Note 26. Earmarked Funds

Medicare is the largest earmarked fund group managed by the Department; therefore, Medicare financial data is presented in a separate column in the schedule below.

The HHS has designated as earmarked funds the HI and SMI trust funds, which also include the Payments to the Health Care Trust Funds appropriation and the Health Care Fraud and Abuse Control Account. In addition, portions of the Program Management appropriation have been allocated to the HI and SMI trust funds.

The Medicare programs include: (a) Medicare HI Trust Fund, (b) Medicare SMI Trust Fund, (c) Medicare Prescription Drug Benefit – Part D, and (d) Medicare/Medicaid Integrity Program (MIP).

The Social Security Act provides for payments to the HI and SMI trust funds: HI (for the Uninsured and Federal Uninsured payments) and SMI (appropriated funds to provide for Federal matching of SMI premium collections). The Medicare Modernization Act of 2003 prescribes that funds covering the Medicare Prescription Drug Benefit, retiree drug coverage reimbursements to the States and Transitional Assistance benefits be transferred from Payments to the Health Care Trust Funds to SMI. A transfer of general funds to the HI Trust Fund is made in amounts equal to Self-Employment Contribution Act tax credits and the increase to the tax payment from Old Age Survivors and Disability Insurance beneficiaries.

There were no legislative changes that significantly changed the purpose of or redirected a significant portion of an earmarked fund during this reporting period.

Earmarked Funds (In Millions)	Earmarked Funds		Eliminations	Earmarked Funds Total
Earmarked Funds (In Millions)	Medicare	Others	Eliminations	Earmarked Funds Total
Balance Sheet as of September 30, 2007
Assets
Fund balance with Treasury	$ 8,793	$ 679	$ -	$ 9,472
Investments	363,195	2,680	-	365,875
Other Assets	65,614	24	(53,206)	12,432
Total Assets	$ 437,602	$ 3,383	$ (53,206)	$387,779
Entitlement Benefits Due and Payable	$ 41,604	$ -	$ -	$ 41,604
Other Liabilities	57,089	439	(53,206)	4,322
Total Liabilities	$ 98,693	$ 439	$ (53,206)	$ 45,926

Unexpended Appropriations	$ 8,978	$ (91)	$ -	$ 8,887
Cumulative Results of Operations	329,931	3,035	-	332,966
Total Liabilities and Net Position	$ 437,602	$ 3,383	$ (53,206)	$387,779

Statement of Net Cost For the Period Ended September 30, 2007
Gross Program Costs	$ 417,817	$ 380	$ -	$ 418,197
Earned Revenues	(50,266)	(610)	-	(50,876)
Net Cost of Operations	$ 367,551	$ (230)	$ -	$ 367,321

Statement of Changes in Net Position For the Period Ended September 30, 2007
Net Position Beginning of Period	$ 329,511	$ 2,619	$ -	$ 332,130

Non-Exchange Revenue		337		206,935
Other Financing Sources	170,351	(242)	-	170,109
Net Cost of Operations	(367,551)	230	-	(367,321)
Change in Net Position	$ 9,398	$ 325	$ -	$ 9,723

Net Position End of Period	$ 338,909	$ 2,944	$ -	$ 341,853

Earmarked Funds (In Millions)	Earmarked Funds		Eliminations	Earmarked Funds Total
Earmarked Funds (In Millions)	Medicare	Others	Eliminations	Earmarked Funds Total
Balance Sheet as of September 30, 2006
Assets
Fund balance with Treasury	$ 28,726	$ 820	$ -	$ 29,546
Investments	339,545	2,431	-	341,976
Other Assets	46,484	42	(42,637)	3,889
Total Assets	$ 414,755	$ 3,293	$ (42,637)	$ 375,411

Entitlement Benefits Due and Payable	$ 40,824	$ -	$ -	$ 40,824
Other Liabilities	44,420	674	(42,637)	2,457
Total Liabilities	$ 85,244	$ 674	$ (42,637)	$ 43,281

Unexpended Appropriations	$ 27,658	$ 7	$ -	$ 27,665
Cumulative Results of Operations	301,853	2,612	-	304,465
Total Liabilities and Net Position	$ 414,755	$ 3,293	$ (42,637)	$ 375,411

Statement of Net Cost For the Period Ended September 30, 2006
Gross Program Costs	$ 386,924	$ 199	$ -	$ 387,123
Earned Revenues	(49,955)	(512)	-	(50,467)
Net Cost of Operations	$ 336,969	$ (313)	$ -	$ 336,656

Statement of Changes in Net Position For the Period Ended September 30, 2006
Net Position Beginning of Period	$ 276,020	$ 2,342	$ -	$ 278,362

Non-Exchange Revenue	197,843	155	116	198,114
Other Financing Sources	192,617	(191)	(116)	192,310
Net Cost of Operations	(336,969)	313	-	(336,656)
Change in Net Position	$ (53,491)	$ 277	$ -	$ 53,768

Net Position End of Period	$ 329,511	$ 2,619	$ -	$ 332,130

The list below includes the Treasury fund symbols that are “Other Earmarked Funds”:

75X8510 (no year) Administration on Aging Gift Fund
75X8512 (no year) Agency for Healthcare Research and Quality Gift Fund
75X0943 (no year) Disease Control, Research, & Training, CDC (partial – user fee portion only)
75 0943 (fiscal year) Disease Control, Research, & Training, CDC (partial – multi-year royalties)
75X5146 (no year) Cooperative Research and Development Agreements, CDC
75X8250 (no year) Gifts and Donations, CDC
20X8145 (no year) Allocation Transfer from EPA Hazardous Superfund, CDC
75X5148 (no year) Cooperative Research and Development Agreements, FDA
75X8247 (no year) Food and Drug Administration Unconditional Gift Fund
75X0600 (no year) User Fee Act(s), FDA
75X4309 (no year) Revolving Fund for Certification and Other Services, FDA
75X8249 (no year) Unconditional Gift Fund, HRSA
75X8254 (no year) Conditional Gift Fund, HRSA
75X8889 (no year) Patients Benefit Fund, HRSA
20X8175 (no year) Vaccine Injury Compensation Trust Fund, HRSA
75X5071 (no year) Operation and Maintenance of Quarters, IHS
75X8073 (no year) Contributions, Indian Health Facilities, IHS
75X8511 (no year) IHS Gift Fund
75X8248 (no year) NIH Unconditional Gift Fund
75X8253 (no year) NIH Conditional Gift Fund
75X8393 (no year) Health Care Fraud and Abuse Control Accounts, CMS
75X8888 (no year) Patients Benefit Fund, NIH
75X5145 (no year) Cooperative Research and Development Agreements, NIH
75 3966 (fiscal year) Royalties, NIH
75X8513 (no year) SAMHSA Gift Fund
75X8514 (no year) Office of the Secretary Gift Fund

Report Date: November 15, 2007