Annual Statistical Supplement, 2009

Health Care Programs

Medicare

Trust Funds

Table 8.A1 Hospital Insurance, calendar years 1966–2008 (in millions of dollars)
Year Receipts Expenditures Trust fund assets at
end of year
Total Payroll taxes Income from taxation of benefits Transfers from Railroad Retirement account Reimbursements from general revenues for— Premiums from voluntary enrollees Interest on investments and other income a,b Total Benefit payments b,c Administrative expenses
Uninsured persons Military wage credits Amount d Percentage
of benefit payments
1966 1,943 1,858 . . . 16 26 11 . . . 32 999 891 108 12.1 944
1967 3,559 3,152 . . . 44 301 11 . . . 51 3,430 3,353 77 2.3 1,073
1968 5,287 4,116 . . . 54 1,022 22 . . . 74 4,277 4,179 99 2.4 2,083
1969 5,279 4,473 . . . 64 617 11 . . . 113 4,857 4,739 118 2.5 2,505
1970 5,979 4,881 . . . 66 863 11 . . . 158 5,281 5,124 157 3.1 3,202
1971 5,732 4,921 . . . 66 503 48 . . . 193 5,900 5,751 150 2.6 3,034
1972 6,403 5,731 . . . 63 381 48 . . . 180 6,503 6,318 185 2.9 2,935
1973 10,821 9,944 . . . 99 451 48 2 278 7,289 7,057 232 3.3 6,467
1974 12,024 10,844 . . . 132 471 48 5 523 9,372 9,099 272 3.0 9,119
1975 12,980 11,502 . . . 138 621 48 7 664 11,581 11,315 266 2.4 10,517
1976 13,766 12,727 . . . 143 e 141 9 746 13,679 13,340 339 2.5 10,605
1977 15,856 14,114 . . . f 803 e 143 g 12 784 16,019 15,737 283 1.8 10,442
1978 19,213 17,324 . . . 214 f 688 141 13 834 18,178 17,682 496 2.8 11,477
1979 22,825 20,768 . . . 191 734 141 16 975 21,073 20,623 450 2.2 13,228
1980 26,097 23,848 . . . 244 697 141 18 1,149 25,577 25,064 512 2.0 13,749
1981 35,725 32,959 . . . 276 659 207 22 1,603 30,726 30,342 384 1.3 18,748
1982 37,998 34,586 . . . 351 808 207 24 2,022 36,144 35,631 513 1.4 8,164 h
1983 44,570 37,259 . . . 358 878 3,456 i 27 2,593 39,877 39,337 540 1.4 12,858
1984 46,720 42,288 . . . 351 752 250 33 3,046 43,887 43,257 629 1.5 15,691
1985 51,397 47,576 . . . 371 766 j -719 41 3,362 48,414 47,580 834 1.8 20,499 h
1986 59,267 54,583 . . . 364 566 91 43 3,619 50,422 49,758 664 1.3 39,957 h
1987 64,064 58,648 . . . 368 447 94 38 4,469 50,289 49,496 793 1.6 53,732
1988 69,239 62,449 . . . 364 475 80 41 5,830 53,331 52,517 815 1.6 69,640
1989 76,721 68,369 . . . 379 515 86 55 7,317 60,803 60,011 792 1.3 85,558
1990 80,372 72,013 . . . 367 413 k -993 122 8,451 66,997 66,239 758 1.1 98,933
1991 88,839 77,851 . . . 352 605 89 432 9,510 72,570 71,549 1,021 1.4 115,202
1992 93,836 81,745 . . . 374 621 86 522 10,487 85,015 83,895 1,121 1.3 124,022
1993 98,187 84,133 . . . 400 367 81 675 12,531 l 94,391 93,487 904 1.0 127,818
1994 109,570 95,280 1,639 413 506 80 907 10,745 104,545 103,282 1,263 1.2 132,844
1995 115,027 98,421 3,913 396 462 61 954 10,820 117,604 116,368 1,236 1.1 130,267
1996 124,603 110,585 4,069 401 419 m -2,293 1,199 10,222 129,929 128,632 1,297 1.0 124,942
1997 130,154 114,670 3,558 419 481 70 1,319 9,637 139,452 137,762 1,690 1.2 115,643
1998 140,547 124,317 5,067 419 34 67 1,316 9,327 135,771 133,990 n 1,782 1.3 120,419
1999 151,597 132,306 6,552 430 652 71 1,447 10,139 130,632 128,766 n 1,866 1.4 141,385
2000 167,185 144,351 8,787 465 470 2 1,382 11,729 131,095 128,458 n 2,636 2.1 177,475
2001 174,630 151,994 7,533 470 453 o -1,175 1,370 13,986 143,379 141,183 n 2,195 1.6 208,726
2002 178,631 152,708 8,316 425 442 0 1,626 15,114 152,526 149,944 n 2,582 1.7 234,831
2003 175,812 149,242 8,318 426 393 0 1,604 15,828 154,616 152,084 n 2,533 1.7 256,026
2004 183,890 156,484 8,577 419 365 173 1,915 15,956 170,587 167,554 3,033 1.8 269,329
2005 199,374 171,384 8,765 445 286 0 2,416 16,078 182,933 180,013 p 2,920 1.6 285,770
2006 211,515 181,274 10,319 471 408 0 2,645 16,398 191,933 188,989 p 2,944 1.6 305,352
2007 223,717 191,855 10,593 483 468 0 2,841 17,477 203,058 200,151 p 2,907 1.5 326,011
2008 230,815 198,693 11,733 526 506 0 2,938 16,419 q 235,556 232,299 r 3,257 1.5 321,270
SOURCE: 2009 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds, Table III.B4, and analogous tables from earlier annual reports. Because the table published in the 2009 Annual Report displays dollars rounded to the tenths of billions, an analogous unpublished table displaying dollars rounded to the millions was also used.
NOTES: Totals do not necessarily equal the sum of rounded components.
. . . = not applicable; HI = Hospital Insurance; SMI = Supplementary Medical Insurance.
a. Other income includes recoveries of amounts reimbursed from the trust fund that are not obligations of the trust fund, receipts from the fraud and abuse control program (beginning in 1997), and other small amounts of miscellaneous income.
b. Values after 2005 include additional premiums for Medicare Advantage (MA) plans that are deducted from beneficiaries' Social Security checks. These additional premiums are beneficiary obligations and occur when a beneficiary chooses an MA plan whose monthly plan payment exceeds the benchmark amount. Beneficiaries subject to such premiums may choose to either reimburse the plans directly or have the premiums deducted from their Social Security checks. The premiums deducted from the Social Security checks are transferred to the HI and SMI trust funds and then transferred from the trust funds to the plans.
c. Includes costs of Peer Review Organizations from 1983 to 2001 (beginning with the implementation of the Prospective Payment System on October 1, 1983) and costs of Quality Improvement Organizations beginning in 2002.
d. Includes costs of experiments and demonstration projects. Beginning in 1997, includes fraud and abuse control expenses, as provided for by Public Law (P.L.) 104-191.
e. No transfer was made in 1976 because of the change in transfer dates from December to March. The 1977 transfer was for benefits and administrative expenses during the 15-month period beginning July 1976 and ending September 1977.
f. No transfer was made in 1977 because of the change in transfer dates from August to June. The 1978 transfer was for contributions during the 15-month period beginning July 1976 and ending September 1977.
g. Includes $2 million in reimbursement from general revenues for costs arising from the granting of deemed wage credits to persons of Japanese ancestry who were interned during World War II.
h. For 1982, assets exclude $12,437 million loaned to the OASI trust fund under the interfund borrowing provisions of the law. Repayments of $1,824 million and $10,613 million were made in 1985 and 1986, respectively.
i. The lump-sum general revenue transfer, as provided for by section 151 of P.L. 98-21.
j. Includes the lump-sum general revenue adjustment of -$805 million, as provided for by section 151 of P.L. 98-21.
k. Includes the lump-sum general revenue adjustment of -$1,100 million, as provided for by section 151 of P.L. 98-21.
l. Includes $1,805 million transfer from the SMI catastrophic coverage reserve fund, as provided for by P.L. 102-394.
m. Includes the lump-sum general revenue adjustment of -$2,366 million, as provided for by section 151 of P.L. 98-21.
n. Includes monies transferred to the SMI trust fund for home health agency costs, as provided for by P.L. 105-33.
o. Includes the lump-sum general revenue adjustment of -$1,177 million, as provided for by section 151 of P.L. 98-21.
p. Certain HI hospice costs were misallocated to, and paid from, the Part B account of the SMI trust fund. See also footnote r.
q. Includes an adjustment of -$853 million for interest inadvertently earned as a result of HI hospice costs that were misallocated to, and paid from, the Part B account of the SMI trust fund from May 2005 to September 2007.
r. Benefit payments were $223,815 million. Amount shown includes a transfer of $8,484 million to the general fund of the Treasury for HI hospice costs that were misallocated to, and paid from, the Part B account of the SMI trust fund from May 2005 to September 2007. (The general fund, in turn, transferred $8,484 million to the Part B account.)
CONTACT: Clare McFarland (410) 786-6390 or supplement@ssa.gov.
Table 8.A2 Supplementary Medical Insurance, calendar years 1966–2008 (in millions of dollars)
Year Receipts Expenditures Trust fund assets at
end of year a
Total Premiums from participants b Government contributions c Transfers from states d Interest
and other income e,f		 Total Benefit payments f,g,h Administrative expenses
Subtotal Part B Part D b Amount Percentage
of benefit payments
Aged Disabled
1966 324 322 322 . . . . . . 0 . . . 2 203 128 75 58.6 122
1967 1,597 640 640 . . . . . . 933 . . . 24 1,307 1,197 110 9.2 412
1968 1,711 832 832 . . . . . . 858 . . . 21 1,702 1,518 184 12.1 421
1969 1,839 914 914 . . . . . . 907 . . . 18 2,061 1,865 196 10.5 199
1970 2,201 1,096 1,096 . . . . . . 1,093 . . . 12 2,212 1,975 237 12.0 188
1971 2,639 1,302 1,302 . . . . . . 1,313 . . . 24 2,377 2,117 260 12.3 450
1972 2,808 1,382 1,382 . . . . . . 1,389 . . . 37 2,614 2,325 289 12.4 643
1973 3,312 1,550 1,491 59 . . . 1,705 . . . 57 2,844 2,526 318 12.6 1,111
1974 4,124 1,804 1,664 140 . . . 2,225 . . . 95 3,728 3,318 410 12.4 1,506
1975 4,673 1,918 1,759 158 . . . 2,648 . . . 107 4,735 4,273 462 10.8 1,444
1976 5,977 2,060 1,878 183 . . . 3,810 . . . 107 5,622 5,080 542 10.7 1,799
1977 7,805 2,247 2,030 217 . . . 5,386 . . . 172 6,505 6,038 467 7.7 3,099
1978 9,056 2,470 2,221 248 . . . 6,287 . . . 299 7,755 7,252 503 6.9 4,400
1979 9,768 2,719 2,451 267 . . . 6,645 . . . 404 9,265 8,708 557 6.4 4,902
1980 10,874 3,011 2,707 304 . . . 7,455 . . . 408 11,245 10,635 610 5.7 4,530
1981 15,374 3,722 i 3,356 i 366 i . . . 11,291 i . . . 361 14,028 13,113 915 7.0 5,877
1982 16,580 3,697 i 3,341 i 356 i . . . 12,284 i . . . 599 16,227 15,455 772 5.0 6,230
1983 19,824 4,236 3,845 391 . . . 14,861 . . . 727 18,984 18,106 878 4.8 7,070
1984 23,180 5,167 4,721 445 . . . 17,054 . . . 959 20,552 19,661 891 4.5 9,698
1985 25,106 5,613 5,105 508 . . . 18,250 . . . 1,243 23,880 22,947 933 4.1 10,924
1986 24,665 5,722 5,218 504 . . . 17,802 . . . 1,141 27,299 26,239 1,060 4.0 8,291
1987 31,844 7,409 j 6,747 j 661 j . . . 23,560 j . . . 876 31,740 30,820 921 3.0 8,394
1988 35,825 8,761 j 7,983 j 778 j . . . 26,203 j . . . 861 35,229 33,970 1,260 3.7 8,990
1989 44,349 k k,l 12,263 9,793 993 . . . 30,852 . . . 1,234 k 39,783 k 38,294 1,489 k 3.9 13,556 k
1990 45,913 11,320 10,311 1,008 . . . 33,035 . . . 1,558 43,987 42,468 1,519 3.6 15,482
1991 51,224 11,934 10,846 1,088 . . . 37,602 . . . 1,688 48,877 47,336 1,541 3.3 17,828
1992 57,237 14,077 m 12,814 m 1,263 m . . . 41,359 m . . . 1,801 50,830 49,260 1,570 3.2 24,235
1993 57,679 14,193 m 12,731 m 1,462 m . . . 41,465 m . . . 2,021 57,783 55,784 n 2,000 3.6 24,131
1994 55,608 17,386 15,569 1,817 . . . 36,203 . . . 2,018 60,317 58,618 1,699 2.9 19,422
1995 60,306 19,717 17,651 2,066 . . . 39,007 . . . 1,582 66,599 64,972 1,627 2.5 13,130
1996 85,609 18,763 16,654 2,109 . . . 65,035 . . . 1,811 70,408 68,598 1,810 2.6 28,332
1997 81,924 19,289 17,079 2,210 . . . 60,171 . . . 2,464 74,124 72,757 1,368 1.9 36,131
1998 87,711 20,933 o 18,594 o 2,338 o . . . 64,068 o . . . 2,711 77,630 76,125 p 1,505 2.0 46,212
1999 80,902 18,967 o 16,604 o 2,362 o . . . 59,095 o . . . 2,841 82,327 80,724 p 1,603 2.0 44,787
2000 89,903 20,555 17,892 2,664 . . . 65,898 . . . 3,450 90,663 88,893 p 1,770 2.0 44,027
2001 98,629 22,764 19,905 2,859 . . . 72,793 . . . 3,071 101,386 99,663 p 1,723 1.7 41,270
2002 106,196 25,066 21,610 3,456 . . . 78,338 . . . 2,792 113,165 110,969 p 2,196 2.0 34,301
2003 115,796 27,402 23,546 3,856 . . . 86,402 . . . 1,992 126,144 123,825 p 2,318 1.9 23,953
2004 133,787 31,435 26,737 4,699 . . . 100,858 . . . 1,495 138,311 135,418 2,893 2.1 19,430
2005 158,089 37,535 31,722 5,813 . . . 119,189 . . . 1,365 153,511 150,326 q 3,185 2.1 24,008
2006 225,525 46,337 r 36,346 6,507 3,484 r 171,910 5,474 1,804 216,414 213,045 q,r 3,369 1.6 33,119
2007 238,380 50,815 s 39,676 7,096 4,042 s 178,404 6,907 2,254 228,635 225,234 q,s 3,401 1.5 42,863
2008 249,994 55,231 t 42,335 7,897 4,999 t 184,055 7,105 3,604 u 232,565 229,295 t,v 3,269 1.4 60,293
SOURCES: 2009 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds, Table III.C1, analogous tables from earlier annual reports, and unpublished Treasury reports. Because the table published in the 2009 Annual Report displays dollars rounded to the tenths of billions, an analogous unpublished table displaying dollars rounded to the millions was also used.
NOTES: Totals do not necessarily equal the sum of rounded components.
. . . = not applicable; SMI = Supplementary Medical Insurance; HI = Hospital Insurance.
a. The financial status of SMI depends on both the assets and the liabilities of the trust fund.
b. For Part D, premiums include both amounts withheld from Social Security benefit checks (and certain other Federal benefit payments) and amounts paid directly to Part D plans; the premiums paid directly to Part D plans are not displayed on Treasury statements and are estimated.
c. For Part B, includes matching payments from the general fund, plus certain interest-adjustment items. For Part D, includes all federal government transfers, including amounts for the general subsidy, reinsurance, employer drug subsidy, low-income subsidy, administrative expenses, risk sharing, and state expenses for making low-income eligibility determinations. Includes amounts for the transitional assistance benefits in 2004–2007.
d. With the availability of Part D drug coverage and low-income subsidies beginning in 2006, Medicaid is no longer the primary payer for full-benefit dual eligibles. States are subject to a contribution requirement and must pay the Part D account in the SMI trust fund a portion of their estimated forgone drug costs for this population. Starting in 2006, states must pay 90 percent of the estimated costs, with this percentage phasing down over a 10-year period, to 75 percent in 2015 and later.
e. Other income includes recoveries of amounts reimbursed from the trust fund that are not obligations of the trust fund and other small amounts of miscellaneous income.
f. Values after 2005 include additional premiums for Medicare Advantage (MA) plans that are deducted from beneficiaries' Social Security checks. These additional premiums are beneficiary obligations and occur when a beneficiary chooses an MA plan whose monthly plan payment exceeds the benchmark amount. Beneficiaries subject to such premiums may choose either to reimburse the plans directly or have the premiums deducted from their Social Security checks. The premiums deducted from the Social Security checks are transferred to the HI and SMI trust funds and then transferred from the trust funds to the plans.
g. Includes costs of Peer Review Organizations from 1983 to 2001 and costs of Quality Improvement Organizations beginning in 2002.
h. For Part D, includes payments to plans, subsidies to employer-sponsored retiree prescription drug plans, payments to states for making low-income eligibility determinations, Part D drug premiums collected from beneficiaries and transferred to Medicare Advantage plans and private drug plans, and premium amounts paid directly by enrollees to plans. (The last item is on an estimated basis; see footnote b.) Includes amounts for the transitional assistance benefits in 2004–2007.
i. Section 708 of Title VII of the Social Security Act modified the provisions for the delivery of Social Security benefit checks when the regularly designated delivery day falls on a Saturday, Sunday, or legal public holiday. Delivery of benefit checks normally due January 1982 occurred on December 31, 1981. Consequently, the SMI premiums withheld from the checks ($264 million) and the associated general revenue contributions ($883 million) were added to the SMI trust fund on December 31, 1981. These amounts are excluded from the premium income and general revenue income for calendar year 1982.
j. Delivery of benefit checks normally due January 1988 occurred on December 31, 1987. Consequently, the SMI premiums withheld from the checks ($692 million) and the associated general revenue contributions ($2,178 million) were added to the SMI trust fund on December 31, 1987. These amounts are excluded from the premium income and general revenue income for calendar year 1988 (see footnote i).
k. Includes the impact of the Medicare Catastrophic Coverage Act of 1988 as provided for by Public Law (P.L.) 100-360.
l. Includes $1,477 million in catastrophic coverage premiums not distributed between aged and disabled enrollees. These premiums were transferred from the HI Catastrophic Coverage Reserve Fund, which was created by the Medicare Catastrophic Coverage Act of 1988. The Medicare Catastrophic Coverage Repeal Act of 1989 mandated that this fund be discontinued and the balance transferred to the SMI trust fund.
m. Delivery of benefit checks normally due January 1993 occurred on December 31, 1992. Consequently, the SMI premiums withheld from the checks ($1,089 million) and the associated general revenue contributions ($3,175 million) were added to the SMI trust fund on December 31, 1992. These amounts are excluded from the premium income and general revenue income for calendar year 1993 (see footnote i).
n. Includes the impact of the transfer to the Hospital Insurance (HI) trust fund of the SMI catastrophic coverage reserve fund on March 31, 1993, as specified in P.L. 102-394. Actual benefit payments for 1993 were $53,979 million, and the amount transferred was $1,805 million.
o. Delivery of benefit checks normally due January 1999 occurred on December 31, 1998. Consequently, the SMI premiums withheld from the checks ($1,512 million) and the associated general revenue contributions ($4,711 million) were added to the SMI trust fund on December 31, 1998. These amounts are excluded from the premium income and general revenue income for calendar year 1999 (see footnote i).
p. Benefit payments less monies transferred from the HI trust fund for home health agency costs, as provided for by P.L. 105-33.
q. Certain HI hospice costs were misallocated to, and paid from, the Part B account of the SMI trust fund. See also footnote v.
r. Includes an estimated $2,299 million for premiums paid directly to Part D plans. See also footnotes b and h. Estimates for 2006 are revised.
s. Includes an estimated $2,376 million for premiums paid directly to Part D plans. See also footnotes b and h. Estimates for 2007 are revised.
t. Includes an estimated $3,125 million for premiums paid directly to Part D plans. See also footnotes b and h.
u. Includes an adjustment of $812 million for interest inadvertently not earned as a result of HI hospice costs that were misallocated to, and paid from, the Part B account of the SMI trust fund from May 2005 to September 2007.
v. Benefit payments were $237,779 million. Amount shown includes -$8,484 million, which represents a transfer from the general fund of the Treasury to the Part B account of the SMI trust fund for HI hospice costs that were misallocated to, and paid from, the Part B account from May 2005 to September 2007. (The HI trust fund, in turn, transferred $8,484 million to the general fund.)
CONTACT: Suzanne Codespote (410) 786-7737 or supplement@ssa.gov.