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In the official reduced form models used by the CBO, Treasury, and the Social Security and Medicare Trustees for projections and policy analysis, many key variables, like real interest rates, health care cost and economic growth, are assumed, often based on a continuation of past trends. By contrast, in our model, these variables are outcomes produced by supply and demand, based on logical functional forms and deep parameter estimates from the literature or empirical analysis. This latter approach provides a more credible and realistic basis for projections with changing underlying conditions and less subject to optimistic hopefulness. We find that, within the next five to ten years, the deficit relative to national income will grow significantly beyond historical experience, and with the prospect of continued increases, without policy changes, may be regarded as unsustainable. In particular, we project that debt-to-GDP will be 132 percent in 2032, compared to CBO's recent projection of 115 percent. In 2052, we project 258 percent compared to CBO's 189 percent. Our projection of national health care spending relative to GDP in 2072 is 29.9 percent, compared to 28.4 percent by CMS, used by the Medicare Trustees. Longer term, our projections show even worse outcomes for debt, deficits, Social Security, Medicare, and health care spending than official projections, and declines in the rate of welfare improvement. These results mainly owe to higher rates of health care inflation, arising from labor shortage effects because health care is produced in a low productivity, labor-dependent sector, and real interest rates rise in the long-run because of increasing debt, bringing about the vicious cycle of growing deficits and debt. Acknowledgements: We appreciate helpful comments from and discussion with James Capretta, Jagadeesh Gokhale, and Steve Robinson. All opinions expressed and mistakes made are our own and not theirs, nor our organizations'., The thing that keeps me up at night actually is the crushing challenge of the diminishing healthcare workforce in our country. We keep opening medical schools, modestly expanding graduate medical [...]

The Supplemental Nutrition Assistance Program (SNAP) is among the nation's largest safety-net programs, helping low-income households afford food, improve nutrition, and support employment. As program expenditures continue to grow, assessing SNAP from the perspective of employment and health outcomes is crucial. We analyze administrative and survey data to document trends in employment and health outcomes for adult SNAP recipients from 1996 to 2019. We find the fastest-growing groups of the adult caseload suffer from low employment levels and poor health outcomes. These results suggest that program reforms should focus on not only reducing hunger but also improving employment and nutrition., The Supplemental Nutrition Assistance Program (or SNAP, formerly called the Food Stamp Program) provides food benefits to 40 million Americans each month at a total cost of over $110 billion [...]

As required by law, the chiefs of the military departments, combatant commands, and selected staff in the Office of the Secretary of Defense are required to submit unfunded priority lists [...]

The defense budget is burdened with a significant and increasing number of programs and activities that do not produce military capability. Absent intervention, this trend is likely to continue. In [...]

Chair Warren, Ranking Member Kennedy, and Members of the Committee, thank you for the opportunity to offer testimony on the dangers of default and near-default. It is an honor. Running [...]

This prepared statement is presented to the Committee on the Budget of the U.S. Senate for its hearing titled 'Left Holding the Bag: The Cost of Oil Dependence in a [...]

The United States Department of Defense purchases more goods, services, and software than all federal agencies combined and is often the target of scrutiny and reform. But the majority of what the military buys is no longer equipment or tangible items but rather labor and technology. Reformers have yet to keep up and continue to overfocus on weapons acquisition when hardware is increasingly the commodity. Despite near-constant attempts at reform, encompassing no less than 14 different efforts over the past eight sessions of Congress, change has not fully met the moment but typically served as short-term budget bogey exercises. Too often, changes are imposed on the Pentagon by Congress--a body that creates many of the problems reforms fail to fix. The Defense Department is a victim of the instability caused by continuing resolutions and lack of clarity, yet Congress further ties its hands regarding finances and sticks to rules from a bygone era when the defense budget was a tiny fraction of the size it is today. This report explains where past reform efforts focused and charts a new course for the Information Age when urgency, flexibility, transparency, and action are the watchwords. It reviews defense reform initiatives of the past decade and more and provides a series of policy recommendations borne out of the belief that to truly reform the Pentagon, change must not be additive. Defense reforms instead must roll back unnecessary strictures, byzantine regulations, and outdated bureaucracy and reduce time, tasks, and attention on unnecessary work. Pentagon reforms should also increase accountability for passing appropriations on time and help realize the true costs of running the US military. The end goal of these reforms is to reduce workload, mission, and the constant churn of forces that are burning out man and machine too quickly. As a result, implementing them will allow the United States to better deter, compete with, and, if necessary, defeat America's great-power adversaries., Washington is rarely without ideas for how to next, and better, reform the Department of Defense. Indeed, there have been so many efficiencies drills over the past two decades that [...]

Our purpose is three-fold. First, we summarize some of the core insights from both classic and more recent papers in the literature on the role of intergovernmental grants in systems of fiscal federalism. Second, we provide an updated look at some of the key institutions through which intergovernmental transfers are implemented in the United States. Third, we consider the rich environment of the COVID-19 pandemic in which new additional intergovernmental transfers were deployed, and present empirical evidence on how they affected state-level corporate tax policy. We conclude by discussing productive directions for future research on the economics of fiscal federalism and the role of intergovernmental grants as policy instruments in federal systems., I Introduction In the literature on fiscal federalism, the sources and implications of strategic interactions both within and between layers of government have long been of interest (Gordon, 1983; Dahlby, [...]

On March 28, 2022, the Biden administration submitted a $773 billion defense budget for fiscal year (FY) 2023. This is $30 billion (4 percent) over the FY2022 enacted level and [...]