[Senate Hearing 118-711]
[From the U.S. Government Publishing Office]
______
S. Hrg. 118-711
NOMINATIONS OF MARJORIE A. ROLLINSON,
PATRICIA HART NEUMAN, AND
DEMETRIOS L. KOUZOUKAS
=======================================================================
HEARING
before the
COMMITTEE ON FINANCE
UNITED STATES SENATE
ONE HUNDRED EIGHTEENTH CONGRESS
FIRST SESSION
on the
NOMINATIONS OF
MARJORIE A. ROLLINSON, TO BE CHIEF COUNSEL, INTERNAL REVENUE SERVICE,
DEPARTMENT OF THE TREASURY; PATRICIA HART NEUMAN, TO BE A MEMBER OF THE
BOARD OF TRUSTEES OF THE FEDERAL OLD-AGE AND SURVIVORS INSURANCE TRUST
FUND AND THE FEDERAL DISABILITY INSURANCE TRUST FUND, THE BOARD OF
TRUSTEES OF THE FEDERAL HOSPITAL INSURANCE TRUST FUND, AND THE BOARD OF
TRUSTEES OF THE FEDERAL SUPPLEMENTARY MEDICAL INSURANCE TRUST FUND; AND
DEMETRIOS L. KOUZOUKAS, TO BE A MEMBER OF THE BOARD OF TRUSTEES OF THE
FEDERAL OLD-AGE AND SURVIVORS INSURANCE TRUST FUND AND THE FEDERAL
DISABILITY INSURANCE TRUST FUND, THE BOARD OF TRUSTEES OF THE FEDERAL
HOSPITAL INSURANCE TRUST FUND, AND THE BOARD OF TRUSTEES OF THE FEDERAL
SUPPLEMENTARY MEDICAL INSURANCE TRUST FUND
__________
SEPTEMBER 28, 2023
__________
Printed for the use of the Committee on Finance
COMMITTEE ON FINANCE
RON WYDEN, Oregon, Chairman
DEBBIE STABENOW, Michigan MIKE CRAPO, Idaho
MARIA CANTWELL, Washington CHUCK GRASSLEY, Iowa
ROBERT MENENDEZ, New Jersey JOHN CORNYN, Texas
THOMAS R. CARPER, Delaware JOHN THUNE, South Dakota
BENJAMIN L. CARDIN, Maryland TIM SCOTT, South Carolina
SHERROD BROWN, Ohio BILL CASSIDY, Louisiana
MICHAEL F. BENNET, Colorado JAMES LANKFORD, Oklahoma
ROBERT P. CASEY, Jr., Pennsylvania STEVE DAINES, Montana
MARK R. WARNER, Virginia TODD YOUNG, Indiana
SHELDON WHITEHOUSE, Rhode Island JOHN BARRASSO, Wyoming
MAGGIE HASSAN, New Hampshire RON JOHNSON, Wisconsin
CATHERINE CORTEZ MASTO, Nevada THOM TILLIS, North Carolina
ELIZABETH WARREN, Massachusetts MARSHA BLACKBURN, Tennessee
Joshua Sheinkman, Staff Director
Gregg Richard, Republican Staff Director
(II)
C O N T E N T S
----------
OPENING STATEMENTS
Page
Wyden, Hon. Ron, a U.S. Senator from Oregon, chairman, Committee
on Finance..................................................... 2
Crapo, Hon. Mike, a U.S. Senator from Idaho...................... 4
ADMINISTRATION NOMINEES
Rollinson, Marjorie A., nominated to be Chief Counsel, Internal
Revenue Service, Department of the Treasury, Washington, DC.... 7
Neuman, Patricia Hart, Sc.D., nominated to be a member of the
board of trustees of the Federal Old-Age and Survivors
Insurance trust fund and the Federal Disability Insurance trust
fund, the board of trustees of the Federal Hospital Insurance
trust fund, and the board of trustees of the Federal
Supplementary Medical Insurance trust fund, Washington, DC..... 8
Kouzoukas, Demetrios L., nominated to be a member of the board of
trustees of the Federal Old-Age and Survivors Insurance trust
fund and the Federal Disability Insurance trust fund, the board
of trustees of the Federal Hospital Insurance trust fund, and
the board of trustees of the Federal Supplementary Medical
Insurance trust fund, Washington, DC........................... 10
ALPHABETICAL LISTING AND APPENDIX MATERIAL
Crapo, Hon. Mike:
Opening statement............................................ 4
Prepared statement........................................... 43
Kouzoukas, Demetrios L.:
Testimony.................................................... 10
Prepared statement........................................... 44
Biographical information..................................... 45
Responses to questions from committee members................ 52
Neuman, Patricia Hart, Sc.D.:
Testimony.................................................... 8
Prepared statement........................................... 58
Biographical information..................................... 59
Responses to questions from committee members................ 88
Rollinson, Marjorie A.:
Testimony.................................................... 7
Prepared statement........................................... 89
Biographical information..................................... 90
Responses to questions from committee members................ 145
Warren, Hon. Elizabeth:
Letters submitted for the record............................. 167
Wyden, Hon. Ron:
Opening statement............................................ 2
Prepared statement........................................... 169
(III)
NOMINATIONS OF MARJORIE A. ROLLINSON,
TO BE CHIEF COUNSEL, INTERNAL REVENUE
SERVICE, DEPARTMENT OF THE TREASURY;
PATRICIA HART NEUMAN, TO BE A MEMBER
OF THE BOARD OF TRUSTEES OF THE
FEDERAL OLD-AGE AND SURVIVORS
INSURANCE TRUST FUND AND THE FEDERAL
DISABILITY INSURANCE TRUST FUND, THE
BOARD OF TRUSTEES OF THE FEDERAL
HOSPITAL INSURANCE TRUST FUND, AND
THE BOARD OF TRUSTEES OF THE
FEDERAL SUPPLEMENTARY MEDICAL
INSURANCE TRUST FUND; AND DEMETRIOS L.
KOUZOUKAS, TO BE A MEMBER OF THE
BOARD OF TRUSTEES OF THE FEDERAL
OLD-AGE AND SURVIVORS INSURANCE TRUST
FUND AND THE FEDERAL DISABILITY
INSURANCE TRUST FUND, THE BOARD OF
TRUSTEES OF THE FEDERAL HOSPITAL
INSURANCE TRUST FUND, AND THE BOARD
OF TRUSTEES OF THE FEDERAL
SUPPLEMENTARY MEDICAL
INSURANCE TRUST FUND
----------
THURSDAY, SEPTEMBER 28, 2023
U.S. Senate,
Committee on Finance,
Washington, DC.
The hearing was convened, pursuant to notice, at 10:05
a.m., in Room SD-215, Dirksen Senate Office Building, Hon. Ron
Wyden (chairman of the committee) presiding.
Present: Senators Crapo, Cardin, Bennet, Casey, Whitehouse,
Hassan, Cortez Masto, Warren, Crapo, Grassley, Thune, Lankford,
Daines, Young, and Blackburn.
Also present: Democratic Staff: Eva DuGoff, Senior Health
Advisor; Eric LoPresti, Detailee; Sarah Schaefer, Chief Tax
Advisor; Joshua Sheinkman, Staff Director; Tiffany Smith,
Deputy Staff Director and Chief Counsel; and Ryder Tobin,
Senior Investigative Counsel and Nominations Advisor.
Republican Staff: Becky Cole, Chief Economist; Erin Dempsey,
Deputy Health Policy Director; Michael Gould, Tax Counsel;
Kellie McConnell, Health Policy Director; Gregg Richard, Staff
Director; Lara Rosner, Social Security Policy Advisor; Don
Snyder, Senior Tax and Oversight Counsel; and James Williams,
Tax and Economic Policy Advisor.
OPENING STATEMENT OF HON. RON WYDEN, A U.S. SENATOR FROM
OREGON, CHAIRMAN, COMMITTEE ON FINANCE
The Chairman. The Finance Committee will come to order. The
Finance Committee meets this morning to discuss an important
set of nominations that are instrumental to the Federal
Government's finances. First will be the nomination of Marjorie
Rollinson to be Chief Counsel at the IRS.
The Chief Counsel's Office is responsible for ensuring that
the agency is implementing tax law by the books. It is
difficult to overstate the importance of this responsibility,
but we are very pleased that the President has sent the Finance
Committee such a qualified nominee.
Ms. Rollinson has spent decades in tax and management
fields in both the public and the private sector, including
several years at the Office of Chief Counsel she's been
nominated to run. If confirmed, she would be the first woman to
serve as Chief Counsel.
As colleagues are aware, the IRS is waist deep in its work
to issue guidance related to the Inflation Reduction Act.
Having a confirmed Chief Counsel will ensure this work is
carried out to the letter of the law. This is particularly
important as this committee, for example, spent years and
years, Ms. Rollinson, working on the clean energy tax credits
and the prescription drug issue in particular.
Now, the Chief Counsel's Office also has an important role
in the IRS's effort to move away from auditing low-income and
middle-class Americans and towards complex pass-throughs and
wealthy individuals. This goes right to the heart of reality in
the tax code. Working Americans, mostly low- and middle-income,
overwhelmingly comply with the law because their information is
automatically passed on to the agency through payroll.
On the other side of the coin are the complicated pass-
throughs and other structures often designed by the wealthy
especially for tax avoidance. I expect any Chief Counsel to
provide support for the agency's effort to put more attention
on billion-dollar partnerships rather than low-income
individuals, and to ensure that legal strategy is sound, as I
have little doubt that those who have made vast sums through
tax avoidance schemes will be fighting this fresh approach with
a legion, a huge number of lawyers and accountants.
It is no secret, as you know, Ms. Rollinson, that Democrats
and Republicans have differing views about how the IRS should
operate. The position of the Chief Counsel has historically
been one that has received bipartisan support, and it is my
hope that that will remain true with Ms. Rollinson's
nomination.
The last Chief Counsel, Michael Desmond, was reported out
of the Finance Committee with a 26-to-2 vote, and was confirmed
by the Senate 84 to 15. I hope, colleagues, we can maintain
this record of bipartisan support.
Now, on to the public trustees. The board of trustees of
Social Security and Medicare is responsible for issuing annual
reports to Congress on the status of the trust funds that
ensure Americans receive their earned benefits now and into the
future. The board is made up of six members: the Treasury
Secretary, the Secretary of Labor, the Secretary of Health and
Human Services, the Commissioner of Social Security, as well as
two public trustees.
The board has been without public trustees for over 8
years. Unlike most nominations that come before us, the public
trustees do not represent the views of the President or the
agencies they will be managing. The public trustees represent
the American people, ensuring their voices and their views are
represented in the annual reports that are done.
The Finance Committee has long held the view that when the
term of a public trustee expires, a new public trustee must be
nominated to bring fresh views to the board. That is going to
include insight on emerging trends in Medicare, like how to
update and strengthen the Medicare guarantee, which has been a
special priority of this committee. We were led by the late,
and I feel great, Senator Orrin Hatch, who led us in this
transformation of Medicare away from acute illness only, to
dealing with cancer and diabetes and heart disease, stroke, and
all of the chronic illnesses.
So, these are the kinds of issues that the group is going
to have to tackle, and seniors are counting on leadership in
areas like chronic care, that has its roots in the bipartisan
work in this committee, and I was honored to have worked with
Senator Hatch on it.
I am glad to see we are going to have two new faces before
the committee, although they need little in the way of
introduction. Patricia Neuman is basically a household name for
all of us who have been toiling on these issues, and for me it
goes back to my Gray Panthers days. She has been a household
word on Medicare policy and finances, and is a long-time leader
at the Kaiser Family Foundation.
She worked in both the House and the Senate, and when
Americans read news articles about health-care policy, there is
a very high probability that Ms. Neuman will have been
interviewed for the article.
Demetrios Kouzoukas has been nominated to fill the
Republican slot for the public trustee. He has extensive
experience across our Federal health programs, serving at both
Health and Human Services and the Centers for Medicare and
Medicaid, as well as a variety of roles in the private sector.
Both nominees, in my view, have the experience needed to
represent the public and ensure the integrity of the board's
reports.
I would like to emphasize that this role requires putting
the public interest first, not the interest and values of your
day job and other financial relationships. The financial future
of both Social Security and Medicare are very much on the minds
of families across the country, as well as lawmakers.
What we will have to do is chart a course that will protect
and strengthen America's earned benefits. So, we thank the
trustees for considering this role, as it is going to require a
substantial amount of time, many dozens of hours of work each
year, and sweat equity to fulfill this public service.
So, I want to congratulate all three nominees and thank
them for joining the committee today. I support all of these
choices. And after Senator Crapo makes his opening remarks, we
have a few routine questions that we ask nominees, and then we
will go forward with our discussion.
Senator Crapo?
[The prepared statement of Chairman Wyden appears in the
appendix.]
OPENING STATEMENT OF HON. MIKE CRAPO,
A U.S. SENATOR FROM IDAHO
Senator Crapo. Thank you very much, Mr. Chairman, and
welcome to our three nominees: Dr. Neuman and Mr. Kouzoukas,
who have been nominated to be the public trustees of Social
Security and Medicare; and Ms. Rollinson, who has been
nominated to be the IRS Chief Counsel. Thank you all for your
willingness to serve.
The trustees are responsible for producing annual reports
that equip Congress and the administration with data needed to
safeguard the long-term security and financial viability of the
Social Security and Medicare trust funds.
Congress added the public trustee positions in 1983 to
increase public confidence in the integrity of the trust funds
and the objectivity of the trustees' reports. The public
trustees are tasked with providing objective, dispassionate
accounts of exactly what is happening with the trust funds.
If confirmed, you must ensure the public has a balanced,
pragmatic understanding of the opportunities and the challenges
that face the two programs, and I look forward to hearing from
both of you today.
Ms. Rollinson, the IRS Chief Counsel is responsible for
fairly and impartially interpreting and enforcing our tax laws,
while also ensuring taxpayer rights are strictly protected.
Given recent IRS controversies and the push for enhanced
enforcement, Americans are rightly concerned with the potential
erosion of their rights and privacy.
The IRS Chief Counsel must have the highest level of skill,
judgment, and integrity above all, and must not let political
pressures affect policy outcomes. Unfortunately, the agencies
to which you have been nominated for key posts have recently
made repeated practice of putting politics first.
My colleagues and I have raised a number of concerns with
recent IRS and Treasury actions that will fall under your
remit. Interpreting the so-called Inflation Reduction Act is
squarely within the IRS Chief Counsel's purview. The IRA
created complexity that has proven unworkable in
implementation, putting many American businesses and consumers
at a significant disadvantage, and has supercharged IRS
enforcement while shortchanging taxpayer service.
Since the bill's rushed and strictly partisan passage, the
Biden administration has resorted to unilaterally walking back
and diluting a number of its own key provisions. The IRS has
simply disregarded statutory deadlines for implementing new
Democrat-led provisions, including enhanced information
reporting and EV tax credits.
Further, Treasury and the IRS's expansive interpretation of
IRA's energy tax provisions has provoked significant criticism
from both sides of the aisle. Other provisions have gone into
effect without necessary guidance, leaving taxpayers without
information needed to comply. I look forward to hearing how you
will address these concerns and use your expertise to put
adherence to the law over desired political outcomes.
If confirmed, you will also have a significant role in
addressing a number of other recent concerning IRS actions: use
of IRA funds to increase enforcement in areas with a long
history of burdensome and low-utility, or ``no change'' audits;
leaks of confidential taxpayer information; destruction of 30
million information returns, which reportedly led to additional
audits of Earned Income Tax Credit claimants; and the ongoing
attempt to stand up and divert resources to an IRS-run tax
preparation program without statutory authority.
The administration's practice of putting politics before
sound policy extends to its failure to protect U.S. interests
in the OECD international tax negotiations. Rather than focus
on fighting discriminatory taxes against U.S. companies and
defending current U.S. law, Treasury has placed the
administration's political agenda first, without regard to the
potential effect on U.S. taxpayers.
This administration failed to halt discriminatory digital
services taxes against U.S. companies, but instead invited
foreign governments to pursue new discriminatory taxes against
our companies in the form of the Under-Taxed Profits Rule, a
surtax which also violates our existing bilateral tax treaties.
As a collateral consequence, Treasury must now exhaust
precious resources, issuing regulations to attempt to mitigate
the double taxation it has created by unilaterally committing
to a global tax deal that undermines U.S. interests. To avoid
these outcomes, I stress the importance of engaging this
committee with transparency and responsiveness.
Too often in recent years, the administration's nominees
have committed to working with us, but have failed to follow
through. On behalf of all American taxpayers, I strongly urge
our nominees here today to commit to timely and thorough
communication with this committee.
Again, I congratulate you on your nominations. And, Ms.
Rollinson, I know you were not there when all the things I just
described happened, but you are going there now, probably. So I
hope that we can have a constructive conversation about how to
deal with these issues during the hearing today and as we move
forward.
Thank you, Mr. Chairman.
[The prepared statement of Senator Crapo appears in the
appendix.]
The Chairman. Thank you, Senator Crapo. And I just want to
say as we begin this hearing, certainly we know that Democrats
and Republicans have some differing views on a number of these
tax issues. Senator Crapo and I always say we are going to work
to try to find common ground wherever possible, and I
appreciate my colleague doing it.
Okay. We are going to introduce our first two nominees. I
will take care of that, and then we are going to have Senator
Cardin introduce our friend, Ms. Neuman.
Ms. Rollinson has decades of tax management experience in
both the public and private sector, including several years at
the Office of the Chief Counsel that she has been nominated to
run.
Demetrios Kouzoukas has been nominated to fill the
Republican slot for the public trustee position. He has
extensive experience across our Federal health programs,
serving both Health and Human Services and the Centers for
Medicare and Medicaid Services, as well as a variety of roles
in the private sector.
Now I am going to turn it over to Senator Cardin to
introduce our final nominee, and he is a lucky fellow to do it,
because we are all people who have worked closely with Ms.
Neuman over the years.
Senator Cardin?
Senator Cardin. Well, thank you, Mr. Chairman, for
recognizing that. You might ask why am I asked to introduce Ms.
Neuman? She is a resident of the District of Columbia, but
Senator Van Hollen and I have sort of adopted the people of the
District, until we do the right thing and give them their own
representatives here in the United States Senate.
But there is another reason I asked to introduce Ms.
Neuman. She has deep roots in Baltimore and my State. It was
her great great grandfather who started the Haas Tailoring
Company, and I mention that because Baltimore, if you go back
about 100 years ago, one of its leading sectors was the garment
and tailoring sector. It was a major part of our economy, and
Haas Tailoring was a high-end tailoring and added to the
richness of Baltimore and its history. So for all those
reasons, it is really my pleasure.
And then the last reason I wanted to take this time, as the
chairman pointed out, is Ms. Neuman served on the Ways and
Means Committee as staff for the Health Subcommittee.
I had the honor of serving on the Ways and Means Health
Subcommittee. I know personally of her dedication, experience,
and work there, and we could not have a stronger candidate
nominee for this particular position. She also served on the
staff of the Senate Committee on Aging.
So she comes with broad, broad experience, and as you
pointed out, she is a nationally recognized Medicare expert
with extensive knowledge on issues associated with coverage,
affordability, spending, and financing care of older Americans
and people with disabilities--proposals to sustain Medicare for
the future.
Dr. Neuman has testified before our committees on numerous
occasions, and she has written extensively in this area. So, we
have a real expert.
I will just give you one last point. Senator Bennet asked
that I acknowledge the fact that she went to the right
undergraduate school, Wesleyan, the same school that Senator
Bennet went to.
For all those reasons, I would urge this committee to
promptly confirm her nomination.
The Chairman. Well said, Senator Cardin.
Let's have our nominees' opening statements. Then we've got
some procedural issues to take care of really quickly, and I
know Senators have questions. Let us begin in terms of openers
with you, Ms. Rollinson.
STATEMENT OF MARJORIE A. ROLLINSON, NOMINATED TO BE CHIEF
COUNSEL, INTERNAL REVENUE SERVICE, DEPARTMENT OF THE TREASURY,
WASHINGTON, DC
Ms. Rollinson. Thank you so much, Chairman Wyden, Ranking
Member Crapo, and members of the committee. I am honored to be
here today as the nominee for Chief Counsel for the Internal
Revenue Service. I want to thank the committee for considering
my nomination, and also the President for placing his
confidence in me.
I would not be here today without the support and
encouragement of my entire family, most especially my husband
Harry of 36 years, my daughters Emma and Claire, and my mother.
My mother Barbara Rollinson, my daughter Claire Oxford, my
sister Barbara Rollinson, and my sister Amy Rubrill are here
with me today. They always inspire me to be and do my best.
I grew up in the DC area surrounded by dedicated public
servants. From a young age, I learned the importance and
dignity of hard work done well. My mother, who raised me and my
three sisters, founded a nursery school. I was in her first
class. She worked there until she retired almost 40 years
later, and helped hundreds of children during the most critical
phase of their development.
My husband Harry spent over half his career teaching in
Virginia public schools. Knowing just how wonderful he is as a
father, I can appreciate the tremendous impact he had on the
lives of his students.
The example of my many friends and family in public service
is what is calling me out of retirement today, in hopes of
becoming IRS Chief Counsel. This is a critical time for the
IRS. The agency has lacked adequate resources for decades, but
with increased funding the IRS can develop into a world-class
organization and promote a fairer tax system.
The IRS also is at the forefront of implementing a
substantial number of recent tax law changes. These efforts
require tireless work from the Office of Chief Counsel, and I
am eager to lead those efforts. My tax technical experience and
leadership experience from time in both the private and public
sectors have prepared me to help the IRS meet these challenges.
I have spent most of my career at Ernst and Young, where I
had many wonderful mentors who taught me valuable lessons about
leadership, collaboration, and serving with integrity. I also
had the privilege of spending more than 5 years at the Office
of Chief Counsel. There I saw employees who exhibited a deep
commitment to integrity, and a profound dedication to the
mission.
Treating taxpayers fairly was the core of everything Chief
Counsel employees did, and it would be the capstone of my
career to serve alongside them again, if I am privileged enough
to be confirmed. Throughout my career, I have learned that
being a successful leader means drawing on the expertise of my
staff, making sure everyone understands the mission, and always
celebrating successes.
I deeply enjoy technical tax work, but what I find most
rewarding is motivating staff to produce exceptional results
and reach their goals.
I look forward to answering your questions and, if
confirmed, to being a close partner to this committee and the
Congress. Thank you.
[The prepared statement of Ms. Rollinson appears in the
appendix.]
The Chairman. Very good.
Dr. Neuman?
STATEMENT OF PATRICIA HART NEUMAN, Sc.D, NOMINATED TO BE A
MEMBER OF THE BOARD OF TRUSTEES OF THE FEDERAL OLD-AGE AND
SURVIVORS INSURANCE TRUST FUND AND THE FEDERAL DISABILITY
INSURANCE TRUST FUND, THE BOARD OF TRUSTEES OF THE FEDERAL
HOSPITAL INSURANCE TRUST FUND, AND THE BOARD OF TRUSTEES OF THE
FEDERAL SUPPLEMENTARY MEDICAL INSURANCE TRUST FUND, WASHINGTON,
DC
Dr. Neuman. Thank you, Chairman Wyden, Ranking Member
Crapo, and members of this committee. I am honored to be here
today to be considered for the public trustee position for the
Medicare, Social Security, and Disability Insurance trust
funds, along with my colleague Demetrios Kouzoukas.
I appreciate your taking the time for this hearing. I am
deeply grateful to President Biden for nominating me to be
considered for this important position. I am also so grateful
for the support of my family, my friends, and colleagues--some
of whom are here today--and especially my husband Perry
Pockros, my daughter Julia, and my son Ben.
Social Security and Medicare are bedrock programs for our
Nation, providing health and economic security to tens of
millions of Americans, mostly older adults but also younger
people with permanent disabilities, among others. These
programs enjoy broad support among the general public, because
Americans understand the vital role that they play.
It is difficult to imagine how families would manage
without the financial protections provided by Social Security
and Medicare. Clearly, Social Security and Medicare face
financial challenges that will require attention in the not-
too-distant future, with an aging population; a declining
worker-to-retiree ratio; and in the case of Medicare, rising
health-care costs.
Both the Social Security and Medicare Hospital Insurance
trust funds are projected to have insufficient funds to fully
cover obligated expenses by the end of the coming decade. Each
year, the trustees issue a report on the financial status of
these programs. The role of the public trustee is to assure the
public of the integrity of the operations and sustainability of
the trust funds, and to help the public understand the fiscal
challenges these programs face.
The trustees work closely with the actuaries from the
Department of Health and Human Services and the Social Security
Administration to be sure that the projections are based on
sound assumptions, the right questions are being asked, and the
presentation of findings is clear, all while recognizing that
modeling is by its very nature an inexact science.
In some ways, I have prepared for this position for my
entire professional life, working on issues related to health
and retirement security for older Americans. My first job on
Capitol Hill was on the staff of the Senate Special Committee
on Aging, chaired by Senator John Heinz, working right here in
the Dirksen Building.
I went on to be trained as a researcher at what is now
called the Johns Hopkins Bloomberg School of Public Health,
where I received a master's degree in health finance and then a
doctorate in health policy. I later served on the professional
staff of the House Ways and Means Committee, Subcommittee on
Health, where the annual report of the Medicare trustees was a
major focus of our work.
Currently, I am a senior vice president, the executive
director of our program on Medicare Policy, and senior advisor
to the CEO at KFF, formerly known as the Kaiser Family
Foundation. Our mission at KFF is to serve as a nonpartisan
source of information for policymakers, the media, the health
policy community, and the public. We do not take policy
positions, similar to the role of the public trustees.
At KFF, I have conducted and directed research, written
numerous papers, and spoken to a broad set of audiences about
Medicare and related issues. I have examined options to
strengthen the financial solvency of the trust fund. I have
been a resource for policymakers and others in explaining the
challenges facing Medicare and the implications for
beneficiaries and program spending.
Collectively, this work has provided the foundational
knowledge and experience needed to carry out the
responsibilities of a public trustee. I understand that the
primary role of a public trustee is to assure the integrity and
objectivity of the projections and that this is not a
policymaking role.
Relatedly, I understand that the data and the analysis and
other information included in the reports are essential to the
important work of policymakers. I believe I have the analytic
skills required to fulfill the role, and the communication
skills to convey this information clearly.
Since I was first nominated, I have been genuinely moved by
the reactions of family members, friends, and colleagues of all
ages, all of whom thanked me in advance for being willing to do
my part as a public trustee, if I am confirmed.
They thank me mainly because they are counting on Medicare
and Social Security to be in strong fiscal shape to support
their health and financial security in retirement, and so am I.
If I am confirmed for this position, I will work to the best of
my ability to fulfill the responsibilities with rigor and
integrity, and I would be honored to serve in this role, and I
look forward to your questions.
[The prepared statement of Dr. Neuman appears in the
appendix.]
The Chairman. Thank you very much. I also remember those
days working with Senator Heinz, whom you were referring to,
because he was hugely helpful as we closed one of the colossal
rip-offs seniors faced with these Medigap policies, where they
would buy counterfeit policies that were not worth the paper
they were written on. So I appreciate that history.
Mr. Kouzoukas, welcome.
STATEMENT OF DEMETRIOS L. KOUZOUKAS, NOMINATED TO BE A MEMBER
OF THE BOARD OF TRUSTEES OF THE FEDERAL OLD-AGE AND SURVIVORS
INSURANCE TRUST FUND AND THE FEDERAL DISABILITY INSURANCE TRUST
FUND, THE BOARD OF TRUSTEES OF THE FEDERAL HOSPITAL INSURANCE
TRUST FUND, AND THE BOARD OF TRUSTEES OF THE FEDERAL
SUPPLEMENTARY MEDICAL INSURANCE TRUST FUND, WASHINGTON, DC
Mr. Kouzoukas. Thank you, Mr. Chairman, Ranking Member
Crapo, and members of the committee. I would like to thank
President Biden for the honor of placing my nomination before
the Senate, and Senate minority leader McConnell for the trust
he placed in me in putting my name forward for the position.
I also thank Dr. Neuman for her collegiality and
professionalism, as we have gone through this process of being
considered together. And I am deeply grateful for the support
of my family, friends, and colleagues, including those watching
from home.
We often hear and talk about how the Social Security and
Medicare programs make up the largest portion of the Federal
budget, and a substantial portion of our Nation's gross
domestic product. It is hard to overstate the fiscal, societal,
and economic impact of these programs, and each of us can see
the role the programs play in the lives of every American
family, whether in paying taxes or as beneficiaries of the
programs, now or in future generations.
In our Constitution, the people vest Congress with the
powers of taxation and spending that underlie these programs.
Given their importance and size, it is imperative that Congress
and the public have the most accurate and objective information
possible about their status and funding.
After all, as Abraham Lincoln is reputed to have said,
``Let the people know the facts, and the country will be
saved.'' The work of the public trustees is essentially to help
ascertain and publish these facts, while being independent of
administering the programs day to day.
This includes witnessing the objectivity and integrity of
the assumptions and calculations, as well as participating in
the associated internal dialogue and deliberations. The result
is enhanced public confidence in the trustees' work.
For me, the opportunity to be considered for this role is
meaningful and humbling, and it is for reasons beyond these
solemn goals or my professional journey. It is also personal.
My first interactions with these programs were as a child of a
parent with disabling and early chronic diseases.
The challenge our immigrant parents had navigating the
health-care and retirement systems planted a powerful seed.
That seed has grown and nourished the perspective that I have
brought to my work throughout my career, especially as a public
servant. Along the way, I have had the honor to work for the
U.S. Department of Health and Human Services in several
different capacities, including at the Centers for Medicare and
Medicaid Services, and from time to time partnering with the
Social Security Administration.
I have also served as a member of the Administrative
Conference of the United States, representing the public to
provide advice to the Federal Government based on my experience
in public administration and benefits programs. These roles,
built on others in the private sector, have allowed me to
develop knowledge and skills especially relevant to the work of
the trustees.
For example, early in my career I worked at a nonprofit
dedicated to improving public employee pension systems,
including their intersection with Social Security. That
provided me with a foundation in retirement policy and social
insurance concepts, and it led to my work in health care as
well.
Later, as both a government lawyer and administrator, I
developed a background in Federal appropriations law and
accounting processes. I have worked extensively with actuaries
in the private and public sectors, including the Office of the
Actuary at the Centers for Medicare and Medicaid Services.
I was particularly honored to represent the Centers for
Medicare and Medicaid Services at the meeting to issue the 2017
Medicare trustees report, where I served as Secretary at the
meeting and signed the report. Finally, as a government
employee, I have testified before and worked with Congress on
complex and technical topics like those addressed by the
trustees. These collective personal and professional
experiences afford me the knowledge, institutional memory, and
judgment to represent the public in the work of the trustees.
If confirmed, I would work to the best of my abilities to
fulfill the expectations of the Greenspan Commission with
regard to this important position--that is, to assure that the
demographic and economic assumptions for the cost estimates of
the future operations of the programs continue to be developed
in an objective manner.
Thank you very much for your consideration of my
nomination. I look forward to answering your questions.
[The prepared statement of Mr. Kouzoukas appears in the
appendix.]
The Chairman. Thank you very much.
So, we have some obligatory questions that we have to go
through with each of the nominees. And let me start first, and
we will have to hear from all of you. Is there anything that
you are aware of in your background that might present a
conflict of interest with the duties of the office to which you
have nominated? Ms. Rollinson?
Ms. Rollinson. No.
Dr. Neuman. No.
Mr. Kouzoukas. No.
The Chairman. Second, do you know of any reason, personal
or otherwise, that would in any way prevent you from fully and
honorably discharging the responsibilities of the office to
which you have been nominated?
Ms. Rollinson. No.
Dr. Neuman. No.
Mr. Kouzoukas. No.
The Chairman. Third, do you agree, without reservation, to
respond to any reasonable summons to appear and testify before
any duly constituted committee of the Congress if you are
confirmed?
Ms. Rollinson. Yes.
Dr. Neuman. Yes.
Mr. Kouzoukas. Yes.
The Chairman. Finally, do you commit to provide a prompt
response in writing to any questions addressed to you by any
Senators of this committee?
Ms. Rollinson. Yes.
Dr. Neuman. Yes.
Mr. Kouzoukas. Yes.
The Chairman. Okay. Let us go to the questions.
I am going to start with you, Ms. Rollinson, and talk about
the implications for the IRS if there is a government shutdown.
Now, you were there at the agency during that time when the
Chief Counsel's Office was coming in and out of government
shutdowns, and you are aware that the IRS in these kinds of
instances has to furlough existing staff.
What I wanted to ask you though is, what does the shutdown
mean for millions of taxpayers, and I am talking about small
businesses, I am talking about veterans, I am talking about
seniors--the millions and millions of typical taxpayers who
cannot get their questions answered, their returns and refunds
processed, the kind of information they need to address their
hopes and plans for their future?
And put it in the context--you know, so much of what goes
on around here, and Senator Crapo and I talk about this, the
government talks all kinds of technical lingo. I do not want to
do that with this question. I want you to take your best and
most experienced take.
What is this going to mean for the small businesses and the
veterans and the seniors, if the government shuts down?
Ms. Rollinson. Thank you so much. I think your staff was
particularly alarmed when I told them that I started during a
government shutdown and then left when there was a government
shutdown. So I have been there for two government shutdowns in
the past, and I will say that, from the perspective of the
Chief Counsel, it is concerning in terms of making sure that we
are going to be staffed.
But the question about looking at it from the taxpayers'
perspective is one that I have seen played out today in many of
the news reports: people debating just how big of an impact is
it on people right away when the government shuts down. And I
think that is something that needs to be considered very
carefully.
From the perspective of the Office of Chief Counsel, it
means making tough decisions about what work will get done
while the government is shut down.
The Chairman. Freeze frame that. So as Counsel, you are
facing questions of, will we be able to do this for veterans or
that for seniors, and maybe we have to put it off, or something
like that? Is that the kind of choice that you saw people
having to make?
Ms. Rollinson. Thank you. When I was there, the workers
were divided between essential and nonessential. I think they
have gotten rid of that title, because it was just a little bit
offensive to the people who were told they were nonessential.
But yes, choices have to be made about what work can get done
while the government is shut down, and it can have an impact on
ongoing litigation, it can have an impact on guidance to the
field. It can have a very direct impact.
The Chairman. And I just want to make sure that when you
talk about litigation and the impact, you are telling us that
coming in and out of government and going through that, this is
not some abstract issue. This is something that is real for the
millions of typical taxpayers. We are still apparently awaiting
more guidance from the government, but based on everything I
have heard and you have been through them, this is real for
those millions of people.
Now, the taxpayers in my State are basically 3,000 miles
away from Washington, DC, and for them Washington, DC most of
the time might as well be on Mars for the impact it has on
them. But I think what I have heard from you in the past, and
others, is that for those seniors, those veterans, those small
businesses, this is not an abstract issue. This can really have
a damaging effect on their lives and their futures. Is that
correct?
Ms. Rollinson. Yes. I think you raise a very good point.
The Chairman. Okay; very good.
Dr. Neuman, just a question for you; and my colleagues
remember this. And we were so thrilled working with Chairman
Hatch, because I went to the chairman, and I said, ``You know,
when I was coming up as director of the Gray Panthers, Medicare
had Part A and Part B. Part A was hospitals, when you broke
your ankle.'' I went to school on a basketball scholarship, saw
a lot of those, people who are still recovering from injuries
that they sustained when they were young. ``And then Part B was
for the doctors; you had a horrible case of the flu.''
So the three of us, working with Chairman Hatch and a lot
of colleagues over here--Senator Cardin, Senator Warner--we
said the future of Medicare is going to be the millions of
seniors who have two or more chronic conditions. Maybe they
have cancer, diabetes, heart issues, these kinds of things.
So we wrote a major bill that I think is really
transformative, and I would be interested in your thoughts
about the impact and how your work will be affected from these
kinds of emerging trends in American health care. Now, I
obviously cannot get into any specific bill, but what I can
tell you is, the Medicare program of today is not the Medicare
program when I was coming up as director of the Gray Panthers.
So how do you factor in these emerging trends?
Dr. Neuman. Thank you for that question, Senator. I am glad
you have brought so much attention to the issue of an aging
population, with people with more chronic conditions, and
living longer, and the importance of doing something to better
manage care for people as they grow older.
This is an important issue. It is an important issue for
Medicare. It is an important issue for medical care. I think
any one of us who may have family members with diabetes or
hypertension or cancer, heart disease, understand just how
important it is to better manage care and work across
specialties so that people get the best possible care and that
certain conditions are prevented, when possible.
As a public trustee, I think the focus would be somewhat
narrower. On the one hand, a public trustee would look at the
extent to which chronic conditions drive spending and affect
spending, and on the other, a public trustee would want to look
at the effect of any interventions or policy changes or
regulations that may actually slow the growth in Medicare
spending.
The Chairman. My time has expired. We are going to have
some suggestions, because I know--for example, I have been
talking to my colleagues and professionals in the field. If
there were grab bars, for example, for elderly folks, that
could prevent a lot of incredibly harmful falls, which
devastate lives and cost enormous sums of money. Those are the
kinds of things that I want to talk to you about.
Senator Crapo?
Senator Crapo. Thank you very much, Mr. Chairman.
My first question is for both Ms. Neuman and Mr. Kouzoukas.
As public trustees, you would be entrusted with providing an
unbiased and independent review of the financial status of the
trust funds. Maintaining the credibility of the reports
submitted to Congress is vital. Their analysis and underlying
economic assumptions are used extensively by public and private
entities to evaluate not only the programs themselves, but also
overall government spending. These reports do not include
policy recommendations, nor do they advise on policy.
The public trustee positions do not provide platforms for
anyone on either side of the ideological spectrum to espouse
their personal policy viewpoints. They are tasked quite simply
to provide objective, dispassionate accounts of exactly what is
happening with the trust funds.
Dr. Neuman and Mr. Kouzoukas, will you commit to
maintaining an independent, nonpartisan, and objective
oversight role, if confirmed?
Dr. Neuman. Yes.
Mr. Kouzoukas. Yes.
Senator Crapo. Thank you.
I would like to go now to Ms. Rollinson. As we talked about
in my office, one of the troubling concerns that I have seen is
a recent trend, that from my perspective is a willingness of
the IRS and Treasury to ignore the plain language and enacted
statutes when issuing regulatory guidance.
For example, in the case of the IRA's new EV tax credit,
the IRS and Treasury proposed rules that had no statutory basis
and simply ignored the statutory deadline for issuing guidance,
which had the effect of temporarily preventing new requirements
from taking effect and allowing scores of credits to be claimed
inappropriately.
There are other recent instances where the IRS and Treasury
have ignored unambiguously stated effective dates and delayed
certain provisions from taking effect. As I said earlier, I
know that you were not in the government at the time these
actions were taken, but do you believe that it is proper for
the IRS to issue guidance that is clearly inconsistent with
statute?
Ms. Rollinson. Thank you for raising this. I was going to
just say, ``no,'' but I will elaborate. The Chief Counsel's
Office is very important in terms of making sure that the laws
passed by Congress are interpreted fairly, and that guidance is
issued quickly. That is how we cut down on disputes. That is
how we make sure that the benefits that Congress is intending
people to get are in fact available.
And so, although I do not know fully the exact regulations
that you are talking about, if I am lucky enough to be
confirmed, it would be a big priority of mine to make sure that
the Office of Chief Counsel is advising fully on what we think
the proper interpretation of the law is.
Senator Crapo. Well, thank you. And if confirmed, how will
you approach--and I think you have answered this, but I would
like you to answer it again. If confirmed, how will you
approach a situation where the statute is clear, but the
administration seeks a different outcome, whether based on
claims of administrative complexity or political expediency?
Ms. Rollinson. That is a very important question. What is
interesting is how often tax law is not that clear. But I agree
with you that to the extent that tax law is clear, we need to
stay within the parameters of the law. And this was my
experience when I was there before and would anticipate it
being my experience if I am lucky enough to be confirmed: I do
think there are healthy debates among lawyers as to what words
mean.
But again, the Office of Chief Counsel's role would be to
advocate for what we think the law says, and as a side matter--
not a side matter but an equally important one--making sure
that the rules that are passed are administrable. And that
would be my focus, if I am lucky enough to be confirmed.
Senator Crapo. Thank you.
Very quickly, one last question before my time runs out. I
am also very concerned about specific instances where the IRS
unilaterally acts without statutory authority, where there is
no language to be clear or unclear about.
Pursuant to the administration's directive, for example,
the IRS has recently begun building a program to prepare tax
returns and give tax advice, allowing the IRS to act as tax
collector, tax enforcer, and tax preparer. That puts them at
the center of each stage of the process, and even though it was
jettisoned from the partisan IRA, many of us worry that the IRS
will move unilaterally into requiring systematic and deeply
intrusive reporting on Americans' bank accounts without
statutory authorization.
My question is, do you believe the IRS has the legal
authority to prepare tax returns or to track deeply in
Americans' bank accounts without congressional authorization?
Ms. Rollinson. Thank you. You are raising what I think are
two separate issues. I will address them separately. One is--
what I believe you are talking about is Direct File, and the
Chief Counsel certainly would not be making a policy call as to
whether it is a good idea to have Direct File, but would
absolutely be engaged in answering the question of whether we
thought there was authority.
And so, if I am confirmed, I look forward to understanding
what the thinking was as the IRS came to the conclusion that
they believe they have the authority, since I understand they
are moving forward with a pilot program.
Senator Crapo. All right; thank you. I see my time is way
over expired.
The Chairman. I thank my colleague.
Senator Grassley is next.
Senator Grassley. Mr. Chairman, I would like to make an
editorial comment before I start my questioning, and it is in
regard to your fourth obligatory question you asked these
folks. Each answered ``yes,'' that they would be glad to
respond to all of our communications and everything, and I do
not question their sincerity on doing that.
But whether you have a Republican or Democrat President, I
have found over the years that it is very, very difficult to
have that completely fulfilled by the people who always say
``yes.'' So I just say a more honest answer would be ``maybe.''
The Chairman. And I would only say, Mr. Grassley, you and I
have teamed up on these things, and we ask tough questions, no
matter whether it is a Democrat or a Republican, and we are
going to continue to do so.
Senator Grassley. Thank you very much.
I am going to start out with Ms. Rollinson, and I want to
make clear that I have questions about whistleblowers. But
there are two different whistleblower issues in this
administration, or even in Republican administrations.
One deals with the IRS whistleblower program for saying
that corporations did not pay a certain amount of taxes. That
legislation has brought in $6 billion, so I see it as a very
worthwhile program. The second issue with whistleblowers deals
with government whistleblowers within.
So I am going to start out with the $6-billion program.
Obviously you know, or maybe you do not know, but I have been a
strong advocate for this program, being involved with its
enactment as well. I have heard concerns from stakeholders that
the Chief Counsel's Office is often a barrier to processing
claims, especially in matters that have gone through the Tax
Court.
I am concerned that there is an attitude in the Chief
Counsel's Office--obviously prior to your going there--that
whistleblowers are a threat to the public fisc. The exact
opposite is true, as I think the $6-billion figure proves.
Whistleblowers are an asset that can help the IRS identify tax
cheats and collect additional revenues.
If confirmed, do you pledge to view whistleblowers as
working with the IRS, and work to process cases quickly and
fairly?
Ms. Rollinson. Thank you, Senator. I am aware of your
interest in this issue, and I share it. I think whistleblowers
are very important in terms of tax administration, and I really
respect the role that they play.
The Office of Chief Counsel should be something quite the
opposite of a barrier, because our role is to advise on how to
interpret the law. So we should be working directly on
understanding the claims that the whistleblower has brought
forward, making sure that the law is being applied correctly,
and helping dispatch the case as quickly as possible.
Senator Grassley. Okay.
One additional concern in this area I have heard from
whistleblowers is that the Chief Counsel's Office often
undermines the Whistleblower Office by improperly asserting
itself into the award determination: this is how much the
whistleblowers should get for this information.
If confirmed, do you pledge to support the role and
decisions made by the Whistleblower Office, and not undermine
its mission by imposing additional burdens on that office?
Ms. Rollinson. Thank you. If confirmed, I would look
forward to working closely with that office, and certainly with
the goal of not undermining their authority.
Senator Grassley. Okay.
Then this goes to the internal whistleblowers. If
confirmed, you will be the chief legal advisor to the IRS
Commissioner. As you probably know, I take whistleblower laws
and protecting them very seriously, and we have had some IRS
whistleblowers go public recently, and they have not been
treated as they should have been.
I want a commitment from you that you will support
whistleblower rights and protections, and that you will take
steps to protect from retaliation all IRS whistleblowers who
come forward, even including those involved in the Hunter Biden
investigation.
Ms. Rollinson. Yes, I agree. It is a very, very different
issue, the internal whistleblower, and I again think it is very
important. Personally, I hope that if I am confirmed, I run an
office where I am open to criticism, that everyone in the
office is open to criticism, and that we take it seriously.
And if it ever goes so far as to be a whistleblower case,
it is very important that the whistleblowers be treated with
respect and that there not be retaliation.
Senator Grassley. Okay.
And then for the trustees of Medicare: the 2023 Medicare
trustee report says, ``This year's determination triggers a
Medicare funding warning.'' The Medicare trustees have issued
this warning over 7 consecutive years. After this determination
is made, the President is required to submit proposed
legislation to Congress, and Congress is supposed to consider
legislation on an expedited basis.
Well, quite obviously, to date no action has been taken
throughout these years. Do you agree with this funding warning
and that Congress should take this warning seriously?
Mr. Kouzoukas. Yes, Senator. The funding warning is
something that Congress put in place, and it is something that
really goes to the heart of the trustees' role, which is to
provide the facts and the data to the Congress and the American
public about the fiscal status and future of the programs. And
there is a role there for the public trustees and the other
trustees to highlight that message.
And the Medicare warning is one way that the Congress has
an opportunity to follow up on the work of the trustees, and I
look forward to collaborating with this body and the rest of
Congress, if confirmed, to provide whatever information and
other data might be helpful in Congress's role following up on
those warnings.
Senator Grassley. Thank you for answering my questions.
The Chairman. Senator Grassley, let me just close up on
this point. For a number of years, I have been your cochair of
the Whistleblower Caucus, and I just want to----
Senator Grassley. And you still are.
The Chairman. And I thank you, and I look forward to
continuing our work.
Senator Whitehouse?
Senator Whitehouse. Thanks, Mr. Chairman. I join you in
commending Chairman Grassley's long support for whistleblowers
and transparency.
Ms. Rollinson, you are headed over to the IRS to be Chief
Counsel, if you are confirmed. You are not there now, as I
understand it?
Ms. Rollinson. That is correct.
Senator Whitehouse. So this is just something for you to
consider when you get over there, if you do not mind hearing me
out here. The Supreme Court rendered a decision, at least a
majority of it did, called Citizens United. I am sure you are
aware of that decision. Citizens United reflects the
proposition that the Supreme Court, 8 to 1, endorsed, that
spending anonymous money in politics is corrupting.
So, a pretty solid message. In fact, they said the only
reason that we are letting unlimited money pour into politics
is because it will be transparent. That is a guard against
corruption. So the premise is, anonymous money in politics,
what we would call ``dark money,'' is corrupting--point 1.
Point 2, we have $2.6 billion in dark money spent in elections,
and more to come. So, $2.6 billion spent in, on its face,
corrupting dark money. So that is kind of a problem for
American democracy.
The device for a lot of this dark money corrupting spending
is 501(c)(3) and 501(c)(4) organizations, and abuse of
501(c)(3) and 501(c)(4) organizations. I will flag some of the
abuses for you. One is to take a 501(c)(3) and a 501(c)(4)
organization that are basically twins: same location, same
board, same staff, a corporate veil between them that you could
pierce with a banana.
And with that, a 501(c)(3) that is supposed to do no
politics can get enmeshed with what a 501(c)(4) is allowed to
do in politics. Policing the boundary between the 501(c)(3) and
501(c)(4)--zero effort that I have ever been able to see by the
IRS. Literally zero effort to even ask or to look and say,
``What's up here?'' These two really do not look that different
as organizations. How are you reflecting the legal difference
between 501(c)(3)s and 501(c)(4)s?
Here is another one. You set up a little flotilla of
related 501(c)(4)s. So when the donor gives a million dollars,
the first 501(c)(4) spends half of it on politics and sends the
other half to the second related entity in the cycle, which
spends $250,000 of the $500,000 on politics, and sends the
other 250 to the next one in the cycle, which spends 125 of the
250 on politics, and so forth.
And so, in a meeting room the size of that table, you could
take a million-dollar contribution and put 90 percent of it
immediately into politics, particularly if it all ends up going
to the same super PAC, for instance, being reassembled on the
other end of this sham operation. Zero inquiry into 501(c)(4)
cycling and the sham operation.
And then finally, misreporting. The IRS receives reports
from these organizations that say to the IRS under oath, ``We
do not spend any money on politics,'' and over and over again
those same organizations have reported to the Federal Election
Commission and other election commissions, ``Oh, we spent $17
million on political ads.''
The discrepancy between those two sworn statements is never
investigated. I strongly suspect that the battering that the
IRS has received by dark money-funded front groups and dark
money-
funded politicians--which included attempts to impeach an IRS
Commissioner, attempts to refer to DOJ IRS staff--have cowed
and intimidated the IRS so badly that it is not even trying to
do its job.
And by the way, no kudos to DOJ on this. DOJ still insists
on an IRS referral, even if it is a simple false statements
case, which is bread and butter DOJ work. So, between the DOJ
and the IRS, neither side is doing its job, and there is a
waist-high pile of baseballs that have piled up between
shortstop and second base, of neither side doing its job to
defend us from what is, by law, ``corrupting political
spending.''
Please--I will follow up with you after your confirmation,
but you cannot just chicken out on doing the job, and I hope
you will bring a spirit of integrity there.
Ms. Rollinson. Thank you.
The Chairman. Thank you, Senator Whitehouse.
Senator Lankford is next.
Senator Lankford. Mr. Chairman, thank you. Thank you to all
of our nominees. This is not a fun process to go through, all
of the questioning and all the prep and everything else that
goes into this. So I appreciate all the work that you have
already done going through this process to be able to get to
this point on this.
I do want to be able to have a conversation with our future
IRS Counsel here, to be able to talk through just the issues
here. It is a pretty straightforward question. The IRS rules,
do they carry the force and effect of law? For IRS rules, do
they carry the force and effect of law?
Ms. Rollinson. Thank you. The IRS has the opportunity to,
with Treasury, issue regulations on legislation that is passed
by Congress, and they--those regulations--are in fact treated
as the interpretation of the law.
Senator Lankford. Right; which, by the way, I agree with,
obviously. They are carrying that out. Most Americans would
also receive that as well. The challenge has been of late that
in the past couple of years, Treasury has said that the IRS,
when it goes through all its rulemaking process and actually
puts its regulations out, is not accountable to OIRA, the
Office of Information and Regulatory Affairs; that other
agencies have to get their guidance checked, but Treasury is
saying IRS does not, that we are going to be exempt from that
process and we can make rules without the oversight of OIRA.
Should OIRA be involved in actually that oversight process,
or can Treasury and IRS make rules outside of the
Administrative Procedures Act?
Ms. Rollinson. You raise a really important point that
actually, when I was there at Chief Counsel the last time, had
just started percolating, because in fact for a long time, the
rules did not go through OIRA. I do think there has been a
change, especially given some of the court cases that have come
out, in terms of what has to happen in order for the
regulations to be considered to have met the APA and be
compliant.
When I left the Office of Chief Counsel last time, our
regulations were going through OIRA. So one thing that will be
interesting, if I am confirmed, is to understand where we are
in that process.
Senator Lankford. Yes. It was about 97 rules as I recount,
went through OIRA oversight during that time period. It seemed
to flow. The initial concern was, well, this is going to slow
the process down. Treasury, IRS, OIRA were able to work out a
time period to be able to make sure that all of this had
guidance.
OIRA's design is to be able to make sure we do not end up
in a bunch of lawsuits, we do not end up with legal challenges.
We actually save the taxpayer money and time, because it has
actually gone through an internal review. It is interesting to
me to be able to say, with all that is going on right now with
IRS and with so many new regs that are coming online, that
suddenly those do not apply to oversight.
We can then look at the statute, apply it ourselves, and no
one should look over our shoulder. I just do not agree with
that. What will be interesting is, you are going to have some
conversation on that. Obviously as the Counsel, you will be in
the middle of it, saying, ``Does this actually apply to us, or
is IRS completely separate from the Administrative Procedures
Act? Can we make up rules without it?''
How will you go about trying to be able to make that
decision? I am not going to put you on the spot on that to make
that decision right now, but you are going to have to put a
process in place to be able to make recommendations to the
administration--should we be independent?
Ms. Rollinson. Yes, thank you. I actually think it is one
of the most important roles of Chief Counsel, to help ensure
that regulations are considered, are found valid, if and when
challenged. They are going to be challenged a lot of the time.
Senator Lankford. Right.
Ms. Rollinson. Taxpayers deserve to understand the guidance
that comes out, that the guidance is going to apply to them. It
is always concerning if people follow the guidance, and then 10
years later, it is found not valid and people have been
following it for years.
So, I will be very interested in making sure that the
Office of Chief Counsel does everything it can to make sure our
regulations are found valid.
Senator Lankford. Okay, that would be helpful. I think
participating in the Administrative Procedures Act is not
onerous. Every other agency does this, and it actually helps
the taxpayer in the long term, to be able to know that there is
another set of eyes to be able to look at this.
I know I am running short of time, but churches and faith-
based entities for years have had a long-term struggle with the
IRS in trying to determine when is it that they are talking
about a moral, cultural issue, and when does that actually get
into a political issue? What is their level of free speech as a
nonprofit and as a faith-based entity?
They have had all kinds of challenges, letters. I know
pastors who have made a tape of a message, where they talked
about an issue, sent it into the IRS and said, ``Does this
cross the line? Give us clarity on this.'' And they have never
been able to get clarity from IRS on that.
There seems to be the sword of Damocles that hangs over
them all the time, waiting for some judgment, some rule to be
able to come down. It is an issue that does need to be
resolved, that faith-based entities also know that they
maintain their free speech the same as everyone else does.
But so far IRS has been unwilling to be able to make that
statement publicly, that faith-based entities do not sacrifice
their First Amendment rights as well. So, any help and any
guidance on that in the days ahead would be very helpful to
faith-based entities all over the country.
Ms. Rollinson. I agree; thank you.
Senator Lankford. Thank you.
The Chairman. I thank my colleague.
Senator Carper is next.
Senator Carper. Thanks; thanks, Mr. Chairman.
I had a chance to welcome you all personally, and I will do
that in front of this mass of people. Before I do that, I want
to say there's a fellow sitting over my right shoulder. His
name is Evan Giesemann. We are only as good as the people who
are on our staffs, and as you know, help us understand some of
the issues. It is more than any one person could probably do.
But Evan has been with us for about 400 years. [Laughter.]
He says it seems that long, but he has actually not done it
here nearly that long. But he has really done great work with
respect to major legislation, including the Inflation Reduction
Act, all kinds of trade legislation, and I--we are going to
miss him. I just want to say publicly in front of him and all
of you, how much we value his service.
Having said that, I want to ask a question, if I could, of
Ms. Rollinson, and I have been a long-time outspoken advocate
for fully funding the IRS. I have sat here, I cannot tell you
how many times, with the Commissioners of the IRS, candidates
or nominees for Commissioner of the IRS. We ask them what can
we do to be helpful as a legislative branch.
Almost everybody says, ``We need funding. We need to be
able to fund the people who work at the IRS to do the work that
needs to be done, and make sure everyone's paying their
share.'' I am proud of the work that we did with the Inflation
Reduction Act, in which my staff and I had played, I think an
important role in providing some badly needed funding for the
agency.
I am encouraged that those investments are paying off. One
of the most important measures, as it concerns the IRS, is
agency responsiveness to everyday taxpayers seeking assistance.
We actually monitor in my office, and we have done this--I have
been in the Senate for 22 years. We actually measure, every
month, constituent services and what do people contact us
about, what issues are they raising?
One of the top issues forever has been the IRS, and the
issue is responsiveness of the IRS. I think I have the right
number here, but in terms--when I ask my staff to find out--in
terms of answering phone calls, the IRS answering phone calls,
during the 2023 filing season, I am told about 87 percent of
the phone calls were answered by the IRS. Actually somebody
picked up the phone; the IRS talked to a constituent.
I have a friend. When you ask him how he is doing, he says,
``Compared to what?'' Well, compared to before 2023, I think we
are looking at numbers, not of 87 percent of calls answered,
but about 15 percent of calls answered. I think that is almost
criminal for the people we are supposed to be serving.
Now, it is a lot better. It is not perfect, but it is a
heck of a lot better.
Question, Ms. Rollinson: if confirmed to be Chief Counsel
of the IRS, how will you help provide clarity and certainty to
taxpayers, not just personal taxpayers, individual taxpayers,
but the business community, nonprofits, and so forth? And how
can you better provide clarity and certainty to those taxpayers
seeking assistance, in helping assure best-in-class customer
service from the agency?
Ms. Rollinson. Thank you, and thank you for the support you
have given to the IRS. I have read about it. It is very
impressive. I think that what the Office of Chief Counsel can
do is to help provide timely guidance, timely guidance so
people understand their obligations.
I am thrilled to see that this year customer service has
increased dramatically at the IRS. What again, in the Office of
Chief Counsel, we can do is make guidance publicly available so
people can file their taxes, and we can promptly assist the IRS
as questions arise, and that would be a very, very important
role.
Senator Carper. Good. Second question, if I could. I
mentioned the importance of our workforce, but one of the most
important tools for success in any organization, including the
IRS, is the strength of its workforce. Unfortunately, during
the 2010s, the IRS budget was depleted, and the agency lost, I
am told, 20,000 full-time employees, leading to an overwhelming
backlog that we have talked about, poor customer service, and
really low morale among IRS workers.
Under the leadership of Commissioner Werfel--who I was
privileged to introduce and actually recommend to the President
to nominate for the leadership post of the IRS--the agency has
taken steps to support its employees and rebuild its workforce.
There is more work to do.
Ms. Rollinson, if confirmed, how will you work with the
other leaders of the IRS to support and empower the agency's
workforce?
Ms. Rollinson. I have to say, one of the reasons I really
am most excited about the possibility of going back is, I think
the people who work there are unbelievably dedicated to the
mission and do a great job. I would love to be part of
recruiting in more people, so that the staffing can be at a
level that gives the American people the tax service they
deserve.
Senator Carper. Mr. Chairman, when we were members of the
House of Representatives, I used to hold town hall meetings a
lot. I am sure you did too. And we do every 2 years--we do a
town hall. We invite the IRS, we invite the Delaware Division
of Revenue to come to help people to actually do tax returns.
And I remember once--we do an exercise trying to balance
the budget, let the people in the town hall meeting participate
in that. I remember one year where they were working on
spending--entitlement spending, discretionary spending, defense
spending, non-defense spending--they could not balance the
budget.
I said to the group--it was about 50 people--I said,
``Well, our revenues can always be part of the solution.'' I
will never forget, Mr. Chairman. A lady in the back row raised
her hand, and she said, ``Congressman, I do not mind paying my
fair share of taxes. I just want to make sure that everybody
else is paying their fair share.'' I think that really sums it
up very well.
Thank you.
The Chairman. Thank you, Senator Carper.
Senator Bennet is next.
Senator Bennet. Thank you, Mr. Chairman. I really
appreciate it, and thank you all for your testimony.
Ms. Rollinson, I only have one thing that I want to focus
on today, and we have talked about it before. I appreciate the
conversation we had a few months ago on our State tax refund
issue that we have in Colorado, called TABOR.
In Colorado, the Taxpayer Bill of Rights amendment, what we
call TABOR, passed in 1992 to ensure that the State refunds
excess tax revenue to taxpayers. For over 30 years--so for
decades and decades and decades--Coloradans have received these
tax refunds, and the IRS has not opined on whether they are
subject to Federal income taxes.
But in February, the IRS announced--without any leadership,
I think, at the IRS--in February the IRS announced that it
would, it would treat TABOR as federally taxable income,
throwing the tax season for Colorado filers into chaos and
breaking with a long-standing precedent. I mean, we said to the
IRS at the time, ``You are doing this, you are giving us this
guidance now right in the middle of tax filing season. It is
the last possible minute when anybody in the State is going to
be prepared to deal with an entirely new rule.''
So, whatever one thinks about the ruling itself or the
opinion itself, I think there is a question here about what is
a useful way for IRS, the agency, to approach these kind of
questions. But I will put that to one side for the moment.
Last month, the IRS proposed a new policy that would tax
some of these State and local refunds, overturning the 30-year
precedent, I think, that the IRS had, of not treating this as
taxable income. I have had a conversation with Commissioner
Werfel at least one, maybe two times with this, and we talked
about this when we met a few months ago.
I do not believe that anybody over at the IRS and in the
Office of the Chief Counsel has grappled with what this is
going to mean for Colorado, and maybe what the distinctions are
between Colorado and other States that are being affected by
this.
When I asked whether the Chief Counsel's Office had
previously reached out to the Colorado Department of Revenue to
discuss the change that the IRS was proposing, the answer was,
``No, we had not even talked to the people in the State to
understand what their perception was of what was being done
here.''
I think their office has failed to recognize that the
proposed policy is a major change from decades of precedent
that is going to have a dramatic effect on Colorado taxpayers.
And I hope that you will agree that this is not the right way
to make these policy changes, and if confirmed, that we will
find a way to be able to work more effectively with States,
give people notice, and have some understanding about what is
happening.
So I guess what I would just ask, more than anything else
on this particular issue is, if you are confirmed, if you would
be willing to work with my office, with the Colorado
delegation, with the Colorado Department of Revenue, to ensure
that the new guidance--while in my view the new guidance would
not tax TABOR refunds--but if you do reach that conclusion at
the end, that it is only after consultation with the folks who
are going to be affected by it. And to the extent that you have
a substantive view of this, I would be happy to hear that
today.
Ms. Rollinson. Thank you. I know this is a very important
issue to you and to all the people in Colorado. And yes, if
confirmed, I would make it a priority to understand what the
thinking has been, and also to work with your office and with
tax authorities in Colorado to make sure that the Office of
Chief Counsel really does understand what the payments are for.
Senator Bennet. I want to say that I think I had some
suggestion from the IRS after the--thank you for that answer. I
had a suggestion from the IRS after the latest iteration of
this came out, suggesting that some changes that were made
temporarily during COVID might have somehow led the IRS to
reach the new conclusion that it did.
I would say first of all, I do not understand that, but
that may be my fault. But I do not understand it. But I also
think that that--it seems to me that that does not necessarily
obviate 30 years of practice among the State of Colorado, our
taxpayers, and the Internal Revenue Service.
So I had hoped that when you get there, we can get some
attention on this and that we can get to a rational conclusion
that makes sense for Colorado's taxpayers.
Mr. Chairman, thank you for giving me the opportunity to
ask questions.
The Chairman. I thank my colleague.
Senator Blackburn is next.
Senator Blackburn. Thank you, Mr. Chairman, and thank you
so much for being before us today. I have a couple of concerns
I wanted to raise with you, because the issues seem to
continue. One is the cybersecurity at the IRS and what is
happening with data, what is happening with data breaches.
There have been some pretty high-profile data breaches--
Pro-Publica. And the GAO has found numerous instances of
willful misuse of information and unlawful, unauthorized access
to information by employees. So on this GAO report, have you
seen that? Have you reviewed the deficiencies, and what are
your thoughts?
Ms. Rollinson. No, I have not seen the report.
Senator Blackburn. Okay. Will you do that and submit
something in writing, because to me, this should be
intolerable.
Ms. Rollinson. I appreciate you raising this. I want a huge
priority of the Office to be, if I am confirmed, making sure
the American public understands that the IRS is putting them
first, and is safeguarding their information. This is a very,
very important issue, and if I am confirmed, I look forward to
getting----
Senator Blackburn. See, I think it is astounding to people
that they have to submit this information to the IRS. They are
required to do this, and then they find out that there are
these data breaches. Each one, it is like, why can't these
people get this right? We do hear a lot about it.
Tennesseans are very concerned about that, and people need
to know that their information is going to be private, that
their name, their address, their Social Security number, their
income, their tax filing is not going to be made public. So
please, let's get some attention on that issue.
I want to talk to you about Commissioner Werfel. When he
was here before us and I questioned him, we looked at that
$400,000 threshold for audits on the American people. He kind
of waffled around a little bit on giving me an answer on
exactly what that meant. Was that going to be net income? Was
it going to be gross income?
Because we have a lot of Main Street small businesses where
their gross is $400,000, but what they make out of that, if
they are a restaurant, if they are a retail shop, it might be--
they might be taking home actually $40,000 to $50,000.
He used a term that was ``total positive income.'' Well,
that meant the gross. So you have--this is something that seems
to be aimed squarely at the middle class, and at the
independent small business owner. So, as you look at this and
you say nobody under $400,000 is going to have an audit, how do
you calculate that? Are you looking at the net, are you looking
at the gross? Or are you going to use this new, made-up term of
total positive income?
Ms. Rollinson. Thank you. I have seen the reports that the
IRS will be going after the larger partnerships, the high-net-
wealth individuals without the intention of auditing those with
less than $400,000. If I am confirmed, I look forward to
understanding what they mean by that term, and I share your
concern that it is something that the IRS needs to be
transparent about, so that everyone understands what is meant.
Senator Blackburn. Well, and when they, when the
administration did this, what were they talking about? They
were talking about high earners, but now, just as we had
predicted, it seems to be pointed squarely, squarely at the mom
and pops, and at the small businesses.
So Tennesseans want to know where that is, where it is
going to land. Is it your total taxable income? Is it going to
be that gross? How are you going to address this, because they
are really quite concerned about what they see as picking
winners and losers at the IRS. They are concerned about people
being targeted for their political or their religious
positions, things that have happened in the recent past at the
IRS. So we will be watching that closely.
Thank you, Mr. Chairman.
The Chairman. I thank my colleague. Let me just follow up
briefly on this point of ``net positive income,'' having talked
to Mr. Werfel in the past. What I believe he is talking about
is the example where a hedge fund manager cannot offset their
income with losses. But we will continue this conversation, and
I look forward to it.
Senator Blackburn. And, Mr. Chairman, on that point, he may
have given you a different answer in a private conversation.
That is not the response that he gave when we had the hearing.
Therefore, you have a lot of small business owners out there
who are quite concerned about the ramifications of this
position, and the lack of clarity of exactly what he is going
to do with that authority.
The Chairman. We will continue this conversation. I will
only say I have heard him say in a number of instances that his
version of approaches like net positive income is designed to
make sure that the very wealthy cannot game the system. But I
get my colleague's point, and I look forward to talking with
her about it.
Senator Cortez Masto?
Senator Cortez Masto. Thank you, Mr. Chair. And
congratulations to all the nominees, and to your families and
everyone who is here to support you, and maybe watching to
support as well.
Let me start with our public trustee nominees, Dr. Neuman
and Mr. Kouzoukas. So, in Nevada, there are over half a million
Nevadans who rely on Medicare to cover their health-care needs,
and there are over half a million Nevadans who count on Social
Security for their financial security, and clearly the solvency
of the Medicare and Social Security trust funds is crucial not
just for my State, but for the country.
In Congress, we have a responsibility to protect that
solvency of these programs. Each year, we look to the trustees'
reporting for an accurate assessment of each fund's fiscal
health. So let me ask both of you, and I will start with Dr.
Neuman. How has your experience prepared you to represent the
public interest in the oversight of these trust funds?
Dr. Neuman. Thank you for the question, and I should say I
am so honored to even be considered for this position. I have
spent my entire professional career working on Medicare and
retirement income issues, and thinking about how the programs
serve the people who rely on them. So, as I approach this
position, I approach it thinking of the people in Nevada and
across the country who are relying on Medicare and Social
Security to be there for them when they need it.
I would approach this position as I approach my other work.
I bring analytic skills and work as a nonpartisan. I try to ask
good questions, and if I am so fortunate to be confirmed, I
would want to ask good questions.
I would want to check that the assumptions of the actuaries
are sound, and to think about what are the new trends that are
happening and how might they affect the projections. What did
COVID mean, for example, for disability? What does the advent
of new drugs, such as Alzheimer's drugs, mean for Medicare
spending?
So I would look to track what is going on with existing
trends, and keep an eye on things that are emerging, in order
to be sure that the work of the trustees and the report that
comes to you are based on solid information and analysis.
Senator Cortez Masto. Thank you.
Mr. Kouzoukas. Senator, I appreciate the opportunity to
discuss my background and qualifications for the role. It is
really a quite humbling role, and one that is very meaningful
to me, both for personal and professional reasons. My first
exposure to the programs was in my own family history, like so
many Americans, and I appreciate the impact that they have on
every American family. And so I think that just makes it all
the more critical that Congress have the right information, a
complete and objective picture about the financial and fiscal
status of the programs, and I would bring to the role a passion
for these issues.
I have dedicated my entire professional life to serving the
populations that these programs serve, and I very much want to
ensure that they continue to have access to the security and
care that these programs provide. I have had the opportunity,
in fact, to work with different parts of the agencies that
produce the reports.
I served as Secretary to the 2017 meeting and signed that
report. So I have some familiarity with the process firsthand,
and I would look to bring these collective experiences to bear
in this role, if confirmed.
Senator Cortez Masto. Thank you.
And then, Ms. Rollinson, I was grateful--Senator Cornyn and
I have worked together on legislation that we included in the
SECURE 2.0 retirement bill that was passed last year that
allows domestic violence survivors to withdraw penalty-free
from their retirement plans. But I think there is more that
needs to be done with respect to helping domestic violence
survivors stay on that path. I think that the IRS can play an
important role. So really what I am looking for--and this is a
conversation I have had with Commissioner Werfel--will really
be just asking if you would commit to working with the
Commissioner on this issue and reviewing where IRS policy can
be updated to help survivors of domestic violence.
Ms. Rollinson. Thank you. That is obviously a very
important issue, and yes, I can commit to spending my time
working on that issue.
Senator Cortez Masto. Thank you. I appreciate that. My time
is up. I again congratulate you all on your nominations, and
thank you for your willingness to serve.
Thank you, Mr. Chairman.
The Chairman. I thank my colleague.
Senator Cassidy is next.
Senator Cassidy. Mr. Kouzoukas and Dr. Neuman, I will focus
my attention on you first. You both come from academic
backgrounds. You both have a lot of experience with this, and I
understand the role of the trustees is to kind of bring a
different perspective to something which is otherwise kind of
within the club, if you will.
Now for example, I understand that there is a controversy
where the Social Security actuaries presume that replacement
rate will be about two kids per family. CBO claims 1.75, and
there are others that say it is actually closer to 1.65. And
then we have the other influence of continued immigration,
which kind of offsets.
Now, that is going to make a huge difference. So, can you
describe your approach as to--you are coming into a group which
kind of has a set perspective, and yet credible outside sources
say maybe that perspective should be challenged. They may be
right, maybe not. How would you handle that, Dr. Neuman?
Dr. Neuman. Thank you, Senator, and I appreciate your
leadership on raising the visibility of issues and challenges
facing Social Security, because I do think these are very
important issues.
The work of the public trustees is very technical, and
reviewing assumptions is extremely important, because any
change in assumptions can have major ripple effects down the
road. I think the role of the public trustees is to bring a
fresh set of eyes to the decisions that have been made, to
bring in experts from outside to be----
Senator Cassidy. Now, I like what you are saying, but
everybody wants to be liked, and as soon as you begin
challenging assumptions of folks who have kind of settled on
those assumptions, there is always a sense of perhaps being
ostracized, et cetera.
And so I guess what I am asking you is, are you all willing
to at least challenge those assumptions, understanding you
might be the fly in the ointment?
Dr. Neuman. Well, I like to think of myself as a straight
shooter, and I understand that people might disagree. But I
would certainly be comfortable raising questions. If there is
conflict, then there is conflict, but I am not going to shy
away from raising questions and confronting assumptions if I
think they are wrong.
Senator Cassidy. Mr. Kouzoukas?
Mr. Kouzoukas. I do not think I could have said it any
better myself. I agree wholeheartedly with that, and I also add
that my experience has been that it is not necessary to always
be perceived as a fly, that sometimes this is about people
understanding that we are all working to the same end, and I
think that that is important in carrying out a duty like this.
And so I would say that my role here, if confirmed, would
be to understand the perspective of the professionals who work
on these issues, and what their viewpoint is, to ask good
questions like Dr. Neuman said. And then ultimately in the end,
that suggests that perhaps what is most important is some level
of transparency about what assumptions are being made, how
something like replacement ratios is being described and
calculated in the report.
Senator Cassidy. And let me just interrupt, because I have
limited time. But echoing a little bit what Senator Crapo
asked, which is, how can you communicate with us? Frankly, you
would have to educate us on the importance of these ripple
effects. What may sound like a small detail, we understand
makes a huge difference 10, 15, 20, and 70 years down the road.
Mr. Kouzoukas, let me ask you this next question my staff
confirmed to me. But the Medicare trustees' effect often
focuses on the HI fund, Part A, and does not really pay a lot
of attention to B and to D. And yet, there is some evidence
that when George Bush passed the Part D program, that it had a
positive effect in terms of reducing hospitalization.
So there is a dynamic iterative effect. If you do something
here, it actually benefits there. In terms of the global
budget, we know that it has a big effect. So, if you only focus
on HI, you do not focus on the Part D program--my gosh, maybe
we are spending a little bit more on drugs, but we are saving a
lot of money on hospitalization--you kind of miss an important
story to tell. How would you handle that, sir?
Mr. Kouzoukas. I think, Senator, this is an example of how
the trustees can contribute to the conversation. While there is
a lot of attention focused on the solvency dates and the like--
and those are really important things--what is also really
important in the work of the trustees is the information and
data they provide around the program, the mechanics of the
program, and why and how they make the calculations they make.
And so, the kinds of issues that you describe are things
that the trustees have worked around and explained in their
reports. And I would look forward to having the opportunity to
address these----
Senator Cassidy. I am almost out of time.
Dr. Neuman, would you add anything to what he just said?
Dr. Neuman. No. I actually agree, and I think it is the
role of the trustees to look at all parts of the program--A, B,
C, and D--and look at the interactions. I believe that is what
they do, but I think what the public trustees can add to the
conversation is making sure that the effects of, say Part D
drugs on Part A, are clearly understood when the report is
released.
The report is long; it has a lot of technical information.
So it is sometimes hard to see what is embedded in the report.
Senator Cassidy. If the chair will indulge me, I would also
ask that you help us put that in the scope of the entire
Federal budget, because if we are going to pay for B and D
separately from A, we may pay a little bit more here but save a
lot there. If that is not delineated, we may not have that
understanding.
You have been indulgent, Mr. Chairman, and I yield.
The Chairman. Well, I just want to say to my colleague--and
I very much look forward to working with him on these issues--
we were talking with Dr. Neuman, for example, about some of the
other emerging trends like chronic care, which came out of this
committee.
And apropos of your point with respect to Part D, I was one
of the Democrats who voted for Part D. I took an awful lot of
flak for it, and I went looking, for example, at the effects of
Part D on these other kinds of programs that you have talked
about.
We need that kind of information. So I want to thank my
colleague for this approach of looking to these emerging
trends, and I look forward, particularly in terms of health
care, to working closely with you.
Senator Cassidy. Okay; thank you.
The Chairman. All right; Senator Hassan is next.
Senator Hassan. Well, thank you, Mr. Chair. I want to thank
you and the ranking member for this hearing, and a ``thank you
and congratulations'' to the panel on your nominations. The
Chief Counsel role is vitally important to the fair and
efficient administration of the IRS, and public trustees
oversee the finances of both the Medicare and Social Security
programs, so obviously very important to all Americans.
The IRS Chief Counsel will be responsible for helping the
agency modernize its IT systems, issue guidance for taxpayers,
and generally help improve the customer service experience for
taxpayers. So, Ms. Rollinson, I start with a couple of
questions for you.
The Inflation Reduction Act's investments in IT
modernization will help better serve taxpayers, as well as
improve administration and implementation of our tax laws. I
was really pleased to see that the IRS's strategic operating
plan, released earlier this year, placed a particular emphasis
on IT modernization.
If confirmed, how will you, Ms. Rollinson, leverage IT
modernization efforts to provide a better customer service
experience for the taxpayer?
Ms. Rollinson. Thank you. Yes, I was very interested and
heartened to see that as well, and having been there 5 years
ago, yes, technology needed to be improved. If I am lucky
enough to be confirmed, I will be very interested to find out
what they have been doing, because I am interested in the role
that technology can have in helping assess what returns should
possibly be audited.
Because we know what the issues are, but how do we find
them in the big complex partnerships? How do we find those
issues? So that would be something I would be very interested
in learning more about.
Senator Hassan. Well, and there are other ways that, of
course, modernization can help the taxpayer experience for
people who do not need to be audited as well; correct?
Ms. Rollinson. Yes, absolutely. That's right.
Senator Hassan. Last year, the bipartisan Home Energy
Savings Act that Senator Collins and I sponsored became law as
part of the Inflation Reduction Act. It expanded tax cuts for
families who make energy-efficient home upgrades, such as
purchasing a heat pump or upgrading the insulation in their
windows or doors. These tax cuts will help Granite Staters
lower their energy bills.
Ms. Rollinson, what recommendations do you have to help
increase homeowners' use of the home energy improvement tax
credits?
Ms. Rollinson. Yes. The bill has many, many interesting
elements in it, and I know that Treasury has announced that
they are through phase one of the guidance. If I am confirmed,
I will want to make sure that the guidance is issued quickly,
so that taxpayers know what they need to do in order to claim
the benefits that they are entitled to, that will encourage
them to make these improvements that you are discussing.
Senator Hassan. Thank you.
One more question for you, Ms. Rollinson. I want to draw
your attention to an issue that some of my constituents have
been dealing with. When the IRS sends out mail notifications,
often it is to inform a taxpayer of an action that the taxpayer
needs to take. Failure to respond can result in delayed refunds
or problems for their small businesses, and sometimes there is
a real disconnect between what the taxpayer says they have
received and what the IRS has sent out.
Our office has dealt with dozens of these kinds of cases,
and often there has been little leniency from the IRS, even
when the taxpayer did nothing wrong. Sometimes they just did
not actually get the notice that the IRS says it sent. So how
would you recommend improving the mail notification system, so
that taxpayers who do not receive notices are not improperly
penalized?
Ms. Rollinson. Thank you. That is a very thoughtful
question, and the mail is something that is near and dear to my
heart. I do think that the Office of Chief Counsel needs to
work with the IRS to understand how to make sure a notice is
received, if they are not being received through the mail, and
certainly be understanding if there are in fact delays.
Senator Hassan. I would appreciate that, because these
cases are extraordinarily frustrating for taxpayers, but they
often end up being assessed penalties that are really
significant harms for them. So I would just urge you to look at
it.
And last question to both of our public trustees, and thank
you both for your willingness to serve. Public trustees play an
essential role in providing unbiased expertise to ensure that
the public understands Medicare's solvency and financial
health. The trustees' work to assess and project the financial
health of the Medicare program creates an essential foundation
for all of us as we do our policymaking.
I am very concerned about trends that drive up health-care
prices for Medicare, including the increase in provider
consolidation that New Hampshire and other States have seen
over the last decade. We obviously need competition, but it is
disappearing in the health-care market, with fewer and fewer
independent providers and fewer and fewer independent
hospitals.
Consolidation and payment incentives that drive
consolidation have contributed to a health-care affordability
crisis for older adults. So, Dr. Neuman and Mr. Kouzoukas, how
will you incorporate your knowledge of consolidation trends in
the health-care market into your work as a public trustee, and
I will start with you, Dr. Neuman.
Dr. Neuman. I am familiar with the issues that you are
raising, and I think they are important issues. Looking at the
effect of consolidation on health-care prices is something that
has been well established in the literature. It has some effect
on Medicare, but a larger effect is on commercial insurance,
people who pay private prices.
I would hope and look forward to working with the trustees
to understand what the effect is on health-care trends.
Consolidation also may have some impact on quality, and the
evidence is a bit mixed on that. I think that is a little bit
beyond the scope of the work of the public trustees, but I
would want to look broadly at this issue, and thank you for
raising it.
Senator Hassan. Well, thank you; and, Mr. Kouzoukas?
Mr. Kouzoukas. I agree that the trustees are obligated to
look at all the trends that shape their projections and
assumptions, and consolidation can play a role in that as well.
So I would look forward to working with the professional staff
that work on the report, the working group, and the trustees to
understand this issue and to contributing to the dialogue
around it as well as the assumptions that they make.
Senator Hassan. Thank you very much.
Thanks for your indulgence, Mr. Chair.
The Chairman. Thank you, Senator Hassan, for asking
specifically about this consolidation issue. We now have
something like 2 million people living in maternity deserts,
and that is because these big systems, several of them--and we
have faced this in Baker City, OR recently--are saying, ``Hey,
there are not as many babies being born, and we are just going
to pack up.'' And we are facing, in Baker City, a hospital that
has been there for 120 years plus, basically saying, ``We are
not going to do it anymore.''
So I want everybody to know that what Senator Hassan is
talking about--and we want you two confirmed--this is a very
powerful emerging trend: 2 million Americans living in
maternity deserts. And this has enormous ramifications for
economic development in rural areas. I see Senator Daines here,
and, my colleagues, this is going to be a major emerging
challenge, and thank you for bringing it up.
Senator Hassan. And, Mr. Chair, I would just add, it
contributes to things like maternity deserts, but it also
clearly is contributing to an increase in prices throughout
systems. So you know, I look forward to working with you on
that. Thank you.
The Chairman. And we very much support both of you,
Democrat and Republican. But this is the kind of emerging trend
we have got to get on top of.
Next is Senator Young.
Senator Young. Thank you, Mr. Chairman. I want to
congratulate our witnesses. Thank you for being here today, and
I am so appreciative that you wish to serve your country in the
respective capacities that you have been nominated for.
Ms. Rollinson, I have a few questions for you. You have an
impressive, an extensive background in the international tax
area, so I suspect you are aware that the Treasury Department
has received significant pushback as it pertains to the
administration's handling of OECD Pilar 2 negotiations,
particularly provisions like the Under-Taxed Profits Rule.
This would uniquely disadvantage U.S. businesses. It would
allow foreign countries to actually tax the U.S. activity of
U.S. companies. I have to read that again. It would allow
foreign countries to tax the U.S. activity of U.S. companies.
So can you please share your views on the current Pillar 2
negotiations?
Ms. Rollinson. Thank you for your question. Yes, I have
seen that. When I was at the Office of Chief Counsel up until
2019, they were just in the very beginning phases of looking at
Pillar 1 and Pillar 2.
The Office of Chief Counsel actually has a very small role
to play in this. These are negotiations that, as you mentioned,
are done by Treasury. We certainly have some people who would
consult on what the current state of the U.S. law was.
Senator Young. Right.
Ms. Rollinson. But the Office of Chief Counsel does not
have a very strong role in those, the negotiations that you are
talking about.
Senator Young. You would--you are nominated to be Chief
Counsel to IRS and, as I understand it, an Assistant General
Counsel of Treasury, right?
Ms. Rollinson. Right.
Senator Young. So more broadly, it is a broader portfolio
than just the Chief Counsel position, as I understand it. So,
if you could just volunteer to me in light of that, how you
anticipate Pillar 2 impacting U.S. companies?
Ms. Rollinson. So, I--it is a very important question, and
I am worried that I am not going to be giving a very
satisfactory answer. I understand the motivation for Pillar 2,
because----
Senator Young. I know you can give a thoughtful answer
because of your extensive experience as an international tax
attorney.
Ms. Rollinson. There you go----
Senator Young. Which you did not challenge. [Laughter.]
Ms. Rollinson. I did not challenge that, yes. But you are
absolutely right--you got me. What I can say is this, that
the----
I understand why Pillar 2 evolved, and the reason I say
that is, what I did not do much of in international tax--but is
critically important--is look at transfer pricing issues. I do
not mean to get technical, but there have been so many disputes
in the U.S. and abroad----
Senator Young. Let's not get technical, because I--the term
``transfer pricing,'' I start to glaze over. Let's just get
really foundational. Let's go back to, do you agree that the
Under-Taxed Profits Rule would disadvantage U.S. businesses by
allowing foreign countries to tax U.S. activity of U.S.
companies?
I have to say, if you disagree with that, I may find it
challenging to support your nomination, because for me it is so
obvious, unless you provide me a very compelling reason why you
disagree.
Ms. Rollinson. Thank you. This is not going to be
compelling to you. However, the rule that you mentioned is
actually one that I would need to get much more information
about. It is not one that I followed carefully once I left, and
it was not there when I left.
So it is something that I would need to get a lot more
information about before I would have a view as to whether it
is disadvantaging companies.
Senator Young. Okay. Well, kindly follow up with me and the
committee, so that everyone has an opportunity to review your
response. I received a lot of these written responses, I will
say this on the record, and it is amazing how your support
staff will provide a very vague and diplomatic response to--we
know how that works.
Ms. Rollinson, in light, once again, of your extensive
international tax experience, you are no doubt aware that I and
many of my colleagues have been particularly critical of the
administration's failure to secure favorable treatment of
important nonrefundable tax credits, such as the R&D credit,
under the proposed Pillar 2 regime.
Based on your experience as an international tax
professional, do you anticipate the current Pillar 2 model
rules will act as a disincentive for companies looking to make
investments in R&D activities in the United States?
Ms. Rollinson. Thank you. Again, I would need to know a lot
more about how it operates right now before I could answer
that.
Senator Young. Okay; I will answer.
Ms. Rollinson. Okay.
Senator Young. This will be a disincentive to U.S.
companies investing in R&D in the United States at the time
that China is offering very generous incentives for research
and development to companies that locate there.
Thank you.
The Chairman. My colleagues and members on both sides know
that I strongly support reauthorizing the R&D program.
Senator Daines?
Senator Daines. Mr. Chairman, thank you. I am glad we are
having this hearing, as this position has been vacant for over
2 years, leaving the IRS without their top legal advisor. In
that time, the IRS has caused direct harm to taxpayers on
numerous occasions, with little to no justification. Let me
speak to a couple of these instances.
During the early years of the Biden administration, June of
2021, ProPublica leaked a staggering amount of private taxpayer
information. This information was legally protected. It was
confidential IRS data, yet to this day the IRS has failed to
find and hold someone accountable.
Despite the Government Accountability Office underscoring
the need to resolve these immediate security weaknesses, the
IRS has continued to mishandle private taxpayer information.
Just last week, my Republican colleagues on this committee,
including myself, sent a letter seeking answers regarding the
destruction of millions of unprocessed taxpayer information
returns.
On June 14th of 2023, heavily armed, in fact 20 heavily
armed IRS agents entered the Highwood Creek Outfitters store in
Great Falls, MT and seized boxes of ATF Forms 4473. Let me say
that again: 20 heavily armed IRS agents entered a business,
Highwood Creek Outfitters, and seized ATF Forms 4437. It is
unclear how these forms pertain to the IRS, as they are not a
financial document, but rather the background check, the form
that contains personal information on gun purchasers.
I filled out many of those forms on firearms I have legally
purchased in Montana. Following inquiries from myself and my
colleagues, I am glad to have finally received a response
announcing the end of these egregious in-person taxpayer
visits. However, as we have seen, the IRS has a lengthy history
of abusing their power and depriving taxpayers of their rights,
and such instances cannot occur again.
Ms. Rollinson, underneath your leadership, what steps would
you take to ensure taxpayer information is protected, and to
put an end to these intimidation practices?
Ms. Rollinson. Thank you, Senator. You really raise a very
important issue of public trust, and I find it very disturbing
to see how the public trust in the IRS has eroded. To me that
is a very critical issue to take on right away. All the issues
you raised really go to that point.
And so, I would be hopeful that if I am confirmed, that
under my leadership we could work to restore the trust by
ensuring that we are working closely with Congress in their
very important oversight role, to make sure that Congress gets
the information that it needs, that we are reporting to the
right people--as I think happened in the ProPublica leak--that
something has gone wrong and do what we can to fix it, and that
we make sure that we are working with Congress in a way that
Congress's trust in the IRS is restored, and that together we
can have the American public's trust restored in the IRS.
Senator Daines. Yes. I will tell you what. I mean, I was
getting calls from a lot of Montanans too. When you talked
about the ProPublica leak, thank you. But what happened in
Great Falls, to have 20 armed IRS agents move into a business
like that and seize the ATF forms--I mean, it was chilling to
see what was happening to a business there in Montana.
There is a lot of damage done here, and a breach of trust,
whether it is leaks from ProPublica or, in this case, a
proactive, premeditated raid with 20 IRS agents armed, to seize
ATF forms.
Ms. Rollinson. Yes, I understand. We absolutely need to
make sure that the IRS is always operating in a fair manner and
treating taxpayers fairly. I agree with you.
Senator Daines. Lastly--and I know I am running out of
time--but I was discouraged to see the plan that Commissioner
Werfel revealed earlier this year, outlining how he plans to
use the $80 billion allocated to the IRS from the so-called
Inflation Reduction Act, the 87,000 agents that have been hired
to increase audits on Montanans and target everyday Americans.
While the administration may claim they are not going to
increase audits to anybody under $400,000, their actions say
otherwise. If the army of these new IRS agents was not proof
enough, just last week the IRS announced their newest effort to
knock on taxpayers' doors.
This unit is specifically focused on targeting pass-through
entities, the LLCs and S corps, which make up over 95 percent
of all businesses and employ about 50 percent of American
workers. These actions show the IRS is not going after wealthy
tax cheats. They are going after Main Street businesses.
Meanwhile, my office hears from constituents every day who
are trying to reach the IRS, and at best they are on hold
listening to mediocre '70s music--on hold for hours before
reaching an agent--and at worst not able to make any contact at
all.
Given your extensive management experience, Ms. Rollinson,
do you think it makes sense to prioritize spending billions of
dollars on Main Street businesses, instead of investing in
customer service efforts at the IRS?
Ms. Rollinson. I do agree that the IRS should be focusing
on improving customer service. I think that will go a long way
to improving the trust that the American public has in the IRS.
I think that is critically important.
Senator Daines. All right.
Thank you, Mr. Chairman.
The Chairman. I thank my colleague. I only want to say with
respect to what is really going on out there in the tax area,
it is reflected in what I did today, releasing data that shows
that there are nearly 1,000 millionaires who simply refuse to
file or pay their taxes, and that is what the new money at the
IRS has got to focus on.
Just get your arms around that. That is not what people
normally think, where the billionaire or millionaire calls up
their tax accountants and tries to work out some sort of way to
not take income or pay payroll taxes. We are talking here about
nonfiling. Thousands of millionaires in the data that I
released today, just for 3 years from the IRS, simply basically
gave a raspberry to the government. They just said, ``We are
not going to file. We are not going to pay.'' And that is
wrong, and that is what we have got to focus on with the IRS.
Senator Menendez?
Senator Menendez. Thank you, Mr. Chairman.
Just for the record, not all '70s music is that bad, so
congratulations to all of the nominees.
Dr. Neuman and Mr. Kouzoukas, my office has heard from
constituents who rely on Social Security and Social Security
Disability payments who have received letters demanding money
back for overpayments made by the agency.
According to recent reports, critically low staffing levels
mean it could be several years before the Social Security
Administration can reassess cases and catch overpayments. Some
individuals are even receiving bills from the Social Security
Administration that date back 40 years. In your view, how much
of this is caused by chronic understaffing at the Social
Security Administration?
Mr. Kouzoukas. Senator, thank you for the question. I think
that this highlights perhaps the distinction between the role
of the trustees and the folks who run the Social Security
program. Obviously, Dr. Neuman and I, if confirmed, would have
the privilege of serving with those folks and that leadership,
and our role would be to assess the financial and fiscal future
of the program, to provide data and information to this
Congress and the public about the Disability Insurance program
in terms of its financial status and the like.
So I think that the kinds of questions you are perhaps
getting at relate to the administration of the program day to
day, which we would not be involved in.
Senator Menendez. Well, except that in terms of its fiscal
integrity, if we are talking about 4 decades later that people
are getting notices, if we are thinking about the rate in which
there may be overpayment; and of course, even though you are
looking at fiscal integrity, I assume that you also want the
program to work well as it relates to the well-being of the
beneficiaries. This is an issue, because we are talking about
millions of dollars. It goes to the fiscal integrity; wouldn't
you agree?
Mr. Kouzoukas. I could see the connection, yes, as part of
a larger, broader picture of the way that the finances roll up
to the program, sure.
Senator Menendez. Let me ask you this, both of you.
According to the Social Security Administration Inspector
General, during fiscal year 2022 the agency--and this goes to
fiscal integrity--clawed back $4.7 billion of overpayments,
while another $21.6 billion remained outstanding. According to
recent reports, those who received Social Security payments say
they have gotten letters stating they must give back thousands
or even tens of thousands of dollars to the government because
of overpayment.
What else would you be looking for to have fiscal integrity
here, to make sure that we are not talking about billions of
dollars, assuming that the administration is right and these
are overpayments? Obviously to some degree, there has to be a
universe of it that is. But it is a very significant number.
Dr. Neuman. I would just add that I totally agree with Mr.
Kouzoukas in his response to your question, but I have also
read these articles that I think you are referring to, and I
understand how this is such a serious issue for families who
are suddenly asked to repay large amounts of money that they
did not know that they owed.
I really think, however, that this is more a question for,
say the Social Security Commissioner, because our role would be
more to look at what are the effects on disability spending
trends and obligations to the Disability trust fund. But the
broader issue is that this can have a profound impact, and it
is very scary for families when they get these letters.
Senator Menendez. Yes, it is usually scary for them. But it
also goes to the integrity of the system, that billions of
dollars are being paid out that in fact should not have been
paid out. Then I do think that as trustees you would be looking
at that as something of concern. Is that a fair statement?
Dr. Neuman. Yes, I think that is a fair statement, and it
is something that I would look forward to discussing with the
actuaries and the public, the other trustees, if I am fortunate
to be confirmed.
Senator Menendez. Mr. Kouzoukas?
Mr. Kouzoukas. I would as well.
Senator Menendez. Okay. I think with that, I am satisfied
with the questions I want to ask you. Thank you very much.
The Chairman. Thank you. We are moving to wrap up. We've
got a couple of procedural things. I have one last question.
I would also like to thank members today for their
participation, and with respect to questions for the record,
the deadline for members to submit QFRs will be next Tuesday,
October 3rd, at 5 p.m. The deadline is firm. We appreciate the
cooperation of everyone here.
What is going to happen now is, I want to make one last
point, and then I am going to hand matters over to the Senator
from Massachusetts, who will ask her questions, and then we
will wrap up.
Senator Warren, one of the areas that I have been
particularly concerned about is what the shutdown is going to
do to seniors and veterans and small business people, in terms
of interruptions. And let me tell you what I have picked up,
according to the news in the last hour.
If you are for shutting down the government, you are
sending a message to America's seniors, for example, you better
not lose your Medicare card, because they are not going to be
able to get replacements. So this idea that it is some kind of
just Washington, you know, ritual or something, that is what it
really means.
If you are for shutting down the government, explain it to
seniors, because a lot of folks--you know, those Medicare cards
can get lost, and seniors are not going to get a replacement.
Senator Warren, thank you for coming.
Senator Warren. Thank you, Mr. Chairman.
So, the IRS makes a lot of decisions that profoundly affect
who actually pays to support our government. That is why I am
very concerned about the revolving door, where large accounting
firms send their lawyers into high-ranking positions at the IRS
to create new tax loopholes for their clients, and then those
firms reward those same lawyers with promotions and bigger
paychecks when they leave government service and come back to
the accounting firm.
Now, Ms. Rollinson, you have been through the revolving
door more than once. You have gone from Ernst and Young to the
IRS, and then from the IRS back to Ernst and Young, and once
again from Ernst and Young back to the IRS, this time as Chief
Counsel.
I think that is a red flag, but you have made an
unprecedented commitment as a nominee. Ms. Rollinson, you have
sent me a letter committing, among other things, to recuse
yourself from any matters related to former clients for your
first 4 years at the agency, and, for 4 years after you leave
the IRS, not to go to work for any company, including Ernst and
Young, that has clients you interact with while you are at the
IRS.
This goes even further than President Biden's strong ethics
requirements. Do I have that right; is that correct?
Ms. Rollinson. Yes, that is correct.
Senator Warren. Ms. Rollinson, I appreciate your taking
these steps to assure the public that you will put their
interests first, and I support your nomination.
Mr. Kouzoukas, you have been nominated to serve as the
public trustee of the Medicare and Social Security trust funds.
I have concerns about your conflicts of interest. Now this
should not be a surprise. I sent you a letter outlining those
concerns.
The position of public trustee was created in the 1980s to
give the public a voice in the board of trustees' solvency
projections for Medicare and Social Security. And a big factor
influencing Medicare solvency today is the growth of Medicare
Advantage, a program that allows for-profit insurance companies
to provide Medicare coverage that experts say is on target this
year to overcharge the government by $75 billion.
In other words, Medicare Advantage has a lot to do with
threatening the solvency of Medicare. Mr. Kouzoukas, you sit on
the board of Clover Health, a for-profit insurance company
that, according to its most recent SEC filing, receives a
``substantial portion'' of its total revenue from Medicare
Advantage premiums. How much are you paid for your work at
Clover?
Mr. Kouzoukas. Senator, I am paid according to the
company's process for----
Senator Warren. Okay, and what is the dollar amount? That
is what I am asking.
Mr. Kouzoukas. Well, there is a portion of the compensation
that relates to equity, and a portion that relates to
particular roles on the board.
Senator Warren. So, you do not know the amount that you are
getting paid from Clover?
Mr. Kouzoukas. I do, Senator.
Senator Warren. But how about you tell me?
Mr. Kouzoukas. Well, there's a portion that relates to
the----
Senator Warren. Could I have a dollar amount, please?
Mr. Kouzoukas. Well, it also depends on the year and the
time----
Senator Warren. Okay. You did a financial disclosure last
year. Would you like to tell me what you said on your financial
disclosure, which you signed under oath?
Mr. Kouzoukas. I believe, Senator, as laid out in your
letter, you pointed to the payment that was from Clover with
regards to 2022, the compensation therein being in the category
of $100,000 or more----
Senator Warren. Okay. So you received $100,000 from Clover
for your service, and if confirmed as a public trustee, do you
plan to quit the Clover board?
Mr. Kouzoukas. Senator, I appreciate the opportunity to
address your question. The role----
Senator Warren. It is really easy. You can say ``yes'' or
you can say ``no.''
Mr. Kouzoukas. Senator, the role of the trustees of the
Social Security----
Senator Warren. Is that a ``yes'' or a ``no''? Do you plan
to quit the job for which you were paid $100,000 a year?
Mr. Kouzoukas. Senator, I am grateful to the President and
his team for the review of my credentials and qualifications as
well----
Senator Warren. Really, you are going to have to answer
this question. Is it ``yes'' or ``no,'' are you planning to
resign the job that pays you $100,000 a year while you are a
trustee for Medicare?
Mr. Kouzoukas. Senator, the review of my current activities
and my credentials and qualifications is one that all nominees
undergo, and that is one that led to the President putting my
nomination before this body. I am grateful for that, and if
given the----
Senator Warren. Look, I am not going to get into why the
President nominated you. What I want to know is, are you going
to keep a job where you get paid by a for-profit outfit
somewhere in the neighborhood of $100,000 while you keep your
government trustee job? Can you answer that question?
Mr. Kouzoukas. Senator, the role of the trustee is
actually----
Senator Warren. Okay. I am going to take that as a ``yes,''
because I am going to assume that if you were going to quit
that job, you would be really happy to tell me that right now,
before we go into the question of what it means for you to keep
this job.
Mr. Kouzoukas, as we both know, as a member of the board,
corporate law requires you to help Clover maximize its profits.
So for example, if you highlighted the amount of fraud that
Medicare Advantage undergoes every year and how that fraud is
undermining the solvency of Medicare, that could lead to
policies that might limit the Medicare Advantage program. And
if that happened, Mr. Kouzoukas, would limiting the Medicare
Advantage program undercut the profitability of Clover, the
company that by law you are supposed to be watching out for?
That was a question.
Mr. Kouzoukas. I am not sure I understood the question or
got the----
Senator Warren. So, all right. My question is, if you are
on the board of Clover, you are legally obligated to try to
help Clover to improve its profitability over time or at least
sustain its profits. That is corporate law 101, right?
So if you are also serving as Medicare trustee--I just want
to be clear here. If the focus in the Medicare program is on
the amount of fraud that is currently in the Medicare Advantage
program, I think it is reasonable to assume that that could
lead to reducing the amount of money that we put into Medicare
Advantage, to putting more restrictions on Medicare Advantage,
to saying we have to put a cop on the beat, maybe cut it out
altogether.
What I am asking you is, would that injure Clover? That is,
would it reduce Clover's profitability?
Mr. Kouzoukas. Senator, I think all Americans, and I
especially would share your attentiveness to the questions of
fraud. I don't think that----
Senator Warren. I appreciate that, but I asked you a pretty
straightforward question. If you are actually going to be a
trustee on behalf of the American people and people who care
about the solvency of Medicare, then I think you ought to be
able to answer.
If Medicare currently, as it stands, put more restrictions
on Medicare Advantage, would that likely cut into the
profitability of Clover, the company from which you receive
more than $100,000 in compensation annually?
Mr. Kouzoukas. Senator, I think that the question you are
asking----
Senator Warren. I know the question I am asking. Could you
answer my question, please?
Mr. Kouzoukas. Yes.
Senator Warren. You want to be a trustee for the American
people. You ought to be able to answer that question.
Mr. Kouzoukas. The question you are asking is one that
deserves a greater context about the role of the trustee.
Senator Warren. No, it deserves an answer. If you want to
be the trustee, then answer the question. If Medicare cut what
goes into Medicare Advantage, would that hurt Clover's
profitability? That is not a hard question, and in fact Clover
has already pretty much answered that in its public documents.
So could you give an answer to that please?
Mr. Kouzoukas. I think, Senator, that what is important to
focus on here----
Senator Warren. I know what is important to focus on here.
That is why I am here, to ask the questions that are important
to focus on. Could you answer my question, please?
Mr. Kouzoukas. Yes, Senator. I think that, if confirmed,
Dr. Neuman and I would be an outside set of eyes and ears----
Senator Warren. That is not my question. Can you answer my
question, or are you just flatly refusing?
Mr. Kouzoukas. Senator, I would be delighted to----
Senator Warren. Then answer my question.
Mr. Kouzoukas. And I think that the question is one that
is, in the context of a hearing----
Senator Warren. No. It is a question that is a straight
financial question. You know, Mr. Kouzoukas, I think you think
you are going to get away with this by just not answering the
question and not having a clip that admits how much money you
are taking from a private insurance company that makes its
money through Medicare Advantage, at the same time that you are
trying to take a public role that will influence whether we
focus on the fraud in Medicare Advantage, or whether we turn a
blind eye to it.
Let us be clear. If Mr. Kouzoukas ignores the fraud, then
he helps Clover. If he focuses on the fraud, he hurts Clover.
The conflict of interest here is so big and so pervasive that
there is no action that Mr. Kouzoukas can take that does not
either help or hurt Clover, the company that pays him $100,000
a year to sit on its board and watch out for the company.
And there is no waiver that can change that fact. This kind
of conflict is shocking, and it is deeply unethical. Not a
single other trustee has ever received compensation from an
insurance company while acting as a Medicare trustee. If you do
not step down from the Clover board, then you should withdraw
your nomination.
If you do not withdraw, given the clear conflicts posed by
your board service, I will strongly oppose your nomination, and
I will encourage ever other Senator in this body to do so as
well.
I am through, and they want me to gavel out when you are
done. So I do not have a gavel, but this hearing is now closed.
Thank you.
[Whereupon, at 12:16 p.m., the hearing was concluded.]
A P P E N D I X
Additional Material Submitted for the Record
----------
Prepared Statement of Hon. Mike Crapo,
a U.S. Senator From Idaho
Thank you, Mr. Chairman, and welcome to our three nominees: Dr.
Neuman and Mr. Kouzoukas, who have been nominated to be public trustees
of Social Security and Medicare; and Ms. Rollinson, who has been
nominated to be IRS Chief Counsel. Thank you all for your willingness
to serve.
The trustees are responsible for producing annual reports that
equip Congress and the administration with data needed to safeguard the
long-term security and financial viability of the Social Security and
Medicare trust funds. Congress added the public trustee positions in
1983 to increase public confidence in the integrity of the trust funds
and objectivity of the trustees' reports. The public trustees are
tasked with providing objective, dispassionate accounts of exactly what
is happening with the trust funds.
If confirmed, you must ensure the public has a balanced, pragmatic
understanding of the opportunities and the challenges that face the two
programs. I look forward to hearing from each of you today.
Ms. Rollinson, the IRS Chief Counsel is responsible for fairly and
impartially interpreting and enforcing our tax laws, while also
ensuring taxpayer rights are strictly protected. Given recent IRS
controversies and the push for enhanced enforcement, Americans are
rightly concerned with the potential erosion of their rights and
privacy. The IRS Chief Counsel must have the highest level of skill,
judgment, and integrity, and above all, must not let political
pressures affect policy outcomes.
Unfortunately, the agencies to which you have been nominated for
key posts have recently made repeated practice of putting politics
first. My colleagues and I have raised a number of concerns with recent
IRS and Treasury actions that will fall under your remit. Interpreting
the so-called Inflation Reduction Act is squarely within the IRS Chief
Counsel's purview.
The IRA created complexity that has proven unworkable in
implementation, putting many American businesses and consumers at a
significant disadvantage, and has supercharged IRS enforcement while
short-changing taxpayer service.
Since the bill's rushed and strictly partisan passage, the Biden
administration has resorted to unilaterally walking back and diluting a
number of key provisions. The IRS has simply disregarded statutory
deadlines for implementing new Democrat-led provisions, including
enhanced information reporting and EV tax credits.
Further, Treasury and IRS's expansive interpretation of IRA's
energy tax provisions has provoked significant criticism from members
on both sides of the aisle. Other provisions have gone into effect
without necessary guidance, leaving taxpayers without information
needed to comply.
I look forward to hearing how you will address these concerns and
use your expertise to put adherence to the law over desired political
outcomes.
If confirmed, you will also have a significant role in addressing a
number of other recent, concerning IRS actions, including: use of IRA
funds to increase enforcement in areas with a long history of
burdensome and low-utility ``no change'' audits; leaks of confidential
taxpayer information; the destruction of 30 million information
returns, which reportedly led to additional audits of Earned Income Tax
Credit claimants; and the ongoing attempt to stand up and divert
resources to an IRS-run tax preparation program without clear statutory
authority.
The administration's practice of putting politics before sound
policy extends to its failure to protect U.S. interests in OECD
international tax negotiations. Rather than focus on fighting
discriminatory taxes against U.S. companies and defending current U.S.
law, Treasury placed the administration's political agenda first
without regard to the potential effect on U.S. taxpayers.
This administration failed to halt discriminatory digital services
taxes against U.S. companies, but instead invited foreign governments
to pursue new discriminatory taxes against our companies in the form of
the Under-Taxed Profits Rule (UTPR), a surtax which also likely
violates our existing bilateral tax treaties. As a collateral
consequence, Treasury must now exhaust precious resources issuing
regulations to attempt to mitigate the double taxation it created by
unilaterally committing to a global tax deal that undermines U.S.
interests.
To avoid these outcomes, I stress the importance of engaging this
committee with transparency and responsiveness. Too often in recent
years, the administration's nominees have committed to working with us,
but have failed to follow through.
On behalf of all American taxpayers, I strongly urge the nominees
here today to commit to timely and thorough communication with this
committee.
Congratulations on your nominations, and I look forward to
discussing these important topics with you.
______
Prepared Statement of Demetrios L. Kouzoukas, Nominated to be a Member
of the Board of Trustees of the Federal Old-Age and Survivors Insurance
Trust Fund and the Federal Disability Insurance Trust Fund, the Board
of Trustees of the Federal Hospital Insurance Trust Fund, and the Board
of Trustees of the Federal Supplementary Medical Insurance Trust Fund
Thank you, Chairman Wyden, Ranking Member Crapo, and members of the
committee. It is a great honor to be nominated to serve as one of the
two public trustees for Social Security and Medicare, and I appreciate
your willingness to consider me for the position. I thank President
Biden for the honor of placing my nomination before the Senate and
Senate Minority Leader McConnell for the trust he placed in me in
putting my name forward for this position. I also thank Dr. Neuman for
her collegiality and professionalism as we have gone through this
process of being considered together. And I am deeply grateful for the
support of my family, friends, and colleagues.
We often hear and talk about how the Social Security and Medicare
programs make up the largest portion of the Federal budget, and a
substantial portion of our Nation's Gross Domestic Product. It is hard
to overstate the fiscal, societal, and economic impact of these
programs. And each of us can see the role the programs play in the
lives of every American family, whether in paying taxes or as
beneficiaries of the programs, now or in future generations. In our
Constitution, the people vest Congress with the powers of taxation and
spending that underlie these programs; given their importance and size,
it is imperative that Congress and the public have the most accurate
and objective information possible about their status and funding.
After all, as Abraham Lincoln is reputed to have said, ``Let the People
know the facts and the country will be saved.'' The work of the public
trustees is essentially to help ascertain and publish these facts while
being independent of administering the programs day to day. This
includes witnessing the objectivity and integrity of the assumptions
and calculations as well as participating in the associated internal
dialogue and deliberations. The end result is enhanced public
confidence in the trustees' work.
For me, the opportunity to be considered for this role is
meaningful and humbling for reasons beyond these solemn goals or my
professional journey. It is also personal. My first interactions with
these programs were as a child of a parent with disabling and early
chronic diseases. The challenge my family had navigating the health-
care and retirement systems planted a powerful seed. That seed has
grown and nourished the perspective that I have brought to my work
throughout my career, especially as a public servant. Along the way, I
have had the honor to work for the U.S. Department of Health and Human
Services in different capacities, including at the Centers for Medicare
and Medicaid Services, and, from time to time, partnering with the
Social Security Administration. I have also served as a member of the
Administrative Conference of the United States, representing the public
to provide advice to the Federal Government based on my experience in
public administration and benefits programs.
These roles built on others in the private sector and allowed me to
develop knowledge and skills especially relevant to the work of the
public trustees. For example, early in my career, I worked at a
nonprofit dedicated to improving public employee pension systems,
including their intersection with Social Security. That provided me
with a foundation in retirement policy and social insurance concepts.
Later, as both a government lawyer and administrator, I developed a
background in Federal appropriations law and accounting processes. I
have worked extensively with actuaries in the private and public
sector, including the Office of the Actuary at the Centers for Medicare
and Medicaid Services. I was particularly honored to represent the
Centers for Medicare and Medicaid Services at the meeting to issue the
2017 Medicare trustees report, serving as secretary at the meeting and
signing the report. Finally, as a government employee, I have testified
before and worked with Congress on complex and technical topics like
those addressed by the trustees.
These collective personal and professional experiences afford me
the knowledge, institutional memory, and judgement to represent the
public in the work of the trustees. If confirmed, I would work to the
best of my abilities to fulfill the expectations of the Greenspan
Commission with regard to this important position--to ``assure that the
demographic and economic assumptions for the cost estimates of the
future operations of the program[s] . . . continue to be developed in
an objective manner.''
Thank you for your consideration of my nomination. I look forward
to answering your questions.
______
SENATE FINANCE COMMITTEE
STATEMENT OF INFORMATION REQUESTED
OF NOMINEE
A. BIOGRAPHICAL INFORMATION
1. Name (include any former names used): Demetrios L. Kouzoukas.
2. Position to which nominated: Member of the board of trustees of
the Federal Hospital Insurance trust fund, the Federal Supplementary
Medical Insurance trust fund, the Federal Old-Age and Survivors
Insurance trust fund, and the Federal Disability Insurance trust fund.
3. Date of nomination: January 3, 2023,
4. Address (list current residence, office, and mailing addresses):
5. Date and place of birth: October 24, 1975; Chicago, IL.
6. Marital status (include maiden name of wife or husband's name):
7. Names and ages of children:
8. Education (list all secondary and higher education institutions,
dates attended, degree received, and date degree granted):
University of Illinois College of Law, 1997-2000, J.D., 2000.
The George Washington University, 1993-1997, B.A., 1997.
Illinois Mathematics and Science Academy, 1990-1993, High
School diploma, 1993.
Maine Township High School East, 1989-1990.
9. Employment record (list all jobs held since college, including the
title or description of job, name of employer, location of work, and
dates of employment for each job):
Team8 (PrestigePEO is Team8's Professional Employer
Organization), Executive and Partner, Vienna, VA, 2022-present.
Self-employed, Paragon Health Institute Initiative Director,
Vienna, VA, 2021-present.
Pro Unlimited, Senior Advisor (for McKinsey and Co.), Vienna,
VA, 2021-present.
CM Life Sciences IV, Inc., nominee for Director, New Castle,
DE, 2021-present.
U.S. Department of Health and Human Services, Director, Centera
for Medicare and Principal Deputy Administrator, Centers for
Medicare and Medicaid Services, Washington, DC and Baltimore,
MD, 2017-2021.
Administrative Conference of the United States, Public Member,
Washington, DC, 2014-2017.
UnitedHealthcare Medicare and Retirement, General Counsel,
Minnetonka, MN, 2012-2016.
Covington and Burling LLP, of Counsel, Washington, DC, 2009-
2012.
U.S. Department of Health and Human Services, Principal
Associate Deputy Secretary, Associate Deputy Secretary,
Washington, DC, 2008-2009.
U.S. Department of Health and Human Services, Deputy General
Counsel, Washington, DC, 2006-2008.
U.S. Department of Health and Human Services, Special Assistant
to the General Counsel, Washington, DC, 2003-2006.
Gardner Carton and Douglas, Associate, Washington, DC, 2000-
2003.
George Mason University School of Law, Adjunct Professor,
Arlington, VA, 2002.
University of Illinois College of Law, Research Assistant,
Champaign, IL, 1999-2000.
U.S. House of Representatives Committee on the Judiciary,
Intern, Washington, DC, 1999.
Garretson and Santora (through First Temporary Services), Legal
Secretary, Chicago, IL, 1998.
National Committee on Public Employee Pension Systems, Office
Manager and Writer, Washington, DC, 1993-1997.
10. Government experience (list any current and former advisory,
consultative, honorary, or other part-time service or positions with
Federal, State, or local governments held since college, including
dates, other than those listed above):
None, other than those listed above.
11. Business relationships (list all current and former positions held
as an officer, director, trustee, partner (e.g., limited partner,
nonvoting, etc.), proprietor, agent, representative, or consultant of
any corporation, company, firm, partnership, other business enterprise,
or educational or other institution):
Partner, Team8.
Director, Clover Health.
Director, Alliance for Health Policy.
Nominee for Director, CM Life Sciences IV, Inc.
Director/Chair (former), Virginians for Limited Government.
In connection with my role at UnitedHealthcare listed above,
there may have been times when I served as Secretary for
meetings of the insurance entities of the organization.
As part of my work as a lawyer in the roles listed above, I
provided advice to and consulted with clients. As part of my
work in other roles listed above, I engaged in consultations.
12. Memberships (list all current and former memberships, as well as
any current and former offices held in professional, fraternal,
scholarly, civic, business, charitable, and other organizations dating
back to college, including dates for these memberships and offices):
Parent teacher associations (Plymouth Creek Elementary School,
Colvin Run Elementary School, Cooper Middle School), 2012-
present.
Woodcrest Homeowners Association, 2012-2018 (estimated).
Vinewood Homeowners Association, 2003-2012.
Glen Forest Community Pool, 2011-2012 (estimated).
Saint Katherine Greek Orthodox Church, Our Lady of Good Counsel
Catholic Church, St. Thomas a Becket Catholic Church, Holy Name
of Jesus Catholic Church, Our Lady of Lourdes Church, various
dates.
Minnesota Zoo Foundation, 2013-2017 (estimated).
Fairfax County and Virginia Association for the Gifted, 2019-
2020 (estimated), and Minnesota Council for the Gifted and
Talented, 2016-2017 (estimated).
Minnesota Historical Society, 2013-2015 (estimated).
Friends of the Hennepin County Library, 2013-2015 (estimated).
Friends of the National Zoo, 2009-2011 (estimated).
Friends of Claude Moore Colonial Farm at Turkey Run, 2009
(estimated).
American Medical Association Digital Medicine Payment Advisory
Group, 2021-present.
Virginia State Bar, 2000-present.
Bar Association of the District of Columbia, 2001-present.
Minnesota State Bar, 2013-2022.
Virginia Bar Association, 2000-2003 (estimated).
Illinois State Bar Association, 1999-2000 (estimated).
American Bar Association, 1998-2000 (estimated).
American Health Lawyers Association, 2000-Present, Co-Chair of
Payers, Plans and Managed Care Practice Group Health Plan
Affinity Group, 2016 (estimated), Program Committees.
The Federalist Society for Law and Public Policy, 1997-Present
(estimated).
Freedom Club, 2014-2017.
Republican National Lawyers Associations, various dates.
Presidential Transition Team, 2016-2017, Agency Action and
Policy Implementation team member.
Food and Drug Law Institute, 2010-2012 (estimated).
Drug Information Association, 2010-2012 (estimated).
Health Care Compliance Association, 2010-2012 (estimated).
National Republican Club of Capitol Hill, 2000-2008
(estimated).
Public Interest Law Foundation, 1997-2000 (estimated).
Young America's Foundation, 1992-1997 (estimated).
George Washington University College Republicans, 1993-1997.
The Conservative Network, 1993-1997 (estimated).
Maine Township Regular Republican Organization, 1989-1995
(estimated).
Mensa, 1985-1989 (estimated).
In addition, I have participated in student activities, as well
as volunteer events or activities connected to charitable or
other organizations.
13. Political affiliations and activities:
a. List all public offices for which you have been a candidate
dating back to the age of 18.
None.
b. List all memberships and offices held in and services
rendered to all political parties or election committees,
currently and during the last 10 years prior to the date of
your nomination.
Fairfax County Republican Committee, member, various dates.
Republican Party of Minnesota Plymouth Precinct 2, member,
various dates, Secretary in 2016-2017 (moved before initiating
substantial duties).
Arlington County Republican Committee, member, various dates.
I have, at times, been a volunteer for various political party
organizations, campaigns, and similar organizations, as well as an
attendee at meetings and delegate at conventions.
c. Itemize all political contributions to any individual,
campaign organization, political party, political action
committee, or similar entity of $50 or more for the past 10
years prior to the date of your nomination.
Harrison for Congress, $2,900 (March 1, 2021).
Michael D. Crain for Fort Worth, $50 (January 28, 2021).
Tracci for Albemarle County Commonwealth's Attorney, $300 (May
7, 2019), $962 (June 13, 2015).
National Republican Congressional Committee, $300 (October 27,
2018).
UnitedHealth Group Incorporated PAC, $288 (December 31, 2016),
$288 (November 28, 2016), $96 (October 19, 2016), $192 (September 30,
2016), $192 (August 31, 2016), $288 (July 31, 2016), $192 (June 30,
2016), $192 (May 31, 2016), $192 (April 30, 2016), $192 (March 31,
2016), $192 (February 29, 2016), $192 (December 31, 2015), $192
(November 30, 2015), $192 (October 31, 2015), $192 (September 30,
2015), $192 (August 31, 2015), $288 (July 31, 2015), $192 (June 30,
2015), $192 (May 31, 2015), $192 (April 30, 2015), $192 (March 31,
2015), $192 (February 28, 2015), $288 (January 31, 2015), $192
(December 31, 2014), $96 (October 15, 2014), $192 (August 31, 2014),
$192 (July 31, 2014), $192 (June 30, 2014), $192 (May 31, 2014), $192
(April 30, 2014), $192 (March 31, 2014), $192 (February 28, 2014),
$1,000 (November 30, 2013), $500 (October 31, 2013).
Friends of Erik Paulsen $500 (November 8, 2016), $1,000 (October
15, 2014).
Scott Walker Inc. $500 (August 8, 2015).
Friends of Pat Toomey $1,000 (December 22, 2015).
Ben Sasse for U.S. Senate $250 (April 4, 2014).
Freedom Club $3,000 (September 8, 2014).
14. Honors and awards (list all scholarships, fellowships, honorary
degrees, honorary society memberships, military medals, and any other
special recognitions for outstanding service or achievement received
since the age of 18):
Young America's Foundation scholarship, 1993 (estimated).
The George Washington University Dean's List, 1993-1997
(various times).
The George Washington University Presidential Academic Award,
1993-1997.
The George Washington University board of trustees scholarship,
1994-1997.
University of Illinois College of Law Illinois Legislature
fellowship, 1999-2000 (estimated).
Northwest Suburban Bar Association scholarship, 1997
(estimated).
University of Illinois College of Law Dean's List, 1997-2000
(various times).
Hellenic Bar Association of Illinois scholarship, 1998
(estimated).
This does not include U.S. Department of Health and Human
Services Departmental Honors Awards, Office of the Secretary
awards, and Centers for Medicare and Medicaid Services Honor
Awards possibly awarded between 2003-2009 and 2017-2021.
15. Published writings (list the titles, publishers, dates, and
hyperlinks (as applicable) of all books, articles, reports, blog posts,
or other published materials you have written):
``Parallel Review: Not for Everyone, Useful for Some, and
Additional Considerations for Improvement,'' American Health
Lawyers Association Life Sciences Practice Group Member
Briefing (December 2011).
``Coverage and Reimbursement for Life Sciences Products--
Recommendations from the MEDCAC,'' Bloomberg Health Law Report,
with Anna Kraus and Katherine Sauser (September 2011),
available at: http://web.archive.org/web/20111018024003/http://
www.cov.com/files/Publication/2049cb18-632e-4f10-9a
84-07593a2e8c30/Presentation/PublicationAttachment/ec9263b0-
f9b9-445c-973a
-0a8dab6b6a34/From%20Research%20to%20Revenue%20-
%20Coverage%20and
%20Reimbursement%20for%20Life%20Sciences%20Products%20-
%20Recommend
.pdf.
``Coverage and Reimbursement Considerations for In Vitro
Diagnostics, Bloomberg Health Law Report,'' with Anna Kraus and
Katherine Sauser (June 2011), available at: http://
web.archive.org/web/20210512111234/https://www.cov.com/-/media/
files/corporate/publications/2011/06/coverage-and-
reimbursement-considerations-for-in-vitro-diagnostics.pdf.
``Coverage and Reimbursement of Laboratory Tests,'' In Vitro
Diagnostics: The Complete Regulatory Guide, Food and Drug Law
Institute (2010).
``Legal Preparedness for Obesity Prevention and Control: The
Structural Framework and the Role of Government,'' The Journal
of Law, Medicine, and Ethics (Summer 2009), available at:
https://web.archive.org/web/20170706064956/https://aslme.org/
media/downloadable/files/links/0/6/06-Kouzoukas.pdf.
``Public Health Emergency Legal Preparedness: Legal
Practitioner Perspectives,'' Journal of Law, Medicine and
Ethics, (Spring 2008), available at: https://
citeseerx.ist.psu.edu/viewdoc/
download?doi=10.1.1.227.5374&rep=rep1
&type=pdf.
``Rx Reimportation: A Legislative History,'' Health Care News
(November 2002), available at: http://web.archive.org/web/
20021105005210/https://www.heart
land.org/Article.cfm?artId=10669.
``HIPAA's Privacy Rule on Research: Insight into the Tension
between Privacy and the Value of Knowledge,'' Topics in Health
Information Management (May 2002) ``HIPAA's Impact on Sites:
Questions and Answers,'' Clinical Trials Advisor, with
Christine Pierre (May 2002).
``Politics, Law Delay Drug Discount Card,'' Health Care News
(January 2002), available at: http://web.archive.org/web/
20041028061905/http://www.heart
land.org/pdf/ACF35D.pdf.
``Lupron and You: How to Avoid Compliance Problems in Your
Relationships With Pharmaceutical Companies,'' BNA's Health Law
Reporter, with Mark Fitzgerald (June 7, 2001).
``Congress Passes FUTA Provision: Planning and Implementation
Issues for Tribal Employees,'' Native American Law Digest, with
Kathleen Nilles and Karen McAfee (March 2001).
16. Speeches (list all formal speeches and presentations (e.g.,
PowerPoint) you have delivered during the past 5 years which are on
topics relevant to the position for which you have been nominated,
including dates):
``Empowering Patients to Drive Value in Medicare,'' American
Health Lawyers Association Health Plan Law and Compliance
Institute (November 2019).
``Keynote Address,'' Centers for Medicare and Medicaid Services
Medicare Advantage and Prescription Drug Plan Fall Conference
and Webcast (November 2019), available at: https://
www.youtube.com/watch?v=FZEAaMklBbs&t=
5473s.
``Emerging Medicare Trends,'' Alliance for Health Policy Health
Policy Conference (October 2019).
Witness, U.S. Senate Special Committee on Aging Hearing on The
Complex Web of Prescription Drug Prices (June 2019), available
at: https://www.
senate.gov/isvp/
?autoplay=false&comm=aging&filename=aging061919.
``Keynote Address,'' Centers for Medicare and Medicaid Services
Medicare Advantage and Prescription Drug Plan Spring Conference
and Webcast (May 2019), available at: https://www.youtube.com/
watch?v=hUUpOWxcugA.
``2019 Policy Priorities for CMS,'' America's Health Insurance
Plans National Health Policy Conference (March 2019).
``Keynote Address,'' Centers for Medicare and Medicaid Services
Medicare Advantage and Prescription Drug Plan Fall Conference
and Webcast (September 2018), available at: https://
www.youtube.com/watch?v=31Fv-EO2T-E.
``Keynote Address,'' Centers for Medicare and Medicaid Services
Medicare Advantage and Prescription Drug Plan Audit and
Enforcement Conference and Webcast (May 2018), available at:
https://www.youtube.com/watch?t=5870&v
=kfhmCH0yaS4.
Witness, U.S. House of Representatives Committee on Ways and
Means Health Subcommittee Hearing on Implementation of MACRA's
Physician Payment Policies (March 2018), available at https://
www.youtube.com/watch?v=WM58J
CX4cSQ.
In addition, I have at times made informal speeches in formats
such as opening remarks, panel discussions, fireside chats, and
class guest lectures.
17. Qualifications (state what, in your opinion, qualifies you to
serve in the position to which you have been nominated):
My interest in and passion for the Medicare program originates
beyond my professional journey. My first interactions with
Medicare were as a child of a parent with chronic disease. The
challenge we had navigating the health-care system planted a
powerful seed. Those experiences shape the perspective that I
have brought to my work in every role I have had the privilege
to play. Along the way, I have had the honor to work for the
U.S. Department of Health and Human Services (including the
Centers for Medicare and Medicaid Services) and with the Social
Security Administration.
This built on initial work on retirement policy and
entitlements at a nonprofit focused on public employee pension
systems (including their intersection with Social Security).
Later, as both a government lawyer and administrator, I
developed a background in Federal appropriations law and
accounting processes, providing context for the trustees' work.
I have also worked extensively with actuaries in the private
and public sector, including the Office of the Actuary at the
Centers for Medicare and Medicaid Services. I represented the
Centers for Medicare and Medicaid Services at the trustees'
meeting to issue the 2017 report, serving as secretary at the
meeting and signing the report. Finally, as a government
employee, I have testified before congressional committees and
otherwise worked with Congress on complex topics like those
addressed by the trustees, so I appreciate the importance of
being able to provide Congress with helpful background to
inform its deliberations.
These collective personal and professional experiences afford
me the knowledge, institutional memory, and judgement to, if
confirmed, represent the public in the work of the trustees.
B. FUTURE EMPLOYMENT RELATIONSHIPS
1. Will you sever all connections (including participation in future
benefit arrangements) with your present employers, business firms,
associations, or organizations if you are confirmed by the Senate? If
not, provide details.
No, as the appointment would be to serve as a special
government employee. I will continue my current employment if
confirmed by the Senate.
2. Do you have any plans, commitments, or agreements to pursue
outside employment, with or without compensation, during your service
with the government? If so, provide details.
Yes. I intend to keep all of my current employment and other
commitments.
3. Has any person or entity made a commitment or agreement to employ
your services in any capacity after you leave government service? If
so, provide details.
No. I intend to keep all of my current employment and other
commitments.
4. If you are confirmed by the Senate, do you expect to serve out
your full term or until the next presidential election, whichever is
applicable? If not, explain.
Yes.
C. POTENTIAL CONFLICTS OF INTEREST
1. Indicate any current and former investments, obligations,
liabilities, or other personal relationships, including spousal or
family employment, which could involve potential conflicts of interest
in the position to which you have been nominated.
In connection with the nomination process, I have consulted
with the Office of Government Ethics and the Designated Agency
Ethics Officials (DAEO) at the Social Security Administration
to identify potential conflicts of interest. Any potential
conflicts of interest will be resolved in accordance with the
terms of an ethics agreement that I have entered into and that
has been provided to this committee. I am not aware of any
other potential conflicts of interest.
2. Describe any business relationship, dealing, or financial
transaction which you have had during the last 10 years (prior to the
date of your nomination), whether for yourself, on behalf of a client,
or acting as an agent, that could in any way constitute or result in a
possible conflict of interest in the position to which you have been
nominated.
In connection with the nomination process, I have consulted
with the Office of Government Ethics and the Designated Agency
Ethics Officials (DAEO) at the Social Security Administration
to identify potential conflicts of interest. Any potential
conflicts of interest will be resolved in accordance with the
terms of an ethics agreement that I have entered into and that
has been provided to this committee. I am not aware of any
other potential conflicts of interest.
3. Describe any activity during the past 10 years (prior to the date
of your nomination) in which you have engaged for the purpose of
directly or indirectly influencing the passage, defeat, or modification
of any legislation or affecting the administration and execution of law
or public policy. Activities performed as an employee of the Federal
Government need not be listed.
I have been involved in issues involving law and public policy
at the Federal, State, and local level. This has included, in
the positions and activities described above, providing legal
advice, supporting judicial and administrative litigation
pleadings and other filings, assisting with comments on
rulemaking, responding to government requests, helping prepare
congressional testimony, participating in research, identifying
regulatory trends, considering impacts of policy changes,
reviewing articles for publication, discussing administrative
process and operations, contributing to educational analyses,
volunteering with political campaigns, and taking part in
presidential transition activities.
4. Explain how you will resolve any potential conflict of interest,
including any that are disclosed by your responses to the above items.
(Provide the committee with two copies of any trust or other
agreements.)
In connection with the nomination process, I have consulted
with the Office of Government Ethics and the Designated Agency
Ethics Officials (DAEO) at the Social Security Administration
to identify potential conflicts of interest. Any potential
conflicts of interest will be resolved in accordance with the
terms of an ethics agreement that I have entered into and that
has been provided to this committee. I am not aware of any
other potential conflicts of interest.
5. Two copies of written opinions should be provided directly to the
committee by the designated agency ethics officer of the agency to
which you have been nominated and by the Office of Government Ethics
concerning potential conflicts of interest or any legal impediments to
your serving in this position.
I understand that my ethics agreement has been provided to the
committee along with the accompanying transmittal documents.
D. LEGAL AND OTHER MATTERS
1. Have you ever been the subject of a complaint or been
investigated, disciplined, or otherwise cited for a breach of ethics
for unprofessional conduct before any court, administrative agency
(e.g., an Inspector General's office), professional association,
disciplinary committee, or other ethics enforcement entity at any time?
Have you ever been interviewed regarding your own conduct as part of
any such inquiry or investigation? If so, provide details, regardless
of the outcome.
No.
2. Have you ever been investigated, arrested, charged, or held by any
Federal, State, or other law enforcement authority for a violation of
any Federal, State, county, or municipal law, regulation, or ordinance,
other than a minor traffic offense? Have you ever been interviewed
regarding your own conduct as part of any such inquiry or
investigation? If so, provide details.
No.
3. Have you ever been involved as a party in interest in any
administrative agency proceeding or civil litigation? If so, provide
details.
No, other than in my role as a government official, when I was
at times a party to court actions, and also to the extent
current board of director members are generally considered as
parties in litigation.
4. Have you ever been convicted (including pleas of guilty or nolo
contendere) of any criminal violation other than a minor traffic
offense? If so, provide details.
No.
5. Please advise the committee of any additional information,
favorable or unfavorable, which you feel should be considered in
connection with your nomination.
None.
E. TESTIFYING BEFORE CONGRESS
1. If you are confirmed by the Senate, are you willing to appear and
testify before any duly constituted committee of the Congress on such
occasions as you may be reasonably requested to do so?
Yes.
2. If you are confirmed by the Senate, are you willing to provide
such information as is requested by such committees?
Yes.
______
Questions Submitted for the Record to Demetrios L. Kouzoukas
Questions Submitted by Hon. Ron Wyden
Question. The role of public trustees is a unique role in public
service. Rather than starting a new job in public service, you now wear
``two hats'': one as the public trustee to the Social Security and
Medicare trust funds, and the other ``hat'' representing your
nongovernment day jobs. Can you talk about how you will approach
dealing with any apparent conflict wearing your two ``hats''?
Answer. The role of the boards of trustees for the Social Security
and Medicare trust funds is one that by its very nature addresses this
question. Specifically, the role of the boards of trustees for the
Social Security and Medicare trust funds is not to make policy in any
way; rather the role is to help provide information and data regarding
the fiscal and actuarial status and future of the programs. By
participating in that process, the public trustees enhance the
credibility of that information and data by being an outside set of
eyes and ears in the assembly and drafting of the board's report. This
process enables policymakers including members of Congress to make the
best decisions around the future of the programs. As such, the role is
separate from the public trustees' nongovernment jobs. Further, in my
ethics agreement, I agree, if confirmed, to consult with the Designated
Agency Ethics Official if an actual or potential conflict does arise
during my appointment, as well as to take measures necessary to resolve
such conflict.
Question. Looking at each of your backgrounds, you both have
extensive experience in the Medicare program, including coverage and
solvency. You would bring a different perspective than past public
trustees, many of whom have Social Security, pensions, or economic
backgrounds. This can be a good thing, as it is important to have a
fresh, outside perspective to the discussion. If confirmed, you would
serve as the public trustee for the Social Security trust funds as
well. While the trustees use the same demographic and economic
assumptions to develop the Social Security and Medicare trustees
reports, changes to those assumptions can have different impacts on
each trust funds' solvency. Can you talk about how you would approach
your role as Social Security public trustee, and whether it would
differ from your role as Medicare public trustee?
Answer. I agree the Social Security and Medicare programs overlap a
great deal. And it makes sense that the same board members have
historically served on the boards for both at the same times. The
programs share not only assumptions but also largely the same
population, many aspects of their financing, and their breadth and
economic impact.
If I am confirmed, I would approach the two roles differently to
some extent by identifying and taking into account the differences in
the history and design of the two programs. This would include, for
example, the administration of the Social Security program as a cash
payment rather than a third-party reimbursement program, as well as
considering what Social Security's longer history tells us about the
ability to make good predictions.
______
Questions Submitted by Hon. Elizabeth Warren
Question. What is the total compensation you received for your 2021
Clover Health board service?
Answer. In accordance with the company's policies, I received
$58,250 and 25,608 restricted stock units.
Question. What were the components of this compensation?
Answer. The components were a cash retainer and restricted stock
units.
Question. Did you receive a bonus from Clover Health? If so, how
big was this bonus, and for what activities did you receive this bonus?
Answer. No.
Question. What is the total compensation you received for your 2022
Clover Health board service?
Answer. In accordance with the company's policies, I received
$90,000 and 20,271 restricted stock units. (My 2022 Financial
Disclosure Report lists, per the instructions for the relevant line,
the amounts paid in 2021 and in 2022 through the filing date for a
total of $103,250.)
Question. What were the components of this compensation?
Answer. The components were a cash retainer and restricted stock
units.
Question. Did you receive a bonus from Clover Health? If so, how
big was this bonus, and for what activities did you receive this bonus?
Answer. No.
Question. What is the total compensation you expect to receive for
your 2023 Clover Health board service?
Answer. In accordance with the company's policies, I received
$70,000 and expect to receive approximately $24,000. I also received
213,576 restricted stock units (including 36,585 units on a one-time
basis) which would be considered income for 2024 upon vesting after a
year of continuous service. (It is typical for members of a board of
directors to receive equity grants in one year which vest in a future
year if still on the board, are considered income for that future year
at the value at that point in time, and may be reported in different
ways on a Financial Disclosure Report depending in part on the timing
of the report.)
Question. What are the expected components of this compensation?
Answer. The components are a cash retainer and restricted stock
units.
Question. Are you eligible to receive a bonus for your 2023
service?
If so, how big are the potential bonuses and for what activities
might you receive this bonus?
Answer. No, I believe that I am not eligible to receive a bonus for
the remainder of 2023. As specified above, some of the restricted stock
units referred to above were on a one-time basis.
Question. How many shares of Clover Health stock do you own,
whether or not such equity is part of your compensation for board
service?
What is the current value of those shares?
Answer. I have 45,879 vested shares. As of October 25, 2023, their
value is $41,659. In addition, there are 213,576 shares which would
vest in 2024 after a year of continuous service and be considered
income then at the value at that point in time.
Question. Do you have any stock options for Clover Health stock? If
so, please describe the number and conditions related to these stock
options.
Answer. No.
Question. Do you have any other financial interest in Clover
Health, beyond the compensation you receive for your board service and
your shares of Clover stock?
Answer. No, other than possibly through personal mutual funds or
similar holdings.
Question. What portion of Clover Health's annual revenue in 2022
came from Medicare Advantage payments?
Answer. The company has reported the following revenue and claims
incurred information for its Medicare Advantage segment in 2022:
Year ended December 31, 2022 (in thousands)
Premiums earned, net (net of ceded premiums of $470) $1,084,869
Non-insurance revenue -
Other income $2,577
Intersegment revenues -
Net medical claims incurred $996,410
Question. Do you agree that Clover Health has a financial interest
in matters affecting the payments the government makes to Medicare
Advantage plans?
Answer. Yes, the company generally has an interest in certain
payment decisions made by the Secretary of Health and Human Services.
These decisions are not made by the boards of trustees for the Social
Security and Medicare trust funds, which do not make policy in any way.
Question. Are Clover Health board members required to meet a code
of ethics, or otherwise subject to any ethics requirements?
Answer. Yes, the company has adopted a code of business conduct and
ethics.
Question. If so, have Clover Health officials determined that your
board service for the company and your service as a Medicare and Social
Security trustee would be consistent with that ethics code?
Answer. The company has not informed me of inconsistencies with the
code and my service, if confirmed, on the boards of trustees for the
Social Security and Medicare trust funds.
Question. Do you have any other financial interests or serve in any
capacity on behalf of any other company with business interests
affected by the Medicare or Social Security programs?
Answer. I don't believe so, other than possibly through personal
mutual funds or similar holdings.
Question. Do the public trustees help oversee the financial
operations of the Medicare trust funds?
Answer. The Medicare trustees report typically includes a section
regarding the ``financial operations'' of the Medicare trust funds.
That section is a statement of revenues and expenditures, which the
Social Security Act specifies be included in the reports. The Medicare
boards of trustees, which includes the public trustees, are responsible
for and oversee the production of the reports, including this section.
Question. Are the public trustees responsible for representing the
interests of the public on the Medicare and Social Security trust
funds?
Answer. While they are not considered ``representative members''
under the Federal Advisory Committee Act regulations, public trustees,
along with the other members of the boards of trustees for the Social
Security and Medicare trust funds, represent the public in the work of
trustees. In particular, the public trustees are members of the public
who serve the function of informing, along with the other trustees,
policymakers and the public about the size of any trust fund deficits
that would need to be resolved in order to avert program insolvency.
Question. Does the role of a public trustee involve developing
projections and recommendations related to the solvency of the Medicare
trust funds?
Answer. The relevant Social Security Act provisions related to the
role of the trustees reference ``general policies followed in managing
the trust fund'' and also require that the Medicare board of trustees
report annually to the Congress on the financial and actuarial status
of the HI and SMI trust funds. This includes solvency projections based
on current law.
Question. Does the Medicare system currently face any solvency
issues?
Answer. Yes, this year's Medicare trustees report projected that,
under current law, the Medicare Hospital Insurance (HI) trust fund
reserves will become depleted in 2031.
Question. Do you agree that Medicare Advantage plans have been
found to overcharge the government for coverage provided to
beneficiaries?
Answer. Yes, there have been instances where Federal agencies have
made such findings with respect to specific Medicare Advantage plans.
The boards of trustees for the Social Security and Medicare trust funds
do not have a role in that process or discuss those cases.
Question. Has Clover Health been investigated by the Department of
Justice for ``upcoding,'' the practice of adding additional risk codes
to beneficiaries' medical records to secure higher capitated payments
from the Centers for Medicare and Medicaid Services (CMS)?
Answer. The company publicly disclosed an inquiry by the U.S.
Attorney's Office for the Eastern District of Pennsylvania, as further
described in the company's previous annual and other filings. Also, an
article published online in 2021 referred to a former employee of the
company being asked about ``promoting higher level coding'' in
connection with that inquiry.
Question. In your ethics agreement with the Social Security
Administration, did you agree to recuse from any particular matter that
would have a direct and predictable effect on your financial interests,
or the financial interests of an entity whose interests are imputed to
you, unless you receive a waiver?
Answer. As part of my nomination process, the Social Security
Administration's (SSA) Office of the General Counsel and the U.S.
Department of Health and Human Services' Office of the General Counsel
thoroughly reviewed my financial holdings, and private-sector
employment and positions. Based on that review, I signed an ethics
agreement drafted by the SSA and approved by the U.S. Office of
Government Ethics. SSA's Designated Agency Ethics Official (DAEO)
forwarded that agreement to the White House and Senate along with a
letter stating that he found ``no conflict of interest or other problem
under applicable laws and regulations'' between my disclosures and the
proposed position.
As part of that agreement, I agreed I would not, if confirmed,
personally and substantially participate in particular matters that
would have a direct and predictable effect on my financial interests,
or the financial interests of an entity whose interests are imputed to
me, unless I received a waiver or qualified for a regulatory exemption.
I also agreed that, if I am confirmed, and circumstances arise where an
actual or potential conflict may exist during my appointment, I will
consult with the SSA's DAEO's office and take measures necessary to
resolve such conflict, including recusal from the matter. It is my
understanding from the DAEO's office that, generally, the content of
the trustees reports do not meet the definition of ``particular
matter'' nor do the reports have a direct and predicable effect on the
Medicare Advantage program.
Question. Will you commit to making this agreement publicly
available?
Answer. Pursuant to the appropriate rules and regulations, yes, I
agree to make this agreement available to the public.
Question. If confirmed as a public trustee, would you only be
eligible to receive a waiver if it is found that the financial interest
at issue is not so substantial as to be deemed likely to affect the
integrity of your government service?
Answer. SSA's DAEO determined that there is ``no conflict of
interest'' caused by my financial interests, including private-sector
positions, thoroughly reviewed as part of the usual vetting process.
Additionally, while a waiver of a conflict could be granted if the DAEO
determined that the facts of a situation supported such a waiver, the
DAEO has not indicated that such a waiver would be required; I
understand this is because, as made clear by the DAEO's conclusion that
there is ``no conflict of interest'' and underlying determinations, if
confirmed, I will not be participating in particular matters, and
instead I will be participating in matters of general applicability
that are also not likely to have a direct or predictable effect on the
financial interests imputed to me. Therefore, I do not anticipate a
waiver being required or applicable.
Question. In your ethics agreement with the Social Security
Administration, did you also commit to avoid any appearance of a
conflict of interest in the event that you are confirmed?
Answer. In that agreement, I committed, if confirmed, to consult
with the DAEO's office if an actual or potential conflict does arise
during my appointment, as well as to take measures necessary to resolve
such conflict.
Question. Would Clover Health's interests be imputed to you, as a
member of its board of directors?
Answer. Yes, the interests thoroughly reviewed by the DAEO in
reaching the conclusion referred to above that there is ``no conflict
of interest'' include those imputed by virtue of serving as a member of
the board of directors.
Question. Do you agree that, under 18 U.S.C. Sec. 208 and 5 CFR
Sec. 2635.402, you would have to recuse from any particular matters
that would have a direct and predictable effect on Clover's financial
interest, if that interest is substantial enough to likely affect the
integrity of your service?
Answer. The Social Security Administration's (SSA) Office of the
General Counsel and the U.S. Department of Health and Human Services'
Office of the General Counsel thoroughly reviewed my financial
holdings, and private-sector employment and positions. SSA's DAEO
determined my financial interests do not conflict with the position for
which I have been nominated. Based on that review, I signed an ethics
agreement drafted by the SSA and approved by the U.S. Office of
Government Ethics in which I stated that if I were asked to participate
personally and substantially in any particular matter that had a direct
and predictable effect on the financial interests imputed to me,
including Clover Health, I would recuse myself from that matter unless
I obtain a waiver or a regulatory exemption applied.
It is my understanding, from the DAEO's office, that the work of
the boards of trustees for the Social Security and Medicare trust funds
does not fall within the definition of a particular matter at 5 CFR
2635.402(b)(3) (defining ``particular matter'' as not extending to the
``consideration or adoption of broad policy options that are directed
to the interests of a large and diverse group of persons''). Also,
there was a determination of the DAEO that the duties of the boards of
trustees for the Social Security and Medicare trust funds do not have a
direct and predicable effect on the Medicare Advantage program as
defined at 5 CFR 2635.402(b)(1) (defining ``direct and predictable
effect'' as specifically excluding an effect where the ``chain of
causation is attenuated or is contingent upon the occurrence of events
that are speculative or that are independent of, and unrelated to, the
matter'').
Question. If the trustees address the threats that overpayments to
Medicare Advantage plans pose to the financial health of the Medicare
program, potentially leading to the adoption of policies that place
more restrictions on Medicare Advantage, would such changes likely cut
into the profitability of Clover?
Answer. While the Centers for Medicare and Medicaid Services
publishes annual parameters for the ``gain/loss margin'' of Medicare
Advantage plans which are incorporated into the annual bid submission
and review process, to my knowledge, the trustees reports have not
discussed topics like ``overpayments'' to Medicare Advantage plans,
either as defined in the Social Security Act or more generally. If I am
confirmed, and the topic came up, I would consult with the appropriate
ethics officials.
The role of the boards of trustees for the Social Security and
Medicare trust funds is not to make policy in any way; rather the role
is to help provide information and data regarding the fiscal and
actuarial status and future of the programs. By participating in that
process, the public trustees enhance the credibility of that
information and data by being an outside set of eyes and ears in the
assembly and drafting of the board's report. This process assists
policymakers such as members of Congress to make the best decisions
around the future of the programs.
Question. Do you believe that a reasonable person could at least
find an appearance of a conflict of interest in a board member of a
Medicare Advantage plan serving as a public trustee?
Answer. The vetting process administered by the Social Security
Administration prior to my nomination for this position resulted in a
conclusion by the SSA's DAEO that, in addition to there being ``no
conflict of interest,'' there is no ``other problem under applicable
laws and regulations.'' I understand from the DAEO's office that the
reasonable person test discussed in relevant Federal regulations with
language like that in this question requires examination of relevant
facts like the role of the boards of trustees for the Social Security
and Medicare trust funds being not to make policy in any way, the
determination of the DAEO that those duties do not have a direct and
predicable effect on a Medicare Advantage plan, the terms of my ethics
agreement requiring me to seek agency counsel should circumstances
change, and the position of trustee being a Special Government Employee
expected to work less than 60 days in a calendar year. These facts
support the DAEO's correct conclusion that there is no ``other problem
under applicable laws and regulations,'' including the appearance of a
conflict of interest as described in relevant regulations or more
generally.
Question. Are you aware of anyone who has previously served as a
public trustee while also being compensated by a Medicare Advantage
plan?
Are you aware of anyone who has previously served as a public
trustee while also being compensated by any private health insurance
company?
Answer. I am not personally aware of all the employment
arrangements or compensation of previous public trustees.
Question. If confirmed as a public trustee, do you plan to quit the
Clover board?
If not, how do you propose to comply with Federal ethics law and
avoid any apparent conflict of interest while simultaneously serving as
both a public trustee of Medicare trust funds and a board member of a
Medicare Advantage plan?
Answer. Prior to being nominated for this position, I discussed my
positions with SSA, and the U.S. Department of Health and Human
Services. They advised that it would be consistent with the ethics laws
and regulations to retain the current positions that I hold in the
private sector, and therefore it is my current intention to retain
those approved positions, including specifically the Clover Health
board. The public trustees' position is considered a ``special
government employee,'' serving fewer than 60 days in any year, and
therefore it is traditional and expected that persons in this role also
hold positions in the private sector.
My ethics agreement specifies the activities and roles that I would
continue if confirmed as a public trustee. This agreement was reviewed
and approved by SSA's DAEO and the Office of Government Ethics.
Additionally, the DAEO forwarded that agreement to the White House and
Senate along with a letter stating that he found ``no conflict of
interest'' between my disclosures and the proposed position. I am
grateful to President Biden and his team for the review, as part of the
nomination process, of my credentials and qualifications as well as
present private-sector positions that I would continue if confirmed. If
confirmed, in the event there are new questions that arise, as stated
in the agreement mentioned above, I will consult with the DAEO's
office, as I have to date, and take any measures identified as
necessary as part of that process.
______
Questions Submitted by Hon. Mike Crapo
Question. What is your understanding of the role of the trustees
with regards to recommending or setting policy?
Answer. The role of the boards of trustees for the Social Security
and Medicare trust funds is not to make policy in any way; rather the
role is to help provide information and data regarding the fiscal and
actuarial status and future of the programs. By participating in that
process, the public trustees enhance the credibility of that
information and data by being an outside set of eyes and ears in the
assembly and drafting of the board's report. This process enables
policymakers such as members of Congress to make the best decisions
around the future of the programs.
Question. Have you addressed any potential conflicts of interest in
your ethics agreement with the Social Security Administration in
consultation with the U.S. Department of Health and Human Services and
the U.S. Office of Government Ethics?
Answer. Yes.
Question. Do you commit to not participating personally or
substantially in any particular matter that to your knowledge would
have a direct and predictable effect on your financial interests unless
a waiver has been issued or a regulatory exemption applies?
Answer. Yes.
Question. If a potential conflict of interest arises, will you
consult with agency officials and take the measures necessary to
resolve the conflict?
Answer. Yes.
______
Prepared Statement of Patricia Hart Neuman, Sc.D., Nominated to be a
Member of the Board of Trustees of the Federal Old-Age and Survivors
Insurance Trust Fund and the Federal Disability Insurance Trust Fund,
the Board of Trustees of the Federal Hospital Insurance Trust Fund, and
the Board of Trustees of the Federal Supplementary Medical Insurance
Trust Fund
Chairman Wyden, Ranking Member Crapo, and members of this
committee, I am honored to be here today to be considered for the
public trustee position for the Medicare, Social Security, and
Disability Insurance trust funds, along with my colleague, Demetrios
Kouzoukas. I appreciate your taking the time for this hearing. I am
deeply grateful to President Biden for nominating me to be considered
for this important position. I am also so very grateful for the support
of my family, friends, and colleagues--some of whom are here today--and
most especially, my husband Perry Pockros, my daughter Julia, and my
son Ben.
Social Security and Medicare are bedrock programs for our Nation,
providing health and economic security to tens of millions of
Americans, mostly older adults but also younger people with permanent
disabilities, and others. These programs enjoy broad support among the
general public because Americans understand the vital role they each
play. It is difficult to imagine how families would manage without the
financial protection provided by Social Security and Medicare.
Clearly, Social Security and Medicare face financial challenges
that will require attention in the not too distant future. With an
aging population, a declining worker to retiree ratio, and--in the case
of Medicare--rising health-care costs, both the Social Security and the
Medicare Hospital Insurance trust funds are projected to have
insufficient funds to fully cover obligated expenses before the end of
this coming decade.
Each year, the trustees issue a report on the financial status of
these programs. The role of the public trustees is to assure the public
of the integrity of the operations and sustainability of the trust
funds, and to help the public understand the fiscal challenges facing
these programs. The trustees work closely with the actuaries from the
Department of Health and Human Services and the Social Security
Administration to be sure that projections are based on sound
assumptions, the right questions are being asked, and the presentation
of findings is clear, while recognizing that modeling by its very
nature is an inexact science.
In some ways, I have prepared for this position my entire
professional life, working on issues related to health and retirement
security for older Americans. My first job on Capitol Hill was on the
staff of the Senate Special Committee on Aging, chaired by Senator
Heinz, working right here in the Dirksen building. I went on to be
trained as a researcher at what is now called the Johns Hopkins
Bloomberg School of Public Health, where I received a masters in health
finance and doctorate in health policy. I later served on the
professional staff of the House Committee on Ways and Means
Subcommittee on Health, where the annual report of the Medicare
trustees was a major focus of our work.
Currently, I am a senior vice president, the executive director of
the Program on Medicare Policy, and senior advisor to the CEO at KFF
(formerly known as the Kaiser Family Foundation). Our mission at KFF is
to serve as a nonpartisan source of information for policymakers, the
media, the health policy community, and the public. We do not take
policy positions--similar to the role of the public trustees.
At KFF, I have conducted and directed research, written numerous
papers and spoken to a broad set of audiences about Medicare and
related issues for older Americans. I have examined options to
strengthen the financial solvency of the Medicare trust fund. I have
been a resource for policymakers and others in explaining the
challenges facing Medicare, and the implications for beneficiaries and
program spending. Collectively, this work has provided the foundational
knowledge and experience needed to carry out the responsibilities of a
public trustee.
I understand that the primary role of a public trustee is to assure
the integrity and objectivity of the projections, and that this is not
a policymaking role. Relatedly, I understand that the data and analysis
and other information included in these reports are essential to the
important work of policymakers. I believe I have the analytic skills
required to fulfill this role and the communication skills to convey
that information clearly.
Since I was first nominated, I have been genuinely moved by the
reactions of family members, friends and colleagues of all ages,
virtually all of whom thank me, in advance, for being willing to do my
part as a public trustee, if I am confirmed, mainly because they are
counting on Medicare and Social Security to be in strong fiscal shape
to support their health and financial security in retirement, as am I.
If I am confirmed for this position, I will work to the best of my
ability to fulfill the responsibilities with rigor and integrity. I
would be honored to serve in this role, and I look forward to your
questions.
Thank you.
______
SENATE FINANCE COMMITTEE
STATEMENT OF INFORMATION REQUESTED
OF NOMINEE
A. BIOGRAPHICAL INFORMATION
1. Name (include any former names used): Patricia Hart Neuman.
2. Position to which nominated: Member of the board of trustees of
the Federal Old-Age and Survivors Insurance trust fund and the Federal
Disability Insurance trust fund; member of the board of trustees of the
Federal Hospital Insurance trust fund; member of the board of trustees
of the Federal Supplementary Medical Insurance trust fund.
3. Date of nomination: April 7, 2022.
4. Address (list current residence, office, and mailing addresses):
5. Date and place of birth: April 9, 1959; Baltimore, MD.
6. Marital status (include maiden name of wife or husband's name):
7. Names and ages of children:
8. Education (list all secondary and higher education institutions,
dates attended, degree received, and date degree granted):
The American School in London, London, UK; 1974-1977; H.S
diploma, 1977.
Wesleyan University, Middletown, CT; 1977-1981, BA with Honors;
1981.
The Johns Hopkins Bloomberg School of Hygiene and Public Health
(previously called Johns Hopkins School of Hygiene and Public
Health, 1985-1993; MHS (1987) and Sc.D. (1993).
9. Employment record (list all jobs held since college, including the
title or description of job, name of employer, location of work, and
dates of employment for each job):
MCI Telecommunications, Washington, DC; data entry; 1981 ( 3
months).
U.S. Senate Special Committee on Aging, Washington DC;
legislative correspondent; professional committee staff; 1982-
1985.
The Johns Hopkins Medical Institutions Center for Hospital
Finance and Management, Baltimore, MD; Research Associate;
1987-1989.
U.S. House of Representatives Committee on Ways and Means,
Subcommittee on Health, Washington, DC; Professional Committee
Staff; 1989-1994.
Henry J Kaiser Family Foundation, Washington, DC; senior vice
president, executive director, Program on Medicare Policy,
senior advisor to the president; 1995-present.
10. Government experience (list any current and former advisory,
consultative, honorary, or other part-time service or positions with
Federal, State, or local governments held since college, including
dates, other than those listed above):
See question 9 for employment in U.S. Senate and U.S. House of
Representatives.
1992--Member of National Advisory Panel on Medicare Education,
https://www.govinfo.gov/content/pkg/FR-2002-01-25/html/02-
1687.htm.
11. Business relationships (list all current and former positions held
as an officer, director, trustee, partner (e.g., limited partner,
nonvoting, etc.), proprietor, agent, representative, or consultant of
any corporation, company, firm, partnership, other business enterprise,
or educational or other institution):
Bread for the City, board of directors.
Grantmakers in Health, board of directors.
Trust u/w Amelia Lange Bell Trust for Nancy Hoving--trustee.
Trust u/w Thomas Hoving Trust for Nancy Hoving--trustee.
LLR Limited partnership (private equity investment fund).
Claire S Frankel Estate--co-trustee (terminated June 2021).
Trimarcat--general partner (terminated May 2019).
12. Memberships (list all current and former memberships, as well as
any current and former offices held in professional, fraternal,
scholarly, civic, business, charitable, and other organizations dating
back to college, including dates for these memberships and offices):
National Academy of Social Insurance.
AcademyHealth--membership lapsed during COVID.
Bread for the City, board of directors (charitable).
Grantmakers in Health, board of directors (nonprofit).
13. Political affiliations and activities:
a. List all public offices for which you have been a candidate
dating back to the age of 18.
None.
b. List all memberships and offices held in and services
rendered to all political parties or election committees,
currently and during the last 10 years prior to the date of
your nomination.
None.
c. Itemize all political contributions to any individual,
campaign organization, political party, political action
committee, or similar entity of $50 or more for the past 10
years prior to the date of your nomination.
Barack Obama (2012): $500.
Maggie Hassan (2012): $50.
Fred Duval (2013): $250.
Hillary Clinton (2016): $250.
Jesse Colvin (2018): $500.
Jacky Rosen (2018): $250.
Theresa Greenfield for Iowa (2020): $50.
Fight for Progress (2020): $50.
The 99 Problems PAC (2020): $100.
ActBlue--Amy McGrath $250.
ActBlue--MarchonPac $200.
ActBlue Kohl for Congress.
ActBlue--Brindisi for Congress in 2020.
14. Honors and awards (list all scholarships, fellowships, honorary
degrees, honorary society memberships, military medals, and any other
special recognitions for outstanding service or achievement received
since the age of 18):
National Center for Health Services Research and Health Care
Technology Assessment, Dissertation Grant, 1989 (awarded in
1989, but unable to accept).
Gerontological Society, Dissertation Grant, 1989 (awarded in
1989, but unable to accept).
Metropolitan Life Foundation Fellow, 1985-1986.
15. Published writings (list the titles, publishers, dates and
hyperlinks (as applicable) of all books, articles, reports, blog posts,
or other published materials you have written):
See attachment A.
16. Speeches (list all formal speeches and presentations (e.g.,
PowerPoint) you have delivered during the past 5 years which are on
topics relevant to the position for which you have been nominated,
including dates):
See attachment A.
17. Qualifications (state what, in your opinion, qualifies you to
serve in the position to which you have been nominated):
I have spent my entire professional life analyzing issues
related to health and retirement security for older Americans.
Over the course of my career, I have been invited as an expert
witness to testify before Congress on a range of issues related
to Medicare and retirement security, written about and spoken
about these issues, examined options to strengthen the
financial solvency of the Medicare trust fund, and have served
as an independent resource for the media and others in
explaining the findings of the annual report of the Medicare
trustees, and the implications for beneficiaries and program
spending. While serving on the professional staff of the House
Ways and Means Committee, the annual report of the Medicare and
Social Security trustees was a major focus of our work. My
doctorate in health policy from the Johns Hopkins University
Bloomberg School of Public Health, and extensive professional
work in the field since then, provides the tools needed to meet
the responsibilities of a trustee, and contribute to the
process of reviewing the annual report to be sure the
underlying assumptions and analyses are sound and the
presentation is clear. I understand that the primary role of a
public trustee is to assure the integrity and objectivity of
the projections, and believe I have the analytic skills
required to fulfill this role and the communication skills to
convey that information clearly to the public. I believe in
public service; it would be an honor to be confirmed for this
position.
B. FUTURE EMPLOYMENT RELATIONSHIPS
1. Will you sever all connections (including participation in future
benefit arrangements) with your present employers, business firms,
associations, or organizations if you are confirmed by the Senate? If
not, provide details.
Not applicable. The public trustee is an uncompensated
position, other than for expenses, so I would need to continue
my current employment if confirmed by the Senate.
2. Do you have any plans, commitments, or agreements to pursue
outside employment, with or without compensation, during your service
with the government? If so, provide details.
I do not have plans, commitments, or agreements to pursue
employment opportunities other than my current position at KFF.
3. Has any person or entity made a commitment or agreement to employ
your services in any capacity after you leave government service? If
so, provide details.
No.
4. If you are confirmed by the Senate, do you expect to serve out
your full term or until the next presidential election, whichever is
applicable? If not, explain.
Yes.
C. POTENTIAL CONFLICTS OF INTEREST
1. Indicate any current and former investments, obligations,
liabilities, or other personal relationships, including spousal or
family employment, which could involve potential conflicts of interest
in the position to which you have been nominated.
None, per review by SSA OGE.
2. Describe any business relationship, dealing, or financial
transaction which you have had during the last 10 years (prior to the
date of your nomination), whether for yourself, on behalf of a client,
or acting as an agent, that could in any way constitute or result in a
possible conflict of interest in the position to which you have been
nominated.
I have consulted with the Office of Government Ethics and the
Social Security Administration designated agency ethics
official to identify potential conflicts of interest.
3. Describe any activity during the past 10 years (prior to the date
of your nomination) in which you have engaged for the purpose of
directly or indirectly influencing the passage, defeat, or modification
of any legislation or affecting the administration and execution of law
or public policy. Activities performed as an employee of the Federal
Government need not be listed.
None. KFF is an independent, nonprofit organization with a
mission to inform policy discussions. We do not lobby or take
positions on policy matters. I have published extensively and
spoken to reporters on related matters but have not engaged for
purposes of influencing the passage, defeat or modification of
any legislation or affecting the administration and execution
of law or public policy.
4. Explain how you will resolve any potential conflict of interest,
including any that are disclosed by your responses to the above items.
(Provide the committee with two copies of any trust or other
agreements.)
Not applicable.
5. Two copies of written opinions should be provided directly to the
committee by the designated agency ethics officer of the agency to
which you have been nominated and by the Office of Government Ethics
concerning potential conflicts of interest or any legal impediments to
your serving in this position.
Not applicable.
D. LEGAL AND OTHER MATTERS
1. Have you ever been the subject of a complaint or been
investigated, disciplined, or otherwise cited for a breach of ethics
for unprofessional conduct before any court, administrative agency
(e.g., an Inspector General's office), professional association,
disciplinary committee, or other ethics enforcement entity at any time?
Have you ever been interviewed regarding your own conduct as part of
any such inquiry or investigation? If so, provide details, regardless
of the outcome.
No.
2. Have you ever been investigated, arrested, charged, or held by any
Federal, State, or other law enforcement authority for a violation of
any Federal, State, county, or municipal law, regulation, or ordinance,
other than a minor traffic offense? Have you ever been interviewed
regarding your own conduct as part of any such inquiry or
investigation? If so, provide details.
No.
3. Have you ever been involved as a party in interest in any
administrative agency proceeding or civil litigation? If so, provide
details.
No.
4. Have you ever been convicted (including pleas of guilty or nolo
contendere) of any criminal violation other than a minor traffic
offense? If so, provide details.
No.
5. Please advise the committee of any additional information,
favorable or unfavorable, which you feel should be considered in
connection with your nomination.
None, other than to reassert my qualifications and interest in
serving as a public trustee, my commitment to fulfill the
duties of the public trustee, and that it would be an honor to
do so.
E. TESTIFYING BEFORE CONGRESS
1. If you are confirmed by the Senate, are you willing to appear and
testify before any duly constituted committee of the Congress on such
occasions as you may be reasonably requested to do so?
Yes
2. If you are confirmed by the Senate, are you willing to provide
such information as is requested by such committees?
Yes.
______
Attachment A
Patricia Hart Neuman, Sc.D., Published Materials
Journal Articles
Dusetzina, Stacie, Juliette Cubanski, Andrew Roberts, Jack Hoadley,
Sarah True, Leonce Nshuti, and Tricia Neuman, ``Trends in
Medicare Part D Coverage of Generics With Equivalent Brand-Name
Drugs,'' The American Journal of Managed Care July 15, 2021, 27
(7). https://www.ajmc.com/view/trends-in-medicare-part-d-
coverage-of-generics-with-equivalent-brand-name-drugs.
Frank, Richard and Patricia Neuman, ``Addressing the Risk of Medicare
Trust Fund Insolvency,'' JAMA Network January 26, 2021, 325
(4)341-342. https://jamanetwork.com/journals/jama/article-
abstract/2775457.
Dusetzina, Stacie, Juliette Cubanski, Leonce Nshuti, Sarah True, Jack
Hoadley, Drew Roberts, and Tricia Neuman, ``Medicare Part D
Plans Rarely Cover Brand-Name Drugs When Generics Are
Available,'' Health Affairs, August 3, 2020. vol. 39. no. 8.
https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.
2019.01694?journalCode=hlthaff.
Neuman, Patricia, and Gretchen Jacobson, ``Medicare Advantage
Checkup,'' New England Journal of Medicine, November 2018;
379:2163-2172. https://www.nejm.org/doi/full/10.1056/
nejmhpr1804089.
Neuman, Patricia, and Gretchen Jacobson, ``Medicare Premium Support
Proposals Could Increase Costs for Today's Seniors, Despite
Assurances,'' Health Affairs blog post, March 2017. https://
www.healthaffairs.org/do/10.1377/hblog2017
0309.059109/full/.
Hoadley, Jack, Patricia Neuman, and Juliette Cubanski, ``The Cost of a
Cure: Revisiting Medicare Part D and Hepatitis C Drugs,''
Health Affairs blog post, November 2016. https://
www.healthaffairs.org/do/10.1377/hblog20161103.0573
56/full/.
Neuman, Patricia and John Rother, Co-Editors, ``Medicare at 50,''
Generations (Journal of the American Society on Aging) Summer
2015, vol. 39, no. 2. https://www.kff.org/wp-content/uploads/
2015/06/generations-medicare-at-50-lessons-and-challenges-
neuman-rother.pdf.
Hoadley, Jack, Juliette Cubanski, and Patricia Neuman, ``Medicare's
Part D Drug Benefit at 10 Years: Firmly Established but Still
Evolving,'' Health Affairs, October 2015 34:1682-1687. https://
www.healthaffairs.org/doi/10.1377/hlthaff.
2015.0927.
Neuman, Patricia, Juliette Cubanski, and Anthony Damico, ``Medicare Per
Capita Spending By Age and Service: New Data Highlights Oldest
Beneficiaries,'' Health Affairs, February 2015 34:335-339.
https://www.healthaffairs.org/doi/10.1377/hlthaff.2014.1371.
Jacobson, Gretchen, Patricia Neuman, and Anthony Damico, ``At Least
Half of New Medicare Advantage Enrollees Had Switched From
Traditional Medicare During 2006-11,'' Health Affairs, January
2015 34(1): 48-55. https://www.
healthaffairs.org/doi/10.1377/hlthaff.2014.0218.
Neuman, Patricia, Barbara Lyons, Jennifer Rentas, and Diane Rowland,
``Dx for a Careful Approach to Moving Dual Eligible
Beneficiaries into Managed Care Plans,'' Health Affairs, June
2012 31(6):1186-94. https://www.
healthaffairs.org/doi/10.1377/hlthaff.2012.0160.
Cubanski, Juliette and Patricia Neuman, ``Medicare doesn't work as well
for younger, disabled beneficiaries as it does for older
enrollees,'' Health Affairs, September 2010 29(9):1725-33.
https://www.healthaffairs.org/doi/10.1377/hlthaff.
2009.0962.
Safran, Dana, Michelle Kitchman Strollo, Stuart Guterman, Angela Li,
William H. Rogers, Patricia Neuman, ``Prescription Coverage,
Use and Spending Before and After Part D Implementation: A
National Longitudinal Panel Study,'' Journal of General
Internal Medicine, January 2010. https://www.ncbi.nlm.nih.gov/
pmc/articles/PMC2811599/.
Neuman, Patricia and Gretchen Jacobson, ``Medicare Part D Update--
Lessons Learned and Unfinished Business,'' New England Journal
of Medicine, June 2009 361:406-414. https://www.nejm.org/doi/
full/10.1056/nejmhpr0809949.
Neuman, Patricia, Juliette Cubanski, Katherine A. Desmond, and Thomas
H. Rice, ``How much `Skin in the Game' Do Medicare
Beneficiaries Have? The Increasing Financial Burden of Health
Care Spending, 1997-2003,'' Health Affairs, November/December
2007. https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.26.
6.1692'ct=.
Neuman, Patricia, Michelle Kitchman Strollo, Stuart Guterman, William
H. Rogers, Angela Li, Angie Mae C. Rodday, and Dana Gelb
Safran, ``Medicare Prescription Drug Benefit Progress Report:
Findings From a 2006 National Survey of Seniors,'' Health
Affairs, August 21, 2007. https://www.healthaffairs.org/doi/
10.1377/hlthaff.26.5.w630.
Wilson, Ira B., Cathy Schon, Patricia Neuman, Michelle Kitchman
Strollo, William H. Rogers, Hong Chang, and Dana Gelb Safran,
``Physician-patient Communication About Prescription Medication
Non-adherence: A 50-State Study of America's Seniors,'' Journal
of General Internal Medicine, January 5, 2007. https://
www.ncbi.nlm.nih.gov/pmc/articles/PMC1824770/.
Cubanski, Juliette and Patricia Neuman, ``Status Report on Medicare
Part D Enrollment in 2006: Analysis of Plan-Specific Market
Share and Coverage,'' Health Affairs, November 21, 2006.
https://www.healthaffairs.org/doi/10.1377/hlthaff.
26.1.w1.
Safran, Dana, Patricia Neuman, Cathy Schoen et al., ``Prescription Drug
Coverage and Seniors: Findings From a 2003 National Survey,''
Health Affairs, April 19, 2005. https://www.healthaffairs.org/
doi/10.1377/hlthaff.W5.152.
McArdle, Frank B, Patricia Neuman, Michelle Kitchman, Kerry Kirland,
and Dale Yamamoto, ``Large Firms' Retiree Health Benefits
Before Medicare Reform: 2003 Survey Results,'' Health Affairs,
January 14, 2004. https://www.
healthaffairs.org/doi/abs/10.1377/
hlthaff.W4.7?journalCode=hlthaff.
Hanson, Kristina, Patricia Neuman, David Dutwin, and Judith Kasper,
``Uncovering the Health Challenges Facing People with
Disabilities: The Role of Health Insurance,'' Health Affairs,
Web Exclusive, November 19, 2003. https://
www.healthaffairs.org/doi/10.1377/hlthaff.W3.552.
Safran, Dana, Patricia Neuman, Cathy Schoen, et al., ``Prescription
Drug Coverage and Seniors: How Well Are States Closing The
Gap?'' Health Affairs, Web Exclusive, July 31, 2002. https://
www.healthaffairs.org/doi/abs/10.1377/hlthaff.
W2.253.
Laschober, Mary, Michelle Kitchman, Patricia Neuman, and Allison
Strabic, ``Trends in Medicare Supplemental Insurance and
Prescription Drug Coverage, 1996-1999,'' Health Affairs, Web
Exclusive, February 27, 2002. https://www.
healthaffairs.org/doi/10.1377/hlthaff.W2.127.
Steinberg, Earl, Benjamin Gutierrez, Aiman Momani, Joseph A. Boscarino,
Patricia Neuman, and Patricia Deverka, ``Beyond Survey Data: A
Claims-Based Analysis of Drug Use and Spending by the
Elderly,'' Health Affairs, Vol. 19, No. 2, March/April 2000.
https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.19.
2.198.
Neuman, Patricia, Dorothy Rice, and Peter Hussey, ``Financing Care for
Aging Women in the U.S.: International Perspectives,'' Aging,
Vol. 12, No. 2, April 2000. https://pubmed.ncbi.nlm.nih.gov/
10902056/.
Laschober, Mary, Patricia Neuman, Michelle Kitchman, Laura Meyer, and
Kathryn Langwell, ``Medicare HMO Withdrawals: What Happens to
Beneficiaries?'' Health Affairs, Vol. 18, Number 6, November/
December 1999. https://www.healthaffairs.org/doi/10.1377/
hlthaff.18.6.150.
Neuman, Patricia, Cathy Schoen, Michelle Kitchman, Diane Rowland, Karen
Davis, and Drew Altman, ``Understanding the Diverse Needs and
Experiences of the Medicare Population,'' Journal of Aging and
Social Policy, Vol. 10, Number 4, 1999. https://
pubmed.ncbi.nlm.nih.gov/10724769/.
Neuman, Patricia and Kathryn Langwell, ``Medicare's Choice Explosion?
Implications for Beneficiaries,'' Health Affairs, December/
January 1999. https://www.healthaffairs.org/doi/10.1377/
hlthaff.18.1.150.
Neuman, Patricia, Ed Maibach, Katharine Dusenbury, Michelle Kitchman,
and Pam Zupp, ``Marketing HMOs to Medicare Beneficiaries,''
Health Affairs, Vol. 17, No. 4, July/August 1998. https://
www.healthaffairs.org/doi/10.1377/hlthaff.17.
4.132.
Lamphere, Jo Ann, Patricia Neuman, Kathryn Langwell, and Daniel
Sherman, ``The Surge in Medicare Managed Care: An Update,''
Health Affairs, Vol. 16, No. 3, May/June 1997. https://
www.healthaffairs.org/doi/abs/10.1377/hlthaff.16.3.
127.
Blendon, Robert, Drew Altman, John Benson, Matt James, Diane Rowland,
Patricia Neuman et al., ``The Public's View of the Future of
Medicare,'' Journal of the American Medical Association,
November 22/29, 1995. https://jamanetwork.com/journals/jama/
article-abstract/392019.
Testimony
``Strategies for Improving Health Coverage and Reducing Costs: Major
Proposals and Key Considerations,'' testimony by Patricia
Neuman before the U.S. House Committee on Ways and Means, June
12, 2019. https://files.kff.org/attachment/Neuman-Testimony-
for-Ways-and-Means-for-Hearing-on-6.12.2019.
``Income Security and the Elderly: Securing Gains Made in the War on
Poverty,'' testimony by Patricia Neuman before the U.S. Senate
Special Committee on Aging, March 5, 2014. https://www.kff.org/
wp-content/uploads/2014/03/testimony-neuman-senate-special-
committee-on-aging-3-5-14.pdf.
``Rethinking Medicare's Benefit Design: Opportunities and Challenges,''
testimony by Patricia Neuman before the Energy and Commerce
Subcommittee on Health, June 26, 2013. https://www.kff.org/wp-
content/uploads/2013/06/neuman-testimony-for-energy-and-
commerce-6-26-2013.pdf.
``Medicare Advantage: Key Issues and Implications for Beneficiaries,''
testimony by Patricia Neuman before the Committee on the
Budget, U.S. House of Representatives, June 28, 2007. https://
www.kff.org/wp-content/uploads/2013/01/7664.
pdf.
``Changing Medicare's Benefit Design: Implications for Beneficiaries,''
testimony by Patricia Neuman before the Subcommittee on Health,
Committee on Ways and Means, U.S. House of Representatives,
February 26, 2013. https://www.kff.org/wp-content/uploads/2013/
02/changing-medicare-s-benefit-design-testimony-022613.pdf.
``Private Fee-For-Service Plans in Medicare: Rapid Growth and Future
Implications,'' testimony by Patricia Neuman before the
Subcommittee on Health, Committee on Ways and Means, U.S. House
of Representatives, May 22, 2007. https://www.kff.org/wp-
content/uploads/2013/01/7648.pdf.
``The State of Retiree Health Benefits: Historical Trends and Future
Uncertainties,'' testimony by Patricia Neuman before the U.S.
Special Committee on Aging, May 17, 2004. https://www.kff.org/
wp-content/uploads/2013/01/the-state-of-retiree-health-
benefits-historical-trends-and-future-uncertainties.pdf.
``Medicare Cost-Sharing: Implications for Beneficiaries,'' testimony by
Patricia Neuman and Thomas Rice before the Subcommittee on
Health, Committee on Ways and Means, U.S. House of
Representatives, May 1, 2003.
``Prescription Drug Discount Card Programs: Implications for Medicare
Beneficiaries,'' testimony by Patricia Neuman before the
Committee on Finance, May 7, 2002.
``Medicare Prescription Drug Coverage: Facts, Options, and
Implications,'' testimony by Patricia Neuman before the
Subcommittee on Health, Committee on Energy and Commerce, U.S.
House of Representatives, April 17, 2002.
``Retirement Security for the American Worker: Opportunities and
Challenges,'' testimony by Patricia Neuman before the
Subcommittee on Employer-Employee Relations, Committee on
Education and the Workforce, November 2001.
``Retiree Benefits and Health Challenges Facing Aging Americans,''
testimony by Patricia Neuman before the Committee on Health,
Education, Labor, and Pensions, U.S. Senate, May 22, 2001.
``Medicare Prescription Drugs,'' testimony by Patricia Neuman before
the Committee on the Budget, U.S. Senate, August 29, 2001.
``Improving Prescription Drug Coverage: Opportunities and Challenges
for Reform,'' testimony by Patricia Neuman before the Committee
on Finance, U.S. Senate, March 22, 2001.
Book
Anderson Gerard, Judith Lave, Catherine Russe, and Patricia Neuman,
Providing Hospital Services. The Johns Hopkins University
Press, 1989. https://www.
amazon.com/Providing-Hospital-Services-Environment-
Administration/dp/080
1838150.
KFF Publications
Ochieng, Nancy, Juliette Cubanski, and Tricia Neuman, Four Key Changes
in the Biden Administration's Final Rule on Medicare Enrollment
and Eligibility, Kaiser Family Foundation, December 2022.
https://www.kff.org/medicare/issue-brief/four-key-changes-in-
the-biden-administrations-final-rule-on-medicare-enrollment-
and-eligibility/.
Freed, Meredith, Tricia Neuman, and Juliette Cubanski, How the 2023
Medicare Physician Fee Schedule Final Rule Changes Medicare
Coverage of Dental Services, Kaiser Family Foundation, December
2022. https://www.kff.org/medicare/issue-brief/how-the-2023-
medicare-physician-fee-schedule-final-rule-changes-medicare-
coverage-of-dental-services/.
Freed, Meredith, Tricia Neuman, Matthew Rae, and Jeannie Fuglesten
Biniek, Medicare Advantage Coverage is Rising for the Declining
Share of Medicare Beneficiaries with Retiree Health Benefits,
Kaiser Family Foundation, December 2022. https://www.kff.org/
medicare/issue-brief/medicare-advantage-coverage-is-rising-for-
the-declining-share-of-medicare-beneficiaries-with-retiree-
health-benefits/.
Biniek, Jeannie Fuglesten, Nolan Sroczynski, Meredith Freed, and Tricia
Neuman, Extra Benefits Offered by Medicare Advantage Firms
Vary, Kaiser Family Foundation, November 2022. https://
www.kff.org/medicare/issue-brief/extra-benefits-offered-by-
medicare-advantage-firms-varies/.
Levinson, Zachary, Scott Hulver, and Tricia Neuman, Hospital Charity
Care: How It Works and Why It Matters, Kaiser Family
Foundation, November 2022. https://www.kff.org/health-costs/
issue-brief/hospital-charity-care-how-it-works-and-why-it-
matters/.
Freed, Meredith, Jeannie Fuglesten Biniek, Anthony Damico, and Tricia
Neuman, Medicare Advantage 2023 Spotlight: First Look, Kaiser
Family Foundation, November 2022. https://www.kff.org/medicare/
issue-brief/medicare-advantage-2023-spotlight-first-look/.
Ochieng, Nancy, Juliette Cubanski, Meredith Freed, and Tricia Neuman, A
Relatively Small Share of Medicare Beneficiaries Compared Plans
During a Recent Open Enrollment Period, November 2022. https://
www.kff.org/medicare/issue-brief/a-relatively-small-share-of-
medicare-beneficiaries-compared-plans-during-a-recent-open-
enrollment-period/.
Biniek, Jeannie Fuglesten, Anthony Damico, Juliette Cubanski, and
Tricia Neuman, Medicare Beneficiaries Rarely Change Their
Coverage During Open Enrollment, November 2022. https://
www.kff.org/medicare/issue-brief/medicare-benefici
aries-rarely-change-their-coverage-during-open-enrollment/.
Freed, Meredith, Tricia Neuman, Jennifer Kates, and Juliette Cubanski,
Deaths Among Older Adults Due to COVID-19 Jumped During the
Summer of 2022 Before Falling Somewhat in September, October
2022. https://www.kff.org/coronavirus-covid-19/issue-brief/
deaths-among-older-adults-due-to-covid-19-jumped-during-the-
summer-of-2022-before-falling-somewhat-in-september/.
Biniek, Jeannie Fuglesten, Meredith Freed, Anthony Damico, and Tricia
Neuman, Spending on Medicare Advantage Quality Bonus Program
Payment Reached $10 Billion in 2022, Kaiser Family Foundation,
August 2022. https://www.kff.org/medicare/issue-brief/spending-
on-medicare-advantage-quality-bonus-program-payment-reached-10-
billion-in-2022/.
Freed, Meredith, Jeannie Fuglesten Biniek, Anthony Damico, and Tricia
Neuman, Medicare Advantage in 2022: Enrollment Update and Key
Trends, August 2022. https://www.kff.org/medicare/issue-brief/
medicare-advantage-in-2022-enrollment-update-and-key-trends/.
Freed, Meredith, Jeannie Fuglesten Biniek, Anthony Damico, and Tricia
Neuman, Medicare Advantage in 2022: Premiums, Out-of-Pocket
Limits, Cost Sharing, Supplemental Benefits, Prior
Authorization, and Star Ratings, August 2022. https://
www.kff.org/medicare/issue-brief/medicare-advantage-in-2022-
premiums-out-of-pocket-limits-cost-sharing-supplemental-
benefits-prior-authorization-and-star-ratings/.
Cubanski, Juliette, Tricia Neuman, Meredith Freed, and Anthony Damico,
How Would the Prescription Drug Provisions in the Senate
Reconciliation Proposal Affect Medicare Beneficiaries? July
2022 (updated January 2023). https://www.kff.org/medicare/
issue-brief/how-will-the-prescription-drug-provisions-in-the-
inflation-reduction-act-affect-medicare-beneficiaries/.
Cubanski, Juliette and Tricia Neuman, FAQs on Medicare Financing and
Trust Fund Solvency, June 2022. https://www.kff.org/medicare/
issue-brief/faqs-on-medicare-financing-and-trust-fund-
solvency/.
Biniek, Jeannie Fuglesten, Juliette Cubanski, and Tricia Neuman,
Traditional Medicare Spending Fell Almost 6 percent in 2020 as
Service Use Declined Early in the COVID-19 Pandemic, Kaiser
Family Foundation, June 2022. https://www.kff.org/medicare/
issue-brief/traditional-medicare-spending-fell-almost-6-in-
2020-as-service-use-declined-early-in-the-covid-19-pandemic/.
Biniek, Jeannie Fuglesten, Juliette Cubanski, and Tricia Neuman, Amid
the COVID-19 Pandemic, Medicare Spending on Skilled Nursing
Facilities Increased More than 4 percent Despite an Overall
Decline in Utilization, Kaiser Family Foundation, June 2022.
https://www.kff.org/medicare/issue-brief/amid-the-covid-19-
pandemic-medicare-spending-on-skilled-nursing-facilities-
increased-more-than-4-despite-an-overall-decline-in-
utilization/.
Koma, Wyatt, Juliette Cubanski, and Tricia Neuman, FAQs on Medicare
Coverage of Telehealth, Kaiser Family Foundation, May 2022.
https://www.kff.org/medicare/issue-brief/faqs-on-medicare-
coverage-of-telehealth/.
Ochieng, Nancy, Matthew Rae, Jeannie Fuglesten Biniek, and Tricia
Neuman, Most Office-Based Physicians Accept New Patients,
Including Patients With Medicare and Private Insurance, Kaiser
Family Foundation, May 2022. https://www.kff.org/medicare/
issue-brief/most-office-based-physicians-accept-new-patients-
including-patients-with-medicare-and-private-insurance/.
Cubanski, Juliette and Tricia Neuman, Selected Out-of-Pocket Costs as a
Share of the Average Social Security Benefit, April 2022.
https://www.kff.org/medicare/slide/selected-out-of-pocket-
costs-as-a-share-of-the-average-social-security-bene
fit/.
Freed, Meredith, Juliette Cubanski, Anthony Damico, and Tricia Neuman,
Help with Medicare Premium and Cost-Sharing Assistance Varies
by State, Kaiser Family Foundation, April 2022. https://
www.kff.org/medicare/issue-brief/help-with-medicare-premium-
and-cost-sharing-assistance-varies-by-state/.
Biniek, Jeannie Fuglesten and Tricia Neuman, The Growth in Share of
Medicare Advantage Spending, Kaiser Family Foundation, April
2022. https://www.
kff.org/medicare/slide/the-growth-in-share-of-medicare-
advantage-spending/.
Cubanski, Juliette, Nolan Sroczynski, and Tricia Neuman, Medicare Part
B Drugs: Cost Implications for Beneficiaries in Traditional
Medicare and Medicare Advantage, Kaiser Family Foundation,
March 2022. https://www.kff.org/medicare/issue-brief/medicare-
part-b-drugs-cost-implications-for-beneficiaries-in-
traditional-medicare-and-medicare-advantage/.
Biniek, Jeannie Fuglesten, Matthew Rae, Gary Claxton, and Tricia
Neuman, Half of Admissions in the Large Group Market Are Paid
Above 150 percent of Medicare Rates, Excluding Maternity
Admissions, Kaiser Family Foundation, March 2022. https://
www.kff.org/private-insurance/issue-brief/half-of-admissions-
in-the-large-group-market-are-paid-above-150-of-medicare-rates-
excluding-maternity-admissions/.
Cubanski, Juliette and Tricia Neuman, Prices Increased Faster Than
Inflation for Half of all Drugs Covered by Medicare in 2020,
Kaiser Family Foundation, February 2022. https://www.kff.org/
medicare/issue-brief/prices-increased-faster-than-inflation-
for-half-of-all-drugs-covered-by-medicare-in-2020/.
Cubanski, Juliette, Nolan Sroczynski, and Tricia Neuman, Simulating the
Impact of the Drug Price Negotiation Proposal in the Build Back
Better Act, Kaiser Family Foundation, January 2022. https://
www.kff.org/medicare/issue-brief/simulating-the-impact-of-the-
drug-price-negotiation-proposal-in-the-build-back-better-act/.
Cubanski, Juliette and Tricia Neuman, How Would Drug Price Negotiation
Affect Medicare Part D Premiums? Kaiser Family Foundation,
January, 2022. https://www.kff.org/medicare/issue-brief/how-
would-drug-price-negotiation-affect-medicare-part-d-premiums/.
Ochieng Nancy, Jeannie Fuglesten Biniek, MaryBeth Musumeci, and Tricia
Neuman, Funding for Health Care Providers During the Pandemic:
An Update, Kaiser Family Foundation, January 2022. https://
www.kff.org/coronavirus-covid-19/issue-brief/funding-for-
health-care-providers-during-the-pandemic-an-update/.
Chidambaram, Priya, Robin Rudowitz, and Tricia Neuman, Key Questions
About Nursing Home Cases, Deaths, and Vaccinations as Omicron
Spreads in the United States, Kaiser Family Foundation, January
2022. https://www.kff.org/coronavirus-covid-19/issue-brief/key-
questions-about-nursing-home-cases-deaths-and-vaccinations-as-
omicron-spreads-in-the-united-states/.
Cubanski, Juliette and Tricia Neuman, Medicare's Coverage Decision for
the New Alzheimer's Drug and Why It Matters, Kaiser Family
Foundation, January, 2022. https://www.kff.org/policy-watch/
medicares-coverage-decision-for-the-
new-alzheimers-drug-and-why-it-matters/.
Cubanski, Juliette and Tricia Neuman, Monthly Part B Premiums and
Annual Percentage Increases, Kaiser Family Foundation, January,
2022. https://www.
kff.org/medicare/slide/monthly-part-b-premiums-and-annual-
percentage-increases/.
Cubanski, Juliette, Tricia Neuman, and Meredith Freed, Explaining the
Prescription Drug Provisions in the Build Back Better Act,
Kaiser Family Foundation, November 2021. https://www.kff.org/
medicare/issue-brief/explaining-the-prescription-drug-
provisions-in-the-build-back-better-act/.
Cox, Cynthia, Robin Rudowitz, Juliette Cubanski, Karen Pollitz,
MaryBeth Musumeci, Usha Ranji, Michelle Long, Meredith Freed,
and Tricia Neuman, Potential Costs and Impact of Health
Provisions in the Build Back Better Act, Kaiser Family
Foundation, November 2021. https://www.kff.org/health-costs/
issue-brief/potential-costs-and-impact-of-health-provisions-in-
the-build-back-better-act/.
Freed, Meredith, Anthony Damico, and Tricia Neuman, Medicare Advantage
2022 Spotlight: First Look, Kaiser Family Foundation, November
2021. https://www.kff.org/medicare/issue-brief/medicare-
advantage-2022-spotlight-first-
look/.
Freed, Meredith, Juliette Cubanski, and Tricia Neuman, COVID-19 Deaths
Among Older Adults During the Delta Surge Were Higher in States
with Lower Vaccination Rates, Kaiser Family Foundation, October
2021. https://www.kff.org/policy-watch/covid-19-deaths-among-
older-adults-during-the-delta-surge-were-higher-in-states-with-
lower-vaccination-rates/.
Freed, Meredith, Juliette Cubanski, Nolan Sroczynski, Nancy Ochieng,
and Tricia Neuman, Dental, Hearing, and Vision Costs and
Coverage Among Medicare Beneficiaries in Traditional Medicare
and Medicare Advantage, Kaiser Family Foundation, September
2021. https://www.kff.org/health-costs/issue-brief/dental-
hearing-and-vision-costs-and-coverage-among-medicare-
beneficiaries-in-traditional-medicare-and-medicare-advantage/.
Cubanski, Juliette, Tricia Neuman and Anthony Damico, Potential Savings
for Medicare Part D Enrollees Under Proposals to Add a Hard Cap
on Out-of-
Pocket Spending, Kaiser Family Foundation, September 2021.
https://www.kff.org/medicare/issue-brief/potential-savings-for-
medicare-part-d-enrollees-under-proposals-to-add-a-hard-cap-on-
out-of-pocket-spending/.
Ochieng, Nancy, Jeannie Fuglesten Biniek, MaryBeth Musumeci, and Tricia
Neuman, Funding for Health Care Providers During the Pandemic:
An Update, Kaiser Family Foundation, August 2021. https://
www.kff.org/policy-watch/funding-for-health-care-providers-
during-the-pandemic-an-update/.
Biniek Fuglesten, Jeannie, Juliette Cubanski, and Tricia Neuman, Higher
and Faster Growing Spending Per Medicare Advantage Enrollee
Adds to Medicare's Solvency and Affordability Challenges,
Kaiser Family Foundation, August 2021. https://www.kff.org/
medicare/issue-brief/higher-and-faster-growing-spending-per-
medicare-advantage-enrollee-adds-to-medicares-solvency-and-
affordability-challenges/.
Cubanski, Juliette and Tricia Neuman, How Would Drug Price Negotiation
Affect Medicare Part D Premiums?, Kaiser Family Foundation,
August 2021. https://www.kff.org/medicare/issue-brief/how-
would-drug-price-negotiation-affect-medicare-part-d-premiums/.
Freed, Meredith, Tricia Neuman, and Juliette Cubanski, 10 FAQs on
Prescription Drug Importation, Kaiser Family Foundation, July
2021. https://www.kff.org/medicare/issue-brief/10-faqs-on-
prescription-drug-importation/.
Cubanski, Juliette, Tricia Neuman, and Meredith Freed, What's the
Latest on Medicare Drug Price Negotiations? Kaiser Family
Foundation, July 2021. https://www.kff.org/medicare/issue-
brief/whats-the-latest-on-medicare-drug-price-negotiations/.
Cubanski, Juliette, Tricia Neuman, and Anthony Damico, Millions of
Medicare Part D Enrollees Have Had Out-of-Pocket Drug Spending
Above the Catastrophic Threshold Over Time, Kaiser Family
Foundation, July 2021. https://www.
kff.org/medicare/issue-brief/millions-of-medicare-part-d-
enrollees-have-had-out-of-pocket-drug-spending-above-the-
catastrophic-threshold-over-time/.
Biniek Fuglesten, Jeannie, Nancy Ochieng, Juliette Cubanski, and Tricia
Neuman, Cost-Related Problems Are Less Common Among
Beneficiaries in Traditional Medicare Than in Medicare
Advantage, Mainly Due to Supplemental Coverage, Kaiser Family
Foundation, June 2021. https://www.kff.org/medicare/issue-
brief/cost-related-problems-are-less-common-among-
beneficiaries-in-traditional-medicare-than-in-medicare-
advantage-mainly due-to-supplemental-coverage/.
Freed, Meredith, Jeannie Fuglesten Biniek, Anthony Damico, and Tricia
Neuman, Medicare Advantage in 2021: Enrollment Update and Key
Trends, Kaiser Family Foundation, June 2021. https://
www.kff.org/medicare/issue-brief/medicare-advantage-in-2021-
enrollment-update-and-key-trends/.
Freed, Meredith, Jeannie Fuglesten Biniek, Anthony Damico, and Tricia
Neuman, Medicare Advantage in 2021: Premiums, Cost Sharing,
Out-of-Pocket Limits and Supplemental Benefits, Kaiser Family
Foundation, June 2021. https://www.kff.org/medicare/issue-
brief/medicare-advantage-in-2021-premiums-cost-sharing-out-of-
pocket-limits-and-supplemental-benefits/.
Biniek Fuglesten, Jeannie, Meredith Freed, Anthony Damico, and Tricia
Neuman, Medicare Advantage in 2021: Star Ratings and Bonuses,
Kaiser Family Foundation, June 2021. https://www.kff.org/
medicare/issue-brief/medicare-advantage-in-2021-star-ratings-
and-bonuses/.
Musumeci, Marybeth, Robin Rudowitz, and Tricia Neuman, How Might
Lowering the Medicare Age Affect Medicaid Enrollees? Kaiser
Family Foundation, June 2021. https://www.kff.org/Medicaid/
issue-brief/how-might-lowering-the-medicare-age-affect-
Medicaid-enrollees/.
Cubanski, Juliette and Tricia Neuman, FDA's Approval of Biogen's New
Alzheimer's Drug Has Huge Cost Implications for Medicare and
Beneficiaries, Kaiser Family Foundation, June 2021. https://
www.kff.org/medicare/issue-brief/fdas-approval-of-biogens-new-
alzheimers-drug-has-huge-cost-implications-for-medicare-and-
beneficiaries/.
Koma, Wyatt, Juliette Cubanski, and Tricia Neuman, Medicare and
Telehealth: Coverage and Use During the COVID-19 Pandemic and
Options for the Future, Kaiser Family Foundation, May 2021.
https://www.kff.org/medicare/issue-brief/medicare-and-
telehealth-coverage-and-use-during-the-covid-19-pandemic-and-
options-for-the-future/.
Ochieng, Nancy, Jeannie Fuglesten Biniek, Karyn Schwartz, and Tricia
Neuman, Medicare-Covered Older Adults Are Satisfied with Their
Coverage, Have Similar Access to Care as Privately Insured
Adults Ages 50 to 64, and Fewer Report Cost-Related Problems,
Kaiser Family Foundation, May 2021. https://www.kff.org/
medicare/issue-brief/medicare-covered-older-adults-are-
satisfied-with-their-coverage-have-similar-access-to-care-as-
privately insured-adults-ages-50-to-64-and-fewer-report-cost-
related-problems/.
Freed, Meredith, Kendal Orgera, Juliette Cubanski, Jennifer Tolbert,
and Tricia Neuman, Vaccination Rates Are Relatively High for
Older Adults, But Lag in Counties in the South, in Counties
with Higher Poverty Rates and in Counties that Voted for Trump,
Kaiser Family Foundation, May 2021. https://www.
kff.org/coronavirus-covid-19/issue-brief/vaccination-rates-are-
relatively-high-for-older-adults-but-lag-in-counties-in-the-
south-in-counties-with-higher-poverty-rates-and-in-counties-
that-voted-for-trump/.
McDermott, Daniel, Lina Stolyar, Elizabeth Hinton, Giorlando Ramirez,
Cynthia Cox, Jeannie Fuglesten Biniek, Tricia Neuman, and Robin
Rudowitz, Health Insurer Financial Performance in 2020, Kaiser
Family Foundation, May 2021. https://www.kff.org/private-
insurance/issue-brief/health-insurer-financial-performance-in-
2020/.
Cubanski, Juliette and Tricia Neuman, Relatively Few Drugs Account for
a Large Share of Medicare Prescription Drug Spending, Kaiser
Family Foundation, April 2021. https://www.kff.org/medicare/
issue-brief/relatively-few-drugs-account-for-a-large-share-of-
medicare-prescription-drug-spending/.
Freed, Meredith, Juliette Cubanski, and Tricia Neuman, Moving the
Needle on Prescription Drug Costs: Using the Innovation Center
and Other Demonstration Authority, Kaiser Family Foundation,
March 2021. https://www.kff.org/medicare/issue-brief/moving-
the-needle-on-prescription-drug-costs-using-the-innovation-
center-and-other-demonstration-authority/.
Koma, Wyatt, Juliette Cubanski, and Tricia Neuman, A Snapshot of
Sources of Coverage Among Medicare Beneficiaries in 2018,
Kaiser Family Foundation, March 2021. https://www.kff.org/
medicare/issue-brief/a-snapshot-of-sources-of-coverage-among-
medicare-beneficiaries-in-2018/.
Cubanski, Juliette and Tricia Neuman, FAQs on Medicare Financing and
Trust Fund Solvency, Kaiser Family Foundation, March 2021.
https://www.kff.org/medicare/issue-brief/faqs-on-medicare-
financing-and-trust-fund-solvency/.
Schwartz, Karyn, Jeannie Fuglesten Biniek, Matthew Rae, Tricia Neuman,
and Larry Levitt, Limiting Private Insurance Reimbursement to
Medicare Rates Would Reduce Health Spending by About $350
Billion in 2021, Kaiser Family Foundation, March 2021. https://
www.kff.org/medicare/issue-brief/limiting-private-insurance-
reimbursement-to-medicare-rates-would-reduce-health-spending-
by-about-350-billion-in-2021/.
Freed, Meredith, Juliette Cubanski, Nancy Ochieng, and Tricia Neuman,
Vaccinating Older Adults in the US Against COVID-19: A Work in
Progress, Kaiser Family Foundation, February 2021. https://
www.kff.org/coronavirus-covid-19/issue-brief/vaccinating-older-
adults-in-the-us-against-covid-19-a-work-in-progress/.
Chidambaram, Priya, Rachel Garfield, Tricia Neuman, and Larry Levitt,
Is the End of the Long-Term Care Crisis Within Sight? New
COVID-19 Cases and Deaths in Long-Term Care Facilities Are
Dropping, Kaiser Family Foundation, February 2021. https://
www.kff.org/policy-watch/is-the-end-of-the-long-term-care-
crisis-within-sight-new-covid-19-cases-and-deaths-in-long-term-
care-facilities-are-dropping/.
Koma, Wyatt, Jeannie Fuglesten Biniek Follow, Nancy Ochieng, Tricia
Neuman, and Karen Smith, Does Education Narrow the Gap in
Wealth Among Older Adults, by Race and Ethnicity?, Kaiser
Family Foundation, February 2021. https://www.kff.org/medicare/
issue-brief/does-education-narrow-the-gap-in-wealth-among-
older-adults-by-race-and-ethnicity/.
Ochieng, Nancy, Juliette Cubanski, Tricia Neuman, Samantha Artiga, and
Anthony Damico, Racial and Ethnic Health Inequities and
Medicare, Kaiser Family Foundation, February 2021. https://
www.kff.org/medicare/report/racial-and-ethnic-health-
inequities-and-medicare/.
Cubanski, Juliette, Meredith Freed, and Tricia Neuman, A Status Report
on Prescription Drug Policies and Proposals at the Start of the
Biden Administration, Kaiser Family Foundation, February 2021.
https://www.kff.org/medicare/issue-brief/a-status-report-on-
prescription-drug-policies-and-proposals-at-the-start-of-the-
biden-administration/.
Freed, Meredith, Juliette Cubanski, Nancy Ochieng, and Tricia Neuman,
At This Early Stage of the COVID-19 Vaccine Roll-Out, Most
Older Adults Have Not Yet Been Vaccinated as Supply Remains
Limited, Kaiser Family Foundation, February 2021. https://
www.kff.org/coronavirus-covid-19/issue-brief/at-this-early-
stage-of-the-covid-19-vaccine-roll-out-most-older-adults-have-
not-yet-been-vaccinated-as-supply-remains-limited/.
Cubanski, Juliette and Tricia Neuman, Price Increases Continue to
Outpace Inflation for Many Medicare Part D Drugs, Kaiser Family
Foundation, February 2021. https://www.kff.org/medicare/issue-
brief/price-increases-continue-to-outpace-inflation-for-many-
medicare-part-d-drugs/.
Ochieng, Nancy, Priya Chidambaram, Rachel Garfield, and Tricia Neuman,
Factors Associated With COVID-19 Cases and Deaths in Long-Term
Care Facilities: Findings from a Literature Review, Kaiser
Family Foundation, January 2021. https://www.kff.org/
coronavirus-covid-19/issue-brief/factors-associated-with-covid-
19-cases-and-deaths-in-long-term-care-facilities-findings-from-
a-literature-review/.
Freed, Meredith, Anthony Damico, and Tricia Neuman, A Dozen Facts About
Medicare Advantage in 2020, Kaiser Family Foundation, January
2021. https://www.kff.org/medicare/issue-brief/a-dozen-facts-
about-medicare-advantage-in-2020/.
McDermott, Daniel, Lina Stolyar, Cynthia Cox, Robin Rudowitz, Rachel
Garfield, Jeannie Fuglesten Biniek, and Tricia Neuman, Health
Insurer Financial Performance Through September 2020, Kaiser
Family Foundation, December 2020. https://www.kff.org/private-
insurance/issue-brief/health-insurer-financial-performance-
through-september-2020/.
Cubanski, Juliette, Tricia Neuman, and Anthony Damico, Who Didn't Get a
Second Shingrix Shot? Implications for Multidose COVID-19
Vaccines, Kaiser Family Foundation, December 2020. https://
www.kff.org/medicare/issue-brief/who-didnt-get-a-second-
shingrix-shot-implications-for-multidose-covid-19-vaccines/.
Levitt, Larry, Samantha Artiga, Matthew Rae, Tricia Neuman, Gary
Claxton, and Jennifer Kates, Estimates of the Initial Priority
Population for COVID-19 Vaccination by State, Kaiser Family
Foundation, December 2020. https://www.kff.org/coronavirus-
covid-19/issue-brief/estimates-of-the-initial-priority-
population-for-covid-19-vaccination-by-state/.
Cubanski, Juliette, Meredith Freed, Tricia Neuman, and Anthony Damico,
Options to Make Medicare More Affordable For Beneficiaries Amid
the COVID-19 Pandemic and Beyond, Kaiser Family Foundation,
December 2020. https://www.
kff.org/medicare/report/options-to-make-medicare-more-
affordable-for-beneficiaries-amid-the-covid-19-pandemic-and-
beyond/.
Chidambaram, Priya, Rachel Garfield, and Tricia Neuman, COVID-19 Has
Claimed the Lives of 100,000 Long-Term Care Residents and
Staff, Kaiser Family Foundation, November 2020. https://
www.kff.org/policy-watch/covid-19-has-claimed-the-lives-of-
100000-long-term-care-residents-and-staff/.
Schwartz, Karyn, Meredith Freed, Juliette Cubanski Follow, Rachel
Dolan, Karen Pollitz , Josh Michaud, Jennifer Kates, and Tricia
Neuman, Vaccine Coverage, Pricing, and Reimbursement in the
U.S., Kaiser Family Foundation, November 2020. https://
www.kff.org/coronavirus-covid-19/issue-brief/vaccine-coverage-
pricing-and-reimbursement-in-the-u-s/.
Biniek Fuglesten, Jeannie, Meredith Freed, Anthony Damico, and Tricia
Neuman, Medicare Advantage 2021 Spotlight: First Look, Kaiser
Family Foundation, October 2020. https://www.kff.org/medicare/
issue-brief/medicare-advantage-
2021-spotlight-first-look/.
Freed, Meredith, Wyatt Koma, Juliette Cubanski, Jeannie Fuglesten
Biniek, and Tricia Neuman, More Than Half of All People on
Medicare Do Not Compare Their Coverage Options Annually, Kaiser
Family Foundation, October 2020. https://www.kff.org/medicare/
issue-brief/more-than-half-of-all-people-on-medicare-do-not-
compare-their-coverage-options-annually/.
Chidambaram, Priya, Tricia Neuman, and Rachel Garfield, Racial and
Ethnic Disparities in COVID-19 Cases and Deaths in Nursing
Homes, Kaiser Family Foundation, October 2020. https://
www.kff.org/coronavirus-covid-19/issue-brief/racial-and-ethnic-
disparities-in-covid-19-cases-and-deaths-in-nursing-homes/.
Ochieng, Nancy, Karyn Schwartz, and Tricia Neuman, How Many Physicians
Have Opted-Out of the Medicare Program?, Kaiser Family
Foundation, October 2020. https://www.kff.org/medicare/issue-
brief/how-many-physicians-have-opted-out-of-the-medicare-
program/.
Koma, Wyatt, Matthew Rae, Amrutha Ramaswamy, Tricia Neuman, Jennifer
Kates, and Lindsey Dawson, Demographics, Insurance Coverage,
and Access to Care Among Transgender Adults, October 2020.
https://www.kff.org/health-reform/issue-brief/demographics-
insurance-coverage-and-access-to-care-among-transgender-
adults/.
Cubanski, Juliette, Karyn Schwartz, Jeannie Fuglesten Biniek, and
Tricia Neuman, Medicare Accelerated and Advance Payments for
COVID-19 Revenue Loss: More Time to Repay?, Kaiser Family
Foundation, October 2020. https://www.kff.org/medicare/issue-
brief/medicare-accelerated-and-advance-payments-for-covid-19-
revenue-loss-more-time-to-repay/.
Cubanski, Juliette, Tricia Neuman, and Anthony Damico, Lower Flu
Vaccination Rates Among Black, Hispanic, and Low-Income Seniors
Suggest Challenges for COVID-19 Vaccination Efforts, Kaiser
Family Foundation, October 2020. https://www.kff.org/medicare/
issue-brief/lower-flu-vaccination-rates-among-black-Hispanic-
and-low-income-seniors-suggest-challenges-for-covid-19-
vaccination-efforts/.
Neuman, Tricia, Meredith Freed, Jennifer Kates, Karen Pollitz, Robin
Rudowitz, Samantha Artiga, Michelle Long, MaryBeth Musumeci,
Alina Salganicoff, Juliette Cubanski, Lindsey Dawson, Rachel
Dolan, Nirmita Panchal, and Rabah Kamal, President Trump's
Record on Health Care, Kaiser Family Foundation, September
2020. https://www.kff.org/health-reform/issue-brief/president-
trumps-record-on-health-care/.
Kates, Jennifer, Josh Michaud, Larry Levitt, Karen Pollitz, Tricia
Neuman, Michelle Long, Robin Rudowitz, MaryBeth Musumeci,
Meredith Freed, and Juliette Cubanski, Comparing Trump and
Biden on COVID-19, Kaiser Family Foundation, September 2020.
https://www.kff.org/coronavirus-covid-19/issue-brief/comparing-
trump-and-biden-on-covid-19/.
Cubanski, Juliette, and Tricia Neuman, Medicare's Finances Have Gotten
Much Worse in Recent Years, Foreshadowing Tough Choices for
November's Winners, Kaiser Family Foundation, September 2020.
https://www.kff.org/policy-watch/medicares-finances-have-
gotten-much-worse-in-recent-years-foreshadowing-tough-choices-
for-novembers-winners/.
Schwartz, Karyn, Eric Lopez, Matthew Rae and Tricia Neuman, What We
Know About Provider Consolidation, Kaiser Family Foundation,
August 2020. https://www.kff.org/health-costs/issue-brief/what-
we-know-about-provider-consolidation/.
True, Sarah, Nancy Ochieng, Juliette Cubanski, Priya Chidambaram, and
Tricia Neuman, Overlooked and Undercounted: The Growing Impact
of COVID-19 on Assisted Living Facilities, Kaiser Family
Foundation, September 2020. https://www.kff.org/coronavirus-
covid-19/issue-brief/overlooked-and-undercounted-the-growing-
impact-of-covid-19-on-assisted-living-facilities/.
Neuman, Tricia, and Juliette Cubanski, Most People Are Unlikely to See
Drug Cost Savings From President Trump's ``Most Favored
Nation'' Proposal, Kaiser Family Foundation, August 2020.
https://www.kff.org/policy-watch/most-people-are-unlikely-to-
see-drug-cost-savings-from-president-trumps-most-favored-
nation-proposal/.
Freed, Meredith, Juliette Cubanski, Tricia Neuman, Jennifer Kates, and
Josh Michaud, What Share of People Who Have Died of COVID-19
Are 65 and Older--and How Does It Vary By State?, Kaiser Family
Foundation, July 2020. https://www.kff.org/coronavirus-covid-
19/issue-brief/what-share-of-people-who-have-died-of-covid-19-
are-65-and-older-and-how-does-it-vary-by-state/.
Rae, Matthew, Tricia Neuman, Jennifer Kates, Josh Michaud, Samantha
Artiga, Gary Claxton, and Anthony Damico, Millions of Seniors
Live in Households with School-Age Children, Kaiser Family
Foundation, July 2020. https://www.kff.org/coronavirus-covid-
19/issue-brief/millions-of-seniors-live-in-households-with-
school-age-children/.
Cubanski, Juliette, Karyn Schwartz, and Tricia Neuman, How Could the
Price of Remdesivir Impact Medicare Spending for COVID-19
Patients, Kaiser Family Foundation, July 2020. https://
www.kff.org/coronavirus-covid-19/issue-brief/how-could-the-
price-of-remdesivir-impact-medicare-spending-for-covid-19-
patients/.
Claxton, Gary, Larry Levitt Follow, Rabah Kamal, Tricia Neuman,
Jennifer Kates, Josh Michaud, Wyatt Koma, and Matthew Rae, How
Many Teachers Are at Risk of Serious Illness if Infected with
Coronavirus?, Kaiser Family Foundation, July 2020. https://
www.kff.org/coronavirus-covid-19/issue-brief/how-many-teachers-
are-at-risk-of-serious-illness-if-infected-with-coronavirus/.
Lopez, Eric, Gary Claxton, Karyn Schwartz, Matthew Rae, Nancy Ochieng,
and Tricia Neuman, Comparing Private Payer and Medicare Payment
Rates for Select Inpatient Hospital Services, Kaiser Family
Foundation, July 2020. https://www.kff.org/medicare/issue-
brief/comparing-private-payer-and-medicare-payment-rates-for-
select-inpatient-hospital-services/.
True, Sarah, Nancy Ochieng, Juliette Cubanski, Wyatt Koma, and Tricia
Neuman, Under the Radar: States Vary in Regulating and
Reporting COVID-19 in Assisted Living Facilities, Kaiser Family
Foundation, June 2020. https://www.kff.org/coronavirus-covid-
19/issue-brief/under-the-radar-states-vary-in-regulating-and-
reporting-covid-19-in-assisted-living-facilities/.
Claxton, Gary, Larry Levitt, Rachel Garfield, Rabah Kamal, Tricia
Neuman, Jennifer Kates, Josh Michaud, Wyatt Koma, and Matthew
Rae, Almost One in Four Adult Workers is Vulnerable to Severe
Illness from COVID-19, Kaiser Family Foundation, June 2020.
https://www.kff.org/coronavirus-covid-19/issue-brief/almost-
one-in-four-adult-workers-is-vulnerable-to-severe-illness-from-
covid-19/.
Cubanski, Juliette, Tricia Neuman, Sarah True, and Anthony Damico,
Insulin Costs and Coverage in Medicare Part D, Kaiser Family
Foundation, June 2020. https://www.kff.org/medicare/issue-
brief/insulin-costs-and-coverage-in-medicare-part-d/.
Cubanski, Juliette, Tricia Neuman, and Wyatt Koma, Older Adults Are Hit
Hard by COVID-19--and Also Losing Jobs, Kaiser Family
Foundation, May 2020. https://www.kff.org/policy-watch/older-
adults-are-hit-hard-by-covid-19-and-also-losing-jobs/.
Koma, Wyatt, Samantha Artiga, Tricia Neuman, Gary Claxton, Matthew Rae,
Jennifer Kates, and Josh Michaud, Low-Income and Communities of
Color at Higher Risk of Serious Illness if Infected with
Coronavirus, Kaiser Family Foundation, May 2020. https://
www.kff.org/coronavirus-covid-19/issue-brief/low-income-and-
communities-of-color-at-higher-risk-of-serious-illness-if-
infected-with-coronavirus/.
Neuman, Tricia and Wyatt Koma, Retirement Insecurity in the Time of
COVID-19: The Next Shoe to Drop?, Kaiser Family Foundation,
April 2020. https://www.kff.org/policy-watch/retirement-
insecurity-in-time-of-covid-19-next-shoe-to-drop/.
Koma, Wyatt, Tricia Neuman, Gretchen Jacobson, and Karen Smith,
Medicare Beneficiaries' Financial Security Before the
Coronavirus Pandemic, Kaiser Family Foundation, April 2020.
https://www.kff.org/medicare/issue-brief/medicare-
beneficiaries-financial-security-before-the-coronavirus-
pandemic/.
Schwartz, Karyn, Jennifer Tolbert, Karyn Pollitz, and Tricia Neuman,
Update on COVID-19 Funding for Hospitals and Other Providers,
Kaiser Family Foundation, April 2020. https://www.kff.org/
policy-watch/update-on-covid-19-funding-for-hospitals-and-
other-providers/.
Koma, Wyatt, Tricia Neuman, Gary Claxton, Matthew Rae, Jennifer Kates,
and Josh Michaud, How Many Adults Are at Risk of Serious
Illness if Infected with Coronavirus? Updated Data, Kaiser
Family Foundation, April 2020. https://www.kff.org/coronavirus-
covid-19/issue-brief/how-many-adults-are-at-risk-of-serious-
illness-if-infected-with-coronavirus/.
Lopez, Eric, Tricia Neuman, Gretchen Jacobson, and Larry Levitt, How
Much More Than Medicare Do Private Insurers Pay? A Review of
the Literature, Kaiser Family Foundation, April 2020. https://
www.kff.org/medicare/issue-brief/how-much-more-than-medicare-
do-private-insurers-pay-a-review-of-the-literature/.
Cox, Cynthia, Robin Rudowitz, Tricia Neuman, Juliette Cubanski, and
Matthew Rae, How Health Costs Might Change with COVID-19,
Kaiser Family Foundation, April 2020. https://www.kff.org/
coronavirus-covid-19/issue-brief/how-health-costs-might-change-
with-covid-19/.
Freed, Meredith, Juliette Cubanski, and Tricia Neuman, Medicare
Beneficiaries Without Supplemental Coverage Are at Risk for
Out-of-Pocket Costs Relating to COVID-19 Treatment, Kaiser
Family Foundation, April 2020. https://www.kff.org/policy-
watch/medicare-beneficiaries-without-supplemental-coverage-are-
at-risk-for-out-of-pocket-costs-relating-to-covid-19-
treatment/.
Cubanski, Juliette, Tricia Neuman, and Anthony Damico, Problems Getting
Care Due to Cost or Paying Medical Bills Among Medicare
Beneficiaries, Kaiser Family Foundation, April 2020. https://
www.kff.org/coronavirus-covid-19/issue-brief/problems-getting-
care-due-to-cost-or-paying-medical-bills-among-medicare-
beneficiaries/.
.Schwartz, Karyn, and Tricia Neuman, A Look at the $100 Billion for
Hospitals in the CARES Act, Kaiser Family Foundation, March
2020. https://www.kff.org/policy-watch/a-look-at-the-100-
billion-for-hospitals-in-the-cares-act/.
Neuman, Tricia, Anthony Damico, and Juliette Cubanski, How Much Could
Medicare Beneficiaries Pay for a Hospital Stay Related to
COVID-19?, Kaiser Family Foundation, March 2020. https://
www.kff.org/coronavirus-covid-19/issue-brief/how-much-could-
medicare-beneficiaries-pay-for-a-hospital-stay-related-to-
covid-19/.
Neuman, Tricia, Karyn Pollitz, Jennifer Tolbert, Robin Rudowitz, and
Wyatt Koma, 10 Key Questions on Public Option Proposals, Kaiser
Family Foundation, December 2019. https://www.kff.org/health-
reform/issue-brief/10-key-questions-on-public-option-
proposals/.
Koma, Wyatt, Juliette Cubanski, Gretchen Jacobson, Anthony Damico, and
Tricia Neuman, No Itch to Switch: Few Medicare Beneficiaries
Switch Plans During the Open Enrollment Period, Kaiser Family
Foundation, December 2019. https://www.kff.org/medicare/issue-
brief/no-itch-to-switch-few-medicare-beneficiaries-switch-
plans-during-the-open-enrollment-period/.
Freed, Meredith, Juliette Cubanski, and Tricia Neuman, A Look at Recent
Proposals to Control Drug Spending by Medicare and its
Beneficiaries, Kaiser Family Foundation, November 2019. https:/
/www.kff.org/medicare/issue-brief/a-look-at-recent-proposals-
to-control-drug-spending-by-medicare-and-its-beneficiaries/.
Cubanski, Juliette, Wyatt Koma, Anthony Damico, and Tricia Neuman, How
Much Do Medicare Beneficiaries Spend Out of Pocket on Health
Care?, Kaiser Family Foundation, November 2019. https://
www.kff.org/medicare/issue-brief/how-much-do-medicare-
beneficiaries-spend-out-of-pocket-on-health-care/.
Jacobson, Gretchen, Meredith Freed, Anthony Damico, and Tricia Neuman,
Medicare Advantage 2020 Spotlight: First Look, Kaiser Family
Foundation, October 2019. https://www.kff.org/medicare/issue-
brief/medicare-advantage-2020-spotlight-first-look/.
Cubanski, Juliette and Tricia Neuman, Assessing Drug Price Increases in
Medicare Part D and the Implications of Inflation Limits,
Kaiser Family Foundation, October 2019. https://www.kff.org/
medicare/issue-brief/assessing-drug-price-increases-in-
medicare-part-d-and-the-implications-of-inflation-limits/.
Cubanski, Juliette and Tricia Neuman, How Will The Medicare Part D
Benefit Change Under Current Law and Leading Proposals? Kaiser
Family Foundation, October 2019. https://www.kff.org/medicare/
issue-brief/how-will-the-medicare-part-d-benefit-change-under-
current-law-and-leading-proposals/.
Freed, Meredith, Lisa Potetz, Gretchen Jacobson, and Tricia Neuman,
Policy Options for Improving Dental Coverage for People on
Medicare, Kaiser Family Foundation, September 2019. https://
www.kff.org/medicare/issue-brief/policy-options-for-improving-
dental-coverage-for-people-on-medicare/.
Cubanski, Juliette, Tricia Neuman, and Meredith Freed, The Facts on
Medicare Spending and Financing, Kaiser Family Foundation,
August 2019. https://www.kff.org/medicare/issue-brief/the-
facts-on-medicare-spending-and-financing/.
Kirzinger, Ashley, Tricia Neuman, Juliette Cubanski and Mollyann
Brodie, Data Note: Prescription Drugs and Older Adults, Kaiser
Family Foundation, August 2019. https://www.kff.org/health-
reform/issue-brief/data-note-prescription-drugs-and-older-
adults/.
Jacobson, Gretchen, Rachel Fehr, Cynthia Cox, and Tricia Neuman,
Financial Performance of Medicare Advantage, Individual, and
Group Health Insurance Markets, Kaiser Family Foundation,
August 2019. https://www.kff.org/medicare/issue-brief/
financial-performance-of-medicare-advantage-individual-and-
group-health-insurance-markets/.
Pollitz, Karen, Tricia Neuman, Jennifer Tolbert, Robin Rudowitz,
Cynthia Cox, Gary Claxton, and Larry Levitt, What's the Role of
Private Health Insurance Today and Under Medicare-for-all and
Other Public Option Proposals? Kaiser Family Foundation, July
2019. https://www.kff.org/health-reform/issue-brief/whats-the-
role-of-private-health-insurance-today-and-under-medicare-for-
all-and-other-public-option-proposals/.
Cubanski, Juliette, Tricia Neuman, and Anthony Damico, How Many
Medicare Part D Enrollees Had High Out-of-Pocket Drug Costs in
2017?, Kaiser Family Foundation, June 2019. https://
www.kff.org/medicare/issue-brief/how-many-medicare-part-d-
enrollees-had-high-out-of-pocket-drug-costs-in-2017/.
Jacobson, Gretchen, Meredith Freed, Anthony Damico, and Tricia Neuman,
A Dozen Facts About Medicare Advantage in 2019, Kaiser Family
Foundation, June 2019. https://www.kff.org/medicare/issue-
brief/a-dozen-facts-about-medicare-advantage-in-2019/.
Cubanski, Juliette, Anthony Damico, and Tricia Neuman, 10 Things to
Know About Medicare Part D Coverage and Costs in 2019, Kaiser
Family Foundation, June 2019. https://www.kff.org/medicare/
issue-brief/10-things-to-know-about-medicare-part-d-coverage-
and-costs-in-2019/.
Jacobson, Gretchen, Tricia Neuman, Meredith Freed, and Anthony Damico,
What Percent of New Medicare Beneficiaries Are Enrolling in
Medicare Advantage?, Kaiser Family Foundation, June 2019.
https://www.kff.org/medicare/issue-brief/what-percent-of-new-
medicare-beneficiaries-are-enrolling-in-medicare-advantage/.
Jacobson, Gretchen, Tricia Neuman, and Anthony Damico, Do People Who
Sign Up for Medicare Advantage Plans Have Lower Medicare
Spending?, Kaiser Family Foundation, May 2019. https://
www.kff.org/medicare/issue-brief/do-people-who-sign-up-for-
medicare-advantage-plans-have-lower-medicare-spending/.
Cubanski, Juliette, Tricia Neuman, Sarah True, and Anthony Damico, How
Much Does Medicare Spend on Insulin?, Kaiser Family Foundation,
April 2019. https://www.kff.org/medicare/issue-brief/how-much-
does-medicare-spend-on-insulin/.
Freed, Meredith, Tricia Neuman, and Gretchen Jacobson, Drilling Down on
Dental Coverage and Costs for Medicare Beneficiaries, Kaiser
Family Foundation, March 2019. https://www.kff.org/medicare/
issue-brief/drilling-down-on-dental-coverage-and-costs-for-
medicare-beneficiaries/.
Cubanski, Juliette, Wyatt Koma, and Tricia Neuman, The Out-of-Pocket
Cost Burden for Specialty Drugs in Medicare Part D in 2019,
Kaiser Family Foundation, February 2019. https://www.kff.org/
medicare/issue-brief/the-out-of-pocket-cost-burden-for-
specialty-drugs-in-medicare-part-d-in-2019/.
Cubanski, Juliette, Anthony Damico, Tricia Neuman, and Gretchen
Jacobson, Sources of Supplemental Coverage Among Medicare
Beneficiaries in 2016, Kaiser Family Foundation, November 2018.
https://www.kff.org/medicare/issue-brief/sources-of-
supplemental-coverage-among-medicare-beneficiaries-in-2016/.
Cubanski, Juliette, Wyatt Koma, Anthony Damico, and Tricia Neuman, How
Many Seniors Live in Poverty?, Kaiser Family Foundation,
November 2018. https://www.kff.org/medicare/issue-brief/how-
many-seniors-live-in-poverty/.
Jacobson, Gretchen, Anthony Damico, and Tricia Neuman, A Dozen Facts
About Medicare Advantage, Kaiser Family Foundation, November
2018. https://www.kff.org/medicare/issue-brief/a-dozen-facts-
about-medicare-advantage/.
Cubanski, Juliette and Tricia Neuman, Medicare's Income-Related
Premiums Under Current Law and Changes for 2019, Kaiser Family
Foundation, October 2018. https://www.kff.org/medicare/issue-
brief/medicares-income-related-premiums-under-current-law-and-
changes-for-2019/.
Jacobson, Gretchen and Tricia Neuman, Prior Authorization in Medicare
Advantage Plans: How Often Is It Used? Kaiser Family
Foundation, October 2018. https://www.kff.org/medicare/issue-
brief/prior-authorization-in-medicare-advantage-plans-how-
often-is-it-used/.
Cubanski, Juliette, Anthony Damico, and Tricia Neuman, Medicare Part D:
A First Look at Prescription Drug Plans in 2019, Kaiser Family
Foundation, October 2018. https://www.kff.org/medicare/issue-
brief/medicare-part-d-a-first-look-at-prescription-drug-plans-
in-2019/.
Jacobson, Gretchen, Anthony Damico, and Tricia Neuman, Medicare
Advantage 2019 Spotlight: First Look, Kaiser Family Foundation,
October 2018. https://www.kff.org/medicare/issue-brief/
medicare-advantage-2019-spotlight-first-
look/.
Neuman, Tricia, Karen Pollitz, and Jennifer Tolbert, Medicare-for-All
and Public Plan Buy-In Proposals: Overview and Key Issues,
Kaiser Family Foundation, October 2018. https://www.kff.org/
health-reform/issue-brief/medicare-for-all-and-public-plan-buy-
in-proposals-overview-and-key-issues/.
Cubanski, Juliette, Tricia Neuman, and Anthony Damico, Closing the
Medicare Part D Coverage Gap: Trends, Recent Changes, and
What's Ahead, Kaiser Family Foundation, August 2018. https://
www.kff.org/medicare/issue-brief/closing-the-medicare-part-d-
coverage-gap-trends-recent-changes-and-whats-ahead/.
Boccuti, Cristina, Gretchen Jacobson, Kendal Orgera, and Tricia Neuman,
Medigap Enrollment and Consumer Protections Vary Across States,
Kaiser Family Foundation, July 2018. https://www.kff.org/
medicare/issue-brief/medigap-enrollment-and-consumer-
protections-vary-across-states/.
Cubanski, Juliette, Anthony Damico, and Tricia Neuman, Medicare Part D
in 2018: The Latest on Enrollment, Premiums, and Cost Sharing,
Kaiser Family Foundation, May 2018. https://www.kff.org/
medicare/issue-brief/medicare-part-d-in-2018-the-latest-on-
enrollment-premiums-and-cost-sharing/.
Cubanski, Juliette, Kendal Orgera, Anthony Damico, and Tricia Neuman,
The Financial Burden of Health Care Spending: Larger for
Medicare Households than for Non-Medicare Households, Kaiser
Family Foundation, March 2018. https://www.kff.org/medicare/
issue-brief/the-financial-burden-of-health-care-spending-
larger-for-medicare-households-than-for-non-medicare-
households/.
Cubanski, Juliette, Tricia Neuman, Anthony Damico, and Karen Smith,
Medicare Beneficiaries' Out-of-Pocket Health Care Spending as a
Share of Income Now and Projections for the Future, Kaiser
Family Foundation, January 2018. https://www.kff.org/medicare/
report/medicare-beneficiaries-out-of-pocket-health-care-
spending-as-a-share-of-income-now-and-projections-for-the-
future/.
Cubanski, Juliette, and Tricia Neuman, FAQs: What's the Latest on IPAB?
Kaiser Family Foundation, November 2017, https://www.kff.org/
medicare/issue-brief/faqs-whats-the-latest-on-ipab/.
Cubanski, Juliette, and Tricia Neuman, Medicare's Income-Related
Premiums Under Current Law and Proposed Changes, Kaiser Family
Foundation, November 2017. https://www.kff.org/medicare/issue-
brief/medicares-income-related-premiums-under-current-law-and-
proposed-changes/.
Cubanski, Juliette, Tricia Neuman, Kendal Orgera, and Anthony Damico,
No Limit: Medicare Part D Enrollees Exposed to High Out-of-
Pocket Drug Costs Without a Hard Cap on Spending, Kaiser Family
Foundation, November 2017. https://files.kff.org/attachment/
Issue-Brief-No-Limit-Medicare-Part-D-Enrollees-Exposed-to-High-
Out-of-Pocket-Drug-Costs-Without-a-Hard-Cap-on-Spending.
Cubanski, Juliette, Anthony Damico, Jack Hoadley, Kendal Orgera, and
Tricia Neuman, Medicare Part D: A First Look at Prescription
Drug Plans in 2018, Kaiser Family Foundation, October 2017.
https://www.kff.org/medicare/issue-brief/medicare-part-d-a-
first-look-at-prescription-drug-plans-in-2018/.
Jacobson, Gretchen, Anthony Damico, and Tricia Neuman, Medicare
Advantage 2018 Data Spotlight: First Look, Kaiser Family
Foundation, October 2017. https://www.kff.org/medicare/issue-
brief/medicare-advantage-2018-data-spotlight-first-look/.
Jacobson, Gretchen, Matthew Rae, Tricia Neuman, Kendal Orgera, and
Cristina Boccuti, Medicare Advantage: How Robust Are Plans'
Physician Networks?, Kaiser Family Foundation, October 2017.
https://www.kff.org/medicare/report/medicare-advantage-how-
robust-are-plans-physician-networks/.
Jacobson, Gretchen, and Tricia Neuman, Some Counties May Lack an ACA
Marketplace Insurer Next Year--But Many More Lack Medicare
Advantage Plans Today, Kaiser Family Foundation, August 2017.
https://www.kff.org/medicare/issue-brief/some-counties-may-
lack-an-aca-marketplace-insurer-next-year-but-many-more-lack-
medicare-advantage-plans-today/.
Cubanski, Juliette, and Tricia Neuman, What Are the Implications for
Medicare of the American Health Care Act and the Better Care
Reconciliation Act?, Kaiser Family Foundation, July 2017.
https://www.kff.org/medicare/issue-brief/what-are-the-
implications-for-medicare-of-the-american-health-care-act-and-
the-better-care-reconciliation-act/.
Neuman, Tricia, Karen Pollitz, and Larry Levitt, How the Senate Better
Care Reconciliation Act (BCRA) Could Affect Coverage and
Premiums for Older Adults, Kaiser Family Foundation, June 2017.
https://www.kff.org/health-reform/issue-brief/how-the-senate-
better-care-reconciliation-act-bcra-could-affect-coverage-and-
premiums-for-older-adults/.
Jacobson, Gretchen, Anthony Damico, Tricia Neuman, and Marsha Gold,
Medicare Advantage 2017 Spotlight: Enrollment Market Update,
Kaiser Family Foundation, June 2017. https://www.kff.org/
medicare/issue-brief/medicare-advantage-2017-spotlight-
enrollment-market-update/.
Neuman, Tricia, Karen Pollitz, and Larry Levitt, How ACA Repeal and
Replace Proposals Could Affect Coverage and Premiums for Older
Adults and Have Spillover Effects for Medicare, Kaiser Family
Foundation, June 2017, https://www.kff.org/health-reform/issue-
brief/how-aca-repeal-and-replace-proposals-could-affect-
coverage-and-premiums-for-older-adults-and-have-spillover-
effects-for-medicare/.
Jacobson, Gretchen, Shannon Giffin, Tricia Neuman, and Karen Smith,
Income and Assets of Medicare Beneficiaries, 2016-2035, Kaiser
Family Foundation, April 2017. https://www.kff.org/medicare/
issue-brief/income-and-assets-of-medicare-beneficiaries-2016-
2035/.
Jacobson, Gretchen, Tricia Neuman, and MaryBeth Musumeci, What Could a
Medicaid Per Capita Cap Mean for Low-Income People on
Medicare?, Kaiser Family Foundation, March 2017. https://
www.kff.org/medicare/issue-brief/what-could-a-Medicaid-per-
capita-cap-mean-for-low-income-people-on-medicare/.
Cubanski, Juliette, and Tricia Neuman, 10 Essential Facts About
Medicare's Financial Outlook, Kaiser Family Foundation,
February 2017. https://www.kff.org/medicare/issue-brief/10-
essential-facts-about-medicares-financial-outlook/.
Boccuti, Cristina and Tricia Neuman, Private Contracts Between Doctors
and Medicare Patients: Key Questions and Implications of
Proposed Policy Changes, Kaiser Family Foundation, January
2017. https://www.kff.org/medicare/issue-brief/10-essential-
facts-about-medicares-financial-outlook/.
Jacobson, Gretchen, Anthony Damico, Tricia Neuman, and Marsha Gold,
Medicare Advantage Plans in 2017: Short-term Outlook is Stable,
Kaiser Family Foundation, December 2016. https://www.kff.org/
medicare/issue-brief/medicare-advantage-plans-in-2017-short-
term-outlook-is-stable/.
Cubanski, Juliette, Tricia Neuman, Gretchen Jacobson, and Cristina
Boccuti, What Are the Implications of Repealing the Affordable
Care Act for Medicare Spending and Beneficiaries?, Kaiser
Family Foundation, December 2016. https://www.kff.org/health-
reform/issue-brief/what-are-the-implications-of-repealing-the-
affordable-care-act-for-medicare-spending-and-beneficiaries/.
Hoadley, Jack, Juliette Cubanski, and Tricia Neuman, Medicare Part D: A
First Look at Prescription Drug Plans in 2017, Kaiser Family
Foundation, December 2016. https://www.kff.org/medicare/issue-
brief/medicare-part-d-a-first-look-at-prescription-drug-plans-
in-2017/.
Neuman, Tricia and Juliette Cubanski, The Gap in Medigap, Kaiser Family
Foundation, September 2016. https://www.kff.org/medicare/
perspective/the-gap-in-medigap/.
Cubanski, Juliette, Tricia Neuman, and Anthony Damico, How Much Has
Medicare Spent on the EpiPen Since 2007?, Kaiser Family
Foundation, September 2016. https://www.kff.org/medicare/issue-
brief/how-much-has-medicare-spent-on-the-epipen-since-2007/.
Jacobson, Gretchen, Tricia Neuman, and Anthony Damico, Medicare
Advantage Plan Switching: Exception or Norm?, Kaiser Family
Foundation, September 2016. https://www.kff.org/medicare/issue-
brief/medicare-advantage-plan-switching-exception-or-norm/.
Hoadley, Jack, Juliette Cubanski, and Tricia Neuman, Medicare Part D in
2016 and Trends over Time, Kaiser Family Foundation, September
2016. https://www.kff.org/medicare/report/medicare-part-d-in-
2016-and-trends-over-time/.
Cubanski, Juliette, Tricia Neuman, and Anthony Damico, Similar but Not
the Same: How Medicare Per Capita Spending Compares for Younger
and Older Beneficiaries, Kaiser Family Foundation, August 2016.
https://www.kff.org/medicare/issue-brief/similar-but-not-the-
same-how-medicare-per-capita-spending-compares-for-younger-and-
older-beneficiaries/.
Cubanski, Juliette, Tricia Neuman, and Anthony Damico, Medicare's Role
for People Under Age 65 with Disabilities, Kaiser Family
Foundation, August 2016. https://www.kff.org/medicare/issue-
brief/medicares-role-for-people-under-age-65-with-
disabilities/.
Jacobson, Gretchen and Tricia Neuman, Turning Medicare Into a Premium
Support System: Frequently Asked Questions, Kaiser Family
Foundation, July 2016. https://www.kff.org/medicare/issue-
brief/turning-medicare-into-a-premium-support-system-frequently
asked-questions/.
Cubanski, Juliette, Tricia Neuman, Shannon Giffin, and Anthony Damico,
Medicare Spending at the End of Life: A Snapshot of
Beneficiaries Who Died in 2014 and the Cost of Their Care,
Kaiser Family Foundation, July 2016. https://www.
kff.org/medicare/issue-brief/medicare-spending-at-the-end-of-
life/.
Cubanski, Juliette, Tricia Neuman, Zachary Levinson, Gretchen Jacobson,
Monica Brenner, and James Mays, Modifying Medicare's Benefit
Design: What's the Impact on Beneficiaries and Spending?,
Kaiser Family Foundation, June 2016. https://www.kff.org/
medicare/report/modifying-medicares-benefit-design-whats-the-
impact-on-beneficiaries-and-spending/.
Jacobson, Gretchen, Ariel Trilling, Tricia Neuman, Anthony Damico, and
Marsha Gold, Medicare Advantage Hospital Networks: How Much Do
They Vary?, Kaiser Family Foundation, June 2016. https://
www.kff.org/medicare/report/medicare-advantage-hospital-
networks-how-much-do-they-vary/.
Jacobson, Gretchen, Giselle Casillas, Anthony Damico, Tricia Neuman,
and Marsha Gold, Medicare Advantage 2016 Spotlight: Enrollment
Market Update, Kaiser Family Foundation, May 2016. https://
www.kff.org/medicare/issue-brief/medicare-advantage-2016-
spotlight-enrollment-market-update/.
Neuman, Tricia and Anthony Damico, Fading Fast: Fewer Seniors Have
Retiree Health Insurance, Kaiser Family Foundation, May 2016.
https://www.kff.org/medicare/issue-brief/fading-fast-fewer-
seniors-have-retiree-health-insurance/.
Neuman, Tricia, Traditional Medicare . . . Disadvantaged?, Kaiser
Family Foundation, March 2016. https://www.kff.org/medicare/
perspective/traditional-medicare-disadvantaged/.
Jacobson, Gretchen, Marsha Gold, Anthony Damico, Tricia Neuman, and
Giselle Casillas, Medicare Advantage 2016 Data Spotlight:
Overview of Plan Changes, Kaiser Family Foundation, December
2015. https://www.kff.org/medicare/issue-brief/medicare-
advantage-2016-data-spotlight-overview-of-plan-changes/.
Hoadley, Jack, Juliette Cubanski, and Tricia Neuman, It Pays to Shop:
Variation in Out-of-Pocket Costs for Medicare Part D Enrollees
in 2016, Kaiser Family Foundation, December 2015. https://
www.kff.org/medicare/issue-brief/it-pays-to-shop-variation-in-
out-of-pocket-costs-for-medicare-part-d-enrollees-in-2016/.
Cubanski, Juliette and Tricia Neuman, What's in Store for Medicare's
Part B Premiums and Deductible in 2016, and Why?, Kaiser Family
Foundation, November 2015. https://www.kff.org/medicare/issue-
brief/whats-in-store-for-medicares-part-b-premiums-and-
deductible-in-2016-and-why/.
Neuman, Tricia, Gretchen Jacobson, and Giselle Casillas, Medicare
Advantage and Traditional Medicare: Is the Balance Tipping?,
Kaiser Family Foundation, October 2015. https://www.kff.org/
medicare/issue-brief/medicare-advantage-and-traditional-
medicare-is-the-balance-tipping/.
Hoadley, Jack, Juliette Cubanski, and Tricia Neuman, Medicare Part D: A
First Look at Plan Offerings in 2016, Kaiser Family Foundation,
October 2015. https://www.kff.org/medicare/issue-brief/
medicare-part-d-a-first-look-at-plan-offerings-in-2016/.
Jacobson, Gretchen, Anthony Damico, and Tricia Neuman, What's In and
What's Out? Medicare Advantage Market Entries and Exits for
2016, Kaiser Family Foundation, October 2015. https://
www.kff.org/medicare/issue-brief/whats-in-and-whats-out-
medicare-advantage-market-entries-and-exits-for-2016/.
Cubanski, Juliette, Tricia Neuman, and Chapin White, The Latest on
Geographic Variation in Medicare Spending: A Demographic Divide
Persists But Variation Has Narrowed, Kaiser Family Foundation,
October 2015. https://www.kff.org/medicare/report/the-latest-
on-geographic-variation-in-medicare-spending-a-demographic-
divide-persists-but-variation-has-narrowed/.
Hoadley, Jack, Juliette Cubanski, and Tricia Neuman, Medicare Part D at
Ten Years: The 2015 Marketplace and Key Trends, 2006-2015,
Kaiser Family Foundation, October 2015. https://www.kff.org/
medicare/report/medicare-part-d-at-ten-years-the-2015-
marketplace-and-key-trends-2006-2015/.
Hoadley, Jack, Laura Summer, Elizabeth Hargrave, Samuel Stromberg,
Juliette Cubanski, and Tricia Neuman, To Switch or Be Switched:
Examining Changes in Drug Plan Enrollment among Medicare Part D
Low-Income Subsidy Enrollees, Kaiser Family Foundation, July
2015. https://www.kff.org/medicare/report/to-switch-or-be-
switched-examining-changes-in-drug-plan-enrollment-among-
medicare-part-d-low-income-subsidy-enrollees/.
Jacobson, Gretchen, Anthony Damico, and Tricia Neuman, Data Note:
Medicare Advantage Enrollment, by Firm, 2015, Kaiser Family
Foundation, July 2015. https://www.kff.org/medicare/issue-
brief/data-note-medicare-advantage-enrollment-by-firm-2015/.
Jacobson, Gretchen, Anthony Damico, Tricia Neuman, and Marsha Gold,
Medicare Advantage 2015 Spotlight: Enrollment Market Update,
Kaiser Family Foundation, June 2015. https://www.kff.org/
medicare/issue-brief/medicare-advantage-2015-spotlight-
enrollment-market-update/.
Cubanski, Juliette, and Tricia Neuman, Medicare's Income-Related
Premiums: A Data Note, Kaiser Family Foundation, June 2015.
https://www.kff.org/medicare/issue-brief/medicares-income-
related-premiums-a-data-note/.
Boccuti, Cristina, Giselle Casillas, and Tricia Neuman, Reading the
Stars: Nursing Home Quality Star Ratings, Nationally and by
State, Kaiser Family Foundation, May 2015. https://www.kff.org/
medicare/issue-brief/reading-the-stars-nursing-home-quality-
star-ratings-nationally and-by-state/.
Jacobson, Gretchen, Tricia Neuman, and Anthony Damico, Medigap
Enrollment Among New Medicare Beneficiaries: How Many 65-Year
Olds Enroll in Plans With First-Dollar Coverage?, Kaiser Family
Foundation, April 2015. https://www.kff.org/medicare/issue-
brief/medigap-enrollment-among-new-medicare-beneficiaries/.
Cubanski, Juliette, Christina Swoope, Christina Boccuti, Gretchen
Jacobson, Giselle Casillas, Shannon Giffin, and Tricia Neuman,
A Primer on Medicare: Key Facts About the Medicare Program and
the People it Covers, Kaiser Family Foundation, March 2015.
https://www.kff.org/medicare/report/a-primer-on-medicare-key-
facts-about-the-medicare-program-and-the-people-it-covers/.
Boccuti, Cristina and Tricia Neuman, How Much (More) Will Seniors Pay
for a Doc Fix? (Policy Insight), Kaiser Family Foundation,
March 2015. https://www.kff.org/medicare/perspective/how-much-
more-will-seniors-pay-for-a-doc-fix/.
Jacobson, Gretchen, Christina Boccuti, Juliette Cubanski, Christina
Swoope, and Tricia Neuman, Summary of Medicare Provisions in
the President's Budget for Fiscal Year 2016, Kaiser Family
Foundation, February 2015. https://www.
kff.org/medicare/issue-brief/summary-of-medicare-provisions-in-
the-presidents-budget-for-fiscal-year-2016/.
Neuman, Tricia, Juliette Cubanski, Jennifer Huang, and Anthony Damico,
The Rising Cost of Living Longer: Analysis of Medicare Spending
by Age for Beneficiaries in Traditional Medicare, Kaiser Family
Foundation, January 2015. https://www.kff.org/medicare/report/
the-rising-cost-of-living-longer-analysis-of-medicare-spending-
by-age-for-beneficiaries-in-traditional-medicare/.
White, Chapin, Juliette Cubanski, and Tricia Neuman, How Much of the
Medicare Spending Slowdown Can be Explained? Insights and
Analysis from 2014, Kaiser Family Foundation, December 2014.
https://www.kff.org/medicare/issue-brief/how-much-of-the-
medicare-spending-slowdown-can-be-explained-insights-and-
analysis-from-2014/.
Jacobson, Gretchen, Anthony Damico, Tricia Neuman, and Marsha Gold,
Medicare Advantage 2015 Data Spotlight: Overview of Plan
Changes, Kaiser Family Foundation, December 2014. https://
www.kff.org/medicare/issue-brief/medicare-advantage-2015-data-
spotlight-overview-of-plan-changes/.
Neuman, Tricia, Open Enrollment: Insights from Medicare for Health
Insurance Marketplaces, Kaiser Family Foundation, October 2014.
https://www.kff.org/health-reform/perspective/open-enrollment-
insights-from-medicare-for-health-insurance-marketplaces/.
Jacobson, Gretchen, Tricia Neuman, and Anthony Damico, What's In and
What's Out? Medicare Advantage Market Entries and Exits for
2015, Kaiser Family Foundation, October 2014. https://
www.kff.org/medicare/issue-brief/whats-in-and-whats-out-
medicare-advantage-market-entries-and-exits-for-2015/.
Neuman, Tricia and Juliette Cubanski, The Mystery of the Missing $1,200
Per Person: Can Medicare's Spending Slowdown Continue?, Kaiser
Family Foundation, September 2014. https://www.kff.org/health-
costs/perspective/the-mystery-of-the-missing-1000-per-person-
can-medicares-spending-slowdown-continue/.
Hoadley, Jack, Laura Summer, Elizabeth Hargrave, Juliette Cubanski, and
Tricia Neuman, Medicare Part D in Its Ninth Year: The 2014
Marketplace and Key Trends, 2006-2014, Kaiser Family
Foundation, August 2014. https://www.
kff.org/medicare/report/medicare-part-d-in-its-ninth-year-the-
2014-marketplace-and-key-trends-2006-2014/.
Cubanski, Juliette, Christina Swoope, Anthony Damico, and Tricia
Neuman, How Much Is Enough? Out-of-Pocket Spending Among
Medicare Beneficiaries: A Chartbook, Kaiser Family Foundation,
July 2014. https://www.kff.org/medicare/report/how-much-is-
enough-out-of-pocket-spending-among-medicare-beneficiaries-a-
chartbook/.
Neuman, Tricia and Gretchen Jacobson, Medicare Advantage: Take Another
Look, Kaiser Family Foundation, May 2014. https://www.kff.org/
medicare/perspective/medicare-advantage-take-another-look/.
McArdle, Frank, Tricia Neuman, and Jennifer Huang, Retiree Health
Benefits at the Crossroads. Kaiser Family Foundation, April
2014. https://www.kff.org/medicare/report/retiree-health-
benefits-at-the-crossroads/.
Neuman, Tricia and Christina Swoope, Summary of Medicare Provisions in
the President's Budget for Fiscal Year 2015, Kaiser Family
Foundation, March 2014. https://www.kff.org/medicare/issue-
brief/summary-of-medicare-provisions-in-the-presidents-budget-
for-fiscal-year-2015/.
Cubanski, Juliette, Tricia Neuman, and Zachary Levinson, Adding an Out-
of-Pocket Spending Maximum to Medicare: Implementation Issues
and Challenges, Kaiser Family Foundation, February 2014.
https://www.kff.org/medicare/issue-brief/adding-an-out-of-
pocket-spending-maximum-to-medicare-implementation-issues-and-
challenges/.
Jacobson, Gretchen, Jennifer Huang, and Tricia Neuman, Medigap Reform:
Setting the Context for Understanding Recent Proposals, Kaiser
Family Foundation, January 2014. https://www.kff.org/medicare/
issue-brief/medigap-reform-setting-the-context/.
Cubanski, Juliette, Tricia Neuman, Gretchen Jacobson, and Karen E.
Smith, Raising Medicare Premiums for Higher-Income
Beneficiaries: Assessing the Implications, Kaiser Family
Foundation, Janurary 2014. https://www.kff.org/medicare/issue-
brief/income-relating-medicare-part-b-and-part/.
Jacobson, Gretchen, Jennifer Huang, and Tricia Neuman, Income and
Assets of Medicare Beneficiaries 2013-2030, Kaiser Family
Foundation, January 2014. Unable to locate electronic copy.
Cubanski, Juliette, Christina Swoope, Anthony Damico, and Tricia
Neuman, Health Care on a Budget: The Financial Burden of Health
Spending by Medicare Households, Kaiser Family Foundation,
Janurary 2014. https://www.kff.org/medicare/issue-brief/health-
care-on-a-budget-the-financial-burden-of-health-spending-by-
medicare-households/.
Boccuti, Cristina, Christina Swoope, Anthony Damico, and Tricia Neuman,
Medicare Patients' Access to Physicians: A Synthesis of the
Evidence, Kaiser Family Foundation, December 2013. https://
www.kff.org/medicare/issue-brief/medicare-patients-access-to-
physicians-a-synthesis-of-the-evidence/.
Gold, Marsha, Gretchen Jacobson, Anthony Damico, and Tricia Neuman,
Medicare Advantage 2014 Spotlight: Plan Availability and
Premiums, Kaiser Family Foundation, November 2013. https://
www.kff.org/medicare/issue-brief/medicare-advantage-2014-
spotlight-plan-availability-and-premiums/.
Hoadley, Jack, Elizabeth Hargrave, Laura Summer, Juliette Cubanski, and
Tricia Neuman, To Switch or Not to Switch: Are Medicare
Beneficiaries Switching Drug Plans To Save Money?, Kaiser
Family Foundation, October 2013. https://www.kff.org/medicare/
issue-brief/to-switch-or-not-to-switch-are-medicare-
beneficiaries-switching-drug-plans-to-save-money/.
Jacobson, Gretchen, Jennifer Huang, and Tricia Neuman, Wide Disparities
in the Income and Assets of People on Medicare by Race and
Ethnicity: Now and in the Future, Kaiser Family Foundation,
September 2013. https://www.kff.org/medicare/report/wide-
disparities-in-the-income-and-assets-of-people-on-medicare-by-
race-and-ethnicity-now-and-in-the-future/.
Jacobson, Gretchen, Tricia Neuman, and Jennifer Huang Projecting
Medicare Advantage Enrollment: Expect the Unexpected? Kaiser
Family Foundation, June 2013. https://www.kff.org/medicare/
perspective/projecting-medicare-advantage-enrollment-expect-
the-unexpected/.
Jacobson, Gretchen, Jennifer Huang, and Tricia Neuman, Medigap Reform:
Setting the Context for Understanding Recent Proposals, Kaiser
Family Foundation, June 2013. https://www.kff.org/medicare/
issue-brief/medigap-reform-setting-the-context/.
Levinson, Zachary, Anthony Damico, Juliette Cubanski, and Tricia
Neuman, A State-by-State Snapshot of Poverty Among Seniors:
Findings From Analysis of the Supplemental Poverty Measure,
Kaiser Family Foundation, May 2013. Unable to locate electronic
copy.
Jacobson, Gretchen, Tricia Neuman, and Anthony Damico, Transforming
Medicare into a Premium Support System: Implications for
Beneficiary Premiums, Kaiser Family Foundation, October 2012.
https://www.kff.org/wp-content/uploads/2013/01/8373.pdf.
Hoadley, Jack, Laura Summer, Elizabeth Hargrave, Juliette Cubanski, and
Tricia Neuman, Analysis of Medicare Prescription Drug Plans in
2012 and Key Trends Since 2006, Kaiser Family Foundation,
September 2012. https://www.kff.org/wp-content/uploads/2013/01/
8357.pdf.
Yee, Tracy, Peter Cunningham, Gretchen Jacobson, Tricia Neuman, and
Zachary Levinson, Cost and Access Challenges: A Comparison of
Experiences Between Uninsured and Privately Insured Adults Aged
55 to 64 with Seniors on Medicare, Kaiser Family Foundation,
May 2012. https://www.kff.org/wp-content/uploads/2013/01/
8320.pdf.
McArdle, Frank, Zachary Levinson, and Tricia Neuman, How Does the
Benefit Value of Medicare Compare to the Benefit Value of
Typical Large Employer Plans? A 2012 Update, Kaiser Family
Foundation, April 2012. https://www.kff.org/wp-content/uploads/
2013/01/7768-02.pdf.
Jacobson, Gretchen, Tricia Neuman, and Anthony Damico, Medicare's Role
for Dual Eligible Beneficiaries, Kaiser Family Foundation,
April 2012. https://www.
kff.org/wp-content/uploads/2013/01/8138-02.pdf.
Kosimar, Harriet, Juliette Cubanski, Lindsey Dawson, and Tricia Neuman,
Key Issues in Understanding the Economic and Health Security of
Current and Future Generations of Seniors, Kaiser Family
Foundation, March 2012. https://www.kff.org/wp-content/uploads/
2013/01/8289.pdf.
Cubanski, Juliette, Anthony Damico, Zachary Levinson, Jennifer Huang,
and Tricia Neuman, Health Care on a Budget: The Financial
Burden of Health Spending by Medicare Households, An Updated
Analysis of Health Care Spending as a Share of Total Household
Spending, Kaiser Family Foundation, March 2012. Unable to
locate electronic copy.
Cubanski, Juliette, Tricia Neuman, and Gretchen Jacobson, Income-
Relating Medicare Part B and Part D Premiums Under Current Law
and Recent Proposals: What are the Implications for
Beneficiaries?, Kaiser Family Foundation, February 2012. Unable
to locate electronic copy.
Cubanski, Juliette, Tricia Neuman, and Zachary Levinson, Restructuring
Medicare's Benefit Design: Implications for Beneficiaries and
Spending, Kaiser Family Foundation, November 2011. https://
www.kff.org/wp-content/uploads/2013/01/8256.pdf.
Hoadley, Jack, Laura Summer, Elizabeth Hargrave, Juliette Cubanski, and
Tricia Neuman, Analysis of Medicare Prescription Drug Plans in
2011 and Key Trends Since 2006, Kaiser Family Foundation,
November 2011. https://www.kff.org/wp-content/uploads/2013/01/
8237.pdf.
Hoadley, Jack, Laura Summer, Elizabeth Hargrave, Juliette Cubanski, and
Tricia Neuman, Medicare Part D 2011 Data Spotlight: The
Coverage Gap, Kaiser Family Foundation, September 2011. https:/
/www.kff.org/wp-content/uploads/2013/01/8222.pdf.
Neuman, Tricia, Juliette Cubanski, Daniel Waldo, Franklin Eppig, and
James Mays, Raising the Age of Medicare Eligibility: A Fresh
Look Following Implementation of Health Reform, Kaiser Family
Foundation, July 2011. https://www.kff.org/wp-content/uploads/
2013/01/8169.pdf.
Jacobson, Gretchen, Jennifer Huang, and Tricia Neuman, Projecting
Income and Assets: What Might the Future Hold for the Next
Generation of Medicare Beneficiaries?, Kaiser Family
Foundation, June 2011. https://www.kff.org/wp-content/uploads/
2013/01/8172.pdf.
Ebeler, Jack, Tricia Neuman, and Juliette Cubanski, The Independent
Payment Advisory Board: A New Approach to Controlling Medicare
Spending, Kaiser Family Foundation, April 2011. https://
www.kff.org/health-reform/issue-brief/the-independent-payment-
advisory-board-a-new/.
Jacobson, Gretchen, Patricia Neuman, Anthony Damico, and Barbara Lyons,
The Role of Medicare for the People Dually Eligible for
Medicare and Medicaid, Kaiser Family Foundation, January 2011.
Unable to locate electronic copy.
Jacobson, Gretchen, Tricia Neuman, and Anthony Damico, Medicare
Spending and Use of Medical Services for Beneficiaries in
Nursing Homes and Other Long-Term Care Facilities: A Potential
for Achieving Medicare Savings and Improving the Quality of
Care, Kaiser Family Foundation, October 2010. https://
www.kff.org/wp-content/uploads/2013/01/8109.pdf.
Hargrave, Elizabeth, Jack Hoadley, Laura Summer, Juliette Cubanski, and
Tricia Neuman, Medicare Part D 2010 Data Spotlight: Coverage of
Top Brand-Name and Specialty Drugs, Kaiser Family Foundation,
August 2010. https://www.kff.org/medicare/issue-brief/coverage-
of-top-brand-name-and-specialty/
Hoadley, Jack, Laura Summer, Elizabeth Hargrave, Juliette Cubanski, and
Tricia Neuman, Medicare Prescription Drug Plans In 2010 and Key
Changes Over Five Years, Kaiser Family Foundation, August 2010.
https://www.kff.org/medicare/issue-brief/medicare-prescription-
drug-plans-in-2010-and/
Neuman, Tricia, Juliette Cubanski, Elizabeth Hargrave, Jack Hoadley,
and Laura Summer, Medicare Part D 2010 Data Spotlight: Prices
for Brand-Name Drugs in the Coverage Gap, Kaiser Family
Foundation, March 2010. https://www.kff.org/medicare/issue-
brief/medicare-part-d-2010-data-spotlight-prices-for-brand-
name-drugs-in-the-coverage-gap/
Hoadley, Jack, Laura Summer, Elizabeth Hargrave, Juliette Cubanski, and
Tricia Neuman, Medicare Part D 2010 Data Spotlight: A
Comparison of PDPs Offering Basic and Enhanced Benefits, Kaiser
Family Foundation, November 2009. https://www.kff.org/medicare/
report/medicare-part-d-2010-data-spotlight-a/
Hoadley, Jack, Laura Summer, Elizabeth Hargrave, Juliette Cubanski, and
Tricia Neuman, Medicare Part D 2010 Data Spotlight: Premiums,
Kaiser Family Foundation, November 2009. https://www.kff.org/
medicare/report/medicare-part-d-2010-data-spotlight-premiums/
Hoadley, Jack, Laura Summer, Elizabeth Hargrave, Juliette Cubanski, and
Tricia Neuman, Medicare Part D 2010 Data Spotlight: Benefit
Design and Cost Sharing, Kaiser Family Foundation, November
2009. https://www.kff.org/medicare/report/medicare-part-d-2010-
data-spotlight-benefit/.
Hoadley, Jack, Juliette Cubanski, Elizabeth Hargrave, Laura Summer, and
Tricia Neuman, Medicare Part D Spotlight: Part D Plan
Availability in 2010 and Key Changes Since 2006, Kaiser Family
Foundation, October 2009. https://www.kff.org/medicare/issue-
brief/medicare-part-d-spotlight-part-d-plan/.
Salganicoff, Alina, Juliette Cubanski, Usha Ranji, and Tricia Neuman,
Health Coverage and Expenses: Impact on Older Women's Economic
Well-Being, Kaiser Family Foundation, July 2009. https://
www.kff.org/wp-content/uploads/2013/01/
articlejournalwomenpoliticspolicy_30_222-247_2009.pdf.
Hargrave, Elizabeth, Jack Hoadley, Juliette Cubanski, and Tricia
Neuman, Medicare Prescription Drug Plans in 2009 and Key
Changes Since 2006: Summary of Findings, Kaiser Family
Foundation, May 2009. https://www.kff.org/medicare/issue-brief/
medicare-prescription-drug-plans-in-2009-and/.
Hargrave, Elizabeth, Jack Hoadley, Juliette Cubanski, and Tricia
Neuman, Medicare Part D 2009 Data Spotlight: Ten Most Common
Brand-Name Drugs, Kaiser Family Foundation, May 2009. https://
www.kff.org/medicare/issue-brief/medicare-part-d-2009-data-
spotlight-ten/.
Hoadley, Jack, Elizabeth Hargrave, Juliette Cubanski, and Tricia
Neuman, Medicare Part D 2009 Data Spotlight: Specialty Tiers,
Kaiser Family Foundation, May 2009. https://www.kff.org/
medicare/issue-brief/medicare-part-d-2009-data-spotlight-
specialty/.
Neuman, Patricia and Juliette Cubanski, The Social Security COLA and
Medicare Part B Premium: Questions, Answers, and Issues. Kaiser
Family Foundation, May 2009. Unable to locate electronic copy.
Jacobson, Gretchen, Karyn Schwartz, and Tricia Neuman, Health Insurance
Coverage of Older Adults: Implications of a Medicare Buy-in.
Kaiser Family Foundation, May 2009. https://www.kff.org/wp-
content/uploads/2013/01/7904.pdf.
Neuman, Tricia, Juliette Cubanski, and Anthony Damico, Revisiting `Skin
in the Game' Among Medicare Beneficiaries: An Updated Analysis
of the Increasing Financial Burden of Health Care Spending From
1997 to 2005. Kaiser Family Foundation, February 2009. (Updated
June 2010). https://www.kff.org/medicare/issue-brief/
revisiting-skin-in-the-game-among-medicare-beneficiaries-an-
updated-analysis-of-the-increasing-financial-burden-of-health-
care-spending-from-1997-to-2005/.
Cubanski, Juliette, Anthony Damico, and Tricia Neuman, Health Care on a
Budget: An Analysis of Spending by Medicare Households. Kaiser
Family Foundation, February 2009. (Updated June 2010). https://
www.kff.org/wp-content/uploads/2013/01/7859.pdf.
Hoadley, Jack, Jennifer Thompson, Elizabeth Hargrave, Juliette
Cubanski, and Tricia Neuman, Medicare Part D 2009 Data
Spotlight: Premiums, Kaiser Family Foundation, October 2008.
https://www.kff.org/medicare/report/medicare-part-d-2009-data-
spotlight-premiums/.
Hoadley, Jack, Jennifer Thompson, Elizabeth Hargrave, Juliette
Cubanski, and Tricia Neuman, Medicare Part D 2009 Data
Spotlight: The Coverage Gap, Kaiser Family Foundation, October
2008. https://www.kff.org/medicare/report/medicare-part-d-2009-
data-spotlight-the/.
Summer, Laura, Jack Hoadley, Elizabeth Hargrave, Juliette Cubanski, and
Tricia Neuman, Medicare Part D 2009 Data Spotlight: Low-Income
Subsidy Plan Availability, Kaiser Family Foundation, October
2008. https://www.kff.org/medicare/issue-brief/medicare-part-d-
2009-data-spotlight-low/.
Yamamoto, Dale, Patricia Neuman, and Michelle Kitchman Strollo, How
Does the Benefit Value of Medicare Compare to the Benefit Value
of Typical Large Employer Plans?, Hewitt Associates/Kaiser
Family Foundation, September 2008. Unable to locate electronic
copy.
Hoadley, Jack, Elizabeth Hargrave, Juliette Cubanski, and Tricia
Neuman, The Medicare Part D Coverage Gap: Costs and
Consequences in 2007, Kaiser Family Foundation, August 2008.
https://www.kff.org/medicare/report/the-medicare-part-d-
coverage-gap-costs-and-consequences-in-2007/.
Hoadley, Jack, Elizabeth Hargrave, Juliette Cubanski, and Tricia
Neuman, Medicare Prescription Drug Plans in 2008 and Key
Changes Since 2006: Summary of Findings, Kaiser Family
Foundation, March 2008. https://www.kff.org/medicare/issue-
brief/medicare-prescription-drug-plans-in-2008-and/.
Hoadley, Jack, Elizabeth Hargrave, Katie Merrell, Juliette Cubanski,
and Tricia Neuman, Medicare Part D 2008 Data Spotlight:
Utilization Management, Kaiser Family Foundation, January 2008.
https://www.kff.org/medicare/issue-brief/medicare-part-d-2008-
data-spotlight-utilization/.
Hoadley, Jack, Elizabeth Hargrave, Katie Merrell, Juliette Cubanski,
and Tricia Neuman, Medicare Part D 2008 Data Spotlight:
Formularies, Kaiser Family Foundation, January 2008. https://
www.kff.org/medicare/issue-brief/medicare-part-d-2008-data-
spotlight-formularies/.
Hoadley, Jack, Elizabeth Hargrave, Katie Merrell, Juliette Cubanski,
and Tricia Neuman, Medicare Part D 2008 Data Spotlight: Benefit
Design, Kaiser Family Foundation, January 2008. https://
www.kff.org/medicare/issue-brief/medicare-part-d-data-
spotlight-benefit-design/.
Hoadley, Jack, Jennifer Thompson, Elizabeth Hargrave, Katie Merrell,
Juliette Cubanski, and Tricia Neuman, Medicare Part D 2008 Data
Spotlight: The Coverage Gap, Kaiser Family Foundation, October
2007. https://www.kff.org/medicare/issue-brief/medicare-part-d-
2008-data-spotlight-the/.
Hoadley, Jack, Jennifer Thompson, Elizabeth Hargrave, Katie Merrell,
Juliette Cubanski, and Tricia Neuman, Medicare Part D 2008 Data
Spotlight: Premiums, Kaiser Family Foundation, October 2007.
https://www.kff.org/medicare/issue-brief/medicare-part-d-2008-
data-spotlight-premiums/.
Neuman, Patricia, Michelle Kitchman Strollo, Kim Boortz, Stuart
Guterman, Sophie Kasimow, Angela Li, and Dana Gleb Safran,
Medicare Prescription Drug Benefit Progress Report: Findings
from the Kaiser/Commonwealth/Tufts-New England Medical Center
2006 national Survey of Seniors and Prescription Drugs. August
2007. https://www.healthaffairs.org/doi/10.1377/
hlthaff.26.5.w630.
Hoadley, Jack, Elizabeth Hargrave, Katie Merrell, Juliette Cubanski,
and Tricia Neuman, Benefit Design and Formularies of Medicare
Drug Plans: A Comparison of 2006 and 2007 Offerings, Kaiser
Family Foundation, October 2006. https://www.kff.org/medicare/
report/benefit-design-and-formularies-of-medicare-drug/.
Hoadley, Jack, Elizabeth Hargrave, Juliette Cubanski, and Tricia
Neuman, An In-Depth Examination of Formularies and Other
Features of Medicare Drug Plans, Kaiser Family Foundation,
March 2006. https://www.kff.org/wp-content/uploads/2013/01/
7489.pdf.
Cubanski, Juliette, Patricia Neuman, Jennifer Kates, Alicia Carbaugh,
and Esther Han, The Role of Part D for People with HIV/AIDS:
Coverage and Cost of Antiretrovirals Under Medicare Drug Plans.
Kaiser Family Foundation. Unable to locate electronic copy.
Mays, Jim, Monica Brenner, Patricia Neuman, Juliette Cubanski, and Gary
Claxton, Estimates of Medicare Beneficiaries' Out-of-Pocket
Drug Spending in 2006, Kaiser Family Foundation, November 2004.
Unable to locate electronic copy.
McArdle, Frank, Dale Yamamoto, Michelle Kitchman, and Patricia Neuman,
Kaiser/Hewitt Surveys on Retiree Health Benefits, 2002-2005.
Unable to locate electronic copy.
Leon, Joel, Patricia Neuman, and Stephen Parente, Understanding the
Growth in Medicare's Home Health Expenditures, Washington, DC,
Henry J. Kaiser Family Foundation, July 1997. Unable to locate
electronic copy.
Other Publications
Tricia Neuman, ``What Will Candidates Say About Medicare This
Election?'', American Society of Aging, Generations Today.
https://generations.asaging.org/what-candidates-say-about-
medicare-election (September-October 2020).
Presentations/Public Videos
The National Voices of Medicare Summit and Senator Jay Rockefeller
Lecture, https://docs.google.com/presentation/d/
184AAhBs2xLHzUcN7aQPJIoV5QmM
QOpco/
edit?usp=sharing&ouid=110899830386816181002&rtpof=true&sd=true
(October 2022).
KFF Web Briefing, Aug. 11 Event: Understanding the Health Care
Provisions in the Inflation Reduction Act, https://www.kff.org/
medicare/event/august-11-web-event-understanding-health-care-
provisions-inflation-reduction-act/ (August 2022).
The National Voices of Medicare Summit and Senator Jay Rockefeller
Lecture, https://medicareadvocacy.org/2022-summit-attendee-
page/ (May 2022).
Alliance for Health Policy, Understanding the Medicare Population and
Consumer Affordability, https://www.allhealthpolicy.org/
understanding-the-medicare-population-and-consumer-
affordability/ (May 2022).
Virta Health, The Rx Affordability Crisis, https://www.youtube.com/
watch?v=ISAB
7V71YTw (February 2022).
Hackensack University Medical Center Department of Medicine Grand
Rounds, Medicare: What's Next on the Policy Agenda, https://
docs.google.com/presentation/d/
1Hr6x2baIz0DvFniIftQ6iY8CyIAG0M20/edit?usp=sharing&ouid=110
899830386816181002&rtpof=true&sd=true (January 2022).
KFF Web Briefing, Dec. 8 Event: Unpacking the Prescription Drug
Provisions of the Build Back Better Act, https://www.kff.org/
health-costs/event/unpacking-prescription-drug-provisions-of-
build-back-better-act/ (December 2021).
C-Span, Future of Medicare and Rising Premiums, https://www.c-span.org/
video/?516209-3/washington-journal-tricia-neuman-discusses-
future-medicare-rising-medicare-premiums (November 2021).
The Gerontological Society of America, The Evolving and Essential Role
of Interdisciplinary Care of the Mouth, Ears and Eyes of Older
Adults, https://www.youtube.com/watch?v=4_7O_KOeGUs (November
2021).
Health Care Council of Chicago, Federal Policy Update: A strategic Look
at Medicare Expansion, https://www.youtube.com/watch?v=HVe-
XWXVtII (October 2021).
Kaiser Permanente, Medicare Advantage in the Current Environment,
https://docs.google.com/presentation/d/1XMTNWc7P7TzZdLc-
vC10B0GGFRzegV6d/
edit?usp=sharing&ouid=110899830386816181002&rtpof=true&sd=true
(October 2021).
AHIP, 2021 National Conference on Medicare, Medicaid and Dual
Eligibles, https://docs.google.com/presentation/d/
1HvKiM9qglp0E-s_Wqb-9LcZxc0KVPn4_/
edit?usp=sharing&ouid=110899830386816181002&rtpof=true&sd=true
(September 2021).
The National Voices of Medicare Summit and Senator Jay Rockefeller
Lecture, https://medicareadvocacy.org/wp-content/uploads/2021/
04/CMA-Summit-2021-Slides.pdf. (April 2021).
Committee for a Responsible Federal Budget, Virtual Event: New Ideas to
Lower Health Care Costs, https://www.crfb.org/events/virtual-
event-new-ideas-lower-health-care-costs (March 2021).
National Institute for Health Care Management (NIHCM), The Challenges
of Aging During COVID-19: Long Term Care, Vaccination, and
Isolation, https://nihcm.org/publications/the-challenges-of-
aging-during-covid-19-long-term-care-vaccination-and-isolation
(January 2021).
National Forum, Weighing the Tradeoffs of Traditional Medicare vs.
Medicare Advantage, https://docs.google.com/presentation/d/
1vOMtkpJO-lo2Axh0FJg3srh-kWPFYiWN/
edit?usp=sharing&ouid=110899830386816181002&rtpof=true&sd=
true (October 2020).
The Gazette, Iowa Ideas 2020, https://www.youtube.com/watch?v=d-
fGvYqb9x8 (October 2020).
Center for Medicare Advocacy, Virtual National Voices of Medicare
Summit, https://docs.google.com/presentation/d/
12KclDhmiZbYHKWlTba46NZbRCk0W
1faK/
edit?usp=sharing&ouid=110899830386816181002&rtpof=true&sd=true
(April 2020).
AARP, Coronavirus Tele-Town Hall: What You Need to Know About
Telehealth, https://www.aarp.org/health/conditions-treatments/
info-2020/tele-town-hall-coronavirus-04-16.html (April 2020).
National Academy of Social Insurance, Health Care Coverage and Costs:
Assessing Medicare-Based Approaches, https://www.nasi.org/
thirty-second-annual-policy-conference/ (March 2020).
KFF, Where Do the Democratic Candidates Stand on Health Reform and
Prescription Drug Prices?, https://www.kff.org/slideshow/where-
do-the-democratic-candidates-stand-on-health-reform-and-
prescription-drug-prices/ (February 2020).
The Conference for Consulting Actuaries, All for One and Medicare for
All: An Overview of Proposals and Key Issues, https://
docs.google.com/presentation/d/15ek6USfJcegrmi-
ZmGlluYABkD0azP8L/edit?usp=sharing&ouid=11089983038
6816181002&rtpof=true&sd=true (February 2020).
National Retiree Legislative Network, Medicare: Trends and Future
Outlook, https://docs.google.com/presentation/d/
1CdVGGVJYvS1maXBa4fe4e37wEoMC
jHd6/
edit?usp=sharing&ouid=110899830386816181002&rtpof=true&sd=true
(February 2020).
USC Annenberg Center for Health Journalism, The Rise of Medicare
Advantage, https://centerforhealthjournalism.org/content/rise-
medicare-advantage (December 2019).
Talbot County Democratic Forum, 2020 Presidential Candidate Health Care
Plans, https://docs.google.com/presentation/d/
15Cg9XHhKpR7iHsMJQULU3UkhZh
5fu_kQ/
edit?usp=sharing&ouid=110899830386816181002&rtpof=true&sd=true
(November 2019).
Patient Access Network (PAN) Foundation, Access and Affordability:
Trends to Date and Implications for the Future, https://
docs.google.com/presentation/d/1Jg3n-O6rKrujrPvADTXkLCrcQTlB-
MSD/edit?usp=sharing&ouid=1108998303
86816181002&rtpof=true&sd=true (November 2019).
Alliance for Health Policy, Modernizing Medicare Part D, https://www.
allhealthpolicy.org/modernizing-medicare-part-d/ (October
2019).
New Democratic Coalition, What Are the Key Provisions of Major
Proposals to Lower Medicare Drug Prices?, https://
docs.google.com/presentation/d/115xIAH
VaBi6Bpgxq_lFkfQvtlYPyiUbN/
edit?usp=sharing&ouid=1108998303868161810
02&rtpof=true&sd=true (October 2019).
Winston Health Policy Scholarship Symposium, Perspectives on Current
Health Policy Topics: Research and Polling on Medicare-for-all
and Drug Pricing, https://docs.google.com/presentation/d/
1RV04SteKfxOanqV5WactRHPWIoL7BmbN/
edit?usp=sharing&ouid=110899830386816181002&rtpof=true&sd=true
(October 2019).
AcademyHealth, Research Meeting: Gaps in Medicare: Non-Covered
Services, Out-of-Pocket Limits, and Beneficiary Protections,
https://academyhealth.confex.
com/academyhealth/2019arm/meetingapp.cgi/Session/20867 (June
2019).
Health and Aging Policy Fellows Spring Symposium, Medicare-for-All and
Other Public Plan Options: Implications for Older Adults,
https://docs.google.com/presentation/d/1IOfwDhr4KGEJc4lMgu-
ndaGJ450t6FMC/edit?usp=sharing&
ouid=110899830386816181002&rtpof=true&sd=true (June 2019).
KFF Web Briefing, Making Sense of Medicare-for-All and Other Plans to
Expand Public Coverage, https://www.kff.org/health-reform/
event/may-21-web-briefing-making-sense-of-medicare-for-all-and-
other-plans-to-expand-public-coverage/ (May 2019).
Medicare Rights Center, Medicare-for-all and Public Plan Option
Proposals: Status Report, https://docs.google.com/presentation/
d/1R25cv8aAhMRBFsKzgAGEqT
dLIAnsplPB/
edit?usp=sharing&ouid=110899830386816181002&rtpof=true&sd
=true (May 2019).
The Atlantic, The Future of Care: Future of Medicare, https://
www.youtube.com/watch?v=IlBBsveB79Y (May 2019).
NPR, Medicare: An Overview, https://docs.google.com/presentation/d/
13nmBdM-KjzmOPFq5wKEkV8AALlPtHH8b/
edit?usp=sharing&ouid=11089983038681618
1002&rtpof=true&sd=true (April 2019).
Center for Medicare Advocacy, https://docs.google.com/presentation/d/
1OBYjJDw
jbIk0OLCMs-qT2pR45hq1IKzR/
edit?usp=sharing&ouid=1108998303868161810
02&rtpof=true&sd=true (April 2019).
Leadership Council of Aging Organizations (LCAO) Health Committee,
Medicare-for-All and Other Public Plan Options, https://
docs.google.com/presentation/d/1GIV-
zsaaWo8RWgPfujAseuyRX1cNy64A/edit?usp=sharing&ouid=11089983038
6816181002&rtpof=true&sd=true (February 2019).
The Gerontological Society of America, Medicare-for-All and Public Plan
Buy-In Proposals, https://docs.google.com/presentation/d/
1vJxFCl5TMWGUImL4cOOgOk
uw3tRfzt-W/
edit?usp=sharing&ouid=110899830386816181002&rtpof=true&sd=
true (November 2018).
The Gerontological Society of America, Economic Insecurity in Later
Life: How Health Costs Factor In, https://docs.google.com/
presentation/d/1UTG7A2D
Tvlgy7JeFuTsUnkqDm2ovCzuG/
edit?usp=sharing&ouid=1108998303868161810
02&rtpof=true&sd=true (November 2018).
Alliance for Health Policy, Aging in America: Challenges and
Opportunities, https://docs.google.com/presentation/d/
1vwKm8Iy4kKEftNgg1838eHgeDX71v1
UM/
edit?usp=sharing&ouid=110899830386816181002&rtpof=true&sd=true
(July 2018).
Politico, Avoiding 9-1-1--How to Improve Health Care in Nursing Homes
and Bend the Cost Curve, https://www.politico.com/video/2018/
03/21/911-event3-21-18-001-112-065334 (March 2018).
Center for Medicare Advocacy, National Voices of Medicare Summit,
https://docs.
google.com/presentation/d/1tJizbnMGeTfOAJJ2ZFsqx4AjG7cwnUIo/
edit?usp=
sharing&ouid=110899830386816181002&rtpof=true&sd=true (March
2018).
AARP, Social Isolation: An Important Health and Public Health Issue and
a Significant Cost to Medicare, https://www.aarp.org/ppi/info-
2018/social-isolation-event.html (January 2018).
The National Health Law Program (NHeLP) Conference, Medicare: Overview
and Challenges, https://docs.google.com/presentation/d/
134set9da76BspZwZOxD2
Xax1kkxA-cEK/
edit?usp=sharing&ouid=110899830386816181002&rtpof=true&
sd=true (December 2017).
KFF, Web Briefing: The Future of Delivery System Reform in Medicare:
Assessing the Evidence and Looking Ahead, https://www.kff.org/
medicare/event/web-briefing-the-future-of-delivery-system-
reform-in-medicare-assessing-the-evidence-and-looking-ahead/
(November 2017).
Other Interviews (non-video)
LeadingAge, Vaccine Report Insights: Interview with Tricia Neuman,
https://leadingage.org/regulation/vaccine-report-insights-
interview-tricia-neuman-%E2
%80%93-february-18-2021 (February 2021).
Podcasts
``What's Next Living Longer, Better Smarter: Medicare, Your Money and
the Inflation Reduction Act,'' Mary Furlong and Associates.
Podcast audio, November 1, 2022. https://www.maryfurlong.com/
2022/11/01/whats-next-living-longer-better-smarter-medicare-
your-money-the-inflation-reduction-act-episode-39/.
``The Costly, Confusing Medicare Choices Facing 62 Million Americans,''
Tradeoffs. Podcast audio, October 28, 2021. https://
tradeoffs.org/2021/10/28/the-costly confusing-medicare-choices-
facing-62-million-americans-transcript/.
``What lowering the Medicare eligibility age would mean for health
care,'' Marketplace. Podcast audio, June 15, 2021. https://
www.marketplace.org/2021/06/15/what-lowering-medicare-
eligibility-age-would-mean-for-american-health-care/.
``Dr. Ruth Link-Gelles on the Retail Pharmacy Program and Tricia Neuman
on Vaccine Data Difficulties,'' LeadingAge Coronavirus
Spotlights. Podcast audio, February 18, 2021. https://
soundcloud.com/user-801206844/dr-ruth-link-gelles-on-the-
retail-pharmacy-program-and-tricia-neuman-on-vaccine-data-
difficulties.
``Coronavirus Tele-Town Hall'' Take on Today--AARP. Podcast audio,
April 20, 2020. https://www.aarp.org/podcasts/take-on-today/
info-2020/coronavirus-town-hall-4-16.html.
``Navigating Medicare in the age of COVID-19,'' RetirementRevised.
Podcast audio, April 2, 2020. https://
retirementrevised.substack.com/p/navigating-medicare-in-the-
age-of-140.
``All about Medicare,'' What the Health--KHN. Podcast audio, August,
22, 2019. https://khn.org/news/khns-what-the-health-all-about-
medicare/.
______
Questions Submitted for the Record to Patricia Hart Neuman, Sc.D.
Questions Submitted by Hon. Ron Wyden
Question. The role of public trustees is a unique role in public
service. Rather than starting a new job in public service, you now wear
``two hats'': one as the public trustee to the Social Security and
Medicare trust funds, and the other ``hat'' representing your
nongovernment day jobs. Can you talk about how you will approach
dealing with any apparent conflict wearing your two ``hats''?
Answer. The public trustee is considered a ``special governmental
employee'' and is not a full-time position. Public trustees typically
serve in this role in addition to having full-time employment. I am
currently a senior vice president at KFF, executive director of KFF's
Program on Medicare Policy and senior advisor to KFF's president and
CEO. If I am confirmed, I would continue my employment at KFF and also
serve as a public trustee.
I do not foresee future conflicts with these two roles but do think
it would be appropriate to make clear when I am and am not speaking in
my role as a public trustee, including when I am giving public
presentations, speaking to the media or writing papers.
Question. Looking at each of your backgrounds, you both have
extensive experience in the Medicare program, including coverage and
solvency. You would bring a different perspective than past public
trustees, many of whom have Social Security, pensions, or economic
backgrounds. This can be a good thing, as it is important to have a
fresh, outside perspective to the discussion. If confirmed, you would
serve as the public trustee for the Social Security trust funds as
well. While the trustees use the same demographic and economic
assumptions to develop the Social Security and Medicare trustees
reports, changes to those assumptions can have different impacts on
each trust funds' solvency. Can you talk about how you would approach
your role as Social Security public trustee, and whether it would
differ from your role as Medicare public trustee?
Answer. I would approach the role of public trustee for Social
Security much as I would for Medicare. While the Medicare and Social
Security programs serve somewhat different functions, they share a
number of similar features and future challenges. For example, the
solvency projections of the Supplementary Medical Insurance trust fund,
the Federal Hospital Insurance trust fund, the Federal Old-Age and
Survivors Insurance trust fund, and the Federal Disability Insurance
trust fund are each affected by trends and assumptions related to
birthrates, immigration patterns, mortality, and growth in the economy.
In addition, Medicare's fiscal health is also influenced by changes in
health-care spending, and the various factors that influence Medicare
spending trends.
The primary roles of the trustees--to review the assumptions made
by the actuaries, consider whether the assumptions are reasonable, how
emerging trends may affect projections, and communicate the findings
clearly to the public--apply similarly to Social Security and Medicare,
though Medicare may be somewhat more complicated by underlying payment
reforms that affect spending, health care trend data and more frequent
changes in policy. In addition, the role of the public trustee is to
give the public confidence in the objectivity of the projections that
apply to each of the trust funds, including explaining changes that may
have occurred from one year to the next, and the urgency and magnitude
of the fiscal challenges facing the programs and the people they serve.
The attributes that I bring to the work pertaining to the Medicare
trust funds will apply to work that is involved for the Federal Old-Age
and Survivors Insurance and Federal Disability Insurance trust funds.
______
Questions Submitted by Hon. Mike Crapo
Question. What is your understanding of the role of the trustees
with regards to recommending or setting policy?
Answer. The role of the public trustee is to work with the
actuaries of the Social Security Administration and Department of
Health and Human Services to produce the annual reports required by law
based on sound and objective data and analysis, and to give the public
confidence that the assumptions built into the report and projections
presented in the report are reasonable. My understanding is that the
public trustees do not take positions on policy issues or make
recommendations for specific policy solutions.
Question. Have you addressed any potential conflicts of interest in
your ethics agreement with the Social Security Administration in
consultation with the U.S. Department of Health and Human Services and
the U.S. Office of Government Ethics?
Answer. Yes.
Question. Do you commit to not participating personally or
substantially in any particular matter that to your knowledge would
have a direct and predictable effect on your financial interests unless
a waiver has been issued or a regulatory exemption applies?
Answer. Yes.
Question. If a potential conflict of interest arises, will you
consult with agency officials and take the measures necessary to
resolve the conflict?
Answer. Yes.
______
Prepared Statement of Marjorie A. Rollinson, Nominated to be Chief
Counsel, Internal Revenue Service, Department of the Treasury
Chairman Wyden, Ranking Member Crapo, and members of the committee,
I am honored to be here today as the nominee for Chief Counsel for the
Internal Revenue Service. I want to thank the committee for considering
my nomination and also the President for placing his confidence in me.
I could not be here today without the support and encouragement of
my entire family, most especially of Harry, my husband of 36 years, my
daughters Emma and Claire, and my mother. They always inspire me to be
and do my best.
I grew up in the DC area, surrounded by dedicated public servants.
From a young age, I learned the importance and dignity of hard work
done well. My mother, who raised me and my three sisters, founded a
nursery school. (I was in her first class.) She worked there until she
retired almost 40 years later and helped hundreds of children during
the most critical phase of their development. My husband Harry spent
over half of his career teaching in Virginia public schools. Knowing
just how wonderful he is as a father, I can appreciate the tremendous
impact he had on the lives of his students.
The example of my many friends and family in public service is what
is calling me out of retirement today, in hopes of becoming the IRS
Chief Counsel. This is a critical time for the IRS. The agency has
lacked adequate resources for decades, but with increased funding, the
IRS can develop into a world class service organization and promote a
fairer tax system. The IRS also is at the forefront of implementing a
substantial number of recent tax law changes. These efforts require
tireless work from the Office of Chief Counsel, and I am eager to lead
those efforts.
My technical tax expertise and leadership experience from time in
both the private and public sectors have prepared me to help the IRS
meet these challenges. I spent most of my career at Ernst and Young,
where I had many wonderful mentors who taught me valuable lessons about
leadership, collaboration, and serving with integrity. I also had the
privilege of spending more than 5 years at the Office of Chief Counsel.
There, I saw employees who exhibited a deep commitment to integrity and
a profound dedication to the mission. Treating taxpayers fairly was at
the core of everything Chief Counsel employees did, and it would be the
capstone of my career to serve alongside them again, if I am privileged
to be confirmed.
Throughout my career, I have learned that being a successful leader
means drawing on the expertise of my staff, making sure everyone
understands the mission, and always celebrating successes. I deeply
enjoy technical tax work, but what I find most rewarding is motivating
staff to produce exceptional results and reach their goals.
I look forward to answering your questions and, if confirmed, to
being a close partner to this committee and the Congress.
______
SENATE FINANCE COMMITTEE
STATEMENT OF INFORMATION REQUESTED
OF NOMINEE
A. BIOGRAPHICAL INFORMATION
1. Name (include any former names used): Marjorie Anne Rollinson
(nickname: Margie).
2. Position to which nominated: Chief Counsel, Internal Revenue
Service.
3. Date of nomination: June 6, 2023.
4. Address (list current residence, office, and mailing addresses):
5. Date and place of birth: August 20, 1962, Washington, DC.
6. Marital status (include maiden name of wife or husband's name):
7. Names and ages of children:
8. Education (list all secondary and higher education institutions,
dates attended, degree received, and date degree granted):
Hamilton College.
Dates Attended: September 1980-May 1981.
Wellesley College.
Dates Attended: September 1981-May 1984.
Bachelor of Arts, May 1984.
University of Maryland, College of Law.
Dates Attended: September 1984-May 1987.
Juris Doctor, May 1987.
9. Employment record (list all jobs held since college, including the
title or description of job, name of employer, location of work, and
dates of employment for each job):
Ernst and Young.
Deputy Director of the National Tax Department.
Washington, DC.
March 2019-February 2022.
Office of Chief Counsel, Internal Revenue Service.
Associate Chief Counsel (International).
Washington, DC.
October 2016-January 2019.
Deputy Associate Chief Counsel (Technical).
Washington, DC.
October 2013-September 2016.
Georgetown University.
Adjunct Professor of Law.
Washington, DC.
August 2016-December 2016.
Ernst and Young.
Principal.
Washington, DC.
March 2002-September 2013.
Principal.
Mclean, VA.
October 1999-August 2002.
Principal.
Washington, DC.
September 1997-September 1999.
Senior Manager.
Washington, DC.
October 1992-September 1997.
Manager.
Washington, DC.
February 1991-September 1992.
Manager.
Baltimore, MD.
September 1989-January 1991.
Ernst and Whinney.
(Merged with Arthur Young in 1989 to form Ernst and Young.)
Senior Tax Consultant.
Baltimore, MD.
August 1987-August 1989.
10. Government experience (list any current and former advisory,
consultative, honorary, or other part-time service or positions with
Federal, State, or local governments held since college, including
dates, other than those listed above):
None.
11. Business relationships (list all current and former positions held
as an officer, director, trustee, partner (e.g., limited partner,
nonvoting, etc.), proprietor, agent, representative, or consultant of
any corporation, company, firm, partnership, other business enterprise,
or educational or other institution):
As noted above, I was a Principal (which is a partner) of Ernst
and Young from 1997-2013 and 2019-2022.
12. Memberships (list all current and former memberships, as well as
any current and former offices held in professional, fraternal,
scholarly, civic, business, charitable, and other organizations dating
back to college, including dates for these memberships and offices):
The dates below are to the best of my recollection.
Member, Maryland Bar Association, December 1987-present.
Member, American Bar Association, 1997-2022 (although, not
every year).
Member, Brewster Ladies Library, 2022-present.
Member, Friends of Brewster Elders, 2022-present.
Member, Massachusetts Audubon Society, 2018-present.
Member, Brewster Cemetery Association, 2021-present.
13. Political affiliations and activities:
a. List all public offices for which you have been a candidate
dating back to the age of 18.
None.
b. List all memberships and offices held in and services
rendered to all political parties or election committees,
currently and during the last 10 years prior to the date of
your nomination.
None.
c. Itemize all political contributions to any individual,
campaign organization, political party, political action
committee, or similar entity of $50 or more for the past 10
years prior to the date of your nomination.
I made no political contributions while I was employed by the
Federal Government (2013-2019). To the best of my knowledge, below is a
list of political contributions I made in the last 10 years that total
over $50.
------------------------------------------------------------------------
Date Contributed To Amount
------------------------------------------------------------------------
11/04/2020 ActBlue (earmarked for Biden Fight Fund) $110
------------------------------------------------------------------------
8/13/2020 ActBlue (earmarked for Biden Fight Fund) $100
------------------------------------------------------------------------
7/30/2020 Biden Victory Fund $100
------------------------------------------------------------------------
14. Honors and awards (list all scholarships, fellowships, honorary
degrees, honorary society memberships, military medals, and any other
special recognitions for outstanding service or achievement received
since the age of 18):
Exceptional Service Award from the U.S. Treasury Department,
May 2019.
Chief Counsel Distinguished Service Award, January 2019.
15. Published writings (list the titles, publishers, dates and
hyperlinks (as applicable) of all books, articles, reports, blog posts,
or other published materials you have written):
See attachments.
16. Speeches (list all formal speeches and presentations (e.g.,
PowerPoint) you have delivered during the past 5 years which are on
topics relevant to the position for which you have been nominated,
including dates):
I moderated a Practising Law Institute class entitled ``Basics
of International Taxation'' on July 20, 2021. Attached is the
transcript of this session. I have only been able to locate a
transcript for one session, although I moderated the whole day.
I participated in an Ernst and Young external webcast entitled
``Proposed Foreign Tax Credit Regulations would add new
requirements and elections'' on October 15, 2020. Attached is
the slide deck used for this webcast.
I participated in an Ernst and Young external webcast entitled
``Final and Proposed Foreign Tax Credit Regulations'' on
December 13, 2019. Attached is the slide deck used for this
webcast.
I participated in an Ernst and Young external webcast entitled
``New Treasury regulations concerning Subpart F income, global
intangible low-taxed income (GILTI) inclusions, and the
dividends received deduction'' on June 21, 2019. Attached is
the slide deck used for this webcast.
In addition, from March 2020 to February 2022, I participated
in a series of webcasts hosted by Ernst and Young entitled
``Tax in the time of COVID-19.'' The dates and full titles of
these webcasts are listed below. The recordings and slide decks
only remain available online for some time, so I am not able to
access those materials for some of the webcasts in which I
participated. To the best of my knowledge, slide decks and
recordings are available only for webcasts starting on July 24,
2020 forward (marked with an asterisk), and the slide decks for
those webcasts are attached. These were informal and unscripted
events, and I did not prepare or provide formal speeches or
presentations.
Policy perspectives: Tax in the time of COVID-19, March 20,
2020: https://event.on24.com/wcc/r/2229259/
0487BC58EE1CCC37A8C807576A6E0B0C.
Tax in the time of COVID-19: keeping abreast of rapidly
changing tax developments, March 27, 2020: https://
event.on24.com/wcc/r/2242042/0D62D4
F17C35C1A58C7536C572CD7F33.
Tax in the time of COVID-19: tax implications and
opportunities stemming from the CARES Act, April 3, 2020:
https://event.on24.com/wcc/r/2249111/
00D225C362418A5D9B96DD6C7C6C6381.
Tax in the time of COVID-19: what US and global tax
administrations are doing in response to the pandemic, April
10, 2020: https://event.on24.com/wcc/r/2261245/
9DE486DED79033F1911188570FDA9A79.
Tax in the time of COVID-19: examining developments
affecting disaster losses, qualified improvement property and
compliance, April 17, 2020: https://event.on24.com/wcc/r/
2283730/F03B252E81FEF47391B420DFB4DE
B71A.
Tax in the time of COVID-19: how the pandemic is affecting
the economy, compliance and transfer pricing, April 24, 2020:
https://event.on24.com/wcc/r/2283743/
A7364A198DBDEBA680E9B75A0A0B5A9B.
Tax in the time of COVID-19: the latest out of Washington
including the employer retention credit and IRS filing
guidance, May 1, 2020: https://event.on24.com/wcc/r/2307300/
2335DAC9E4C53C4AAD898D6773602CE3.
Tax in the time of COVID-19: updates on IRS operations and
global developments, May 8, 2020: https://event.on24.com/wcc/r/
2318685/19FCF4E
3463E308D7977D4E82AC1D313.
Tax in the time of COVID-19: what's happening in
international tax, on Capitol Hill and at the IRS, May 15,
2020: https://event.on24.com/wcc/r/2348509/
FDDB5EF07ADCBDDF9D265C93FD3D0BDD.
Tax in the time of COVID-19: what's new and notable in tax
credits, refunds and at the IRS, May 29, 2020: https://
event.on24.com/wcc/r/2372423/03DD948DB65D5AD2A8AC4C55E9EB2FA1.
Tax in the time of COVID-19: an update on U.S. legislative,
state and IRS developments, June 12, 2020: https://
event.on24.com/wcc/r/2399701/F22FA5FA1B309C85CE9D3B8E80B3767A.
Tax in the time of COVID-19: preparing for potential future
tax changes, June 26, 2020: https://event.on24.com/wcc/r/
2407637/FEC1365480EB
C9B9C8E6A189945947D6.
Tax in the time of COVID-19: update on the Employee
Retention Credit, net operating losses and IRS developments,
July 10, 2020: https://event.on24.com/wcc/r/2448899/
48008ACFD386B7E15B8B9FCBE9688EBA.
* Tax in the time of COVID-19: global, IRS and Treasury
developments, July 24, 2020: https://event.on24.com/wcc/r/
2448931/2D69911CC3FCC
B9198F26EC73C3D2BD8.
* Tax in the time of COVID-19: update on legislative,
regulatory and IRS developments, August 7, 2020: https://
event.on24.com/wcc/r/2549636/953D8652DEECB7A5A8585B51C4C9E6EF.
* Tax in the time of COVID-19: update on legislative,
economic, regulatory and IRS developments, August 21, 2020:
https://event.on24.com/wcc/r/2561002/
115D50A7C216B64EAD411756650734C6.
* Tax in the time of COVID-19: update on legislative,
economic, regulatory and IRS developments, September 11, 2020:
https://event.on24.com/wcc/r/2632715/
253246C7DF41E857E6B2F62FAF3EB3DE.
* Tax in the time of COVID-19: update on legislative,
economic, regulatory and IRS developments, September 25, 2020:
https://event.on24.com/wcc/r/2665699/
C1862AC9BC97276144C000EF579CFCF4.
* Tax in the time of COVID-19: update on legislative,
economic, regulatory and IRS developments, October 9, 2020:
https://event.on24.com/wcc/r/2735211/
9EBAEE60263EBCA043C16969B355C85D.
* Tax in the time of COVID-19: update on legislative,
economic, regulatory and IRS developments, October 23, 2020:
https://event.on24.com/wcc/r/2772357/
683EAC5C6766EF74F1BE1A4612EFC2A5.
* Tax in the time of COVID-19: post-election outlook,
November 20, 2020: https://event.on24.com/wcc/r/2845392/
02BB19E8B63D2E7C5B1DF1E440B
FC20F.
* Tax in the time of COVID-19: post-election outlook,
December 4, 2020: https://event.on24.com/wcc/r/2862160/
601C3356B11870AB5780868414F6E
E2D.
* Tax in the time of COVID-19: post-election outlook,
December 18, 2020: https://event.on24.com/wcc/r/2879453/
6C372C5A8F87C6E4270CEF185C41
0E67.
* Tax in the time of COVID-19: post-election outlook,
January 8, 2021: https://event.on24.com/wcc/r/2937023/
F8BC1FCAB193674FCD0495F6C2C
F116C.
* Tax in the time of COVID-19: post-election outlook,
January 22, 2021: https://event.on24.com/wcc/r/3151723/
0FD304CC14FCA234FC4987FC5BD
F24B5.
* Tax in the time of COVID-19: update on legislative,
economic, regulatory and IRS developments, February 5, 2021:
https://event.on24.com/wcc/r/2987070/
00987601769E0BAB8FA431BBBC69838F.
* Tax in the time of COVID-19: update on legislative,
economic, regulatory and IRS developments, February 19, 2021:
https://event.on24.com/wcc/r/2999202/
D4DC00DBFBC8D1287A9F49C929E74F09.
* Tax in the time of COVID-19: update on legislative,
economic, regulatory and IRS developments, March 5, 2021:
https://event.on24.com/wcc/r/3031123/
2AF8F633FE24158D85DC364D7C68DBF9.
* Tax in the time of COVID-19: update on legislative,
economic, regulatory and IRS developments, March 19, 2021:
https://event.on24.com/wcc/r/3057498/
5503AF67B7E076A85FB2151742B1BCE6.
* Tax in the time of COVID-19: update on legislative,
economic, regulatory and IRS developments, April 2, 2021:
https://event.on24.com/wcc/r/3062419/
4D772973FFE7F8D863E60B10056FA7A3.
* Tax in the time of COVID-19: update on legislative,
economic, regulatory and IRS developments, April 16, 2021:
https://event.on24.com/wcc/r/3098610/
123304CEDC428EBFF7C5A4EF611F9CBE.
* Tax in the time of COVID-19: update on legislative,
economic, regulatory and IRS developments, May 14, 2021:
https://event.on24.com/wcc/r/3151723/
0FD304CC14FCA234FC4987FC5BDF24B5.
* Tax in the time of COVID-19: update on legislative,
economic, regulatory and IRS developments, June 4, 2021:
https://event.on24.com/wcc/r/3191435/
F7A0FA96FC005BC2065F4264AEB3D27E.
* Tax in the time of COVID-19: update on legislative,
economic, regulatory and IRS developments, June 18,
2021:https://event.on24.com/wcc/r/3240977/
FD4E0B725AE039D609DDCD308339D318.
* Tax in the time of COVID-19: update on legislative,
economic, regulatory and IRS developments, July 2, 2021:
https://event.on24.com/wcc/r/3264042/
B4ABD1339A2B1C1198EDE1923EBC1835.
* Tax in the time of COVID-19: update on legislative,
economic, regulatory and IRS developments, July 16, 2021:
https://event.on24.com/wcc/r/3296788/
DC4F0000E9EA61A1ADD4E611AF16EB1C.
* Tax in the time of COVID-19: update on legislative,
economic, regulatory and IRS developments, July 30, 2021:
https://event.on24.com/wcc/r/3320498/
252771BEC6E3793A23A3376878CD77F6.
* Tax in the time of COVID-19: update on legislative,
economic, regulatory and IRS developments, September 10, 2021:
https://event.on24.com/wcc/r/3359657/
C2A2A6CACCACB814ECB82C217FEF5B9E.
* Tax in the time of COVID-19: update on legislative,
economic, regulatory and IRS developments, September 24, 2021:
https://event.on24.com/wcc/r/3411210/
E50885CA4A8DD4B60701A6BEC95178C5.
* Tax in the time of COVID-19: update on legislative,
economic, regulatory and IRS developments, October 8, 2021:
https://event.on24.com/wcc/r/3438598/
4692FE559E2A19F8C0BEB89BA79C8461.
* Tax in the time of COVID-19: update on legislative,
economic, regulatory and IRS developments, October 22, 2021:
https://event.on24.com/wcc/r/3461187/
0567C36D54BC784244A7DFFF1D65AA79.
* Tax in the time of COVID-19: update on legislative,
economic, regulatory and IRS developments, November 5, 2021:
https://event.on24.com/wcc/r/3485464/
9829D8A25FBD7BE7274FC5F1223D7866.
* Tax in the time of COVID-19: update on legislative,
economic, regulatory and IRS developments, November 19, 2021:
https://event.on24.com/wcc/r/3508641/
D2799BF0DF5F84145E4D4B65D5B19DCB.
* Tax in the time of COVID-19: update on legislative,
economic, regulatory and IRS developments, December 17, 2021:
https://event.on24.com/wcc/r/3554693/
A1CCF8DD176296DFD901B9FC0B73CA91.
* Tax in the time of COVID-19: update on legislative,
economic, regulatory and IRS developments, January 21, 2022:
https://event.on24.com/wcc/r/3572625/
39C42C984C5AA8AF07185B96BE08FC90.
* Tax in the time of COVID-19: update on legislative,
economic, regulatory and IRS developments, February 4, 2022:
https://event.on24.com/wcc/r/3612146/
5EEC7E025B28D36E37E1BC70E6346765.
* Tax in the time of COVID-19: update on legislative,
economic, regulatory and IRS developments, February 18, 2022:
https://event.on24.com/wcc/r/3631707/
4E8383CF0F46EA211DAE4CFBD4404A22.
17. Qualifications (state what, in your opinion, qualifies you to
serve in the position to which you have been nominated):
I have had a long career of honing my tax technical skills and
gaining leadership acumen as I led increasingly large groups of
professionals. I began my career the year after the passage of
the historic 1986 Tax Act at Ernst and Whinney, preparing both
individual and corporate returns. In 1991, I transferred to the
National Tax Department of Ernst and Young as a manager and
began focusing on international tax. The National Tax practice
had been set up to mirror the Office of Chief Counsel, with
different departments focusing on corporate, international tax,
partnership taxation, exempt organizations, etc.
In the International Tax Department, I analyzed new regulations
and informed our practice offices around the country about new
developments. My client responsibilities were focused almost
exclusively on large U.S. multinational corporations. In 1997,
I was promoted to Principal in the International Tax
Department. Early on in my time as a Principal, I was
transferred to the Mid-Atlantic area to lead the International
Tax group there. I was responsible for about 40 professionals,
which helped me grow my leadership skills. In 2003, I was asked
to lead the International Tax Department in the national
office. In that role, I led a group of over 50 professionals
and developed a talent for helping professionals grow and
contribute at their highest potential.
In 2013, I was afforded the opportunity join the Federal
Government as the Deputy Associate Chief Counsel (Technical).
This role was similar to the one I had had at Ernst and Young,
and I was excited and proud to join the Federal workforce. Two
years later, I was named Associate Chief Counsel
(International) and was responsible for a group of 100
professionals. In this capacity, I had the opportunity to
collaborate closely with all of the other Associate Chief
Counsels, as well many officials at the Internal Revenue
Service, the Department of the Treasury, and the Department of
Justice. Our office was extraordinarily active following the
passage of the 2017 Tax Cuts and Jobs Act, and we produced
high-quality guidance in record time.
In 2019, I returned to Ernst and Young to serve as the deputy
director of the National Tax Department--which, at the time,
had over 1,200 professionals. I led the National Tax Department
until I retired in February 2022. These experiences and
qualifications have prepared me well to lead the Office of
Chief Counsel. I am a strong tax technical lawyer with decades
of experience, and I am familiar with the Office of Chief
Counsel. I have successfully led large offices and know that I
work very well with colleagues of different specialties and
backgrounds.
B. FUTURE EMPLOYMENT RELATIONSHIPS
1. Will you sever all connections (including participation in future
benefit arrangements) with your present employers, business firms,
associations, or organizations if you are confirmed by the Senate? If
not, provide details.
I am currently retired and, consistent with my Ethics
Agreement, plan to continue receiving my Ernst and Young
pension. I have a relatively small 401(k) account that I earned
while at Ernst and Young. I plan to roll that amount into my
IRA account in the near future. Ernst and Young does not
control the account and no longer makes any contributions to
the account.
2. Do you have any plans, commitments, or agreements to pursue
outside employment, with or without compensation, during your service
with the government? If so, provide details.
No.
3. Has any person or entity made a commitment or agreement to employ
your services in any capacity after you leave government service? If
so, provide details.
No.
4. If you are confirmed by the Senate, do you expect to serve out
your full term or until the next presidential election, whichever is
applicable? If not, explain.
Yes.
C. POTENTIAL CONFLICTS OF INTEREST
1. Indicate any current and former investments, obligations,
liabilities, or other personal relationships, including spousal or
family employment, which could involve potential conflicts of interest
in the position to which you have been nominated.
None.
2. Describe any business relationship, dealing, or financial
transaction which you have had during the last 10 years (prior to the
date of your nomination), whether for yourself, on behalf of a client,
or acting as an agent, that could in any way constitute or result in a
possible conflict of interest in the position to which you have been
nominated.
None.
3. Describe any activity during the past 10 years (prior to the date
of your nomination) in which you have engaged for the purpose of
directly or indirectly influencing the passage, defeat, or modification
of any legislation or affecting the administration and execution of law
or public policy. Activities performed as an employee of the Federal
Government need not be listed.
None.
4. Explain how you will resolve any potential conflict of interest,
including any that are disclosed by your responses to the above items.
(Provide the committee with two copies of any trust or other
agreements.)
In connection with the nomination process, I have consulted
with the Office of Government Ethics and the Designated Agency
Ethics Official at the Department of the Treasury to identify
any potential conflict of interest. Any conflict of interest
will be resolved according to the terms of an ethics agreement
that I have entered into with the Treasury Department's
Designated Agency Ethics Official and that will be provided to
this committee. In the event that an actual or potential
conflict of interest arises during my appointment, I will
consult with the Treasury Department's ethics counsel and take
the measures necessary to resolve the conflict.
5. Two copies of written opinions should be provided directly to the
committee by the designated agency ethics officer of the agency to
which you have been nominated and by the Office of Government Ethics
concerning potential conflicts of interest or any legal impediments to
your serving in this position.
I understand that my ethics agreement has been provided to the
committee along with the accompanying transmittal documents.
D. LEGAL AND OTHER MATTERS
1. Have you ever been the subject of a complaint or been
investigated, disciplined, or otherwise cited for a breach of ethics
for unprofessional conduct before any court, administrative agency
(e.g., an Inspector General's office), professional association,
disciplinary committee, or other ethics enforcement entity at any time?
Have you ever been interviewed regarding your own conduct as part of
any such inquiry or investigation? If so, provide details, regardless
of the outcome.
No.
2. Have you ever been investigated, arrested, charged, or held by any
Federal, State, or other law enforcement authority for a violation of
any Federal, State, county, or municipal law, regulation, or ordinance,
other than a minor traffic offense? Have you ever been interviewed
regarding your own conduct as part of any such inquiry or
investigation? If so, provide details.
No.
3. Have you ever been involved as a party in interest in any
administrative agency proceeding or civil litigation? If so, provide
details.
When I was the Deputy Associate Chief Counsel (International),
my office dismissed an employee for cause. He filed a complaint
against the agency asking to be reinstated, and by the time his
hearing took place, I was the Associate Chief Counsel
(International). I was called to give an account of the
incident that led to the employee's dismissal (conduct he
admitted to). He was not reinstated.
4. Have you ever been convicted (including pleas of guilty or nolo
contendere) of any criminal violation other than a minor traffic
offense? If so, provide details.
No.
5. Please advise the committee of any additional information,
favorable or unfavorable, which you feel should be considered in
connection with your nomination.
None.
E. TESTIFYING BEFORE CONGRESS
1. If you are confirmed by the Senate, are you willing to appear and
testify before any duly constituted committee of the Congress on such
occasions as you may be reasonably requested to do so?
Yes.
2. If you are confirmed by the Senate, are you willing to provide
such information as is requested by such committees?
Yes.
______
Attachments
Published Writings
Articles, Letters, EY Tax Alerts
------------------------------------------------------------------------
Title Date Publisher Body Notes
------------------------------------------------------------------------
Practice Guide 1996 American
to Institute of
International Certified
Tax Planning Public
Accountants,
Tax Division
------------------------------------------------------------------------
Notice 2007-13 1/08 Journal of MRNOTICE_2007
and the International _13_ AND_THE
Substantial Taxation 19, _SUBSTANTIAL
Assistance J. Int'l _ ASSISTANCE
Rules--A Good Tax'n 18 _RULES_A_ GO
Start, But Checkpoint OD_START_BUT
More _ MORE_CLARI
Clarification FICATION_ RE
Required QUIRED__Jo.p
df
------------------------------------------------------------------------
Second Round 5/30/05 Social Science Preview only--
of Guidance Research no link
on Dividend Network publicly
Repatriation available
Provisions
------------------------------------------------------------------------
INFO 2015- 3/27/15 Bloomberg Tax Department of MRIRS__INFO_2
0013--Section the Treasury 015--013__Se
4371--Imposit Internal ction_4.pdf
ion of Tax Revenue
Service
Information
Letter
------------------------------------------------------------------------
AM 2018-003-- 8/03/18 Bloomberg Tax Department of MRIRS_AM_2018-
Section 482-- the Treasury 003_ -
Allocation of Internal _Section_482
Income and Revenue .pdf
Deductions Service Legal
Among Advice Issued
Taxpayers by Associate
Chief Counsel
(AMs)
------------------------------------------------------------------------
AM 2017-005-- 11/24/17 Bloomberg Tax Department of MRIRS_AM_2017-
Section 367-- the Treasury 005_-
Foreign Internal P_Section_36
Corporations PRevenue 7.pdf
Service Legal
Advice Issued
by Associate
Chief Counsel
(AMs)
------------------------------------------------------------------------
Year of the 3/02/98 Tax Notes MR78tn1163.pd
PFIC? First Federal f
the '97 Act,
and Now
Guidance on
Making QEF
Election
------------------------------------------------------------------------
U.S. eyes 5/99 International MR10IntlTaxRe
international Tax Review v51.pdf
overhaul Vol. 10, Iss.
5, (May
1999): 51-52
------------------------------------------------------------------------
U.S. reforms 5/99 International MR10IntlTaxRe
face uneasy Tax Review 10 v53.pdf
future Int'l Tax
Rev. 53
------------------------------------------------------------------------
IRS Extends 5/31/99 International MR10IntlTaxRe
Grouping Tax Review v23.pdf
Opportunity
------------------------------------------------------------------------
Time Is 10/05 International MR16IntlTaxRe
Running out Tax Review 16 v29.pdf
for Cash Int'l Tax
Repatriation Rev. 29
(2005)
------------------------------------------------------------------------
Practical Fall 1997 International MR23IntlTaxJ1
Application Tax Journal .pdf
under the 23 INT'l TAX
Check-the-Box J. 1 (1997)
Regime
------------------------------------------------------------------------
Budget 2/06 International MR17IntlTaxRe
Reconciliatio Tax Review 17 v22.pdf
n Is Next for Int'l Tax
Congress' Tax Rev. 22
Law Writers (2006)
------------------------------------------------------------------------
Different ETI 8/04 International MR15IntlTaxRe
Repeal Bills Tax Review 15 v22.pdf
Means Int'l Tax
Difficult Rev. 22
Negotiations (2004)
Ahead
------------------------------------------------------------------------
U.S. Taxation 1/01/94 St. Mary's Law MRARTICLE_U.S
of U.S. Journal 26 . TAXATION
Persons Doing St. Mary's L. OF U.S.
Business or J. 107, 109 PERSONS
Investing in DOING
Mexico: An BUSINESS
Overview O.dox
PArticle:
U.S. Taxation
of U.S.
Persons Doing
Business or
Investing in
Mexico: An
Overview
------------------------------------------------------------------------
Basics of 7/21/21 PLI Transcript
International MRPLI072021.
Taxation pdf
2021; Earning
Income from
Cross-Border
Activities
------------------------------------------------------------------------
Basics of 7/21/21 PLI Transcript
International MRPLIEarning
Taxation Income
2021; Earning Through a
Income Foreign
Through a Corporation
Foreign (1).pdf
Corporation
------------------------------------------------------------------------
Tax Clinic, 1/05 The Tax Link not
Practical Adviser available
Advice on online
Current
Issues
------------------------------------------------------------------------
Final 10/01/07 The Tax
Regulations Adviser
on Dual
Consolidated
Losses: A
Practical
Guide (Part
II)
------------------------------------------------------------------------
Final 9/01/07 The Tax
Regulations Adviser
on Dual
Consolidated
Losses: A
Practical
Guide (Part
I)
------------------------------------------------------------------------
New Rules on 1/01/10 The Tax
Treatment of Adviser
Certain Stock
of a Foreign
Corporation
Under Sec.
7874
------------------------------------------------------------------------
Allocation and 6/06 The Tax
apportionment Adviser
of expenses
for Section
199 purposes:
for many
taxpayers,
calculation
of the
Section 199
deduction
will require
an enormous
amount of
work. This
article
focuses on
one aspect of
the
deduction,
the
allocation
and
apportionment
of expenses
under the
Section 861
regulations
and the
proposed
Section 199
regulations.
------------------------------------------------------------------------
Final Regs. on 1/01/07 The Tax Published in
Partnership Advisor Factiva
Allocations MR010707
of CFTEs
------------------------------------------------------------------------
House Ways and 9/17/21 EY EY Tax Alert
Means
Committee
Chair
proposes
comprehensive
international
tax changes
for
reconciliatio
n bill
------------------------------------------------------------------------
Discussion 8/29/21 EY EY Tax Alert
draft
released by
Senators
Wyden, Brown,
Warner
proposes
significant
changes to
current
international
tax rules
------------------------------------------------------------------------
FIRST 4/10/20 EY EY Tax Alert
IMPRESSIONS:
Taxpayers
need to
consider
international
tax
implications
of making
certain net
operating
loss
elections
under Revenue
Procedure
2020-24
------------------------------------------------------------------------
Source-of- 1/08/20 EY EY Tax Alert
income rules
modified by
proposed
regulations
implementing
TCJA changes
------------------------------------------------------------------------
Final and 12/08/19 EY EY Tax Alert
proposed
regulations
provide
additional
guidance for
determining
allowable
foreign tax
credits
------------------------------------------------------------------------
Considerations 6/05/19 EY Internal-only
related to EY Tax Alert
the potential MR2019-1038
delay in
finalization
of Tax Cuts
and Jobs Act
proposed
regulation
packages
------------------------------------------------------------------------
Service rules 7/01/13 EY EY Tax Alert
on Written
application before links
of were
manufacturing available
exception MR070113
where sales
activities
did not
include the
taking of
title
------------------------------------------------------------------------
U.S. Supreme 5/28/13 EY EY Tax Alert
Court Written
resolves before links
circuit were
split, rules available
UK Windfall MR2013-1020
Profits Tax
is creditable
under Section
901
------------------------------------------------------------------------
EY Tax Alert 3/29/13 EY EY Tax Alert
provides in- Written
depth before links
analysis of were
final and available
temporary MR2013-0636
regulations
on outbound
asset
reorganizatio
n
------------------------------------------------------------------------
Treasury 3/26/13 EY EY Tax Alert
regulations Written
issued before links
concerning were
outbound available
asset MR2013-0601
reorganizatio
ns
------------------------------------------------------------------------
Senator Levin 2/18/13 EY EY Tax Alert
reintroduces Written
Cut before links
Unjustified were
Tax Loopholes available
Act MR2013-0364
------------------------------------------------------------------------
IRS proposes 2/04/13 EY EY Tax Alert
changes to Written
rules for before links
failure to were
comply with available
gain MR2013-0255
recognition
agreements
and other
filings
------------------------------------------------------------------------
Continued 11/26/12 EY EY Tax Alert
attention Written
Prequired for before links
listed were
transactions available
identified in MR2012-1914
PNotice 2001-
45
------------------------------------------------------------------------
Notice 2012-39 7/20/12 EY EY Tax Alert
announces Written
regulations before links
to be issued were
under Section available
367(d) MR2012-1240
affecting
certain
outbound
transfers of
intangible
property in
asset
reorganizatio
ns
------------------------------------------------------------------------
HP's 6/28/12 EY EY Tax Alert
investment in Written
Pforeign before links
entity were
characterized available
as debt: MR2012-1113
foreign tax
credits and
capital loss
disallowed
------------------------------------------------------------------------
Treasury 7/27/12 EY EY Tax Alert
issues final Written
and proposed before links
regulations were
clarifying available
prior MR2012-1107
guidance on
ODLs and the
coordination
with OFL and
SLL
provisions
------------------------------------------------------------------------
New Section 6/12/12 EY EY Tax Alert
7874 Written
regulations before links
establish were
bright-line available
rule for MR2012-1020
substantial
business
activities
test
------------------------------------------------------------------------
Treasury and 2/15/12 EY EY Tax Alert
IRS issue Written
temporary before links
regulations were
on Section available
909 foreign MR2012-0342
tax credit
splitting
events and
final
``technical
taxpayer''
regulations
under Section
901
------------------------------------------------------------------------
IRS and 1/22/12 EY EY Tax Alert
Treasury Written
amend Section before links
861 interest were
allocation available
and MR2012-0138
apportionment
regulations
for corporate
partners with
10% or
greater
interest and
users of FMV
method
------------------------------------------------------------------------
Third Circuit 1/03/12 EY EY Tax Alert
U.S. Court of Written
Appeals holds before links
UK ``Windfall were
Profits'' tax available
is not MR2012-0015
creditable
income tax
for U.S.
foreign tax
credit
purposes
------------------------------------------------------------------------
Treasury 12/21/11 EY EY Tax Alert
releases Written
final before links
regulations were
on foreign available
base company MR2011-2153
sales income
branch rules
------------------------------------------------------------------------
Treasury and 12/12/11 EY EY Tax Alert
IRS issue Written
final before links
regulations were
on available
disregarded MR2011-2083
entities and
conduit
financing
------------------------------------------------------------------------
Proposed 11/09/11 EY Tax Alert
regulations Written
clarify rules before links
for were
controlling available
domestic MR2011-1889
shareholders
to adopt or
change a
method of
accounting or
tax year on
behalf of a
foreign
corporation
------------------------------------------------------------------------
Treasury and 11/08/11 EY EY Tax Alert
IRS issue Written
proposed before links
regulations were
on the available
taxation of MR2011-1887
income of
foreign
governments
under Section
892
------------------------------------------------------------------------
EY 4/20/10 EY EY Tax Alert
coordinating Written
approach to before links
understanding were
economic available
substance MR2010-0575
codification
------------------------------------------------------------------------
Omission of 4/02/10 EY EY Tax Alert
international Written
information before links
results in were
statute available
suspension MR2010-0506
for entire
return
------------------------------------------------------------------------
Webinars, Webcasts, Presentations
------------------------------------------------------------------------
Title Date Group Notes
------------------------------------------------------------------------
Issues Under the 3/19/22 International Tax Webinar
Proposed FTC Institute
Regulations and
Some Early
Observations on
the Proposed FDII
Regulations
------------------------------------------------------------------------
Tax Reform Update 3/22/18 International Tax Webinar
with the IRS Institute
------------------------------------------------------------------------
Navigating the 3/18/15 International Tax Webinar
Subpart F Services Institute
Rules
------------------------------------------------------------------------
Issues Under the 3/19/19 International Tax Webinar
Proposed FTC Institute
Regulations
------------------------------------------------------------------------
Outbound Transfers 12/17/15 USA Branch of the IFA USA New York
to Partnerships International Region Fall
after Notice 2015- Fiscal Association Seminar
54
------------------------------------------------------------------------
Luncheon Speaker 12/07/15 USA Branch of the IFA USA New York
International Region Fall
Fiscal Association Meeting
------------------------------------------------------------------------
More ``Known 5/15 Proskauer 2015 May Meeting
Unknowns''--How do Preliminary
Members of Program
Consolidated MRMoreKnownUnknown
Groups Recover s.pdf
``Previously Taxed
Income?''
------------------------------------------------------------------------
New Treasury 6/21/19 EY EY Webcast
regulations on MRSection 245A
subpart F income, temp regs and
GILTI inclusions, GILTI final regs--
and the DRD under Final slides
Section 245A v2.pdf
------------------------------------------------------------------------
Final and proposed 12/13/19 EY EY Webcast
foreign tax credit MRfinal_and_Ppropo
regulations sed_ftc_regulation
s_Pdecember_2019--
final_slides_v2P.p
df
------------------------------------------------------------------------
Tax in the time of 4/10/20 EY EY Webcast
COVID-19: what MRtax_in_the_time_
U.S. and global Pof_covid19_april_
tax 10_final_Pslides.P
administrations pdf
are doing in
response to the
pandemic
------------------------------------------------------------------------
Proposed foreign 10/15/20 EY EY Webcast
tax credit MRproposed_ftc_Pre
regulations would gulations_october2
add new 020_finalP_slides.
requirements, pdf
election
------------------------------------------------------------------------
Unknown title 5/05/16 ABA Tax Section Materials only
2016 May Meeting available to
members: https://
www.americanbar.or
g/groups/taxation/
events_cle/
meeting_materials/
16may_Pmaterials/
------------------------------------------------------------------------
Codification of the 9/29/10 Bloomberg Tax (BNA) Webinar replay not
Economic Substance available online
Doctrine: Issues,
Uncertainties, and
Application
------------------------------------------------------------------------
______
Question 16, October 15, 2020 Webcast Slides
Proposed Foreign Tax Credit Regulations Would Add
New Requirements, Election
October 15, 2020
Disclaimer
_______________________________________________________________________
This presentation is provided solely for educational
purposes; it does not take into account any specific individual's or
entity's facts and circumstances. It is not intended, and should not be
relied upon, as tax, accounting, or legal advice. Ernst & Young LLP
expressly disclaims any liability in connection with the use of this
presentation or its contents by any third party.
Neither EY nor any member firm thereof shall bear any
responsibility whatsoever for the content, accuracy, or security of any
third-party websites that are linked (by way of hyperlink or otherwise)
in this presentation.
The views expressed by the presenters are not necessarily
those of Ernst & Young LLP or other members of the global EY
organization or of any other company or organization.
______
Today's Moderator
Jose Murillo
Director of National Tax Department's International Tax and Transaction
Services
Ernst & Young LLP
Today's Presenters
Marjorie Rollinson Doug Bailey Martin Milner
National Tax Department Financial Services National Tax
Office Department
Deputy Leader International Tax and International Tax and
Ernst & Young LLP Transaction Services Transaction Services
Ernst & Young LLP Ernst & Young LLP
______
Today's Agenda
_______________________________________________________________________
1. Allocation of foreign taxes.
2. Creditability of foreign taxes.
3. Accrual of foreign taxes.
4. Miscellaneous topics.
5. Applicability dates.
6. One-minute recap.
______
Polling Question
_______________________________________________________________________
Do you know how many of the provisions in the Proposed Regulations will
impact your company?
A. None
B. One to two provisions
C. Three to four provisions
D. Don't know
E. Does not apply (EY, faculty, other)
______
Allocation of Foreign Taxes
Disregarded Payments
_______________________________________________________________________
2020 Proposed Regulations contain a new comprehensive set of rules
addressing the allocation and apportionment of foreign income taxes
relating to disregarded payments.
Generally assign recipient's foreign gross income arising
from the receipt of disregarded payments and the associated foreign
taxes based on the current or accumulated income of the payor.
Leverages the income reattribution rules used in the
foreign branch and global intangible low-taxed income (GILTI) high-tax
exclusion provisions.
Gross income and foreign taxes are allocated at the
``taxable unit'' level.
For individuals or domestic corporations, ``taxable
unit'' means a foreign branch, foreign branch owner, or certain non-
branch taxable units.
For foreign corporations, ``taxable unit'' means a
tested unit.
______
Special Rules
------------------------------------------------------------------------
Special rule for allocation and apportionment of
Transaction taxes
------------------------------------------------------------------------
Disposition of Assigned to the same category as the corresponding
stock under U.S. U.S. dividend (i.e., Section 1248) and capital
law gain amounts (to the extent thereof), with any
remaining foreign gross income assigned to
groupings based on the tax book value of the
corporation's stock as determined under the asset
method in Treas. Reg. Section 1.861-9
------------------------------------------------------------------------
Partnership Assigned to the same category as the corresponding
distribution or U.S. capital gain amount (to the extent thereof),
disposition of a with any excess assigned to groupings based on the
partnership tax book value of the partnership interest or the
interest partner's pro rata share of partnership assets (as
applicable) under Treas. Reg. Section 1.861-9(e)
------------------------------------------------------------------------
Disregarded Payee--Assigned to the same groupings
reattribution as the associated reattribution amounts
payments Payor--Payor's gross income is not
reduced by disregarded reattribution payments for
purposes of allocating and apportioning payor's
foreign taxes
------------------------------------------------------------------------
Disregarded Treated as a contribution and assigned
payments in excess to the residual grouping if made from one taxable
of reattribution unit to a taxable unit owned by the first tested
payments unit
If not a contribution, then treated as
a remittance and assigned based on the groupings
to which the assets of the payor are assigned
under the rules of Treas. Reg. Section 1.861-9
------------------------------------------------------------------------
Disregarded Assigned based on the groupings to which the assets
remittances of the payor are assigned under the rules of
Treas. Reg. Section 1.861-9
------------------------------------------------------------------------
______
Disregarded Reattribution Payment
_______________________________________________________________________
$100 passive foreign personal holding company income
(FPHCI).
$300 gross tested income.
If regarded, the $1,000 payment would be allocated
ratably to FPHCI and tested income.
No Country A taxes.
$1000 foreign gross income.
$100 Country B taxes.
[GRAPHIC] [TIFF OMITTED] T2823.001
.epsReattribution
Payor taxes are allocated without regard to reattribution
of gross income.
Payee taxes are allocated after $400 of gross income is
reattributed to Payee ($100 of FPHCI, $300 of tested income).
Excess of disregarded payment over reattributed income
($600x) is treated as a contribution from Payor to Payee.
______
Allocation of Foreign Taxes
Payee
$10 --passive FPHCI
$30 --tested income
$60 --residual (no credits)
______
Stock Sale and Partnership Distributions
_______________________________________________________________________
[GRAPHIC] [TIFF OMITTED] T2823.002
.eps__
Facts
Foreign: $1000 capital gain
U.S.: $400 dividend (Section 964(e)), $100 capital gain
CFC2 tax book value: 100% general category tested income
group
$100 foreign tax
______
Allocation of Foreign Taxes
$40 general category
$50 general category tested income group
$10 passive category
______
[GRAPHIC] [TIFF OMITTED] T2823.003
.eps__
Facts
Foreign: $1000 dividend
U.S.: $800 return of basis, $200 capital gain
Tax book value of FP assets: 100% general category tested
income group
$100 WHT
______
Allocation of foreign taxes
$80 general category tested income group
$20 passive category
______
Branch Reattribution in Consolidated Groups
_______________________________________________________________________
Prior to redetermination P has:
$400 U.S. source income general category
$600 foreign source income passive category
$350 services payment that would be allocated to
general if regarded
[GRAPHIC] [TIFF OMITTED] T2823.004
.epsConsolidated Return
$350 is an intercompany transaction between P and U.S. Sub
Timing, character and source of U.S. Sub's income and P's
deduction are redetermined as if divisions of one corporation
Reattribution
P's $350 of foreign source income is redetermined to be
U.S. source branch category
______
Polling Question
_______________________________________________________________________
What rule in Prop. Reg. Section 1.861-20 would most impact your
company?
A. Partnership distributions or dispositions of a partnership interest
B. Disregarded remittances (dividends)
C. Disregarded reattribution payments
D. Not sure
E. Does not apply (EY, faculty, other)
______
Creditability of Foreign Taxes
Proposed Section 901 Creditable Foreign Taxes
_______________________________________________________________________
Current Reg. Section 1.901-2
A foreign levy is a foreign income tax creditable under
Section 901 if:
It is a tax;
The predominant character of that tax is that of an
income tax in the U.S. sense; met if the foreign tax is:
Likely to reach net gain in the normal
circumstances in which it applies (net gain requirement)
Realization requirement
Gross receipts requirement
Net income requirement
Not a soak-up tax
______
Prop. Reg. Section 1.901-2
Would revise the definition of a foreign income tax by:
Modifying the realization, gross receipts and net
income requirements; and
Establishing a jurisdictional nexus requirement
between the income subject to tax and the foreign jurisdiction (which
would apply foreign taxes under Sections 901 and 903).
Would also:
Examine the terms of foreign tax law instead of
application of tax in practice (reducing need for empirical analysis);
and
Modify the rules for determining the amount of
foreign tax paid and eligible for credit.
______
Jurisdictional Nexus Requirements
Response to Foreign Countries Adopting Novel
Extraterritorial Taxes (e.g., digital services taxes)
------------------------------------------------------------------------
Non-residents Residents
------------------------------------------------------------------------
Property situs
Activities nexus nexus Sourcing nexus Arm's length
------------------------------------------------------------------------
Incom Incom Inco Fore
e taxable in e from sales or me (other than ign tax imposed
foreign country dispositions of income from on residents of
limited to property taxable sales or the foreign
income on basis of dispositions of country may be
attributable to situs of property) imposed on
non-resident's property include taxable in worldwide
activities only gains foreign country income, but
within foreign attributable to on a source- must provide
country disposition of basis is taxed that any
(including real property based on allocation made
functions, located in foreign pursuant to the
assets and risks foreign country; sourcing rules foreign
located in that are country's
foreign reasonably transfer
country); similar to pricing rules
those of U.S. is determined
under arm's
length
principles;
Witho Or
ut taking into movable property
account as a forming part of
significant business
factor certain property of
destination- taxable presence
based criteria in foreign
(e.g., location country;
of customers and
users)
For With
------------------------------------------------------------------------
Proposed Section 903 ``in Lieu of'' Taxes
_______________________________________________________________________
Revised Substitution Requirement
The foreign tax analyzed under Section 903 (tested foreign
tax) satisfies the substitution requirement only if, based on foreign
law, four tests are met:
(1) A foreign net income tax must be generally imposed by the same
foreign country (generally-imposed net income tax);
(2) Neither the generally-imposed net income tax nor any other separate
foreign net income tax imposed by same foreign country is imposed with
respect to any portion of the income to which the amounts that form the
base of the tested foreign tax relate (excluded income);
(3) ``But for'' the tested foreign tax, the generally-imposed net
income tax would be imposed on the excluded income; and
(4) If the generally-imposed net income tax were applied to excluded
income, the generally-imposed net income tax would either continue to
qualify as a foreign net income tax or would itself constitute a
separate levy that is a foreign net income tax.
The tested foreign tax, by virtue of the substitution
requirement, must also satisfy the jurisdictional nexus requirements.
Special rule for cross-border, source-based withholding
taxes in order to clarify the application of the substitution
requirement to such taxes.
______
Polling Question
_______________________________________________________________________
To what extent would the new jurisdictional nexus requirements, if
finalized, impact the amount of foreign tax credits that your company
could claim?
A. Significantly
B. Moderately
C. Little to no effect
D. Not sure
E. Does not apply (EY, faculty, other)
______
Allocating Taxes With Respect to Covered Events
_______________________________________________________________________
[GRAPHIC] [TIFF OMITTED] T2823.005
.epsFacts
CFC1 checks the box to be disregarded from USP on 4/1
CFC1 (now a DRE) accrues $100x of foreign taxes on 12/31
Allocation of Foreign Taxes
$75x foreign taxes to USP
$25x foreign taxes to CFC1
Consider Section 901 vs 960
2020 Proposed Regulations expand circumstances in which
foreign taxes are allocated
See e.g., Treas. Reg. Section 1.9012(f)(4)(ii)
(allocating taxes between transferor and transferee upon a transfer of
a disregarded entity).
Proposed allocation rule applies to a partnership,
disregarded entity, or corporation that undergoes one or more ``covered
events.''
Covered events:
Partnership termination;
Transfer of a disregarded entity;
Change in the entity classification of a disregarded
entity or corporation; or
Certain changes in a partner's interest in a
partnership
Foreign withholding taxes are not subject to the
allocation rules
Proposed rules for allocating foreign taxes in connection
with Section 336(e) or 338 elections
Proposed Section 901 Regulations on Crediting and Deducting Foreign
Income Taxes
Rules Addressing Changes From Crediting to Deducting
(and Vice Versa) Foreign Income Taxes
Require that an election to claim a credit (or change from
deduction to credit) for foreign income taxes paid or accrued in a year
be made before expiration of the 10-year refund limitation period under
Section 6511(d)(3).
Require choice to deduct (or change from credit to
deduction) for foreign income taxes paid or accrued in a year be made
before expiration of 3-year refund limitation period under Section
6511(a).
Preamble notes rule eliminates current mismatch
where a taxpayer who makes timely election to change from crediting to
deducting may be time-barred from obtaining a refund of U.S. tax for
the deduction year
But allow a taxpayer claiming foreign tax credits (FTCs)
for the year to also deduct additional taxes finally determined and
paid as a result of foreign tax redetermination in that year, if such
taxes relate back to prior year in which taxpayer deducted foreign
income taxes
______
Accrual of Foreign Taxes
Proposed Section 905 Regulations
_______________________________________________________________________
Rules for Accrual-Method Taxpayers
All events test under Section 461 applies to determine
when foreign income taxes accrue for FTC purposes, and incorporate
``relation-back doctrine'' to treat foreign income taxes as accruing at
end of year to which tax relates once all events test is met.
A 52-53 week U.S. tax year that ends in same calendar
month as foreign tax year (and closes within six days of close of
foreign tax year) is treated as ending on last day of the foreign tax
year for purposes of determining amount of foreign taxes that accrue
during the 52-53 week U.S. tax year.
Contested foreign income taxes do not accrue until contest
is resolved, even if taxpayer remits the contested taxes in an earlier
year.
Would withdraw revenue rulings that allow credit for
portion of contested taxes that has been paid but remains contested
But allow an election to claim a ``provisional
credit'' for portion of taxes paid even though contest is not resolved,
subject to requirement for IRS to examine whether taxpayer exhausted
all effective and practical remedies and notifying IRS of when contest
concludes.
______
Proposed Section 905 Regulations on When Foreign Income Taxes Accrue
_______________________________________________________________________
Address Instances in Which an Improper Method of Accounting for
Accruing Foreign Income Taxes Has Been Established
Require taxpayers to file Form 3115 to obtain permission
to change from improper method to proper method of accruing foreign
income taxes.
Provide a ``modified cut-off'' approach for adjusting
foreign income taxes that can be claimed as a credit or deduction in
year of change from improper to proper method.
Treat a Change From Deducting to Crediting Foreign Income Taxes (and
Vice Versa) as a Foreign Tax Redetermination Under Section 905(c)
Would allow the IRS to assess and collect any tax
deficiencies in intervening years resulting from change in election,
even if three-year limitation period has expired under Section 6501(a)
(e.g., change to credit foreign income taxes previously deducted and
increased a net operating loss (NOL) claimed in an intervening year).
______
Polling Question
_______________________________________________________________________
What impact would the expanded scope of foreign tax redeterminations
have on your company's compliance burden?
A. Significant impact
B. Moderate impact
C. Little to no impact
D. Not sure
E. Does not apply (EY, faculty, other)
______
Miscellaneous Topics
Miscellaneous Topics
_______________________________________________________________________
(1) Disallowance of FTC or deduction under Section 245A(d)
(2) Interest expense allocation and apportionment
Prop. Reg. Section 1.245A(d)-1
_______________________________________________________________________
No credit or deduction would be allowed for foreign income taxes
attributable to ``specified distributions'' or ``specified earnings and
profits''
Specified distributions are distributions to a domestic
corporation that are:
Dividends for which a Section 245A dividends
received deduction is allowed
Hybrid dividends
Distributions of Section 245A(d) previously taxed
earnings and profits (PTEP) (i.e., hybrid dividend or Section 1248/
964(e) PTEP)
Specified earnings and profits of a foreign corporation
are those that, if distributed, would give rise to a specified
distribution if distributed
Foreign income taxes are attributed to specified
distributions and specified earnings and profits under Treas. Reg.
Section 1.861-20
New anti-avoidance rule would treat foreign taxes as
attributable to a specified distribution or specified earnings and
profits if a transaction or series of transactions is undertaken with a
principal purpose of avoiding Section 245A(d) rules
______
Polling Question
_______________________________________________________________________
To what extent would the proposed rule regarding the denial of foreign
tax credits under Section 245A(d) negatively affect your company's
creditable foreign taxes?
A. Significantly
B. Moderately
C. Little to no effect
D. Not sure
E. Does not apply (EY, faculty, other)
______
Interest Expense and Apportionment
_______________________________________________________________________
Special Rule for Foreign Banking Branches
Foreign banking branch interest expense reflected on a
foreign banking branch's books and records, conformed to U.S. federal
income tax principles, would be directly allocated to the foreign
banking branch income of that branch to the extent of such income.
A foreign banking branch is a foreign branch owned
by a bank.
Foreign banking branch interest expense is regarded
interest expense recorded on the separate books and records of a
foreign banking branch.
Foreign banking branch income is gross income
assigned to the foreign branch category that is attributable to a
foreign banking branch (including treaty resourced income).
Similarly to other direct allocation provisions, assets of
a foreign banking branch generating foreign banking branch income to
which foreign banking branch interest expense is directly allocated
under this special rule generally are not taken into account under the
general asset method of Treas. Reg. Section 1.861-9T.
Comments requested on whether disregarded interest
payments between foreign branches and between a foreign branch and a
foreign branch owner are needed and whether comparative leverage ratio
rules are necessary.
______
Interest Expense Allocation and Apportionment
_______________________________________________________________________
Election to Capitalize R&E and Advertising Expenditures
R&E expenditures.
Apportioned among statutory and residual groupings
based on SIC code of R&E expense.
Applicability: effectively applicable only until
2022, at which time Section 174 requires capitalization.
Advertising expenditures.
Apportioned among statutory and residual groupings
based on income expected to be generated from product sales or services
to persons to whom advertising is directed.
CFC Netting
Certain CFC-to-CFC debt no longer treated as related group
indebtedness (RGI), for CFC netting calculation purposes.
Also not treated as RGI for purposes of determining the
foreign base period ratio, including taxable years that end before 2020
Proposed Regulations are filed with the Federal Register
______
Applicability Dates
------------------------------------------------------------------------
Regulation Effective dates
------------------------------------------------------------------------
Proposed modifications to Tax years that begin after December 31, 2019,
Treas. Reg. Section and end on or after 2020 Proposed
1.861-20 Regulations are filed with the Federal
Register
------------------------------------------------------------------------
Proposed regulations Foreign taxes paid or accrued in tax years
under Sections 901 and beginning on or after rule is finalized
903 on creditability of
foreign income taxes
------------------------------------------------------------------------
Proposed modifications to Foreign taxes paid or accrued in tax years
technical taxpayer rules beginning on or after rule is finalized
under Section 901
------------------------------------------------------------------------
Proposed regulations Foreign income taxes paid or accrued in tax
under Sections 901 and years beginning after the rule is finalized
905 related to when a
foreign income tax is
accrued and changes from
claiming credits to
deductions (or vice-
versa) for foreign
income taxes paid or
accrued
------------------------------------------------------------------------
Prop. Reg. Section Tax years of a foreign corporation that
1.245A(d)-1, Section begins after December 31, 2019, and end on
245A(d) disallowance of or after 2020 Proposed Regulations are filed
certain credits and with the Federal Register
deductions for foreign
income taxes
------------------------------------------------------------------------
Prop Reg. Section 1.861- Tax years ending on or after 2020 Proposed
3, source of subpart F, Regulations are filed with the Federal
GILTI and certain Register
inclusions with respect
to passive foreign
investment companies
(and associated Section
78 dividends)
------------------------------------------------------------------------
Proposed revisions to Tax years of a foreign corporation ending on
Treas. Reg. Section or after 2020 Proposed Regulations are filed
1.367(b)-7 with the Federal Register
------------------------------------------------------------------------
Prop. Reg. Section Applies to carrybacks of NOLs incurred in tax
1.904(f)-12(j)(5), years beginning on or after January 1, 2018
carryback of post-2017
NOLs to a pre-2018 tax
year
------------------------------------------------------------------------
Prop. Reg. Section 1.861- Tax years beginning on or after the rule is
9(k), election to finalized
capitalize R&E or
advertising expenses for
purposes of apportioning
interest expenses
------------------------------------------------------------------------
Prop. Reg. Section 1.861- Tax years beginning on or after the rule is
10(g), direct allocation finalized
of interest expense for
foreign bank branches
------------------------------------------------------------------------
Revisions to financial Tax years beginning on or after the rules are
services category income finalized
rules under Treas. Reg.
Section 1.904-4(e)
------------------------------------------------------------------------
Modifications to Treas. Tax years beginning after December 31, 2019,
Reg. Section 1.904-4(f) and ending on or after 2020 Proposed
foreign branch category Regulations are filed with the Federal
income definition Register
------------------------------------------------------------------------
Prop. Reg. Section Proposed to apply to tax years beginning on
1.250(b)-5(c)(5), or after January 1, 2021 (consistent with
clarification of the Section 250 regulations generally)
``electronically
supplied services''
under Section 250
------------------------------------------------------------------------
______
Contact Us
Jose Murillo + 1 202-327-6044
Ernst & Young LLP [email protected]
Marjorie Rollinson + 1 202-327-5757
Ernst & Young LLP [email protected]
Doug Bailey + 1 704-954-7853
Ernst & Young LLP [email protected]
Martin Milner + 1 202-327 7453
Ernst & Young LLP [email protected]
______
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______
Question 16: December 13, 2019 Webcast Slides
Final and Proposed Foreign Tax Credit Regulations
December 13, 2019
Disclaimer
_______________________________________________________________________
This presentation is provided solely for the purposes of
enhancing knowledge on tax matters; it does not take into account any
specific taxpayer's facts and circumstances. It is not intended, and
should not be relied upon, as accounting, tax or legal advice. Ernst &
Young LLP expressly disclaims any liability in connection with the use
of this presentation or its contents by any third party.
Neither EY nor any member firm thereof shall bear any
responsibility whatsoever for the content, accuracy, or security of any
third-party websites that are linked (by way of hyperlink or otherwise)
in this presentation.
The views expressed by the presenters are not necessarily
those of Ernst & Young LLP or other associated company or organization.
______
Today's Moderator
Jose E. Murillo
Director of National Tax Department's International Tax and Transaction
Services
Ernst & Young LLP
______
Today's Presenters
Marjorie Rollinson Anna Voortman Martin Milner
National Tax Department National Tax Department National Tax
Department
Deputy Leader International Tax and International Tax and
Ernst & Young LLP Transaction Services Transaction Services
Ernst & Young LLP Ernst & Young LLP
______
Today's Agenda
1. Overview
2. Final regulations
3. Proposed regulations
4. Final and proposed Sec. 905(c) regulations
5. One-minute recap
______
Overview
Foreign Tax Credit (FTC) Regulations
Final regulations are generally consistent with the
proposed regulations published on November 28, 2018, with certain
modifications.
Proposed regulations address the allocation and
apportionment of expenses and current year foreign taxes.
Final and proposed regulations provide guidance for
applying modified Sec. 905(c).
______
Final FTC Regulations
Changes in Final Regulations
------------------------------------------------------------------------
Additions Changes not made
------------------------------------------------------------------------
Safe harbors for No FTC for Sec. 956
transitioning pre-2018 FTC inclusions
carryforwards to post-2017 tax Sec. 78 gross-up for
years Sec. 960(b) taxes
Foreign branch category Foreign taxes paid or
accrued on base differences
allocated to foreign branch or
residual category
Exclude transfers No carryover of foreign
of certain intangible property taxes paid or accrued by a
(IP) by a foreign branch to controlled foreign corporation
its foreign branch owner from (CFC)
the IP reallocation rule
Inventory and non- Continue to deliberate
inventory disregarded property the availability of a Sec. 245A
sales, including reallocation deduction to a CFC
based on hypothetical
depreciation/amortization
Reduce previously taxed Must compute separate
earnings and profits (PTEP) groups limitation loss for Sec. 951A
to 10 (global intangible low-taxed
income (GILTI)) category
Various changes to Must allocate and
interest expense apportionment apportion expenses to Sec. 951A
category
------------------------------------------------------------------------
Pre-2018 FTC and Loss Accounts
_______________________________________________________________________
Transition rules for pre-2018 foreign tax and loss
carryforwards (OFL, SLL, ODL, NOL*)
---------------------------------------------------------------------------
* OFL = overall foreign loss; SLL = separate limitation loss; ODL =
overall domestic loss; NOL = net operating loss
---------------------------------------------------------------------------
General rule
General category pre-2018 foreign tax and loss
carryforwards remain general
Elective reconstruction
General category pre-2018 foreign tax and loss
carryforwards are allocated between general category and foreign branch
category as if the foreign branch category had existed in pre-2018 tax
years (including reallocation rules)
Elective safe harbor #1
General category pre-2018 foreign tax carryforward
for each pre-2018 taxable year is allocated between the general
category and foreign branch category using the following ratio:
[GRAPHIC] [TIFF OMITTED] T2823.006
.eps When foreign taxes are allocated under the
reconstruction method or safe harbor, pre-2018 SLL or ODL accounts may
be allocated ratably between the general and branch baskets using the
same ratio
Elective safe harbor #2
Recapture or utilize pre-2018 loss carryforwards
(SLL, OFL, or NOL) by recharacterizing or offsetting the first
available income in the post-2017 general or foreign branch category
______
Adjustments to Foreign Branch Income
Intangible Property Transfers
_______________________________________________________________________
General Rule
Foreign branch gross income is increased or decreased to
account for transfers of intangible property described in
Sec. 367(d)(4) to (or from) a foreign branch and a foreign branch owner
Treated as having sold the property for annual payment
contingent on the productivity of the property as determined under
367(d)
No ``netting''of offsetting amounts
[GRAPHIC] [TIFF OMITTED] T2823.007
.epsExceptions
Adjustments required only for transfers occurring on or
after December 7, 2018 (date proposed regulations were released)
Adjustments not required for intangible property
considered owned transitorily by a foreign branch
[GRAPHIC] [TIFF OMITTED] T2823.008
.eps__
Polling Question
_______________________________________________________________________
Will the new exceptions to the intangible property rule apply to your
company?
A. Yes, because we transferred IP prior to 12/7/18
B. Yes, because we have had or will have transitory branch ownership
C. No
D. Don't know
E. Does not apply (EY, faculty, other)
______
Foreign Taxes and Timing Differences
_______________________________________________________________________
If income is not recognized for U.S. purposes in the current year, tax
is allocated and apportioned as if the income were recognized in the
current year.
[GRAPHIC] [TIFF OMITTED] T2823.009
.eps__
Proposed FTC Regulations
Research and Experimental (R&E) Expenditures
_______________________________________________________________________
Optional Gross Income Method Eliminated
Modified mandatory gross receipts-based apportionment:
Step 1: R&E expenditures are allocated to a taxpayer's ``gross
intangible income'' in the relevant SIC code category as a class
Intangible income is all gross income attributable to
intangible property including sales, services, and royalties (including
Sec. 367(d) inclusions), but does not include dividends or other
inclusions with respect to stock.
So no R&E expenditures are allocated to a taxpayer's GILTI
or subpart F income inclusion.
Step 2: Allocated R&E expenditures are then apportioned to the
statutory and residual groupings within the class of gross income in a
two-step process:
Exclusive geographic apportionment applies to 50% of R&E.
Remaining R&E expenditures are apportioned to statutory
(Sec. 904 baskets) and residual (U.S.-source) groupings based on gross
receipts (including those of benefitting controlled and uncontrolled
parties) related to the taxpayer's gross intangible income.
______
R&E Expenditures
Effective for taxable years beginning after December 31,
2019.
Taxpayers may rely on the proposed regulations for taxable
years beginning after December 31, 2017.
______
Polling Question
_______________________________________________________________________
Does your company currently allocate R&E expenditures to GILTI or
subpart F inclusions?
A. Yes
B. No
C. Don't know
D. Does not apply (EY, faculty, other)
______
Stewardship Expenses
_______________________________________________________________________
Definition of Stewardship Expenses Retained
Step 1: Allocate to dividends and inclusions received or accrued (or to
be received or accrued) from related corporations
Stewardship expenses allocated to GILTI and subpart F
inclusions, as well as Sec. 78 gross-up amounts
Step 2: Apportion based on relative values of taxpayer's stock assets
in the same manner that is applied for allocating and apportioning
interest expense
Applicability: generally applies to taxable years that end on or after
the date proposed regs are filed in the federal register
It is now more important to properly identify what activities and costs
constitute stewardship
______
Litigation Damages Awards, Prejudgment Interest, and Settlement
Payments
_______________________________________________________________________
Facts
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.eps In 2015, FDE sells Product A in Country X generating
foreign source general category income.
In 2019, FDE makes a deductible payment for damages caused
by Product A (sold in 2015) in Country X.
In 2019, FDE sells Product A to customers in Country X
generating U.S. source foreign branch category income.
Expected Result
The deduction is allocated to U.S. source foreign branch category
income, consistent with the sales of Product A in 2019 (i.e., rather
than the 2015 sales).
______
Polling Question
_______________________________________________________________________
What impact would the proposed stewardship rules have on your company's
foreign source income calculation?
A. Increase foreign source income
B. Decrease foreign source income
C. No impact on foreign source income
D. Don't know
E. Does not apply (EY, faculty, other)
______
Interest Expense Allocation And Apportionment
_______________________________________________________________________
Guaranteed Payments for the Use of Capital
Treated as interest expense for allocation and
apportionment purposes and as ``interest equivalents'' that are foreign
personal holding company income under Sec. 954(c)
Partnership to Partner Loans
Harmonizes the treatment of loans made by a partnership to
its partner(s) with the treatment of downstream partnership loans
Requires the matching of interest income to the statutory
and residual categories to which the interest expense is attributable
Assets Funded by Disallowed Interest
Assets are only connected with capitalized, deferred or disallowed
interest if using debt proceeds in the acquisition causes interest to
be capitalized, deferred or disallowed
Sec. 163(l) disallows interest because of ability to
settle in stock; not use of debt
______
Polling Question
_______________________________________________________________________
Which proposed expense allocation and apportionment rules would have
the biggest impact on your company?
A. R&E expenditures
B. Stewardship expenses
C. Litigation damages awards, prejudgment interest, and settlement
payments
D. Other
E. Do not expect any impact as a result of the proposed regulations
F. Does not apply (EY, faculty, other).
______
Allocating and Apportioning Current Year Foreign Taxes
_______________________________________________________________________
Step 1: Assign the taxpayer's foreign gross income to statutory and
residual groupings
Amount determined under foreign law but
characterized under U.S. law
If a corresponding U.S. item exists in same tax
year, foreign gross income assigned to same grouping as corresponding
U.S. item
Corresponding U.S. item can be of a different
amount
Special rules apply if the corresponding U.S.
item is zero or less
If a corresponding U.S. item not recognized, or
recognized in different U.S. tax year, foreign gross income assigned as
if the event resulted in the recognition of U.S. gross income in the
year the tax is paid
If a corresponding U.S. item is recognized but
excluded from U.S. gross income, foreign source gross income is
assigned as if the foreign gross income is includible in U.S. gross
income
If a current year foreign tax is paid or accrued
with respect to a base difference, the foreign tax is assigned to the
residual grouping
Step 2: Allocate and apportion the deductions allowed under foreign law
to the foreign gross income in the statutory and residual groupings
Step 3: Allocate and apportion foreign income tax by reference to the
foreign taxable income in the statutory and residual groupings
______
Exclusive List of Base Differences
_______________________________________________________________________
1. Death benefits described in Sec. 101
2. Gifts and inheritances described in Sec. 102
3. Contributions to capital described in Sec. 118
4. Receipt of money or other property in exchange for stock described
in Sec. 1032 (including transfers described in Sec. 351(a))
5. Receipt of money or other property in exchange for a partnership
interest described in Sec. 721
6. Return of basis distribution under Sec. 301(c)(2)
7. Distribution to a partner described in Sec. 733
If paid by a U.S. taxpayer, foreign taxes are assigned to
the foreign branch category
If paid by a CFC, foreign taxes are assigned to the
residual category and no credit is allowed
______
Polling Question
_______________________________________________________________________
Does your company anticipate incurring foreign taxes associated with
base differences?
A. Yes
B. No
C. Don't know
D. Does not apply (EY, faculty, other)
______
Special Rules
------------------------------------------------------------------------
Special rule for allocation and apportionment of
Transaction taxes
------------------------------------------------------------------------
Distributions that Assigned to the same category as the corresponding
are recognized for U.S. dividend and capital gain amounts (to the
U.S. and foreign extent thereof), with any foreign distribution
tax purposes that corresponds to a U.S. return of capital being
treated as a base difference
------------------------------------------------------------------------
Distributions that Assigned as if a distribution were made for U.S.
are recognized purposes in the year the foreign tax is paid
only for foreign
tax purposes
------------------------------------------------------------------------
Disregarded Deemed to be made ratably out of the foreign
payments by a branch's accumulated after-tax income, which is
foreign branch allocated by reference to the relative tax book
values of the branch's assets (including stock)
------------------------------------------------------------------------
Disregarded With one exception, assigned to the residual
payments by an grouping (i.e., branch category for U.S. owners,
foreign branch residual income for CFC owners)
owner to a foreign
branch
------------------------------------------------------------------------
Taxes paid by a Allocated and apportioned by reference to the
U.S. shareholder reverse hybrid's foreign income; however, Prop.
on income from Reg. Sec. 1.904-6(f) assigns to the GILTI basket
reverse hybrids based on the GILTI inclusion percentage
------------------------------------------------------------------------
Gain on the sale of Assigned as if the DRE's assets were sold for
a disregarded foreign tax purposes (e.g., by reference to the
entity (DRE) DRE's inside asset basis under foreign law)
------------------------------------------------------------------------
Actual Distributions and Reverse Hybrids
_______________________________________________________________________
Actual Distributions
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.epsFacts
Foreign: $1000 dividend
U.S.: $400 dividend, $500 return of capital, $100
capital gain
$100 foreign withholding tax (WHT)
Allocation of Foreign Taxes
$40 general category
$50 residual income grouping (no credit)
$10 passive category
Reverse Hybrid
[GRAPHIC] [TIFF OMITTED] T2823.012
.epsFacts
$1000 tested income
$100 foreign taxes
60% Sec. 951A inclusion percentage
Allocation of Foreign Taxes
$60 --Sec. 951A category
$40 --general category?
______
Disregarded Payments
_______________________________________________________________________
Taxes Imposed on Disregarded Payments Generally Governed by One of
Three Special Rules
A. Disregarded payments by a foreign branch
B. Disregarded payments by a foreign branch owner
C. Disregarded payments in exchange for property
______
Disregarded Payments by a Foreign Branch
_______________________________________________________________________
Scope: An item of foreign gross income that a taxpayer
includes by reason of the receipt of a disregarded payment made by a
foreign DRE or other foreign branch.
Assignment: Assigned to a grouping by deeming the payment
to be made ratably out of all of the accumulated after-tax income of
the foreign branch.
Accumulated after-tax income deemed to have
arisen in groupings in the same ratio as tax book value of the assets
of the branch in the groupings.
Assets include stock held by foreign branch.
Payment cannot be made with a principal purpose
of avoiding an operative section or result in a ``material
distortion.''
______
Disregarded Payments by a Foreign Branch
_______________________________________________________________________
[GRAPHIC] [TIFF OMITTED] T2823.013
.epsFacts
$1,000 payment
$100 foreign taxes
FDRE assets--60% general/40% passive
Allocation of Foreign Taxes
$60 --general category
$40 --passive category
______
Disregarded Payments by a Foreign Branch Owner
_______________________________________________________________________
Scope: An item of foreign gross income that a taxpayer
includes by reason of the receipt of a disregarded payment made by a
foreign branch owner to a foreign branch (not including disregarded
payments in exchange for property).
Assignment: Residual grouping
If foreign branch owner is a U.S. person, taxes are
assigned to foreign branch category
If foreign branch owner is a CFC, taxes are assigned
to residual income category (no credits)
Exception: Does not apply to disregarded sales or
exchanges of property.
______
Disregarded Sales or Exchanges of Property
_______________________________________________________________________
Scope: An item of foreign gross income attributable to
gain recognized under foreign law by reason of a disregarded payment
received in exchange for property.
Assignment: Characterized and assigned to the grouping to
which the corresponding U.S. item would be assigned if the event giving
rise to the foreign gross income resulted in the recognition of gross
income or loss for U.S. tax purposes in that U.S. taxable year.
______
Disregarded Payments by a Foreign Branch Owner
_______________________________________________________________________
[GRAPHIC] [TIFF OMITTED] T2823.014
.epsScenario 1
$1,000 payment for property
If regarded, the property sale would produce general
category gross tested income
$100 foreign taxes
Foreign taxes are allocated to general category tested
income
Scenario 2
$1,000 payment for services
$100 foreign taxes
Foreign taxes are allocated to the residual category (no
credit)
______
Polling Question
_______________________________________________________________________
Which of the special rules for allocating and apportioning current year
foreign taxes would most impact your company?
A. Disregarded payments by foreign branches
B. Disregarded payments by a foreign branch owner
C. Foreign taxes paid on inclusions from reverse hybrids
D. Other
E. Don't know
F. Does not apply (EY, faculty, other)
______
Final and Proposed Sec. 905(c) Regulations
Final Sec. 905(c) Regulations
_______________________________________________________________________
Finalizes provisions from 2007 temporary regulations:
Definition of foreign tax redetermination
Change in foreign tax liability and certain
other changes that affect FTC
Includes:
Refunds
Corrections or adjustments to reflect final
liability
Additional payments, including contested
taxes
Taxes not paid within 24 months of close of
taxable year
Currency translation rules
24-month change, inflationary currencies,
accrued taxes translated on date of payment, and Sec. 988 gain/loss on
functional currency change
______
Proposed Sec. 905(c) Regulations
_______________________________________________________________________
Re-proposes and modifies provisions from 2007 temporary
regulations
Foreign tax redetermination
Adds changes that may affect U.S. tax liability
Amount of foreign tax credit, distributions and
inclusions, high tax exception
Repeal of Sec. 902--no prospective pooling adjustments
Requires adjustments to E&P, taxable income, and
inclusions for year to which foreign taxes relate and any affected
subsequent year
Even if no change to originally claimed FTC
Same rule for post-2018 redeterminations for
pre-2017 years
Successor rule
Redetermination made as if it occurred in hands of
original taxpayer
Notification requirements
Incorporates and modifies notification requirements
in 2007 temporary regulations
Generally satisfied by submitting amended return,
Form 1116/1118, and statement
Exception: No change to U.S. tax due--adjust carryovers and
attach statement to return for year in which redetermination
occurs.
______
Polling Question
_______________________________________________________________________
On average, how often do you anticipate filing amended returns by
reason of Sec. 905(c)?
A. Multiple times a year
B. Once a year
C. Once every 2+ years
D. Do not expect to file amended returns by reason of Sec. 905(c)
E. Don't know
F. Does not apply (EY, faculty, other)
______
Contact us
_______________________________________________________________________
Jose Murillo + 1 202-327-6044
Ernst & Young LLP [email protected]
Marjorie Rollinson + 1 202-327-5757
Ernst & Young LLP [email protected]
Anna Voortman + 1 312-879-3264
Ernst & Young LLP [email protected]
Martin Milner + 1 202-327-7453
Ernst & Young LLP [email protected]
______
Upcoming Thought Center Webcasts
taxnews.ey.com/news/2019-0001-upcoming-tax-webcasts
Tuesday, December 17: Accounting for income taxes: a
quarterly perspective
Wednesday, December 18: Year-end planning for alternative
asset managers: reflecting on year one of tax reform reporting
Thursday, January 9: Research credit: recent federal cases
point to a challenging examination environment (Available soon)
Thursday, January 16: Planning implications for 2019
returns (Available soon)
Thanks for Participating.
[GRAPHIC] [TIFF OMITTED] T2823.015
.eps[GRAPHIC] [TIFF OMITTED] T2823.016
.epsReceiving CPE/CE Credit
_______________________________________________________________________
To be eligible for CPE/CE credit, you must meet all of the
minimum eligibility criteria:
Participate for a minimum of 50 minutes to start
earning credit
Respond to the polling questions
Webcast technology automatically determines whether
participants qualify for credit based on the eligibility requirements
above.
Certificates will be available for qualified non-EY
participants to print at the conclusion of the webcast by clicking on
the yellow Certification icon at the bottom of this interface.
EY participants' awards will be posted in your CPE history
within 10 business days.
______
How do I get my CPE Certificate?
_______________________________________________________________________
At the end of the webcast, complete the feedback form.
Click on the teal Survey Icon.
[GRAPHIC] [TIFF OMITTED] T2823.017
.eps Then, click on the yellow Certification icon to
download your certificate.
In addition, you will receive an email following the
webcast with a link to download your certificate.
______
If you are Participating in a Group
_______________________________________________________________________
Each person who logged in to the webcast should: