Headlines about "Health plan costs - misc"

Gathered from the web by the editors at BenefitsLink.com.
[Guidance Overview] IRS Will Treat Child of Divorced Parents as the Dependent of Both for Certain Health and Fringe Benefits
Excerpt: "The IRS has carved out a limited exception to IRC § 152(e) which – after changes made by the Gulf Opportunity Zone Act of 2005 and Working Families Tax Relief Act of 2004 (WFTRA) – requires the custodial parent to release the claim to the exemption in order for the non-custodial parent to claim the child as a dependent. IRS has stated that, for purposes of certain enumerated health and fringe benefits, it will treat the child as a dependent of both parents regardless of whether the custodial parent releases the claim to the exemption. IRS Revenue Procedure 2008-48." (Deloitte via BenefitsLink.com)

Battle Brewing Over High-Deductible Plans
Excerpt: "A contractual battle pitting major health insurers in California against brokers and employers casts a bright light on whether recent attempts to assist employees with high-deductible health plans in the face of rising medical costs defeats the purpose of helping them spend out-of-pocket dollars more wisely – a philosophical hallmark of the worksite market." (Employee Benefit News and SourceMedia, Inc.)

Workers to Pay More for Health Care, According to Study
Excerpt: "Get ready for another hike in copays and deductibles. A survey being released Thursday by the Mercer consulting firm found 59 percent of companies intend to keep down rising health care costs in 2009 by raising workers' deductibles, copays or out-of-pocket spending limits. On average, health care costs will go up by an estimated 5.7 percent next year for both workers and their employers, the study found. That repeats this year's 5.7 percent hike and a 6.1 percent jump in 2007." (The Houston Chronicle)

Coverage for Autism Therapy Prompts State Mandates and Lawsuits Against Blues Plans
Excerpt: "An explosion in the number of children diagnosed with autism has led to lawsuits against Blue Cross and Blue Shield plans and other carriers over health insurance coverage for controversial therapies. Concerns over autism therapy also have prompted several states, such as Arizona, Florida and Pennsylvania, to enact new autism benefit mandates, forcing Blues plans to revise coverage policies." (AISHealth.com)

Wall Street Journal Examines Insurer WellPoint's Strategy To Raise Premiums, Retain Plan Members
Excerpt: "The Wall Street Journal on Wednesday examined how WellPoint CEO Angela Braly 'is attempting a delicate balancing act: raising premiums enough to placate investors but not so much as to send customers fleeing elsewhere.' According to the Journal, the 'conundrum of how to reassure investors that profit will be maintained without losing business is confronting the entire health insurance industry,' but 'the challenge is acute at WellPoint, which covers or administers health benefits for 35 million people across 14 states.'" (Kaiser Family Foundation)

Group Purchasing Organizations Are Feeling Pressure of Higher Material Costs for Health Products
Excerpt: "One fact stood out as Modern Healthcare spoke with purchasing organizations in follow-up conversations to our annual Group Purchasing Survey: The increased cost of raw materials used in the production and transportation of medical products has trickled down the supply chain, forcing GPOs to work harder than ever this past year to hold down pricing on healthcare products." (ModernHealthcare.com; free registration required)

Long-Term Care Insurance and Tax Planning
Excerpt: "The number of baby boomers in or near retirement is rising, and so too is the demand for long-term care (LTC) insurance. Depending on the age of the insured, such coverage can be expensive, but fortunately for them, Congress and some states have provided income tax incentives for the purchase of certain LTC insurance policies -- called 'qualified' LTC contracts -- in IRC § 7702B." (American Institute of Certified Public Accountants)

GM Offers More Buyouts - Extends Deal to 9,000 Salaried Workers
Excerpt: "About 9,000 workers have been offered the deal, according to a source familiar with the plan. If they all accepted, it would trim about 28 percent of GM's salaried work force and shave about 20 percent of its white-collar costs. The voluntary offers, which GM started making in recent weeks, come a month after GM said it wanted to trim its salaried work force expenses by more than 20 percent in the U.S. and Canada. That includes ending its salaried retirement health coverage for employees over 65 starting Jan. 1 and eliminating salaried raises through the end of 2009." (AP via The Detroit News)

[Guidance Overview] Solving Small Employers' GASB 45 Puzzle
Excerpt: "GASB 45 has already placed requirements on large government entities. Now smaller public employers face their own deadlines. GASB 45 poses a particular challenge to these entities because of the cost of valuing the liability and the potential size of the liability relative to their overall budget. This article outlines a sensible approach for these smaller public employers." (Milliman)

State Differences in Offer Rates and Enrollment in Employer-Sponsored Health Insurance Plans Requiring No Employee Contribution to the Premium Cost, 2005 (PDF)
6 pages. Excerpt: "This Statistical Brief presents estimates of offer rates and enrollment in employer-sponsored health insurance plans requiring no employee contribution in the ten most populous states in 2005. The availability of such plans varies considerably by state and firm size, among other factors. State variations from the national average are discussed." (U.S. Agency for Healthcare Research and Quality)

[Opinion] The Pioneering Massachusetts Program to Provide Health Insurance for All Citizens
Excerpt: "The number of uninsured has dropped -- Massachusetts now has the lowest rate in the nation -- and so have the number of those who turn to costly emergency rooms for routine care. And while the state has had to seek additional sources of revenue -- mainly because of the program's popularity -- the gains in the first 21 months suggest that the plan could become a model for universal health coverage for other states or the nation." (The New York Times; free registration required)

Health Plans Work to Counter Ailing Enrollment Among Small Employers Jolted by Economy
Excerpt: "Since September, the percentage of small employers that don't offer health coverage has jumped from 29% to 34%, according to the 2008 American Express OPEN Spring Monitor, a semiannual survey of small-business owners. And over the past six months, 20% of employers say they have been shopping for a new carrier to secure a better rate. Several publicly traded health plans say they are feeling the hit." (AISHealth.com)

[Opinion] Comments to Massachusetts Connector Board on Minimum Creditable Coverage Requirements (PDF)
7 pages. Excerpt: "The proposed minimum creditable coverage (MCC) guidance approved by the Connector Board in July provides valuable and welcome guidance in many areas. However, we are concerned about the impact these requirements will have on the Massachusetts employees and retirees of many national employers. As of the date of these comments, we have reviewed the health programs of approximately 20 large national employers, several of whom are headquartered in Massachusetts. Although these employer plans provide comprehensive benefits, most of the employer programs we have reviewed have one or more options that fail to satisfy the MCC requirements based on the regulations and the comments we have received from the Connector." (Buck Consultants)

Lower Medical Cost Trend Rate Is Good News, Bad News for Health Plans and Employers
Excerpt: "First, the good news: The annual medical trend rate for health care in 2008 increased by its lowest percentage since 2001. The bad news: The average increase is still in the double digits and is three times the Labor Dept.'s Consumer Price Index, according to results of a study released Aug. 11 by Aon Corp." (AISHealth.com)

[Opinion] Lessons from the Massachusetts Experiment in Health Care Reform
Excerpt: "Bottom line, health care in Massachusetts is extremely expensive, thanks to supply-side factors -- which means expanding and sustaining full coverage is, fiscally speaking, a tough proposition. Luckily, steps are being taken to address cost issues : in June, the state's biggest insurer and the state itself said that they would stop reimbursing doctors and hospitals for 28 medical errors." (The Century Foundation)

[Guidance Overview] Recent Developments under the Massachusetts Health Care Reform Act Affecting Employers
Excerpt: "This advisory explains the following recent developments under the Act as they affect employers, either directly (in the case of the fair share contribution requirement) or indirectly (in the case of the definition of 'minimum creditable coverage') . . . ." (Mintz, Levin, Cohn, Ferris, Glovsky and Popeo P.C.)

Patients Suffer As Care, Coverage Limits Collide; Physicians Say Insurers Intrude on Treatment
Excerpt: "Increasing healthcare costs and an influx of expensive drugs and tests, combined with an aging population, set off a healthcare crisis in the United States. Contending with soaring costs, insurers changed the business of health care by requiring preauthorizations, mandating cheaper drugs, and tightening controls on treatment decisions. But among the first casualties of these changes, many physicians said, was the doctor-patient relationship." (Toledo Blade)

Alabama Board Approves Plan To Charge State Employees for Obesity, Health Problems
Excerpt: "The Alabama State Employees' Insurance Board last week approved a plan that will require state employees who are obese or have health problems to make progress to address those issues or pay a monthly charge for health insurance, the AP/Philadelphia Inquirer reports." (KaiserNetwork.org)

A Tax Revolt Is Quietly Brewing in Some States
Excerpt: "These and other battles come at a time when many states are struggling to cope with tough economic times." (Wall Street Journal via Baltimore Sun)

Governments Mostly Undecided on OPEB Funding Strategy
Excerpt: "Strategies to deal with new standards imposed by the Governmental Accounting Standards Board (GASB) have yet to be widely decided by governments, despite a compliance deadline of the end of 2009. A study conducted by the nonprofit Cobalt Community Research found 74% of local governments that provide retiree health care are aware of the GASB 45 requirements, and 47% report that they have already calculated their retiree health care liability or the calculation is in process. GASB 45 requires states to identify the costs for other post employment benefits (OPEB) in their FY 2008 financial reports." (PLANSPONSOR.com; free registration required)

Covering the Uninsured in 2008: Current Costs, Sources of Payment, and Incremental Costs
Excerpt: "Government programs finance about 75 percent of uncompensated care. If all uninsured people were fully covered, their medical spending would increase by $122.6 billion. The increase represents 5 percent of current national health spending and 0.8 percent of gross domestic product. However, it is neither the cost of a specific plan nor necessarily the same as the government's costs, which could be higher, depending on plans' financing structures and the extent of crowd-out." (Health Affairs)

Court OKs Trust to Handle Goodyear Retiree Health Care Benefits, Company Says
Excerpt: "Goodyear Tire & Rubber Co. has announced that the voluntary employees' beneficiary association trust that's intended to take responsibility for much of the company's retiree health care benefits has been approved by U.S. District Court Judge John R. Adams. Under the terms of a settlement, Goodyear will make a $1 billion cash contribution to the trust, which will provide health care benefits to the company's current and future retirees who are members of the United Steelworkers union." (Workforce Management; free registration required)

New Study Examines Current Health Care Spending on Uninsured and Projects Cost If the Population Were Insured
Excerpt: "The study is an update of a previous Kaiser study and also projects the additional cost to the nation's health care system if all the uninsured were covered by insurance. If everyone were covered, overall costs would increase by $123 billion dollars, or an additional five percent of national health spending. The analysis does not assess how much a universal coverage plan would cost the government, which would vary depending on the details of the approach." (Kaiser Family Foundation)

Americans Who Lack Health Insurance Will Spend About $30 Billion Out of Pocket on Medical Care This Year
Excerpt: "The new study estimates the government pays 75%, or $42.9 billion, of the amount uninsured patients can't pay -- through Medicaid, the federal-state health-insurance for the poor and Medicare, the federal program for the elderly and disabled, as well as state and local taxes." (The Wall Street Journal)

Audio and Text: Candidates' Plans to Cut Health Costs May Not Pay Off
Excerpt: "Plans by both Democratic Sen. Barack Obama and Republican Sen. John McCain aim to hold down costs and improve the quality of care. And both candidates propose to do so through the existing private health insurance system. The idea is that with more customers, insurers will compete for business by offering good policies and finding ways to make care more efficient and thus cheaper." (Morning Edition via National Public Radio)

Costs of Barstow, California, Police and Firefighters Go Far Beyond Wages
Excerpt: "The annual cost of retirement benefits -- including the employers' contribution and the portion of the employees' contribution that employers pick up as an added benefit -- amounts to about $23,738 per firefighter/paramedic. The city pays an annual average of $24,094 in retirement benefits per officer, according to numbers provided by the city and fire district." (Desert Dispatch)

Survey Reveals Most HR Professionals Want Government to Play Role in Regulating Healthcare Costs
Excerpt: "A majority of corporate human resource managers believe the federal government should play a role in regulating healthcare costs and coverage, but neither political party offers a clear-cut resolution. . . . The 1,242 respondents were almost evenly divided on whether the viewpoints of either John McCain or Barack Obama could positively affect the current state of rising health care costs and coverage in the United States. However, almost half of those surveyed felt that neither the Republican nor Democratic party would be effective in addressing the issue." (Marketwire via NewsEdge via Human Resource Executive Online)

[Guidance Overview] DOL Service Provider Disclosure Regs: A New and Improved (?) Way of Doing Business
Excerpt: "The proposed regulations are intended to introduce transparency to service providers' fees and potential conflicts of interest, so as to provide plan fiduciaries with sufficient information to be able to make informed decisions about services and costs, and will require major changes in how service providers operate as well as impact employers who contract for those services. The regulations would take effect 90 days after publication of the final regulations." (Patterson Belknap Webb & Tyler LLP)

2009 Segal Health Plan Cost Trend Survey (PDF)
6 pages. Excerpt: "The 2009 Segal Health Plan Cost Trend Survey forecasts continued declines in trends for 2009, marking the sixth consecutive year of declining trends. Most trend rates are projected to be lower in 2009 than in 2008, but cost trends for all medical plan types are higher than inflation." (The Segal Group, Inc.)

Delivery Firm Seeks OK to Use In-House Insurance Firm for U.S. Benefits
Excerpt: "U.S. affiliates of German delivery giant Deutsche Post, including DHL Express, are asking the Labor Department for permission to fund employee benefit risks through the Vermont branch of its in-house insurance company." (Workforce Management; free registration required)

Health Care/Insurance No Longer Primary Election Issue for Candidates
Excerpt: "The continual tussle between the two presumptive presidential nominees -- Obama and McCain -- has largely centered recently on national security and the high price of gasoline. Public opinion polls have shown that among the top issues of concern to Americans, health care is languishing far behind the economy, the war and the price of gas. One CBS poll from July put voter interest in health care at just 3 percent. In August, it was at 8 percent." (Chicago Tribune)

California Assembly OKs Amended Bill Capping Health Insurers' Administrative Costs
Excerpt: "On Tuesday, the California Assembly voted 41-26 to approve legislation that would require health insurers to spend 85% of premiums and other fees on patient benefits, the AP/Los Angeles Daily News reports." (California HealthCare Foundation)

South Carolina Will Begin Charging Public Employees Who Smoke More Each Month for Health Insurance Coverage
Excerpt: "Each employee who falls into [the category of either being a smoker or has insured dependents who smoke] will have to pay $25 a month extra for health insurance than nonsmokers. The charge is per policy, not the number of smokers in the family. The new rules will take effect in January 2010, giving smokers ample time to quit if they choose." (The Herald, Rock Hill, South Carolina)

Lack of Insurance, High Medical Costs a Problem for More Americans
Excerpt: "Americans are struggling to pay medical bills and are accumulating medical debt at an increasing rate, according to a survey released today. 'A perfect storm of negative economic trends is battering working families across the United States,' said the survey by the Commonwealth Fund . . . ." (The Washington Post; free registration required)

Abstract of 2009 Segal Health Plan Cost Trend Survey
Excerpt: "The 2009 Segal Health Plan Cost Trend Survey, which is based on a survey of managed care organizations (MCOs), health insurers, pharmacy benefit managers (PBMs) and third party administrators (TPAs), forecasts continued declines in trends for most of the coverages surveyed. Trend is the projected change in health plans' per-capita claims cost determined by insurance carriers, MCOs and TPAs." (The Segal Group, Inc.)

HSA Savings Insufficient to Fund Retiree Health
Excerpt: "According to the [Employee Benefit Research Institute] analysis, one of the difficulties in using an HSA to save money for premiums and out-of-pocket expenses during retirement is that individuals also can (and might need to) use the money in the account to pay for health care services during their working years or to pay COBRA premiums and insurance premiums during periods of unemployment." (Wolters Kluwer)

[Guidance Overview] Employer Did Not Violate State Law or Employment Agreement When It Withheld COBRA Premiums from Severance Pay
Excerpt: "EBIA Comment: Addressing COBRA obligations in severance arrangements can be complicated. This case illustrates the need for clear language regarding the employer's COBRA payment obligations. In addition, although ERISA's preemption provision arguably blocks enforcement of state wage-withholding laws against ERISA plans, employers should nevertheless keep an eye out for the possible application of state restrictions when they withhold COBRA premiums from severance payments." (Employee Benefits Institute of America)

[Guidance Overview] No Breach of Fiduciary Duties by Broker or by Directors Who Selected Insurance Policy
Excerpt: "EBIA Comment: We thought this case was interesting for two reasons. The first is a reminder that fiduciary status is generally not an 'all or nothing' concept, but is a functional test that requires a determination of whether a person is a fiduciary regarding the particular activities in question. The second is this court's conclusion that deciding to purchase and renew a policy is analogous to the fiduciary function of choosing a plan service provider. This would seem to imply that ERISA's fiduciary standards, including its 'prudent person' rule, apply to a plan's selection of a particular policy among competing alternatives." (Employee Benefits Institute of America)

Health Care Debate May Hinge on Pooling
Excerpt: "Small businesses . . ., among the most hard-pressed in the country to find affordable health care, are hitching their wagon to a series of bills now before Congress which are designed to drive down health-care costs by allowing small firms to leverage their collective muscle through the formation of pools." (Reuters)

In Battle Against Rising Health Care Costs, Some Employers Finding Collaboration Works
Excerpt: "Increasingly, employers are engaging with local providers, inviting outsiders to take part in their on-site health fairs or investing in health information technology and health improvement research projects. While much of this collaborative work is being performed in conjunction with local business health coalitions, in some cases individual employers are breaking free from the pack and taking leading roles." (Workforce Management; free registration required)

Employers Finalizing Negotiations for 2009 Health Care Coverage Offerings
Excerpt: "Negotiations often revolve around contract terms, administrative fees, discounts on health-care provider networks, medical management programs and the pricing and level of services offered, Stacey said. Employers typically examine a vendor's performance record on customer service and data-collection techniques so they can stay on top of what's driving health-care costs." (MarketWatch)

Rule Would Toughen Massachusetts Health Care Coverage Requirement
Excerpt: "Massachusetts Gov. Deval Patrick's administration has issued a regulation that would tighten the rules employers in the state must meet to avoid paying an assessment to the state to help provide coverage to the uninsured." (Workforce Management; free registration required)

Health-Care Costs May Overwhelm Retirees's Retirement Finances
Excerpt: "The rising cost of health care is making it harder for Americans to put enough away for retirement, an academic report indicates. A study released . . . by Boston College's Center for Retirement Research found that when the costs of health care are considered, 28 percent of all workers incorrectly think they will have enough money for retirement. According to the center's National Retirement Risk Index, these people are actually 'at risk' and don't perceive the financial problems that lie ahead." (The Columbus Dispatch)

Investment Trusts for Other Post-Employment Benefits (PDF)
3 pages. Excerpt: "GASB 45 forces public employers to calculate a liability for their other post-employment benefits (OPEB). The cost of this liability can be staggering. What's a public employer to do? A GASB trust offers one option for prefunding these benefits." (Milliman)

More Turn to Professional Groups for Health Insurance
Excerpt: "As health-insurance premiums rise and the economy struggles, an increasing number of small-business owners and individuals without job-based insurance are turning to professional associations and trade and affinity groups that offer grouplike health coverage to their members." (The Wall Street Journal)

No Help Coming for Massachusetts City's Retiree Medicare Cost
Excerpt: "It looks like Worcester's municipal retirees will not be getting help from the city anytime soon when it comes to paying their Part B Medicare costs. City Manager Michael V. O'Brien said there is no 'fiscally feasible means' for the city to pick up the tab for any portion of the retirees' Part B Medicare costs without a reduction in municipal services or raising property taxes." (Worcester Telegram & Gazette Corp.)

Verizon Contract Includes Health Care, Pension Reform
Excerpt: "A new tentative three-year union contract with Verizon will continue providing health care for both active and retired workers and increase wages and pensions for 65,000 workers." (PLANSPONSOR.com; free registration required)

Report Says Jacksonville FL Police and Fire Pensions Are Too Expensive
Excerpt: "Jacksonville's pension plans need drastic improvements and could better serve city taxpayers by being replaced by other types of retirement benefits, including 'defined contribution' programs similar to 401(k) plans, a nonprofit organization's analysis concludes." (Florida Times-Union)

Massachusetts Gov. Patrick Signs Sweeping Health Care Legislation
Excerpt: "Massachusetts Gov. Deval Patrick (D) on Sunday signed into law broad health care legislation that will raise $100 million in state funds and fees on private companies to fund the state's health insurance law, the Boston Globe reports." (Kaiser Family Foundation)

Health Care Costs Seen Rising 10 Percent in 2009
Excerpt: "Health care costs are expected to rise more than 10 percent into next year, according to a survey of insurers by Aon Consulting Worldwide. But that increase is the smallest Aon has seen in six years. Experts say it shows that efforts to tame costs, such as employee wellness or disease management programs, may be paying off." (AP via The New York Times; free registration required)

Study Shows Health Insurance Sales Across State Lines Would Reduce Uninsured
Excerpt: "A study evaluating different scenarios that would allow people to purchase health insurance across state lines found that 12 million previously uninsured people would be able to get insurance if there were competition between states. The study was presented during an American Enterprise Institute panel discussion on interstate competition for individual insurance as a way to increase access to the uninsured." (Congressional Quarterly Inc.)

Commonwealth of Massachusetts Faces $13.3b Healthcare Bill for Retirees
Excerpt: "The state must come up with about $200 million a year for the next 20 years to pay off an estimated $13.3 billion in looming healthcare costs for its retirees, according to a stark new report . . . ." (Boston Globe)

Saving for Health Care Expenses in Retirement: The Use of Health Savings Accounts (PDF)
Pages 9-13 of 16 pages. Excerpt: "This analysis revisits the savings needed to cover health insurance premiums and out-of-pocket expenses for health care services in retirement and evaluates the use of health savings accounts (HSAs) to save for those expenses. Proponents of HSAs often tout them as a vehicle for funding future retiree health care costs. But, while HSAs represent an important option for consumers seeking more control over their health care spending, statutory contribution limits make it unlikely that these accounts will play more than a minor part in savings for health care costs in retirement." (Employee Benefit Research Institute)

[Opinion] Americans Need Federal Help with Retirement
Excerpt: "As more and more retirees are depleting their savings to pay for their health care needs, the federal government is not doing enough to fix this growing problem. On June 16th Congressman John McHugh (NY-23) and I introduced the Retiree Health Account Act (H.R. 6288) that would provide Americans with the tax incentives needed to set aside funds for retiree health costs." (Rep. John 'Randy' Kuhl via The Courier (NY))

Massachusetts Employers Spared Higher Health Assessments
Excerpt: "Legislation nearing final approval by Massachusetts lawmakers imposes new assessments on insurers and hospitals to help fund part of the state's health care reform law, but it spares employers -- at least for now -- from making bigger contributions." (Workforce Management; free registration required)

Massachusetts House Approves Bill to Raise $89M from Insurers, Health Care Providers
Excerpt: "The Massachusetts House on Tuesday voted 135-21 to approve a bill that would require insurance companies and health care providers in the state to contribute more money to close a funding gap in the state's health insurance law, the AP/Boston Globe reports." (Kaiser Family Foundation)

Rockefeller Foundation's $70 Million Effort Seeks New Safety Net for Workers
Excerpt: "Out of such concern, the foundation has created the Campaign for American Workers, which has made 15 grants aimed primarily at restoring health and retirement security. Those grants, for instance, have gone to groups to develop affordable health coverage for workers under 35 and to increase retirement savings among African-Americans." (The New York Times; free registration required)

Massachusetts Governor Wants Employers to Pay More to Fund Universal Health Plan
Excerpt: "How Massachusetts employers would pay more under Patrick's proposal: To avoid a $295 per-employee assessment, employers would have to enroll at least 25 percent of full-time employees in their health plans and pay at least 33 percent of premiums for individual coverage. If revenue from Fair Share assessments does not generate $38 million a year, the per-employee assessment would be increased. Fair Share assessments would be paid quarterly." (Workforce Management; free registration required)

Report Predicts Health Care Cost Trends Will Level Off
Excerpt: "The growth in health care costs paid by employers is expected to level off in 2009 after five years of deceleration, a report from PricewaterhouseCoopers' Health Research Institute predicts. Based on a survey of more than 500 employer and health plans providing coverage to 11 million lives, New York-based PricewaterhouseCoopers found that medical costs will increase by 9.6 percent on average next year, compared with an average of 9.9 percent this year." (Workforce Management; free registration required)

Financing Retiree Health Care: Assessing GASB 45 Estimates of Liabilities (PDF)
9 pages. Excerpt: "If a government uses pay-as-you-go financing for its retiree medical plan, the actuarial accrued liabilities (AAL) are equal to the unfunded actuarially accrued liabilities (UAAL). Using these data, the actuary also determines the annual required contribution (ARC), which is equal to current expenditures plus the additional contribution needed to completely fund the UAAL over a 30-year period. This Issue Brief discusses these assumptions and their importance in determining financial challenges facing state and local governments." (Center for State and Local Government Excellence)

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