Most of us remember the classic Saturday morning School House Rock segment, “I’m Just a Bill,” which taught us the steps on how a bill becomes a law. While entertaining and informative, it did not address the many other factors that often determine whether a bill makes it into law.
Before identifying those factors, I want to discuss challenges and opportunities regarding the future of the Medicare program. Medicare is critically important, but faces a funding crisis. The Hospital Insurance Trust Fund, which is used to pay for health care in facilities and is funded through a payroll tax, has paid out more than it has taken in for a number of years. So it is no surprise that the Hospital Insurance Trust Fund is projected to go bankrupt in 2026.1 Separately, spending for outpatient health care and medicine is projected to rise so dramatically that it puts a strain on taxpayers and will likely crowd out federal investments in other priority areas.1