Medicare Part C Update from 2023 Medicare Trustees Report

Usgovernmentspending.com has updated its estimate of Medicare Part C, the Medicare Advantage program using data in the Medicare Trustees Report of 2023 that was released at the end of March 2023. You can see the results here.

The Budget of the United States Government reports Medicare outlays as a single line item, subfunction 571 in Historical Table 3.2, but Usgovernmentspending.com shows a breakdown of the Medicare program into its constituent parts, as follows:

1. Part A: Hospital Insurance
2. Part B: Supplementary Medical Insurance
3. Part C: Medicare Advantage
4. Part D: SMI Drug Plan

These data are constructed from data in the Public Budget Database, which provide details on Part A, Part B, and Part D, with Part C embedded in the Part A and Part B outlays. Part C is constructed from data in Table IV.C2 in the Medicare Trustees Report 2023 which reports the payments made to private Medicare health plans and the projected payments in future years.

You can inspect the extracted data from Medicare Trustees Reports Table IV.C2 here. And see the blog entry that introduced the Medicare Part C breakout to usgovernmentspending.com here.

Here is a breakdown of Medicare budgeted outlays on usgovernmentspending.com for FY 2023 before and after today's update.

Budgeted Outlays in percent GDP	Part A	Part B	Part C	Part D	Total Medicare
FY2023 before update	0.76	0.59	1.53	0.35	3.25% GDP
FY2023 after update	0.75	0.59	1.45	0.34	3.15% GDP

The update indicates a  small increase in budgeted Medicare Part C over the previous estimate in the Medicare Trustees Report in 2022.

Medicare Part C Update from 2022 Medicare Trustees Report

Usgovernmentspending.com has updated its estimate of Medicare Part C, the Medicare Advantage program using data in the Medicare Trustees Report of 2022 that was released June 4, 2022. You can see the results here.

The Budget of the United States Government reports Medicare outlays as a single line item, subfunction 571 in Historical Table 3.2, but Usgovernmentspending.com shows a breakdown of the Medicare program into its constituent parts, as follows:

1. Part A: Hospital Insurance
2. Part B: Supplementary Medical Insurance
3. Part C: Medicare Advantage
4. Part D: SMI Drug Plan

These data are constructed from data in the Public Budget Database, which provide details on Part A, Part B, and Part D, with Part C embedded in the Part A and Part B outlays. Part C is constructed from data in Table IV.C2 in the Medicare Trustees Report 2022 which reports the payments made to private Medicare health plans and the projected payments in future years.

You can inspect the extracted data from Medicare Trustees Reports Table IV.C2 here. And see the blog entry that introduced the Medicare Part C breakout to usgovernmentspending.com here.

Here is a breakdown of Medicare budgeted outlays on usgovernmentspending.com for FY 2022 before and after today's update.

Budgeted Outlays in percent GDP	Part A	Part B	Part C	Part D	Total Medicare
FY2022 before update	0.69	0.68	1.39	0.37	3.14% GDP
FY2022 after update	0.69	0.66	1.42	0.37	3.14% GDP

The update indicates a  small increase in budgeted Medicare Part C over the previous estimate in the Medicare Trustees Report in 2021.

Medicare Part C Added

On March 15, 2014 we updated usgovernmentspending.com to show details of the federal Medicare Part C program, Medicare Advantage.

Historical Table 3.2, published each year in the Historical Tables section of the Budget of the United States, is the primary source we use for showing federal outlays down to the "subfunction" level.  Table 3.2 includes about 80 line items.  But Medicare appears as a single line item, subfunction 571.

Previously, we have broken out outlays for Part A Hospital Insurance, Part B Supplementary Medical Insurance, and Part D SMI Drug programs from single subfunctions.   We have constructed these outlays from detailed items published in the Public Budget Database.

Details of Part C Medicare are not provided in the Public Budget Database, but they are shown in the annual Medicare Trustees Report, and we have extracted data from the reports to construct a data series for Part C Medicare Advantage.  You can inspect the extracted data from Medicare Trustees Reports here.

Strictly speaking, Part C Medicare Advantage started in 2006.  But the Balanced Budget Act of 1997 created Medicare+Choice, really a precursor of Medicare Advantage, and the Medicare Trustees Report tracks the cost of Medicare+Choice's payments to private health plans and then Medicare Advantage's payments to private health plans.  Thus we have extended Part C back to 1998.

In the Public Budget Database Part C Medicare Advantage outlays are included as part of Part A and Part B outlays.  They are recorded in the Medicare Trustees Report as “Medicare Payments to Private Health Plans” from Part A and Part B trust funds.  In creating the new Part C line items we have reduced the HI (Part A) Benefits and SMI (Part B) Benefits line items so that the overall totals remain the same.

Also, Medicare Part A and Part B subtract "Premiums and Collections" from their published Outlays.  For Part A this is a nominal amount.  But we have prorated the Part B Premiums and Collections between Part B and Part C, and we have provided a line item for Part C "Prorated Premiums and Collections."  The proration for Part B Premiums and Collections looks like this:

SMI (Part C) Prorated Premiums and Collections = SMI (Part B) Premiums and Collections * (SMI (Part C) Private Health Plan Bid + SMI (Part C) Private Health Plan Rebate) / ( SMI (Part C) Private Health Plan Bid + SMI (Part C) Private Health Plan Rebate+ SMI (Part B) Benefits)

The SMI (Part B) Premiums and Collections is reduced by the amount of SMI (Part C) Prorated Premiums and Collections.

usgovernmentspending.com has now surfaced the Part A, Part B. Part C, and Part D outlays up to the subfunction level by extending our unofficial subfunctions for the Medicare program as follows:

New sub- function	Description
572	HI (Part A) Benefits
573	HI (Part A) Administration
574	HI (Part A) Premiums and Collections
575	SMI (Part B) Benefits
576	SMI (Part B) Administration
577	SMI (Part B) Prorated Premiums and Collections
581	SMI Drug (Part D) Benefits
582	SMI Drug (Part D) Administration
583	SMI Drug(Part D) Premiums and Collections
584	Other
585	HI (Part C) Private Health Plan Bid
586	HI (Part C) Private Health Plan Rebate
587	SMI (Part C) Private Health Plan Bid
588	SMI (Part C) Private Health Plan Rebate
589	SMI (Part C) Prorated Premiums and Collections

You can find the new detailed Medicare numbers on the Medicare Spending Details page here and the Medicare Spending by Year page here.  You can also look at the Entitlements History page here.

Reminder: The fifteen "subfunctions" 572 through 589 are not official US government subfunctions.

See the blog entry that announced Medicare Part A, Part B, Part D details here.

New Medicare Breakdown

On May 12, 2013 we updated usgovernmentspending.com to show details of the federal Medicare program.

Historical Table 3.2, published each year in the Historical Tables section of the Budget of the United States, is the primary source we use for showing federal outlays down to the "subfunction" level.  Table 3.2 includes about 80 line items.  But Medicare appears as a single line item, subfunction 571.

The details of Medicare can be found in the Outlays table of the the Public Budget Database section of the budget and usgovernmentspending.com shows Medicare details on its Numbers page.  There you can find outlays for the three major parts of Medicare, the Part A Hospital Insurance (HI) program, the Part B Supplemental Medical Insurance (SMI) program, and the Part D Drug benefit when you drill down below the subfunction level.

usgovernmentspending.com has now surfaced the Part A, Part B and Part D outlays up to the subfunction level by creating our own unofficial subfunctions for the Medicare program as follows:

New sub- function	Description
572	HI (Part A) Benefits
573	HI (Part A) Administration
574	HI (Part A) Premiums and Collections
575	SMI (Part B) Benefits
576	SMI (Part B) Administration
577	SMI (Part B) Premiums and Collections
581	SMI Drug (Part D) Benefits
582	SMI Drug (Part D) Administration
583	SMI Drug(Part D) Premiums and Collections
584	Other

You can find the new detailed Medicare numbers on the Medicare Spending Details page here and the Medicare Spending by Year page here.  You can also look at the Entitlements History page here.

Reminder: The ten "subfunctions" 572 through 784 are not official US government subfunctions.