1Transitioning to Bundled Payments in Medicare
Michael Chernew and Dana Goldman
![15 Ways to Rethink the Federal Budget | Brookings (1) 15 Ways to Rethink the Federal Budget | Brookings (1)](https://i0.wp.com/c24215cec6c97b637db6-9c0895f07c3474f6636f95b6bf3db172.ssl.cf1.rackcdn.com/interactives/2016/federal-budget-hamilton-231/assets/hamilton1.jpg)
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
2Reforming Federal Support for Risky Development
David R. Conrad and Edward A. Thomas
![15 Ways to Rethink the Federal Budget | Brookings (2) 15 Ways to Rethink the Federal Budget | Brookings (2)](https://i0.wp.com/c24215cec6c97b637db6-9c0895f07c3474f6636f95b6bf3db172.ssl.cf1.rackcdn.com/interactives/2016/federal-budget-hamilton-231/assets/hamilton2.jpg)
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
3Restructuring Cost Sharing and Supplemental Insurance for Medicare
Jonathan Gruber
![15 Ways to Rethink the Federal Budget | Brookings (3) 15 Ways to Rethink the Federal Budget | Brookings (3)](https://i0.wp.com/c24215cec6c97b637db6-9c0895f07c3474f6636f95b6bf3db172.ssl.cf1.rackcdn.com/interactives/2016/federal-budget-hamilton-231/assets/hamilton3.jpg)
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
4An Evidence-Based Path to Disability Insurance Reform
Jeffrey B. Liebman and Jack A. Smalligan
![15 Ways to Rethink the Federal Budget | Brookings (4) 15 Ways to Rethink the Federal Budget | Brookings (4)](https://i0.wp.com/c24215cec6c97b637db6-9c0895f07c3474f6636f95b6bf3db172.ssl.cf1.rackcdn.com/interactives/2016/federal-budget-hamilton-231/assets/hamilton4.jpg)
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
5Eliminating Fossil Fuel Subsidies
Joseph E. Aldy
![15 Ways to Rethink the Federal Budget | Brookings (5) 15 Ways to Rethink the Federal Budget | Brookings (5)](https://i0.wp.com/c24215cec6c97b637db6-9c0895f07c3474f6636f95b6bf3db172.ssl.cf1.rackcdn.com/interactives/2016/federal-budget-hamilton-231/assets/hamilton5.jpg)
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
6Better Ways to Promote Saving through the Tax System
Karen Dynan
![15 Ways to Rethink the Federal Budget | Brookings (6) 15 Ways to Rethink the Federal Budget | Brookings (6)](https://i0.wp.com/c24215cec6c97b637db6-9c0895f07c3474f6636f95b6bf3db172.ssl.cf1.rackcdn.com/interactives/2016/federal-budget-hamilton-231/assets/hamilton6.jpg)
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
7Limiting Individual Income Tax Expenditures
Diane M. Lim
![15 Ways to Rethink the Federal Budget | Brookings (7) 15 Ways to Rethink the Federal Budget | Brookings (7)](https://i0.wp.com/c24215cec6c97b637db6-9c0895f07c3474f6636f95b6bf3db172.ssl.cf1.rackcdn.com/interactives/2016/federal-budget-hamilton-231/assets/hamilton7.jpg)
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
8Replacing the Home Mortgage Interest Deduction
Alan D. Viard
![15 Ways to Rethink the Federal Budget | Brookings (8) 15 Ways to Rethink the Federal Budget | Brookings (8)](https://i0.wp.com/c24215cec6c97b637db6-9c0895f07c3474f6636f95b6bf3db172.ssl.cf1.rackcdn.com/interactives/2016/federal-budget-hamilton-231/assets/hamilton8.jpg)
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
9Funding Transportation Infrastructure with User Fees
Jack Basso and Tyler Duvall
![15 Ways to Rethink the Federal Budget | Brookings (9) 15 Ways to Rethink the Federal Budget | Brookings (9)](https://i0.wp.com/c24215cec6c97b637db6-9c0895f07c3474f6636f95b6bf3db172.ssl.cf1.rackcdn.com/interactives/2016/federal-budget-hamilton-231/assets/hamilton9.jpg)
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
10Creating an American Value-Added Tax
William G. Gale and Benjamin H. Harris
![15 Ways to Rethink the Federal Budget | Brookings (10) 15 Ways to Rethink the Federal Budget | Brookings (10)](https://i0.wp.com/c24215cec6c97b637db6-9c0895f07c3474f6636f95b6bf3db172.ssl.cf1.rackcdn.com/interactives/2016/federal-budget-hamilton-231/assets/hamilton10.jpg)
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
11The Many Benefits of a Carbon Tax
Adele C. Morris
![15 Ways to Rethink the Federal Budget | Brookings (11) 15 Ways to Rethink the Federal Budget | Brookings (11)](https://i0.wp.com/c24215cec6c97b637db6-9c0895f07c3474f6636f95b6bf3db172.ssl.cf1.rackcdn.com/interactives/2016/federal-budget-hamilton-231/assets/hamilton11.jpg)
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
12Overhauling the Temporary Work Visa System
Pia M. Orrenius, Giovanni Peri, and Madeline Zavodny
![15 Ways to Rethink the Federal Budget | Brookings (12) 15 Ways to Rethink the Federal Budget | Brookings (12)](https://i0.wp.com/c24215cec6c97b637db6-9c0895f07c3474f6636f95b6bf3db172.ssl.cf1.rackcdn.com/interactives/2016/federal-budget-hamilton-231/assets/hamilton12.jpg)
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
13Increasing the Role of the Private Sector in Housing Finance
Phillip Swagel
![15 Ways to Rethink the Federal Budget | Brookings (13) 15 Ways to Rethink the Federal Budget | Brookings (13)](https://i0.wp.com/c24215cec6c97b637db6-9c0895f07c3474f6636f95b6bf3db172.ssl.cf1.rackcdn.com/interactives/2016/federal-budget-hamilton-231/assets/hamilton13.jpg)
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
14National Defense in a Time of Change
Gary Roughead and Kori Schake
![15 Ways to Rethink the Federal Budget | Brookings (14) 15 Ways to Rethink the Federal Budget | Brookings (14)](https://i0.wp.com/c24215cec6c97b637db6-9c0895f07c3474f6636f95b6bf3db172.ssl.cf1.rackcdn.com/interactives/2016/federal-budget-hamilton-231/assets/hamilton14b.jpg)
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
15Making Defense Affordable
Cindy Williams
![15 Ways to Rethink the Federal Budget | Brookings (15) 15 Ways to Rethink the Federal Budget | Brookings (15)](https://i0.wp.com/c24215cec6c97b637db6-9c0895f07c3474f6636f95b6bf3db172.ssl.cf1.rackcdn.com/interactives/2016/federal-budget-hamilton-231/assets/hamilton15.jpg)
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