medicare HI Trust Fund to highlight the unique financing of SMI. Currently, SMI is the only one of the programs that is funded through transfers from the General Fund, which is part of the other Government accounts (the SMI Part D account also receives transfers from the states). The direct transfers finance roughly three-fourths of SMI Program expenses. The transfers are automatic; their size depends on how much the program requires, not on how much revenue comes into the Treasury. If General Fund revenues become insufficient to cover both the mandated transfer to SMI and expenditures on other general Government programs, Treasury has to borrow to make up the difference. In the longer run, if transfers to SMI increase beyond growth in general revenues—and as shown in the Medicare Trustees Report and Chart 5 later in this section, they are projected to increase significantly in coming years—then Congress must either raise taxes, cut other Government spending, reduce SMI benefits, or borrow even more.

The dotted lines between the middle boxes of Figure 1 also represent intragovernmental transfers but those transfers arise in the form of “borrowing/lending” between the Government accounts. Interest credited to the trust funds arises when the excess of program income over expenses is loaned to the General Fund. The vertical lines labeled Surplus Borrowed represent these flows from the trust funds to the other Government accounts. These loans reduce the amount the General Fund has to borrow from the public to finance a deficit (or likewise increase the amount of debt paid off if there is a surplus). However, the General Fund has to credit interest on the loans from the trust fund programs, just as if it borrowed the money from the public. The credits lead to future obligations for the General Fund (which is part of the other Government accounts). These transactions are indicated in Figure 1 by the vertical arrows labeled Interest Credited. The credits increase trust fund income exactly as much as they increase credits (future obligations) in the General Fund. From the governmentwide standpoint, at least in an accounting sense, these interest credits are a wash.

When the trust funds get the receipts that they loan to the General Fund, these receipts provide additional authority to spend on benefits and other program expenses. The General Fund, in turn, has taken on the obligation of paying interest on these loans every year and repaying the principal when trust fund income from other sources falls below expenditures.

How loans from the trust funds to the General Fund and later repayments of those loans affect tax income and expenditures of the General Fund is uncertain. Two extreme cases encompass the possibilities. At one extreme, each dollar the trust funds loan to the General Fund might reduce borrowing from the public by a dollar at the time the loan is extended, in which case the General Fund could repay all trust fund loans by borrowing from the public without raising the level of public debt above the level that would have occurred in the absence of the loans. At the other extreme, each dollar the trust funds loan to the General Fund might result in some combination of higher General Fund spending and lower General Fund revenues amounting to one dollar at the time the loans are extended, in which case General Fund loan repayments to the trust funds might initially be financed with borrowing from the public but must at some point be financed with a combination of higher General Fund taxes and lower General Fund spending than would have occurred in the absence of the loans. In this latter extreme, trust fund loans result in additional largess (i.e., higher spending and/or lower taxes) in General Fund programs at the time the loans are extended, but ultimately that additional largess is financed with additional austerity (i.e., lower spending and/or higher taxes) in General Fund programs at later dates. The actual impact of trust fund loans to the General Fund and their repayment on General Fund programs is at one of these two extremes or somewhere in between.

Actual dollar amounts roughly corresponding to the flows presented in Figure 1 are shown in Table 1 for fiscal year 2016. In Table 1, revenues from the public (left side of Figure 1) and expenditures to the public (right side of Figure 1) are shown separately from transfers between Government accounts (middle of Figure 1). Note that the transfers ($300.1 billion) and interest credits ($100.6 billion) received by the trust funds appear as negative entries under “All Other” and are thus offsetting when summed for the total budget column. These two intragovernmental transfers are the key to the differences between the trust fund and budget perspectives.

From the governmentwide perspective, only revenues received from the public (and states in the case of Medicare, Part D) and expenditures made to the public are important for the final balance. Trust fund revenue from the public consists of payroll taxes, benefit taxes, and premiums. For HI, the difference between total expenditures made to the public ($290.6 billion) and revenues ($278.7 billion) was $12.0 billion in 2016, indicating that HI had a relatively small negative effect on the overall budget outcome in that year. For the SMI account, revenues from the public (premiums) were relatively small, representing about 25 percent of total expenditures made to the public in 2016. The difference ($304.8 billion) resulted in a net draw on the overall budget balance in that year. For OASDI, the difference between total expenditures made to the public ($916.0 billion) and revenues from the public ($859.4 billion) was $56.6 billion in 2016, indicating that OASDI had a negative effect on the overall budget outcome in that year. Combined OASDI payroll and benefit tax revenues were increased by $42.4 billion in fiscal year 2016.

The trust fund perspective is captured in the bottom section of each of the three trust fund columns. For HI, total expenditures exceeded total revenues by $3.5 billion in 2016, as shown at the bottom of the first column. This cash deficit was made up by calling in past loans made to the General Fund (i.e., by redeeming trust fund assets). For SMI, total expenditures exceeded total revenues by $3.3 billion. The total revenue for SMI is $400.8 billion ($99.3 + $301.5), which includes $301.5 billion transferred from other Government accounts (General Fund). Transfers to the SMI Program from other Government accounts (the General Fund), amounting to about 74.1 percent of program costs, are obligated under current law and, therefore, appropriately viewed as revenue from the trust fund perspective. For OASDI, total revenues of $950.2 billion ($859.4 + $90.7) exceeded total expenditures of $916.0 billion by $34.1 billion. Total revenues for OASDI included $90.7 billion in transfers from the General Fund, made up of interest credits of $90.6 billion and transfers of $0.2 billion called for by Public Laws 111-147, 111-312, 112-78, and 112-96 to make up for the reduction in payroll tax revenues attributable to the temporary payroll tax rate reductions.

Table 1
Revenues and Expenditures for Medicare and Social Security
Trust Funds and the Total Federal Budget for
the Fiscal Year Ended September 30, 2016
Trust Funds
(In billions of dollars) HI SMI OASDI Total All Other Total1
Payroll taxes and other public revenues:
Payroll and benefit taxes 273.5
-
859.4 1,132.9
-
1,132.9
Premiums 5.2 86.7
-
91.9
-
91.9
Other taxes and fees
-
12.6
-
12.6 2,029.3 2,041.9
Total 278.7 99.3 859.4 1,237.4 2,029.3 3,266.7
 
Total expenditures to the public2 290.6 404.1 916.0 1,610.7 2,243.4 3,854.1
 
Net results for budget perspective3 (12.0) (304.8) (56.6) (373.3) (214.1) (587.4)
 
Revenues from other Government accounts:
Transfers 0.4 299.5 0.2 300.1 (300.1)  
Interest credits 8.0 2.0 90.6 100.6 (100.6)  
Total 8.4 301.5 90.7 400.7 (400.7)  
 
Net results for trust fund perspective3 (3.5) (3.3) 34.1 27.4 N/A N/A
 

1This column is the sum of the preceding two columns and shows data for the total federal budget. The figure $587.4 was the total federal deficit in fiscal year 2016.

2The OASDI figure includes $4.7 billion transferred to the Railroad Retirement Board for benefit payments and is therefore an expenditure to the public.

3Net results are computed as revenues less expenditures.

Notes: Totals may not equal the sum of components due to rounding.
"N/A" indicates not applicable.

Cash Flow Projections

Background

Economic and Demographic Assumptions. The Boards of Trustees9 of the OASDI and Medicare Trust Funds provide in their annual reports to Congress short-range (10-year) and long-range (75-year) actuarial estimates of each trust fund. Because of the inherent uncertainty in estimates for 75 years into the future, the Boards use three alternative sets of economic and demographic assumptions to show a range of possibilities. The economic and demographic assumptions used for the most recent set of intermediate projections for Social Security and Medicare are shown in the “Social Security” and “Medicare” sections of Note 22–Social Insurance.

Beneficiary-to-Worker Ratio. The expenditure projections for both the OASDI and Medicare Programs reflect the aging of the large baby-boom generation, born in the years 1946 to 1964, and its ultimate passing. Under the intermediate assumptions, cost rates are projected to rise rapidly between 2017 and 2035, primarily because the number of beneficiaries rises much more rapidly than the number of covered workers as the baby-boom generation retires. Chart 1 shows that the number of OASDI beneficiaries per 100 covered workers is projected to grow rapidly from 36 in 2016 to 46 in 2035 as the baby boom generation enters their retirement years and receives benefits. In rough terms, the beneficiary-to-worker ratio at any point in time reflects the birth rates experienced by the generations who are retired. The baby-boom generation had lower fertility rates than their parents, and it is expected that lower fertility rates will persist for all future generations; therefore, the ratio of beneficiaries to workers will rise rapidly and reach a permanently higher level after the baby-boom generation retires. Due to increasing longevity, the ratio of beneficiaries to workers will generally rise slowly thereafter, reaching 50 beneficiaries per 100 workers by 2090. A similar demographic pattern confronts the Medicare Program.

This site requires the Adobe Flash Player to view the charts. If you don't have flash or Flash is not available, you can download the chart's data source here in XML format.

Source: http://www.ssa.gov/OACT/TR/2016/lr4b3.html

Social Security Projections

Income and Expenditures. Chart 2 shows historical values and actuarial estimates of combined OASDI annual noninterest income and expenditures for 1970-2090. The estimates are for the open-group population of all workers and beneficiaries projected to be alive in each year. The expenditure projections in Chart 2 and all subsequent charts assume all scheduled benefits are paid regardless of whether the income and assets are available to finance them.

This site requires the Adobe Flash Player to view the charts. If you don't have flash or Flash is not available, you can download the chart's data source here in XML format.

Source: http://www.ssa.gov/OACT/TR/2016/lr6g10.html

Social Security’s surplus of noninterest income over expenditures was positive every year between 1984 and 2009, became negative in 2010, and is projected to remain negative in all years of the projection period. This pattern reflects the aging of the population documented in Chart 1, as well as growth of the economy and growth in the price level. As described above, surpluses that occurred prior to 2010 were “loaned” to the General Fund and accumulated, with interest, increasing reserve spending authority for the trust fund. The reserve spending authority represents an obligation for the General Fund. The government could finance this redemption by increasing its borrowing from the public, raising taxes (other than OASDI payroll taxes), and/or reducing expenditures (other than OASDI cost).

Income and Expenditures as a Percent of Taxable Payroll. Chart 3 shows annual noninterest income and expenditures expressed as percentages of taxable payroll, commonly referred to as the income rate and cost rate, respectively. Dividing noninterest income and expenditures by taxable payroll serves to isolate the effect of demographics on Social Security finances, and usefully gauges Social Security’s financial imbalances against the size of the Social Security tax base. The time path of the cost rate in Chart 3 closely parallels that of the beneficiary-to-worker ratio in Chart 1. Under the intermediate assumptions, demographic factors would by themselves cause the projected cost rate to rise rapidly for the next two decades before leveling off in about 2035. However, the recent recession led to lower taxable earnings than expected and more beneficiaries than expected, which in turn sharply, but temporarily, increased the cost rate starting in 2009. Social Security began using interest credits to meet full benefit obligations in 2010, and is projected to begin drawing down trust fund asset reserves starting in 2020 and to deplete those reserves in 2034. After trust fund asset reserves are depleted, continuing noninterest income will be sufficient to finance 79 percent of scheduled benefits for the rest of 2034, declining to 74 percent of scheduled benefits for 2090.

This site requires the Adobe Flash Player to view the charts. If you don't have flash or Flash is not available, you can download the chart's data source here in XML format.

Source: http://www.ssa.gov/OACT/TR/2016/lr4b1.html

Income and Expenditures as a Percent of GDP. Chart 4 shows estimated annual noninterest income and expenditures, expressed as percentages of GDP, which is the total value of goods and services produced in the United States. This alternative perspective shows the size of the OASDI Program in relation to the capacity of the national economy to sustain it. In 2016, OASDI cost was about $929 billion, which was about 5.0 percent of GDP. The cost of the program (based on current law) will grow from 5.0 percent of GDP in 2016 to about 5.9 percent of GDP in 2030, hit a peak of 6.0 percent of GDP in 2037, then decline to 5.9 percent by 2050, and generally increase to 6.1 percent of GDP by 2090. The rapid increase from 2017 to 2030 is projected to occur as baby boomers become eligible for OASDI benefits, lower birth rates result in fewer workers per beneficiary, and beneficiaries continue to live longer. In 2090, expenditures are projected to exceed income by approximately 1.51 percent of GDP. As the economy recovers, Social Security’s non-interest income, which reflects scheduled tax rates, increases from its current level of about 4.6 percent of GDP to about 4.8 percent of GDP for 2025. Thereafter, non-interest income as a percent of GDP declines gradually, to about 4.6 percent by 2090, because the share of employee compensation provided as non-covered fringe benefits is expected to increase gradually.

This site requires the Adobe Flash Player to view the charts. If you don't have flash or Flash is not available, you can download the chart's data source here in XML format.

Source: http://www.ssa.gov/OACT/TR/2016/lr6g4.html

Sensitivity Analysis. Actual future income from OASDI payroll taxes and other sources and actual future expenditures for scheduled benefits and administrative expenses will depend upon a large number of factors: the size and composition of the population that is receiving benefits, the level of monthly benefit amounts, the size and characteristics of the work force covered under OASDI, and the level of workers’ earnings. These factors will depend, in turn, upon future marriage and divorce rates, birth rates, death rates, migration rates, labor force participation and unemployment rates, disability incidence and termination rates, retirement age patterns, productivity gains, wage increases, cost-of-living increases, and many other economic as well as demographic factors.

This section presents estimates that illustrate the sensitivity of long-range expenditures and income for the OASDI Program to changes in selected individual assumptions. In this analysis, the intermediate assumption is used as the reference point, and one assumption at a time is varied. The variation used for each individual assumption reflects the levels used for that assumption in the low-cost (Alternative I) and high-cost (Alternative III) projections. For example, when analyzing sensitivity with respect to variation in real wages, income, and expenditure projections using the intermediate assumptions are compared to the outcome when projections are done by changing only the real wage assumption to either low-cost or high-cost alternatives.

The low-cost alternative is characterized by assumptions that improve the financial status of the program (relative to the intermediate assumption) such as slower improvement in mortality (beneficiaries die younger). In contrast, assumptions under the high-cost alternative worsen the financial outlook.

Table 2 shows the effects of changing individual assumptions on the present value of estimated OASDI expenditures in excess of income (the shortfall of income relative to expenditures in present value terms). The assumptions are shown in parentheses. For example, the intermediate assumption for the annual rate of reduction in age-sex-adjusted death rates is 0.78 percent. For the low-cost alternative, a slower reduction rate (0.42 percent) is assumed as it means that beneficiaries die at a younger age relative to the intermediate assumption, resulting in lower expenditures. Under the low-cost assumption, the shortfall drops from $14,169 billion to $11,915 billion, a 16 percent smaller shortfall. The high-cost death rate assumption (1.16 percent) results in an increase in the shortfall, from $14,169 billion to $16,601 billion, a 17 percent increase in the shortfall. Clearly, alternative death rate assumptions have a substantial impact on estimated future cash flows in the OASDI Program.

A higher fertility rate means more workers relative to beneficiaries over the projection period, thereby lowering the shortfall relative to the intermediate assumption. An increase in the rate from 2.0 to 2.2 percent results in a 10 percent smaller shortfall (i.e., expenditures less income), from $14,169 billion to $12,754 billion. If the ultimate total fertility rate were changed from 2.0 to 1.8 percent, the shortfall for the period of estimated OASDI income relative to cost would increase from $14,169 billion to $15,466 billion, a 9 percent increase in the shortfall.

The annual real-wage differential is the difference between the percentage increases in: (1) the average annual wage in OASDI covered employment; and (2) the average annual Consumer Price Index (CPI). Higher real wage growth results in faster income growth relative to expenditure growth. Table 2 demonstrates that if the ultimate real-wage differential were changed from 1.20 percentage points, the intermediate assumption, to 0.59 percentage points, the shortfall for the period of estimated OASDI income relative to cost would increase to $16,357 billion from $14,169 billion; if the ultimate real-wage differential were changed from 1.20 to 1.83 percentage points, the shortfall would decrease from $14,169 billion to $10,846 billion.

Table 2 demonstrates that if the ultimate annual increase in the CPI were changed from 2.6 percent, the intermediate assumption, to 2.0 percent, the shortfall for the period of estimated OASDI income relative to cost would increase to $14,620 billion from $14,169 billion; if the ultimate annual increase in the CPI were changed to 3.2 percent, the shortfall would decrease from $14,169 billion to $13,676 billion. The seemingly counter-intuitive result that higher CPI increases result in decreased shortfalls (and vice versa) is explained by the time lag between the effects of the CPI changes on taxable payroll and on benefit payments. The effect on taxable payroll due to a greater increase in average wages is experienced immediately, while the effect on benefits is experienced with a lag of about one year. For this reason, larger increases in the CPI cause earnings and income to increase sooner and, therefore, by more each year, than benefits and cost.

Very little difference is discernible in the first few years among the estimates of present values of net annual cash flow based on the three sets of assumptions about annual immigration. However, as the effect of these three levels of net annual immigration accumulate, variations in present values become more apparent. Because immigration generally occurs at relatively young adult ages, the effects initially are similar to those of total fertility rates. There is no significant effect on beneficiaries (and, therefore, on benefits) in the early years but the effect on the numbers of workers (and, therefore, on payroll tax income) is immediate. Therefore, even in the early years, the present values, year by year, are generally higher (less negative in later years) for higher net annual immigration. However, the increased payroll taxes for a given year are eventually offset by benefits paid in that year to earlier immigrant cohorts. Therefore, the present values based on the three assumptions about net annual immigration become more similar at the end of the projection period. Table 2 shows that if the intermediate immigration assumptions were changed so that the average level for the 75-year period decreased from 1,291,000 persons to 961,000 persons, the present value of the shortfall for the period of estimated OASDI income relative to cost would increase to $14,946 billion from $14,169 billion. If, instead, the immigration assumptions were changed so that net annual immigration would be expected to average 1,629,000 persons, the present value of the shortfall would decrease from $14,169 billion to $13,461 billion.

Finally, Table 2 shows the sensitivity of the shortfall to variations in the real interest rate or, in present value terminology, the sensitivity to alternative discount rates assuming a higher discount rate results in a lower present value. The shortfall is 15 percent lower, decreasing from $14,169 billion to $12,064 billion, when the real interest rate is 3.2 percent rather than 2.7 percent. The shortfall is 19 percent higher, increasing to $16,814 billion, when the real interest rate is 2.2 percent rather than 2.7 percent.

Table 2
Present Values of Estimated OASDI Expenditures in Excess of Income
Under Various Assumptions, 2016-2090

(Dollar values in billions; values of assumptions shown in parentheses)

Financing Shortfall Range
Assumption Low Intermediate High
Average annual reduction in death rates 11,915
(0.42)
14,169
(0.78)
16,601
(1.16)
Total fertility rate 12,754
(2.2)
14,169
(2.0)
15,466
(1.8)
Real wage differential 10,846
(1.83)
14,169
(1.20)
16,357
(0.59)
CPI change 13,676
(3.2)
14,169
(2.6)
14,620
(2.0)
Net immigration 13,461
(1,629,000)1
14,169
(1,291,000)1
14,946
(961,000)1
Real interest rate 12,064
(3.2)
14,169
(2.7)
16,814
(2.2)

1Amounts represent the average annual net immigration over the 75-year projection period.

Source: 2016 OASDI Trustees Report and SSA.

Medicare Projections

Medicare Legislation. The Affordable Care Act as amended by the Health Care and Education Reconciliation Act of 2010 (the “Affordable Care Act” or ACA) significantly improves projected Medicare finances. The most important cost saving provision in the ACA is a revision in payment rate updates for Parts A and B services other than for physicians’ services. Prior to the ACA, Medicare payment rates for most non-physician provider categories were updated annually by the increase in providers’ input prices for the market basket of employee wages and benefits, facility costs, medical supplies, energy and utility costs, professional liability insurance, and other inputs needed to produce the health care goods and services.10 To the extent that health care providers can improve their productivity each year, their net costs of production (other things being equal) will increase more slowly than their input prices—but the Medicare payment rate updates prior to the ACA were not adjusted for potential productivity gains. Accordingly Medicare costs per beneficiary would have increased somewhat faster than for the health sector overall. In particular, it is assumed that the full market basket increase would be approximately 3.4 percent annually. The ACA requires that many of these Medicare payment updates be reduced by the 10-year moving average increase in economy-wide productivity, which the Trustees assume will be 1.1 percent per year over the long range. The ACA also achieves substantial cost savings by benchmarking payment rates for private health plans providing Parts A and B services (Part C or Medicare Advantage) to more closely match per beneficiary costs. Partly offsetting these changes was an increase in prescription drug coverage. In addition, the ACA increases Part A revenues by: (a) taxing high-cost employer-provided health care plans and thereby giving employers incentives to increase the share of compensation paid as taxable earnings, and (b) imposing a new 0.9 percent surtax on earnings in excess of $200,000 (individual tax return filers) or $250,000 (joint tax return filers) starting in 2013.

The ACA substantially reduces the Medicare cost projections. Growth in Medicare cost per beneficiary in excess of growth in per capita GDP is referred to as “excess cost growth.” In the 2009 Financial Report, the last report released prior to the passage of the ACA, excess cost growth was assumed to average one percentage point over the last 50 years of the 75-year projection period—that is, Medicare expenditures per beneficiary were assumed to grow, on average, about one percentage point faster than per capita GDP over the long range. That assumption for excess cost growth in Medicare was optimistic in the sense that it is smaller than in recent history; excess cost growth averaged 1.4 percentage points between 1985 and 2014, and such growth was slower in recent years, averaging about 0.2 percent from 2008 to 2014.11 Nevertheless, the slowdown has been substantial and has continued for several years. In this year’s Financial Report, long-term excess cost growth is projected to be between 0.9 percent and 1.0 percent, which is slower than the historical average. Although not a factor in the recent slowdown, one reason why that growth will probably remain below historical rates beyond the next 10 years is that the program now includes a number of institutions, incentives, and mechanisms, such as the Center for Medicare & Medicaid Innovation and the Independent Payment Advisory Board, that could reduce spending growth in the program over time.

The 2016 Medicare Trustees’ Report warns that the financial projections for the Medicare program reflect substantial, but very uncertain, cost savings deriving from provisions of the ACA and MACRA, such as the productivity adjustments discussed above, that lower increases in Medicare payment rates to most categories of health care providers. Without fundamental change in the current delivery system, these adjustments would probably not be viable indefinitely. In view of these issues with provider payment rates, actual future costs for Medicare could exceed those shown by the current-law projections that underlie both the Trustees’ Report and this Financial Report.

Changes in Projection Methods. The projections in this year’s report, with one exception related to Part A, are based on current law; that is, it is assumed that laws on the books will be implemented and adhered to with respect to scheduled taxes, premium revenues, and payments to providers and health plans. The one exception is that the projections disregard payment reductions that would result from the projected depletion of the Medicare Hospital Insurance (HI) Trust Fund. Under current law, payments would be reduced to levels that could be covered by incoming tax and premium revenues when the HI Trust Fund was depleted.

Total Medicare. Chart 5 shows expenditures and current-law noninterest revenue sources for HI and SMI combined as a percentage of GDP. For 2016, total Medicare expenditures are expected to continue to exceed noninterest revenue, but by only a very small margin due to the revenue increasing more rapidly than expenditures. A deficit is expected for 2017, and then modest surpluses are projected for 2018 through 2020. Deficits are expected to return in 2021 and to remain for the balance of the projection, as expenditures grow faster than revenue. Under the ACA, beginning in 2013 the HI Trust Fund receives an additional 0.9 percent tax on earnings in excess of $250,000 for joint tax return filers and $200,000 for individual tax return filers. As a result of this provision, it is projected that payroll taxes will grow slightly faster than GDP. HI revenue from income taxes on Social Security benefits will gradually increase as a share of GDP as the share of benefits subject to such taxes increases. Beginning in 2009, as HI payroll tax receipts declined due to the recession and general revenue transfers increased, the latter income source became the largest single source of income to the Medicare program as a whole. General revenue transfers to the Part B account have increased significantly in 2016, as required by the Bipartisan Budget Act (BBA) of 2015 to compensate for premium revenue that has not been received in 2016 under the BBA requirements to calculate the monthly Part B premium as if the hold harmless provision did not apply. After decreasing from 2016 to 2017, general revenues will gradually increase as a share of Medicare financing from 2017 through 2029 and grow to about 48 percent by 2030, stabilizing thereafter. SMI premiums will also grow in proportion to general revenue transfers, placing a growing burden on beneficiaries. For high-income enrollees, SMI premiums began to increase more rapidly in 2011 and will continue to do so as a result of ACA provisions that increase Part D premiums and freeze the income thresholds used to determine Part B and Part D income-related premiums for 2011-2019. MACRA contains further provisions that affect the income-related premium thresholds and that will result in more premium income to Part B and Part D. SMI general revenues currently equal 1.5 percent of GDP and will increase to an estimated 2.7 percent in 2090 under current law.

This site requires the Adobe Flash Player to view the charts. If you don't have flash or Flash is not available, you can download the chart's data source here in XML format.

Source: http://www.ssa.gov/OACT/TRSUM/images/LD_ChartC.html

Medicare, Part A (Hospital Insurance)–Income and Expenditures. Chart 6 shows historical and actuarial estimates of HI annual income (excluding interest) and expenditures for 1970-2089 in nominal dollars. The estimates are for the open-group population.

This site requires the Adobe Flash Player to view the charts. If you don't have flash or Flash is not available, you can download the chart's data source here in XML format.

Source: Centers for Medicare & Medicaid Services

Medicare, Part A Income and Expenditures as a Percent of Taxable Payroll. Chart 7 illustrates income (excluding interest) and expenditures as a percentage of taxable payroll over the next 75 years. The chart shows that beginning in 2016, the expenditure rate exceeds the income rate, and cash deficits continue thereafter. The cost rate declined for 2014 and 2015 and is projected to continue to decline through 2018, largely due to expenditure growth that was constrained in part by the sequester and low payment updates, as well as a rebound of taxable payroll growth from 2007-2009 recession levels. Subsequent to 2018, the cost rate is projected to rise primarily due to retirements of those in the baby boom generation and partly due to a projected return to modest health services cost growth. This cost rate increase is moderated by the accumulating effect of the productivity adjustments to provider price updates, which are estimated to reduce annual HI per capita cost growth by an average of 0.9 percent per year through 2025 and 1.1 percent per year thereafter. Trust fund interest earnings and assets provide enough resources to pay full benefit payments until 2028 with general revenues used to finance interest and loan repayments to make up the difference between cash income and expenditures during that period. Pressures on the federal budget will thus emerge well before 2028. Present tax rates would be sufficient to pay 87 percent of scheduled benefits after trust fund exhaustion in 2028 and 86 percent of scheduled benefits in 2090.

This site requires the Adobe Flash Player to view the charts. If you don't have flash or Flash is not available, you can download the chart's data source here in XML format.

Source: http://www.ssa.gov/OACT/TRSUM/images/LD_ChartB.html

Medicare, Part A Income and Expenditures as a Percent of GDP. Chart 8 shows estimated annual noninterest income and expenditures, expressed as percentages of GDP, the total value of goods and services produced in the United States. This alternative perspective shows the size of the HI Program in relation to the capacity of the national economy to sustain it. Under the intermediate assumptions, the HI balance is negative for each year of the projection period. Annual deficits decrease from 2016 to 2018, increase through 2045, and then generally decline thereafter. The gap between expenditure and income shares of GDP widens to 0.47 percent in 2042, remains fairly stable through 2046, and then commences a slight decline, reaching 0.31 percent of GDP in 2090.

This site requires the Adobe Flash Player to view the charts. If you don't have flash or Flash is not available, you can download the chart's data source here in XML format.

Source: http://www.ssa.gov/OACT/TRSUM/images/LD_ChartB.html

Medicare, Parts B and D (Supplementary Medical Insurance). Chart 9 shows historical and actuarial estimates of Medicare Part B and Part D premiums (and Part D state transfers) as well as expenditures for each of the next 75 years, in dollars. Beneficiary premiums and general revenue contributions for both Part B and Part D are established annually to cover the expected costs for the upcoming year. Should actual costs exceed those anticipated when the financing is determined, future financing rates can include adjustments to recover the shortfall. Likewise, should actual costs be less than those anticipated, the savings would result in lower future financing rates. The gap between program expenditures and revenues from premiums, drug fees, and state transfers grows throughout the projection period. This gap will need to be filled with general revenue transfers.

This site requires the Adobe Flash Player to view the charts. If you don't have flash or Flash is not available, you can download the chart's data source here in XML format.

Source: Centers for Medicare & Medicaid Services

Medicare Part B and Part D Premium as well as State Transfer Income and Expenditures as a Percent of GDP. Chart 10 shows expenditures for the Supplementary Medical Insurance Program over the next 75 years expressed as a percentage of GDP, providing a perspective on the size of the SMI Program in relation to the capacity of the national economy to sustain it. SMI costs are projected to continue to outpace growth in GDP but at a slower rate compared to the last 10 years. Annual SMI expenditures grew from about 1.2 percent of GDP in 2005 to 1.6 percent of GDP in 2006 with the commencement of prescription drug coverage, and in 2015 they amounted to 2.1 percent of GDP. Under current law, SMI expenditures would grow to about 3.5 percent of GDP within 25 years and to 3.8 percent by the end of the projection period. The relatively high growth during the period 2016-2025 is due to the continuing retirement of the baby boom generation, further economic recovery, and modest increases in cost trends. Growth rates are projected to decline during the 2026-2040 period primarily as a result of a deceleration in beneficiary population growth. For the last 50 years of the projection period, cost growth moderates further due to the continued deceleration in beneficiary population growth and lower ultimate growth rate assumptions. As a share of GDP, premium and state transfer income grows from about 0.53 percent in 2016 to 1.10 percent of GDP in 2090. The portion of SMI expenditures financed by General Fund transfers to SMI is projected to be about 74 percent throughout the projection period.

This site requires the Adobe Flash Player to view the charts. If you don't have flash or Flash is not available, you can download the chart's data source here in XML format.

Source: Centers for Medicare & Medicaid Services

Medicare Sensitivity Analysis. This section illustrates the sensitivity of long-range cost and income estimates for the Medicare Program to changes in selected individual assumptions. As with the OASDI analysis, the intermediate assumption is used as a reference point, and one assumption at a time is varied. The variation used for each individual assumption reflects the levels used for that assumption in the low-cost and high-cost projections (see description of sensitivity analysis for OASDI).

Table 3 shows the effects of changing various assumptions on the present value of estimated HI expenditures in excess of income (the shortfall of income relative to expenditures in present value terms). The assumptions are shown in parentheses. Several factors, such as the utilization of services by beneficiaries or the relative complexity of services provided, can affect costs without affecting tax income. Clearly, the financial status of the HI Trust Fund is extremely sensitive to alternative assumptions about the growth in health care cost. For the low-cost alternative, the slower growth in health costs causes the shortfall to drop from $3,822 billion to a surplus of $3,198 billion, a 184 percent change. The high-cost assumption results in nearly quadrupling the shortfall, from $3,822 billion to $15,054 billion.

Relative to the intermediate case, the low and high real wage growth rate scenarios result in about a -54 and +34 percent change in the shortfall, respectively. Wages are a key cost factor in the provision of health care. A higher real-wage differential immediately increases both HI expenditures for health care and wages for all workers. Higher wages results in greater payroll tax income. CPI inflation, fertility, and net immigration changes have very little effect on net HI expenditures. (When CPI inflation is varied, the real interest rate is held constant, which implies that the nominal interest changes one for one with the assumed rate of CPI inflation.) Higher immigration decreases the net shortfall modestly as the 75-year projection period captures a higher share of additional immigrants’ tax payments than it does of their benefits.

Table 3 also shows that the present value of net HI expenditures is 15 percent lower if the real interest rate is 3.2 percent rather than 2.7 percent and 18 percent higher if the real interest rate is 2.2 percent rather than 2.7 percent.

Table 3
Present Values of Estimated Medicare Part A Expenditures in Excess of
Income Under Various Assumptions, 2016-2090

(Dollar values in billions; values of assumptions shown in parentheses)

  Financing Shortfall Range
Assumption 1 Low Intermediate High
Average annual growth in health costs 2 (3,198)
(2.8)
3,822
(3.8)
15,054
(4.8)
Total fertility rate 3 3,318
(2.2)
3,822
(2.0)
4,280
(1.8)
Real wage differential 1,748
(1.8)
3,822
(1.2)
5,116
(0.6)
CPI change 2,902
(3.2)
3,822
(2.6)
5,133
(2.0)
Net immigration4 3,558
(1,629,000)
3,822
(1,291,000)
4,153
(961,000)
Real interest rate 3,266
(3.2)
3,822
(2.7)
4,505
(2.2)

1The sensitivity of the projected HI net cash flow to variations in future mortality rates also is of interest. At this time, however, relatively little is known about the relationship between improvements in life expectancy and the associated changes in health status and per beneficiary health expenditures. As a result, it is not possible at present to prepare meaningful estimates of Part A, mortality sensitivity.
2Annual growth rate is the aggregate cost of providing covered health care services to beneficiaries. The low-cost and high-cost alternatives assume that costs increase 1 percent slower or faster, respectively, than the intermediate assumption, relative to growth in taxable payroll.
3The total fertility rate for any year is the average number of children who would be born to a woman in her lifetime if she were to experience the birth rates by age observed in, or assumed for, the selected year and if she were to survive the entire childbearing period.
4Amount represents the average annual net immigration over the 75-year projection period.

Source: Center for Medicare & Medicaid Services.

Table 4 shows the effects of various assumptions about the growth in health care costs on the present value of estimated SMI (Medicare Parts B and D) expenditures in excess of income. As with HI, net SMI expenditures are very sensitive to changes in the health care cost growth assumption. For the low-cost alternative, the slower assumed growth in health costs reduces the governmentwide resources needed for Part B from $19,964 billion to $14,468 billion and in Part D from $8,657 billion to $6,108 billion, about a 28 percent and 29 percent difference for Part B and Part D, respectively. The high-cost assumption increases governmentwide resources needed to $28,538 billion for Part B and to $12,715 billion for Part D, about a 43 percent and a 47 percent difference for Part B and Part D, respectively.

 

Table 4
Present Values of Estimated Medicare Parts B and D Future Expenditures Less Premium Income and State Transfers Under Three Health Care Cost Growth Assumptions, 2016-2090
  Governmentwide Resources Needed
Medicare Program Low
(3.3)
Intermediate
(4.3)
High
(5.3)
(In billions of dollars)
Part B 14,468 19,964 28,538
Part D 6,108 8,657 12,715

1Annual growth rate is the aggregate cost of providing covered health care services to beneficiaries. The low and high scenarios assume that costs increase one percent slower or faster, respectively, than the intermediate assumption.

Source: Centers for Medicare & Medicaid Services.

Sustainability of Social Security and Medicare

75-Year Horizon

According to the 2016 Medicare Trustees Report, the HI Trust Fund is projected to remain solvent until 2028 and, according to the 2016 Social Security Trustees Report, the OASI and DI Trust Funds are projected to have sufficient asset reserves to pay full benefits on time until 2035 and 2023, respectively. The Bipartisan Budget Act of 2015, passed by Congress and signed into law by the President, reallocated a portion of the payroll tax rate from the OASI Trust Fund to the DI Trust Fund. Under the intermediate assumptions, this reallocation is expected to ensure full payment of disability benefits into 2023. Without reallocation, the DI Trust Fund asset reserves were projected to have been depleted by the fourth quarter of 2016. In each case, some general revenues must be used to satisfy the authorization of full benefit payments until the year of trust fund depletion. This occurs when the trust fund interest income and balances accumulated during prior years are needed to pay benefits, which leads to a transfer from general revenues to the trust funds. Moreover, under current law, General Fund transfers to the SMI Trust Fund will occur into the indefinite future and will continue to grow with the growth in health care expenditures.

The potential magnitude of future financial obligations under these three social insurance programs is, therefore, important from a unified budget perspective as well as for understanding generally the growing resource demands of the programs on the economy. A common way to present future cash flows is in terms of their present value. This approach recognizes that a dollar paid or collected next year is worth less than a dollar today because a dollar today could be saved and earn a year’s worth of interest.

Table 5 shows the magnitudes of the primary expenditures and sources of financing for the three trust funds computed on an open-group basis for the next 75 years and expressed in present values. The data are consistent with the Statements of Social Insurance included in the principal financial statements. For HI, revenues from the public are projected to fall short of total expenditures by $3,822 billion in present value terms which is the additional amount needed in order to pay scheduled benefits over the next 75 years.12  From the trust fund perspective, the amount needed is $3,628 billion in present value after subtracting the value of the existing trust fund balances (an asset to the trust fund account but an intragovernmental transfer to the overall budget). For SMI, revenues from the public for Part B and D combined are estimated to be $28,621 billion less than total expenditures for the two accounts, an amount that, from a budget perspective, will be needed to keep the SMI program solvent for the next 75 years. From the trust fund perspective, however, the present values of total revenues and total expenditures for the SMI Program are roughly equal due to the annual adjustment of revenue from other Government accounts to meet program costs.13 For OASDI, projected revenues from the public fall short of total expenditures by $14,169 billion in present value dollars, and by $11,357 billion from the trust fund perspective.

From the governmentwide perspective, the present value of the total resources needed for the Social Security and Medicare Programs over and above current-law funding sources (payroll taxes, benefit taxes, and premium payments from the public) is $46,612 billion. From the trust fund perspective, which counts the trust funds ($3,076 billion in present value) and the general revenue transfers to the SMI Program ($28,621 billion in present value) as dedicated funding sources, additional resources needed to fund the programs are $14,916 billion in present value.

Table 5
Present Values of Costs Less Revenues of 75-Year Open Group Obligations HI, SMI, and OASDI

(In billions of dollars, as of January 1, 2016)

SMI
  HI Part B Part D OASDI Total
Revenues from the public:
Taxes 20,701 - - 60,232 80,933
Premiums, State transfers - 7,520 3,556 - 11,076
Total 20,701 7,520 3,556 60,232 92,009
 
Total costs to the public 24,523 27,484 12,213 74,401 138,621
 
Net results - budget perspective* 3,822 19,964 8,657 14,169 46,612
 
Revenues from other Government accounts - 19,964 8,657 - 28,621
Trust fund balances as of 1/1/2016 194 68 1 2,813 3,076
 
Net results - trust fund perspective* 3,628 (68) (1) 11,357 14,916

*Net results are computed as costs less revenues and trust fund balances. Negative values are indicative of surpluses.

Note: Totals may not equal the sum of components due to rounding.

Source: 2016 OASDI and Medicare Trustees' Reports

Infinite Horizon

The 75-year horizon represented in Table 5 is consistent with the primary focus of the Social Security and Medicare Trustees’ Reports. For the OASDI Program, for example, an additional $14.2 trillion in present value will be needed above currently scheduled taxes to pay for scheduled benefits ($11.4 trillion from the trust fund perspective). Experts have noted that limiting the projections to 75 years understates the magnitude of the long-range unfunded obligations because summary measures (such as the actuarial balance and open-group unfunded obligations) reflect the full amount of taxes paid by the next two or three generations of workers, but not the full amount of their benefits. One approach to addressing the limitations of 75-year summary measures is to extend the projection horizon indefinitely, so that the overall results reflect the projected costs and revenues after the first 75 years. Such extended projections can also help indicate whether the financial imbalance would be improving or continuing to worsen beyond the normal 75-year period. The open-group infinite horizon net obligation is the present value of all expected future program outlays less the present value of all expected future program tax and premium revenues. Such a measure is provided in Table 6 for the three trust funds represented in Table 5.

From the budget or governmentwide perspective, the values in line 1 plus the values in line 4 of Table 6 represent the value of resources needed to finance each of the programs into the infinite future. The sums are shown in the last line of the table (also equivalent to adding the values in the second and fifth lines). The total resources needed for all the programs sums to $90.5 trillion in present value terms. This need can be satisfied only through increased borrowing, higher taxes, reduced program spending, or some combination.

The second line shows the value of the trust fund at the beginning of 2016. For the HI and OASDI Programs this represents, from the trust fund perspective, the extent to which the programs are funded. From that perspective, when the trust fund is subtracted, an additional $32.1 trillion is needed to sustain the OASDI program into the infinite future, while the HI program reflects a projected surplus of $2.8 trillion over the infinite horizon. However, looking just at present values ignores timing differences in the underlying projected cash flows; the HI Trust Fund is projected to remain solvent only until 2028. As described above, from the trust fund perspective, the SMI Program is fully funded; from a governmentwide basis, the substantial gap that exists between premiums, state transfer revenue, and program expenditures in the SMI Program ($36.8 trillion and $21.5 trillion for Parts B and D, respectively) represents future general revenue obligations of the federal budget.

In comparison to the analogous 75-year number in Table 5, extending the calculations beyond 2090, captures the full lifetime benefits, plus taxes and premiums of all current and future participants. The shorter horizon understates the total financial needs by capturing relatively more of the revenues from current and future workers and not capturing all of the benefits that are scheduled to be paid to them.

Table 6
Present Values of Costs Less Tax, Premium and State Transfer Revenue through the Infinite Horizon, HI, SMI, OASDI
SMI
  HI Part B Part D OASDI Total
(In trillions of dollars, as of January 1, 2016)
Present value of future costs less future taxes, premiums, and state transfers for current participants 10.3 16.7 6.1 31.9 65.0
Less current trust fund balance 0.2 0.1 - 2.8 3.1
Equals net obligations for past and current participants 10.1 16.6 6.1 29.1 61.9
Plus net obligations for future participants (13.0) 20.1 15.4 3.0 25.5
Equals net obligations through the infinite future for all participants (2.8) 36.7 21.5 32.1 87.5
Present values of future costs less the present values of future income over the infinite horizon (2.7) 36.8 21.5 34.9 90.5
 

Note: Totals may not equal the sum of components due to rounding.

Source: 2016 OASDI and Medicare Trustees' Reports

Footnotes

6 Medicare legislation in 2003 created the new Part D account in the SMI Trust Fund to track the finances of a new prescription drug benefit that began in 2006. As in the case of Medicare Part B, approximately three-quarters of revenues to the Part D account will come from future transfers from the General Fund. Consequently, the nature of the relationship between the SMI Trust Fund and the Federal Budget described below is largely unaffected by the presence of the Part D account though the magnitude will be greater. (Back to Content)

7 The federal unified budget encompasses all Government financing and is synonymous with a governmentwide perspective. (Back to Content)

8 Other programs also have dedicated revenues in the form of taxes and fees (and other forms of receipt) and there are a large number of dedicated trust funds in the federal budget. Total trust fund receipts account for about 40 percent of total Government receipts with the Social Security and Medicare Trust Funds accounting for about two-thirds of trust fund receipts. For further discussion, see the report issued by the Government Accountability Office, Federal Trust and Other Earmarked Funds, GAO-01-199SP, January 2001. In the figure and the discussion that follows, all other programs, including these other dedicated trust fund programs, are grouped under “Other Government Accounts” to simplify the description and maintain the focus on Social Security and Medicare. (Back to Content)

9 There are six trustees: the Secretaries of the Treasury (managing trustee), Health and Human Services, and Labor; the Commissioner of the Social Security Administration; and two public trustees who are appointed by the President and confirmed by the Senate for a 4-year term. By law, the public trustees cannot both be members of the same political party. (Back to Content)

10Historically, lawmakers frequently reduced the payment updates below the increase in providers’ input prices in an effort to slow Medicare cost growth or to offset unwarranted changes in claims coding practices. The law did not specify any such adjustments after 2009. (Back to Content)

11Congressional Budget Office, the Long-Term Budget Outlook, June 2016. (Back to Content)

12Interest income is not a factor in this table as dollar amounts are in present value terms. (Back to Content)

13The SMI Trust Fund has $69 billion of existing assets. (Back to Content)

Previous | Next



Open Gov   My Money.gov   USA.gov   Business USA
Facebook   Twitter   You Tube   RSS Feed