I am not an accountant or working in any kind of finance job (although have at various times considered going back to school), but I have been looking through the federal budget from last year trying to make sense of things for the last couple of hours and finally figured I should ask for help. https://www.fiscal.treasury.gov/fsreports/rpt/mthTreasStmt/mts0916.pdf
What I am trying to do specifically is understand the Centers for Medicare and Medicaid. They are an office under the Department of Health and Human Services and you can get the most relevant details about them on page 10 and 11 of the above link.
They spent around $1.4 trillion last year when you add everything up, but at the end of the section for the Department of Health and Human Services, a lot is subtracted (all listed as Intrabudgetary Transactions). Specifically it subtracts about $105 billion for "Proprietary Receipts from the Public", $299 billion for the "Federal Supplementary Medical Insurance Trust Fund", and $21 billion for the "Federal Hospital Insurance Trust Fund." With all of that gone, the budget for the entire department is around $300 billion less than just what is recorded for the Centers for Medicare and Medicaid. I have been trying to figure out what all of these are as how you account for them makes a big difference in how you look at the expense increases.
I believe the Federal Hospital Insurance Trust Fund subtracted is simply subtracting the taxes on the benefits for those who use it. I see somewhat similar numbers to that when comparing it to a report I found online from last year (off a bit, but in the ball park at least). I do not believe this is the payroll tax itself as that is accounted for earlier in Receipts and is a lot bigger number.
The huge $299 billion it subtracts for the Federal Supplementary Medical Insurance Trust Fund is what really throw me off and what I would really like to figure out. This should not be a payroll tax subtracted as a) Medicare payroll taxes are not for SMI, but for the Hospital Insurance and b) that part has already been added an receipts and thus shouldn't be subtracted here. My best guess is the Federal government is funding the trust fund somewhere else and then subtracting it here (which in effect distorts the view of how much we are spending on healthcare), but for the life of me I cannot figure out where.
The "Proprietary Receipts from the Public" is a section most departments have a section for (although it is a lot higher number here). I am less concerned with figuring out the specifics here, but it would be nice too.
Any help appreciated. Thank you.
What I am trying to do specifically is understand the Centers for Medicare and Medicaid. They are an office under the Department of Health and Human Services and you can get the most relevant details about them on page 10 and 11 of the above link.
They spent around $1.4 trillion last year when you add everything up, but at the end of the section for the Department of Health and Human Services, a lot is subtracted (all listed as Intrabudgetary Transactions). Specifically it subtracts about $105 billion for "Proprietary Receipts from the Public", $299 billion for the "Federal Supplementary Medical Insurance Trust Fund", and $21 billion for the "Federal Hospital Insurance Trust Fund." With all of that gone, the budget for the entire department is around $300 billion less than just what is recorded for the Centers for Medicare and Medicaid. I have been trying to figure out what all of these are as how you account for them makes a big difference in how you look at the expense increases.
I believe the Federal Hospital Insurance Trust Fund subtracted is simply subtracting the taxes on the benefits for those who use it. I see somewhat similar numbers to that when comparing it to a report I found online from last year (off a bit, but in the ball park at least). I do not believe this is the payroll tax itself as that is accounted for earlier in Receipts and is a lot bigger number.
The huge $299 billion it subtracts for the Federal Supplementary Medical Insurance Trust Fund is what really throw me off and what I would really like to figure out. This should not be a payroll tax subtracted as a) Medicare payroll taxes are not for SMI, but for the Hospital Insurance and b) that part has already been added an receipts and thus shouldn't be subtracted here. My best guess is the Federal government is funding the trust fund somewhere else and then subtracting it here (which in effect distorts the view of how much we are spending on healthcare), but for the life of me I cannot figure out where.
The "Proprietary Receipts from the Public" is a section most departments have a section for (although it is a lot higher number here). I am less concerned with figuring out the specifics here, but it would be nice too.
Any help appreciated. Thank you.