Energy
Ben Lieberman
Rising energy prices—particularly for oil and gasoline, but also for natural gas—have re-emerged as a major issue in recent years. Thus far, however, Congress has done little of benefit, and its massive Energy Policy Act of 2005 has actually made things worse for the American consumer. Along with the long list of special-interest tax breaks and giveaways to various segments of the energy industry, the bill created a federal requirement that ethanol be added to the gasoline supply. This costly additive has added several cents to the price per gallon.
Congress has not even corrected any of its past mistakes that contribute to today’s problems. During the 1980s and 1990s, Washington placed many energy-rich areas off-limits to drilling, including Alaska’s Arctic National Wildlife Refuge (ANWR) and 85 percent of the nation’s offshore areas. It also saddled the refining sector with numerous regulatory requirements that have done more economic harm than environmental good. Measures to open up these areas to domestic drilling and streamline the regulations have thus far failed to gain passage.
To its credit, the House recently passed H.R. 5254, a modest measure to increase refinery capacity. The House is also considering H.R. 4671, the Deep Ocean Energy Resources Act of 2006, just approved by the House Resources Committee. A much stronger step when compared to the refinery bill, H.R. 4671 would end the federal offshore restrictions and grant coastal states the authority to either allow or restrict drilling off their shores. Both the House and the Senate also have passed bills opening ANWR, but they have not managed to do so in the same bill.
In sum, high energy prices are partially a self-imposed problem, but Congress has yet to do anything constructive about them.
Senate Grade: F
House Grade: D
Needed Improvements: Congress should improve domestic energy supplies by opening up ANWR, streamlining burdensome refinery regulations, and allowing coastal states to opt out of offshore drilling restrictions. Counterproductive price gouging legislation of the sort passed by the House should be avoided.
Additional Background: Ben Lieberman, “Correcting Mistakes of the 1990s Should Top the Energy Agenda for 2006,” Heritage Foundation Backgrounder No. 1921, March 20, 2006, at http://www.heritage.org/Research/Energyand
Environment/bg1921.cfm.
Tax Rates
Daniel J. Mitchell, Ph.D.
High marginal tax rates discourage people from engaging in productive behavior. Individuals are much more likely to work, save, and invest, for instance, if they can keep 80 cents rather than 65 cents of every dollar of wealth they generate for the economy. Policymakers also should be aware that effective marginal tax rates can be punitively high if certain types of income are taxed more than one time. Unfortunately, it is possible for income to be taxed as many as four times, thanks to the combination of the capital gains tax, corporate income tax, personal income tax, and death (estate) tax.
Legislation has been adopted to extend the lower tax rates on dividends and capital gains. Instead of expiring at the end of 2008, they now will expire at the end of 2010. This postpones for another two years the possibility of a significant increase in the double-taxation of income that is saved and invested. Moreover, the House of Representatives has voted to repeal the death tax permanently beginning in 2010. In the Senate, 57 Senators voted for repeal of the tax, but the measure failed because 60 votes were required to overcome a procedural hurdle. The House has responded to the failure of the Senate by passing a reform bill that would lower death tax rates and significantly increase the exempt amount before taxpayers must pay this tax.
The House generally has been more sympathetic to pro-growth tax policy. In conferences between the two chambers, the Senate has resisted constructive reforms.
Senate Grade: C–
House Grade: B
Needed Improvements: Both the House and the Senate should extend the pro-growth provisions of the 2001 and 2003 tax bills. Specifically, the lower income tax rates, lower tax rates on dividends and capital gains, and death tax repeal should be made permanent.
Additional Background: Daniel J. Mitchell, “A Supply-Side Success Story,” Heritage Foundation WebMemo No. 755, June 7, 2005, at http://www.heritage.org/Research/Taxes/wm755.cfm.
Tax Reform
Daniel J. Mitchell, Ph.D.
Fundamental tax reform can boost economic performance not only by lowering marginal tax rates, but also by removing distortions in the tax code that encourage people to misallocate labor and/or capital solely to reduce tax liabilities, even if those decisions do not make economic sense. Tax reform also can improve economic efficiency by dramatically lowering compliance costs and allowing individuals and businesses to use resources more productively.
In a competitive global economy, tax reform is especially important. Indeed, about a dozen nations now have simple and fair flat tax systems. In the United States, tax reform has been placed on the back burner, in part because of the absence of a proposal from the Administration. The news is not entirely bleak, however, since many tax policy changes in recent years—such as lower income tax rates, reduced double-taxation of dividends and capital gains, and potential repeal of the death tax— shift the tax code closer to a simple and fair flat tax.
Senate Grade: C–
House Grade: B
Needed Improvements: The House and Senate should generate support for fundamental tax reform by holding hearings on the adverse impact of the current Internal Revenue Code and exploring the benefits of a simple and fair flat tax.
Additional Background: Daniel J. Mitchell, Ph.D., “A Brief Guide to the Flat Tax,” Heritage Foundation Backgrounder No. 1866, July 7, 2005, at http://www.heritage.org/Research/Taxes/bg1866.cfm.
Medicare
Robert E. Moffit, Ph.D.
With passage of the Medicare Modernization Act of 2003, creating a new prescription drug program, Congress authorized the largest entitlement expansion since the Great Society. Casting aside proposals to fundamentally reform Medicare, Congress empowered Medicare’s hulking bureaucracy to enforce 1,100 pages of new regulations for the drug program alone. Meanwhile, America’s taxpayers are faced with a total Medicare long-term debt of $32.4 trillion, a stunning $8 trillion of which is directly attributable to the Medicare drug provisions alone. Congress has been warned repeatedly that the drug entitlement would impose huge costs but insists on ignoring these warnings.
Last year, the Senate ignored an innovative proposal by Senator John McCain (R–AZ) and Senate members of the Fiscal Watch Team to delay implementation of the drug program and instead create a drug benefit targeted to low-income seniors. In its place, the Senate proposed various administrative modifications, gutted the temporary incentives for the Medicare Advantage program, added new compliance rules on doctors and hospitals under the guise of “pay for performance,” and imposed insulting year-end delays of Medicare payment to doctors and hospitals. The House proposed exactly nothing. The final product was a watered-down version of the Senate bill.
This year, President Bush’s budget offered some modest initiatives, tinkering with government payment formulas and adding new “quality initiatives” and “competitive bidding” for clinical lab services, amounting to $36 billion in savings over five years. The Senate and House rejected even these modest, though flawed, changes.
Senate Grade: F
House Grade: F
Needed Improvements: Members of the House and Senate need to be more responsible and show some respect for current and future taxpayers. They should scale back the Medicare drug program to low-income seniors without coverage, accelerate means-testing for all medical services in Medicare, and start to replace Medicare’s current defined benefit program with a new defined contribution system for the 77 million baby boomers set to retire in five short years.
Additional Background: David C. John and Robert E. Moffit, Ph.D., “Medicare and Social Security: Big Entitlement Costs on the Horizon,” Heritage Foundation WebMemo No. 1054, May 1, 2006, at http://www.heritage.org/research/budget/wm1054.cfm.
Medicaid
Nina Owcharenko
With over 50 million enrollees, Medicaid—the joint federal–state government entitlement program for the poor and indigent—has compromised its mission to the poor: Efforts to expand coverage to new populations, loopholes enabling middle-class Americans to qualify for long-term care services, and cost containment measures such as low reimbursement rates for physicians and restricted access to prescription drugs directly affect the delivery of quality care. The National Governors’ Association reports that Medicaid has surpassed educational spending in the states and consumed 22 percent of state budgets in 2003. The program’s open-ended financing and rigid structural design contribute to short- and long-term federal budget problems.
In the Deficit Reduction Act, Congress made seemingly small but important changes in Medicaid. Congress slowed the overall rate of growth in the program and enacted key policy changes that give states greater flexibility in administering their Medicaid programs. For example, states can now vary benefit packages and cost-sharing requirements among Medicaid enrollees, implement consumer-directed models more easily, and consider a Health Savings Account–type arrangement. Moreover, stricter rules on eligibility for long-term care services were put in place, as were opportunities for states to partner with private long-term care insurance.
Since enacting these changes in the Deficit Reduction Act, the House and Senate have taken a passive status quo approach to Medicaid this year by monitoring the regulatory process and state response and action. The House Energy and Commerce Subcommittee on Health, however, held a hearing on “Planning for Long Term Care,” which shows an understanding that the Deficit Reduction Act did not put an end to Medicaid reform, but rather was simply the first step toward lasting reform.
Senate Grade: C
House Grade: B–
Needed Improvements: Slowing the rate of growth and providing greater flexibility to the states through the Deficit Reduction Act was a good first step, but Congress must now prepare to tackle the larger, more difficult issues surrounding this federal–state program for the poor. The House and Senate should begin by evaluating the program’s current federal matching structure and consider other changes that are consistent with the welfare reform model of reducing dependency and promoting self-sufficiency. The State Children’s Health Insurance Program (SCHIP) is up for reauthorization next year, and Congress should begin to explore ways to expand individual choice and encourage private insurance within this program as well.
Additional Background: Nina Owcharenko, “A Road Map for Medicaid Reform,” Heritage Foundation Backgrounder No. 1863, June 21, 2005, at http://www.heritage.org/research/healthcare/bg1863.cfm.
Health Care Reform
Robert E. Moffitt, Ph.D.
The Bush Administration’s health care reform principles include tax equity in health care insurance; the promotion of portability in health insurance coverage; expanding coverage and coverage options; improving health savings accounts; and advancing information technology, preventive care, and federal medical liability reform. Regrettably, these proposals do not go far enough to reduce the number of the uninsured, and the congressional response to the health care insurance problem has been tepid.
In 2005, the House of Representatives enacted the Small Business Health Fairness Act of 2005 (H.R. 525), creating association health plans, as well as federal medical malpractice reform. This narrow bill, however, provided only for business-based association health plans and ignored the need for individual membership association plans. A consumer-driven health care system would enable individuals and families to choose from a wide variety of options on a level playing field, not just employment-based options. The House leadership also ignored any serious tax credit proposal to help uninsured Americans secure private coverage. Moreover, the Health Care Choice Act, which would have allowed for interstate commerce in health insurance, allowing individuals and families to buy affordable coverage across state lines, was never even brought to the House floor for a vote.
In 2006, House and Senate leaders announced a summer “Health Week.” The Senate scheduled debate on the Health Insurance Marketplace Modernization and Affordability Act (S. 1955), which would have established small-business association plans and harmonized rules governing health insurance in the states. With growing liberal and conservative opposition, the Senate bill was blocked from floor consideration and a vote. In effect, the Senate “Health Week” agenda simply fizzled out. The House reportedly plans to schedule votes on health care legislation before the July 4 recess.
Senate Grade: D
House Grade: F
Needed Improvements: Members of the House and Senate should fix the inequitable and inefficient tax treatment of health insurance; at the very least, they should provide refundable tax credits to help individuals and families buy the health plans that they want. Moreover, Congress should not consider any health care legislation that does not expand personal control over health care dollars, expand consumer choice and competition, and reduce the already excessive level of health care regulation.
Additional Background: Robert E. Moffit and Nina Owcharenko, “A Serious Senate Agenda for ‘Health Week,’” Heritage Foundation WebMemo No. 1052, April 28, 2006, at http://www.heritage.org/research/healthcare/wm1052.cfm; Nina Owcharenko, Edmund F. Haislmaier, and Robert E. Moffit, “Competition and Federalism: The Right Remedy for Excessive Health Insurance Regulation,” Heritage Foundation WebMemo No. 1060, May 5, 2006, at http://www.heritage.org/research/healthcare/wm1060.cfm; and Edmund F. Haislmaier, Robert E. Moffit, and Nina Owcharenko, “A Good Start: The House Health Care Reform Bills,” Heritage Foundation WebMemo No. 803, July 22, 2005, at http://www.heritage.org/research/healthcare/wm803.cfm.

Conclusion
Although the time is short and the hurdles are daunting, there is no compelling reason why Members of Congress cannot rise to the challenge and raise their performance measures on these key domestic policy issues, many of which have already made some progress through the legislative process. Indeed, over the past few weeks, Congress has shown exceptional resolve on a number of controversial issues.
Specifically, the House defeated an effort to spend an additional $1.9 billion on air traffic controller compensation. House and Senate conferees stripped the Emergency Supplemental of egregious earmarks such as the $700 million for the “Train to Nowhere,” $3.5 billion in additional farm subsidies, and the $500 million payment to a profitable defense contractor. The House also defunded Alaska’s infamous “Bridge to Nowhere” and came very close to cutting Amtrak’s subsidy by $300 million.
If members of the House and Senate maintain this pace, they could very easily complete the needed work on the issues included in this third-quarter report card.
Brian M. Riedl is Grover M. Hermann Fellow in Federal Budgetary Affairs, Ronald D. Utt, Ph.D., is Herbert and Joyce Morgan Senior Research Fellow, David C. John is Senior Research Fellow for Retirement Security and Financial Institutions, Ben Lieberman is Senior Policy Analyst, and Daniel J. Mitchell, Ph.D., is McKenna Senior Research Fellow in the Thomas A. Roe Institute for Economic Policy Studies at The Heritage Foundation. Alison Acosta Fraser is Director of the Roe Institute. Robert E. Moffit, Ph.D., is Director of, and Nina Owcharenko is Senior Policy Analyst in, the Center for Health Policy Studies at The Heritage Foundation. Heritage Foundation intern Calley Means assisted in the preparation of this study.