April 5, 2011
Letter to the Honorable Paul Ryan
The Congressional Budget Office (CBO) has conducted a long-term analysis of a budget proposal by Chairman Ryan to substantially change federal payments under the Medicare and Medicaid programs, eliminate the subsidies to be provided through new insurance exchanges under last year's major health care legislation, leave Social Security as it would be under current law, and set paths for all other federal spending (excluding interest) and federal tax revenues at specified growth rates or percentages of gross domestic product (GDP). The results of that analysis are summarized in this document.
CBO has not reviewed legislative language for the proposal, so this analysis does not represent a cost estimate for legislation that might implement the proposal. Rather, it is an assessment of the broad, long-term budgetary impacts of the proposal, with results spanning several decades and measured as a share of GDP. It is therefore quite different from a cost estimate for legislation, which would require much more detailed analysis, focus on the first 10 years, and be based on more recent baseline projections. (CBO's most recent long-term projections, which are the basis for this analysis, were issued in June 2010 and were derived from the agency's March 2010 baseline projections.)
Updated: April 8, 2011