Exhib it 1 Steady U.S. Economic Growth After a Severe ......August 2015 vs. January 2010 Exhib it 11 Sources: Congressional Budget Office (CBO), The Budget and Economic Outlook: 2010

Steady U.S. Economic Growth After a Severe Recession Exhibit 1

Data Source: Bureau of Economic Analysis, Annual to Q3 2015 revised Dec 22, 2015

$10,000

$11,000

$12,000

$13,000

$14,000

$15,000

$16,000

$17,000

Inflation-adjusted GDP (billions)

20002002

20012003

20042005

20062007

20082009

20102011

20122013

2014

Q3 2015

Cumulative growth2009 to Q3 2015

13.8%

Annual Inflation-Adjusted Growth in U.S. Economy and Private Investment, 2010 to 2015

Exhibit 2

Source: U.S. Bureau of Economic Analysis. Inflation-adjusted. Dec. 22, 2015.Notes: GDP = gross domestic product. Annual rate 2010 to 2014; Q3/Q3 2014/15 annual.

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

2010 2011 2012 2013 2014 Q3 2015

Real GDPReal private domestic investment

Inflation-adjusted growth (percent)

U.S. Economic Growth Rivals or Exceeds Other High-Income Countries

Exhibit 3

Source: World Bank database; accessed Sept. 2015. Real GDP = Inflation-adjusted gross domestic product. U.S. GDP is revised.

2011–12

2012–13

2013–14

2011 to 2014

Real GDP growth rates, 2011–14

-2.0% 0.0% 2.0% 4.0% 6.0% 8.0%

US

Canada

UK

Germany

Japan

France

U.S. Jobs Up More than 13 Million Since 2010,5 Million Above Pre-Recession Peak

Exhibit 4

Source: U.S. Bureau of Labor Statistics. Seasonally adjusted. Establishment, Release 1/8/16.

Total nonfarm employment to December 2015 (millions)

100

105

110

115

120

125

130

135

140

145

150

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

2015

2008

138.0

2015

143.2

2010

129.8

Unemployment Rate Drops from 9.9% to 5% by 2015Exhibit 5

Source: U.S. Bureau of Labor Statistics. Monthly seasonally adjusted household to Dec. 2015. Released Jan. 8, 2015. Figure generated online, http://www.bls.gov/ces/data.htm.

10%

8%

6%

4%

01/05 01/06 01/07 01/08 01/09 01/10 01/11 01/12 01/13 01/14 01/15

U.S. unemployment rate (percent)

U.S. Private Jobs Increased by Nearly 14 Million, While Public Employment Declined

Exhibit 6

Source: U.S. Bureau of Labor Statistics. Nonfarm employment, seasonally adjusted. Released Jan 8, 2016.

Change in employment, March 2010 to December 2015 (millions)

-1

1

3

5

7

9

11

13

15

1.9

Privategoods

13.4

Total

12.0

Privateservices

-0.5Government

Full-Time Jobs Account for All Net Job Growth from March 2010 to End of 2015

Exhibit 7

Source: U.S. Bureau of Labor Statistics. Household series, nonfarm employment, seasonally adjusted, Release Jan 2016.Notes: Part-time work is 34 hours or less. “Part-time economic reason” includes unable to find full-time work or poor business conditions.

People employed (millions)

0

25

50

75

100

125

150

19.1

120

March2008

4.89.1

19.9

107

March2010

Full time

Part time, choice

Part time, economic reason

19.9

122

December2015

5.9

19.4

119

December2014

6.7

Job Growth Has Been Similar for Firms of All Sizes

Exhibit 8

Source: U.S. Bureau of Labor Statistics. Business Employment Dynamics through Q1 2015. Modified Nov 2015. Distribution of private sector employees by firm size.

Percent distribution of private jobs,by number of employees

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

29.3

7.9

10.3

52.5

2010

28.1

7.9

10.2

53.7

2015

250+

100–249

50–99

1–49

Employees

Little Growth Seen in Inflation-Adjusted Average Weekly Wages, but 2015Pace Picks Up

Exhibit 9

Source: U.S. Bureau of Labor Statistics. Real weekly earnings, seasonally adjusted for private nonfarm employment. Series uses urban consumer price index to adjust wages for inflation. Data released Nov. 17, 2015.

Change in real weekly wages (percent)

3.9%

1.8%2.1%

0.0%

0.5%

1.0%

1.5%

2.0%

2.5%

3.0%

3.5%

4.0%

4.5%

Cumulative March 2010–October 2015

March 2010–October 2014

October 2014–October 2015

Annual Health Spending Growth Slows to Rate of GDP Growth for Four Years (2010–13), But Rises in 2014

Exhibit 10

NHE = national health expenditures.Source: Centers for Medicare and Medicaid Services, Historic and Projected National Health Expenditures. Updated July 2015.

-2

0

2

4

6

8

10

2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014

NHE GDPPercent change (annual)

Lower 10-Year CBO Medicare Projections, August 2015 vs. January 2010

Exhibit 11

Sources: Congressional Budget Office (CBO), The Budget and Economic Outlook: 2010 to 2020, Jan. 2010; CBO, An Update to the Budget and Economic Outlook: 2015 to 2025, updated Aug. 25, 2015.

Difference in 2020 projected Medicare spending:

Cumulative difference 2010–2020:

$186 billion

$1 trillion$200

$400

$600

$800

$1,000

$1,200

2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025

January 2010 August 2015

2020

$1,038

2020

$852

Projected Medicare spending (millions)

Marked Slowdown in Medicare and Private Spending Growth per Enrollee

Exhibit 12

Source: Centers for Medicare and Medicaid Services, Office of the Actuary, Table 17, July 30, 2015, with projections.

Percent change in spending growth per enrollee

4.75.1

2007

5.45.8

2008

4.4

6.5

2009

1.5

5.4

2010

2.2

3.7

2011

0

3.7

2012

0.2

2.1

2013

2.7

5.4

2014

Medicare

Privately insured

0

1

2

3

4

5

6

7

Ambulatory care–sensitive hospital admissions per 1,000 beneficiaries

Medicare Hospital Admissions for Potentially Preventable Conditions Down 25 Percent

Exhibit 13

Source: Centers for Medicare and Medicaid Services, Public Use File.

90.0

87.2

66.0

36.8

10.0

30.0

50.0

70.0

2007 2008 2009 2010 2011 2012 2013

Age 75+ ACS ages 65 to 75

26.9

Jobs (millions)

Health Care Sector Gained 1.4 Million Jobs Since March 2010, Mainly in Ambulatory Care

Exhibit 14

Source: U.S. Bureau of Labor Statistics. Seasonally adjusted establishment, June 2015 Preliminary, July 5, 2015.

6.9

5.9

5.1

4.9

4.7

4.3

3.3

3.1

2.8

0.0 1.5 3.0 4.5 6.0 7.5 9.0 10.5 12.0 13.5 15.0

June 2015

March 2010

March 2005

Ambulatory Hospital Nursing and residential

Sharp Drop in Uninsured in All Nonelderly Age Groups Following Affordable Care Act’s Insurance Expansions

Exhibit 15

Source: U.S. Bureau of the Census, Health Insurance Coverage in the U.S.: 2014, Current Population Reports, Sept. 2015.

15.3%

12.0%

All Under 65

7.5%

6.2%

Under 19

18.5%

14.3%

19-64

2013

2014

National health expenditures (trillions)

What if Future Increases in U.S. National Health Expenditures Are Limited to Rate of Economic Growth?

Exhibit 16

Source: Author’s analysis based on data from Centers for Medicare and Medicaid Services (CMS), Office of the Actuary, 2014-2024 National Health Expenditures (NHE), projected July 2015; http://cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NationalHealthAccountsProjected.html.

$2.0

$2.5

$3.0

$3.5

$4.0

$4.5

$5.0

Actual

Based on CMSNHE projection

IF NHE growth at same rate as GDP

2008

2009

2010

2011

2012

2013

2014

2015

2016

2017

2018

2019

2020

2021

2022

2023

2024

Health spending growth, 2014–2024: $42.4 trillion if same as GDP growth rate;$45.3 trillion if same as CMS projections. Cumulative

difference:$2.9 trillion

19.6%of GDP

17.4%of GDP