CRS Reports

P.L. 110-173: Provisions in the Medicare, Medicaid, and SCHIP Extension Act of 2007

On December 29, 2007, the President signed S. 2499, the Medicare, Medicaid, and SCHIP Extension Act of 2007 (P.L. 110-173). This Act was passed by the House on December 19, 2007, and by a voice vote in the Senate on December 18, 2007. The Act makes changes to the nation’s three major health programs, Medicare, Medicaid, and the State Children’s Health Insurance Program (SCHIP), as well as other federally funded programs. The most prominent provisions in the Act were to (1) suspend the Medicare physician payment cut scheduled to take effect and (2) provide SCHIP funding through March 2009. P.L. 110-173 mandates a 0.5% increase in the Medicare physician fee schedule for the six-month period from January 1, 2008, through June 30, 2008, and provides FY2008 and FY2009 SCHIP funding allotments through March 31, 2009. The Act also extends a number of expiring provisions and programs. These extensions affect Medicare plans and providers and Medicaid payments and programs. The Act also includes funding for some miscellaneous activities. The Act’s Medicare extensions include incentive payments for certain physicians, and extensions of current law provisions for Medicare Special Needs Plans and cost-based plans. A variety of extensions also affect how long-term care, rural, and acute care hospitals are paid or classified. Other extensions affect Medicare payments for certain services and providers, outpatient physical therapy services, speech language pathology services, certain pathology laboratories, brachytherapy services, and therapeutic radiopharmaceuticals. The Act also includes Medicaid provisions designed to extend certain payments and programs, such as Medicaid disproportionate hospital share (DSH) allotments for Tennessee and Hawaii, the Transitional Medical Assistance (TMA) program, and the Qualifying Individual (QI) program, among other provisions. Miscellaneous provisions include using Medicare funds to make grants to State Health Insurance Assistance Programs, Area Agencies on Aging, and Aging and Disability Resource Centers. The Act also establishes the Medicare Payment Advisory Commission (MedPAC) as a congressional agency. The Act provides a number of offsets to pay for the spending increases, including a reduction in the Medicare Advantage stabilization fund in 2012. The Act also includes provisions affecting Medicare’s responsibility as a secondary payer for covered services, Medicare payments for Inpatient Rehabilitation Facilities (IRFs), payments for most Medicare part B drugs, payments for certain diagnostic laboratory tests, and Medicare Long-Term Care Hospitals. This report provides short descriptions of the provisions contained in P.L. 110-173.

Feb 7, 2008

Automated Political Telephone Calls (“Robo Calls”) in Federal Campaigns: Overview and Policy Options

Feb 7, 2008

Veterans’ Benefits: Pension Benefit Programs

Feb 6, 2008

OMB’s Financial Management Line of Business Initiative: Background, Issues, and Observations

Jan 31, 2008

Railroad Retirement Board: Retirement, Survivor, Disability, Unemployment, and Sickness Benefits

Jan 29, 2008

The Food and Drug Administration: Budget and Statutory History, FY1980-FY2007

Considerable attention has been focused on the ability of the Food and Drug Administration (FDA) to accomplish its mission with the funds provided by congressional appropriations and user fees. FDA regulates a wide range of products valued at more than $1 trillion in the U.S. economy. The agency plays a key public health role. FDA is responsible for the safety of most foods (human and animal) and cosmetics, and it regulates both the safety and the effectiveness of human drugs, biologics (e.g., vaccines), medical devices, and animal drugs. In congressional hearing testimony and at other public venues, former FDA Commissioners, interest group representatives, and former high-ranking individuals in the agency or in the Department of Health and Human Services have argued that FDA is underfunded and at risk of being unable to fulfill all the statutory responsibilities assigned by Congress. Reports by the Institute of Medicine, the Government Accountability Office, and the FDA Science Board have made similar observations. The main voices in support of FDA budget levels, past and present, have been representatives of the various presidential administrations. Calls for cutting the FDA budget or maintaining it at the current level come from organizations, such as CATO and the Hoover Institute, that propose limitations on the agency’s authority and, therefore, its need for funding. Some agency critics have expressed concerns about inefficiencies within FDA and its ability to manage its resources. In order to inform the ongoing discussion about FDA, this report presents FDA’s appropriations history and traces the evolution of the agency’s statutory responsibility. It first provides a 28-year budget history for the agency along with personnel levels as shown by the number of full-time equivalent employees (FTEs). This report found that direct congressional inflation-adjusted appropriations (budget authority) to FDA doubled, and that the contribution of other funds, mostly user fees, increased more than 12-fold, resulting in an overall budget in FY2007 almost 2½ times that in FY1980. Between FY1980 and FY2006, the latest year with final FTE data, the agency’s FTE level increased 19% overall, from a less than 1% increase in budget authority-funded FTEs and an almost fourfold increase in FTEs funded by other sources (mostly user fees). The report also provides a more detailed examination of the budget and personnel levels for each of FDA’s major activity areas: Foods, Human Drugs, Biologics, Animal Drugs and Feeds, and Devices and Radiological Health. Findings include the relationship of user fees to budget authority, declining funding of research, and summaries of the major laws enacted since FY1980.

Jan 29, 2008

The Paris Club and International Debt Relief

Jan 29, 2008

State and Local Restrictions on Employing, Renting Property to, or Providing Services for Unauthorized Aliens: Legal Issues and Recent Judicial Developments

This report discusses the constitutional issues raised in relation to state and local laws intended to deter the presence of unauthorized aliens, along with the implications that federal civil rights statutes might have on the implementation and enforcement of measures restricting such persons' ability to obtain employment, housing, or other state and local benefits or services.

Jan 28, 2008

Coastal Zone Management: Background and Reauthorization Issues

Jan 28, 2008

Temporarily Filling Presidentially Appointed, Senate-Confirmed Positions

Jan 25, 2008

The Proposed U.S.-South Korea Free Trade Agreement (KORUS FTA): Provisions and Implications

Jan 22, 2008

China’s Sovereign Wealth Fund

Jan 22, 2008

Tax Cuts for Short-Run Economic Stimulus: Recent Experiences

Jan 22, 2008

The Rate Reduction Tax Credit - “The Tax Rebate” - in the Economic Growth and Tax Relief Reconciliation Act of 2001: A Brief Explanation

Jan 22, 2008

Engineered Nanoscale Materials and Derivative Products: Regulatory Challenges

Jan 22, 2008

Proliferation Security Initiative (PSI)

This report looks at the background and current status of the Proliferation Security Initiative (PSI), which was formed to increase international cooperation in interdicting shipments of weapons of mass destruction (WMD).

Jan 16, 2008

Edward Byrne Memorial Justice Assistance Grant Program: Legislative and Funding History

Jan 15, 2008

Community Oriented Policing Services (COPS): Background, Legislation, and Issues

Jan 15, 2008

Housing Opportunities for Persons with AIDS (HOPWA)

Jan 14, 2008

Campaign Finance: Legislative Developments and Policy Issues in the 110th Congress

This report provides an overview of major legislative and policy developments related to campaign finance during the 110th Congress. The report discusses legislative and oversight hearings and floor action during the period. It also explores major policy issues that are relevant for Congress, but have largely occurred away from Capitol Hill. As of this writing, approximately 50 bills devoted primarily to campaign finance have been introduced in the 110th Congress, but none have become law. A new lobbying and ethics law, the Honest Leadership and Open Government Act (HLOGA) contains campaign finance provisions related to "bundled" campaign contributions and campaign travel. That measure is the only campaign finance related bill to become law during the 110th Congress.

Jan 14, 2008

Trafficking in Persons: U.S. Policy and Issues for Congress

Jan 10, 2008

Railroad Access and Competition Issues

Jan 10, 2008

The Changing U.S.-Japan Alliance: Implications for U.S. Interests

This report examines policy changes that have driven actual and proposed shifts in the alliance between the U.S. and Japan. Key features of the proposals include a reduction in the number of U.S. Marines in Japan, the relocation of a controversial Marine air base in Okinawa, expanded cooperation in training and intelligence sharing, and command structure changes. The report concludes with a number of potential options for U.S. policymakers to protect U.S. security interests in the Asia Pacific. Those options include further bolstering Japan’s military, reducing the U.S military presence in the region, encouraging Japan to focus on international peacekeeping and reconstruction operations, developing trilateral defense cooperation, and creating a security forum in northeast Asia.

Jan 10, 2008

China’s Holdings of U.S. Securities: Implications for the U.S. Economy

This report examines the importance to the U.S. economy of China’s investment in U.S. securities, as well as U.S. concerns over the possibility that China might unload a large share of those holdings, the likelihood that this would occur, and the potential implications such action could have for the U.S. economy.

Jan 9, 2008

The Impact of Medicare Premiums on Social Security Beneficiaries

This report shows how the deduction of Medicare Part B and Part D premiums affects Social Security beneficiaries. It describes how increases in Social Security benefits and Medicare premiums are calculated under current law and explains the circumstances under which Social Security beneficiaries are held harmless for increases in the standard Part B premium, as well as the premium assistance available to low-income beneficiaries.

Jan 7, 2008

How Crime in the United States Is Measured

Crime data collected through the Uniform Crime Reports (UCR), the National Incident-Based Reporting System (NIBRS), and the National Crime Victimization Survey (NCVS) are used by Congress to inform policy decisions and allocate federal criminal justice funding to states. As such, it is important to understand how each program collects and reports crime data, and the limitations associated with the data. This report reviews (1) the history of the UCR, the NIBRS, and the NCVS; (2) the methods each program uses to collect crime data; and (3) the limitations of the data collected by each program. The report then compares the similarities and differences of UCR and NCVS data. It concludes by reviewing issues related to the NIBRS and the NCVS. The UCR represents the first effort to create a national, standardized measure of the incidence of crime. It was conceived as a way to measure the effectiveness of local law enforcement and to provide law enforcement with data that could be used to help fight crime. UCR data are now used extensively by researchers, government officials, and the media for research, policy, and planning purposes. The UCR also provides some of the most commonly cited crime statistics in the United States. The UCR reports offense and arrest data for 8 different Part I offenses and arrest data for 21 different Part II offenses. The NIBRS was developed by the Federal Bureau of Investigation to respond to the law enforcement community’s belief that the UCR needed to be updated to provide more in-depth data to meet the needs of law enforcement into the 21st century. The NIBRS collects data, including data on offense(s), offender(s), victim(s), arrestee(s), and any property involved in an offense, for 46 different Group A offenses and 11 different Group B offenses. Despite the more detailed crime data that the NIBRS can provide, nationwide implementation of the program has been slow, for a variety of reasons, including cost considerations. The NCVS is the primary source of information on the characteristics of criminal victimization, and on the number and types of crime not reported to law enforcement. The NCVS has four major objectives: (1) to develop detailed information about the victims and consequences of crime, (2) to estimate the number and types of crimes not reported to police, (3) to provide uniform measures of selected types of crimes, and (4) to permit comparisons over time and population type (e.g., urban, suburban, and rural). The NCVS asks respondents whether they have been the victim of rape and sexual assault, robbery, simple and aggravated assault, purse snatching/pickpocketing, burglary, theft, or motor vehicle theft. In addition to collecting data on the number of victimizations, the NCVS gathers data on the details of each incident of victimization. This report will be updated as warranted.

Jan 3, 2008

Railroad Retirement Board: Trust Fund Investment Practices

Jan 2, 2008

Federal Mandatory Minimum Sentencing Statutes

Dec 27, 2007

Obstruction of Congress: a Brief Overview of Federal Law Relating to Interference with Congressional Activities

Dec 27, 2007

Obstruction of Congress: An Abridged Overview of Federal Criminal Laws Relating to Interference with Congressional Activities

Dec 27, 2007

Intellectual Property Rights and International Trade

Dec 20, 2007

Offender Reentry: Correctional Statistics, Reintegration into the Community, and Recidivism

Dec 17, 2007

Modernizing Insurance Regulation: Optional Federal Charter Legislation

Dec 14, 2007

Constitutionality of the Deficit Reduction Act of 2005: Litigation

The Deficit Reduction Act of 2005 has been challenged as unconstitutional in several lawsuits. The plaintiffs have alleged that the House and Senate did not comply with the constitutional provisions relating to enacting bills because the bill that was sent to the President did not pass the chambers in identical form. All the district courts that have decided these cases have dismissed them on the basis of the enrolled bill rule enunciated by the Supreme Court in 1892. This rule provides that courts should not look behind the text of an enrolled bill signed by the presiding officers of the House and the Senate and presented to the President; the signatures of these congressional officers on the enrolled bill attest that it has passed both chambers. Appeals have been filed in some of the decided cases. In two of these appealed cases, district court dismissals have been affirmed. The United States Supreme Court has denied a petition to review a circuit court’s dismissal. This report will be updated to reflect further developments.

Dec 13, 2007

Congressional Franking Privilege: Background and Current Legislation

Dec 11, 2007

Federal Land Ownership: Current Acquisition and Disposal Authorities

Dec 6, 2007

Franking Privilege: Historical Development and Options for Change

Dec 5, 2007

Qualified Charitable Distributions from Individual Retirement Accounts: A Fact Sheet

Dec 4, 2007

U.S. Civilian Space Policy Priorities: Reflections 50 Years After Sputnik

Dec 3, 2007

Climate Change: Science Update 2007

Nov 29, 2007

U.S. Clothing Imports from Vietnam: Trade Policies and Performance

Nov 27, 2007

North Korea’s Nuclear Weapons: Latest Developments

Nov 21, 2007

Item Veto and Expanded Impoundment Proposals: History and Current Status

Nov 21, 2007

Pakistan’s Nuclear Weapons: Proliferation and Security Issues

Nov 9, 2007

Child Support Enforcement: $25 Annual User Fee

Nov 8, 2007

Federal Home Loan Bank System: Policy Issues

The Federal Home Loan Bank (FHLB) System comprises 12 regional banks (the Banks) that form a collective government-sponsored enterprise (GSE). As a GSE, the Banks have special ties to the federal government that accord them “agency” status and lead investors in capital markets to infer that the government would step in to make good any failure in the debt of the Banks. Originally begun in 1932 as lenders to the savings and loan associations that were the primary lenders for home mortgages, the Banks have undergone several changes since the savings and loan crisis of the 1980s. Membership in the Banks has changed, today encompassing more commercial banks than savings associations and including credit unions, insurance companies, and some associated housing providers. Purposes of lending—while still primarily housing-related—now include agricultural and small business lending. The changes have also resulted in special mission set-asides for low- and moderate-income housing and special programs for community development. The five-member Federal Housing Finance Board (FHFB) regulates the System. Some advocate combining the FHFB with the Office of Federal Housing Enterprise Oversight (OFHEO), which is the current regulator of Fannie Mae and Freddie Mac, the other two housing-related GSEs. Differences between FHFB and OFHEO, including capital and ownership standards, requirements for the housing mission, and regulatory powers, complicate regulatory consolidation. In the 110th Congress, two major bills would merge regulation for the housing-related GSEs. Both S. 1100 and H.R. 1427 would combine regulation of the three housing GSEs under a single regulator who would have powers and independence similar to those of the FHFB. H.R. 1427 passed the House on May 22, 2007. S. 1100 was referred to the Senate Committee on Banking, Housing, and Urban Affairs on April 12, 2007. The measures have several important differences. (See CRS Report RL33940, Reforming the Regulation of Government-Sponsored Enterprises in the 110th Congress, by Mark Jickling, Edward V. Murphy, and N. Eric Weiss for additional information.) The slowdown in housing markets and rise in foreclosures have led to concerns about the health of the FHLBs. Some large non-member lenders have affiliates that are members of a regional FHLB. These affiliates could draw on FHLB resources to move some troubled loans onto System balance sheets. This is a concern because some believe that the government would not let the FHLB System fail, and that such affiliate actions could raise the potential risk and cost to taxpayers. Possible mergers of FHLBs is another issue. FHLB Dallas has been in negotiations to merge with FHLB Chicago, in part because of the financial difficulties of FHLB Chicago. The potential merger would be the first of its kind and raises several oversight issues, including FHFB approval powers and System organization. This report will be updated as events warrant.

Nov 8, 2007

U.S. Arms Sales to Pakistan

Nov 8, 2007

Gray Wolves Under the Endangered Species Act: Distinct Population Segments and Experimental Populations

This report looks at the distinct population segments (DPSs) process as it is applied to the gray wolf. It also reviews experimental populations of wolves under the Endangered Species Act (ESA) and their protections.

Nov 5, 2007

Managing the Nuclear Fuel Cycle: Policy Implications of Expanding Global Access to Nuclear Power

Nov 1, 2007

Unlawful Internet Gambling Enforcement Act and Regulations Proposed for Its Implementation

Nov 1, 2007