Introduction

The issue of Iran has become a central preoccupation for the international community in recent months, thanks to the intersection of the historic changes in the region, an American presidential election, sharpening rhetoric from Israel, and Tehran’s relentless determination to advance its nuclear capabilities. The focus of policymakers in Washington and around the world remains fixed on the options for forestalling Iran’s determined march toward a nuclear weapons capability. This is the appropriate objective; the best possible outcome for maintaining peace and security in the Gulf and avoiding a deeply destabilizing nuclear arms race remains a credible, durable solution that curtails Iran’s nuclear ambitions. And while achieving such an outcome remains profoundly problematic, largely as a result of Tehran’s intransigence, preventing Iran from crossing the nuclear weapons threshold—either through persuasion, coercion, or some combination of the two—remains fully and unambiguously within the capabilities of the international community.

The shadow cast by Tehran has created a particularly intense sense of existential anxiety for the smaller Gulf states, including Kuwait, Bahrain, the United Arab Emirates, Qatar, and Oman. After all, these are the same states whose civil orders were repeatedly disrupted by Iranian subversion and sponsorship of terrorism during the first decade after Iran’s Islamic revolution, and whose thriving economies rely on unimpeded access to the global commons. The events of the past decade have only exacerbated the smaller Gulf states’ endemic sense of insecurity. Iran has achieved a synergistic, sometimes even parasitic, relationship with the leadership of post-Saddam Iraq that, together with Tehran’s longstanding relationships with Syria and Lebanese Hizballah, greatly enables its bid for predominance in the heart of the Middle East. Today, the uncertainties surrounding the implications of regional flux have left Tehran simultaneously weakened and emboldened—a particularly dangerous combination for this particular array of Iranian leaders.

With Iran’s nuclear program advancing by the month and its efforts to tilt the regional balance in its favor growing more forceful, the small states of the Persian Gulf must face the distinct dilemma of preparing for the possible worst-case scenario of the nuclearization of their neighborhood, while participating ever more robustly in the international efforts to preclude that very possibility. In some respects, the Gulf states’ situation is unique. Unlike Israel, another small state that perceives an existential threat from Iran, the Gulf states cannot fall back upon either a presumptive nuclear deterrent or a primordial bond to the body politic of the world’s only remaining superpower. And in contrast to Iran’s other neighbors, the vast resources and history of ideological and territorial disputes between the Gulf states and Tehran significantly intensify the stakes. Even before the Gulf became the vital transportation corridor for global energy, the fault line in the regional balance of power had always run between the northern states and their southern rivals. The mere possibility that the north may gain a nuclear advantage is reshaping the security environment for Iran’s neighbors in the Gulf.

Because the threat of Iran looms large, the exigency of considering the widest possible array of alternative prospects for the evolution of this protracted crisis is important. This paper tackles the scenarios that successive American presidents have deemed unacceptable—an Iranian development or acquisition of a nuclear weapons capability or of nuclear weapons themselves—and the implications that such scenarios would have for the global nonproliferation regime and regional security, with a particular focus on the special challenges faced by Iran’s southern neighbors. To protect against threats along their borders, the Gulf states have traditionally hedged their bets by seeking balanced relations with their more powerful neighbors while cultivating extra-regional allies. That formula is already changing, as evidenced by a new assertiveness in Gulf states’ postures toward Tehran and a new creativity in deploying strategies for deterring and mitigating Iran’s efforts to extend its influence and/or destabilize its neighbors. The Gulf states must transform this tactical innovation into a full-fledged new hedging policy: one that deploys every possible tool to prevent a nuclear Iran while taking every possible step to prepare for such an eventuality.

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Since the Affordable Care Act’s (ACA) health insurance marketplaces first took effect in 2014, news story after story has focused on premium increases for certain plans, in certain cities, or for certain individuals. Based on preliminary reports, premiums now appear set to rise by a substantial amount in 2017.

What these individual data points miss, however, is that average premiums in the individual market actually dropped significantly upon implementation of the ACA, according to our new analysis, even while consumers got better coverage. In other words, people are getting more for less under the ACA.

Covered California, that state’s marketplace, just announced premium increases averaging 13.2 percent. But even if premiums increase by the 10 or 15 percent overall that some are predicting for 2017, they will still be far lower than premiums otherwise would have been in the absence of the law. Moreover, this analysis does not include the effects of premium and cost-sharing subsidies that serve to make ACA marketplace plans more affordable for many people.

2014 Premiums In the ACA Marketplaces Were 10-21 Percent Lower Than 2013 Individual Market Premiums

While many stories of pronounced increases are simply the natural result of a law that works differently in every region and for people of different health statuses, it appears to be conventional wisdom that the ACA increased premiums in the individual, non-group insurance market, if only because it increased the quality and robustness of coverage. Indeed, many of the ACA’s new rules do have the anticipated effect of increasing premiums, such as:

• mandated guaranteed issue regardless of health status;
• restrictions on the ability to charge different premiums based on anything besides age and smoking habits;
• requirements for plans to offer certain benefits deemed “essential;”
• limits on out-of-pocket costs an enrollee can pay for covered services in a given year; and
• the elimination of any lifetime limits on coverage.

However, many features of the ACA push in the opposite direction and save consumers money. The individual mandate and federal subsidies greatly expanded the number of people purchasing coverage in the individual market, pushing premiums down both by increasing the sheer size of the market – the bigger the market, the lower the prices – and including many healthier people who previously went uninsured. In addition, the ACA created relatively transparent marketplaces where insurers must compete on premiums for products standardized by actuarial value, allowing competition to drive down prices.

Together, by creating a much larger and more competitive market, these changes placed strong downward pressure on insurance premiums, outweighing the factors pushing in the opposite direction. Stronger rate review and minimum requirements for how much an insurance plan must spend on actual health care expenses furthered this downward pressure on prices.

According to our analysis, average premiums for the second-lowest cost silver-level (SLS) marketplace plan in 2014, which serves as a benchmark for ACA subsidies, were between 10 and 21 percent lower than average individual market premiums in 2013, before the ACA, even while providing enrollees with significantly richer coverage and a broader set of benefits. Silver-level ACA plans cover roughly 17 percent more of an enrollee’s health expenses than pre-ACA plans did, on average. In essence, then, consumers received more coverage at a lower price.

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Editor's note: This piece originally appeared in Health Affairs.

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We’re just over midway through the hazy days of summer vacation, and children without access to high quality enrichment opportunities are already slipping behind their wealthier peers. As noted in a recent New York Times article, in addition to the decrease in math proficiency that most kids experience over the break, low-income children also lose more than two months of reading skills—skills they don’t regain during the school year. This compounds the already deep educational disparities found among students of different socioeconomic groups, which can be observed as early as 18 months of age.

Most efforts to address these gaps focus on improving our K-12 educational systems. Yet, children spend an average of 80 percent of their waking time outside of a classroom—a simple, yet startling statistic that highlights the need to explore a broader range of solutions.

As we learned at a recent Brookings event, Urban Thinkscape, an ongoing project from developmental psychologists Kathy Hirsh-Pasek and Roberta Michnick Golinkoff, might be one of those solutions. Drawing on findings from their research on guided play—particularly from interventions like the Ultimate Block Party and The Supermarket Study—the project embeds playful learning activities, such as games and puzzles, into public places where children routinely spend time during non-school hours. Designed by architect Itai Palti, each installation is created with specific learning goals in mind and reflects best practices in psychological research.

With a pilot led by researcher Brenna Hassinger-Das in progress in the West Philadelphia Promise Zone, the project is already revealing important lessons—not only for educators, but for urban planners and policymakers as well.

The first involves the (often under-appreciated) need to work with local residents. Through meetings and focus groups with leaders of community organizations, neighbors, and Promise Zone stakeholders, the team gained a clearer understanding of resident needs, spurred interest in the project, identified potential sites, and improved designs. Residents were brought into the process early, empowered to offer suggestions at several stages, and will continue to be engaged as the project is implemented and assessed.

The upshot? When community members are meaningfully involved—and local wisdom valued—from the onset, residents become invested in the project and feel a sense of ownership of it over the long haul. This not only improves the likelihood that the project will succeed, but also helps foster neighborhood trust and cohesion, and builds social capital that can be applied to future efforts.

A second lesson is the extent to which a full scaling of the project could help transform distressed neighborhoods through what Project for Public Spaces often refers to as “lighter, quicker, cheaper” interventions.

Many high poverty urban areas are challenged with large numbers of vacant or underutilized properties, as well as dull spaces (like bus stops) that serve only utilitarian functions. The Urban Thinkscape project aims to take such spaces and remake them into opportunities for interaction and learning—and by doing so create tangible improvements to the neighborhood’s physical fabric. While the West Philadelphia pilot has substantial long-term planning behind it, ideally the “playful” installments will be refined over time so they can be more easily and cheaply implemented in other urban neighborhoods.

Finally, the Urban Thinkscape interventions have the potential to advance academic and spatial skills in children, reducing the gap in school readiness, and ultimately fostering better educational and life outcomes.

Many families in high poverty neighborhoods can’t afford extracurricular enrichment activities, particularly during the summer. And even where they might be offered—via community centers, or through other nonprofit initiatives focused on the arts, STEM activities, or sports—children may only experience them at certain times of the week. Urban Thinkscape aims to supplement these activities by embedding learning opportunities into the everyday landscape through interventions that develop numeracy, literacy, and other skills necessary to succeed in school and eventually the workforce. From an urban planning and policy perspective, this individual development is critical to helping build family wealth and vibrant, healthy city neighborhoods.

Though still nascent in its development, the Urban Thinkscape model appears to be a fun, innovative way to give children—and their caregivers—learning opportunities outside the classroom, while creating new gathering spaces and improved public places. In this way, the project is creatively employing the city itself as an agent of change. If the full vision of this work is realized, perhaps we can finally put the brakes on the “summer-slide” such that all kids can start the school year at the top of their game.

The GOP presidential primary process has taken us to places we couldn’t have dreamed mere months ago. Donald Trump’s apparently ever-growing lead—and the foundering of more mainstream candidates like Ted Cruz, Marco Rubio, and John Kasich—carries serious implications for America’s role in the world. As top Republican strategists and political pundits alike toss around ideas for slowing Trump’s momentum—in part due to major concerns about how he’s staked out his foreign policy—I’ll add one more idea into the mix: convince Rubio and Kasich to agree, now and in public, to share a Republican ticket.

It would go like this: John Kasich would drop out of the presidential race before Tuesday, March 15—when winner-take-all votes occur in both Florida and Ohio—and encourage his supporters to vote for Marco Rubio (who performed better than Kasich on Super Tuesday). Rubio, appearing with Kasich at that press conference, would accept Kasich’s endorsement and then promise him the vice presidential spot on the ticket if he (Rubio) were chosen to be the Republican presidential nominee. This Rubio-Kasich team would be promised to the voters even as the primary process marched on. A vote for Rubio would henceforth be viewed (by the candidates and their allies at least) as a vote for Rubio-Kasich together.

The March 15 votes constitute perhaps the last best chance to stop Trump’s march to the nomination. More to the point here, they’re a chance of ensuring that a Republican candidate with a traditional internationalist worldview remains in the race until the convention. Even Hillary Clinton supporters should arguably welcome such a voice on the GOP side, as it could keep the national political discourse more constructive and less demeaning as November approaches.

To be somewhat more specific: Trump is known for his views critical of Mexico, many Muslims, immigration, refugees, trade, and U.S. allies like Japan and South Korea (in light of their purported unwillingness to share the burden of the common defense). He is also known for cozying up to President Vladimir Putin of Russia, and for vague but emphatic talk of getting America back in the habit of winning again. In addition, he advocates more extreme and ruthless measures in the war on terror. 

Whatever the risks, it certainly seems more promising than the path either one of them is on now.

While Rubio is no dove, he has wrestled with the intricacies and complexities of foreign policy during his time in the Senate, and much more than has Trump. He has serious views on the use of force and defense policy, seasoned by reality. Most centrally, he has a Reagan-like view of America’s place in the world—as a country that is stern and unyielding towards its enemies, but open and welcoming to the vast majority of foreigners and foreign nations. This positive, internationalist outlook is in marked contrast to Trump’s worldview. Kasich’s views are much closer to Rubio than to Trump, of course, though he may be more measured and moderate in some of his pro-defense views than Rubio. 

In many foreign policy issues and beyond, Rubio seems more conservative than Kasich. But of course, some divergence of views is inevitable for any eventual presidential ticket—it is even healthy, to an extent. And the kinds of expertise the two men bring to the national debate are largely complimentary, since Kasich has focused more on domestic policy in recent years and Rubio more on national security matters. In other ways, like their strong religious faiths, they seem natural teammates.

Shake it up

Of course, the goal of this Rubio-Kasich ticket would be to win both Florida and Ohio in March. These are not only delegate-rich, winner-take-all states in the nominating process, but key swing states in general elections. Whether or not the Democratic nominee could ultimately best that ticket come November, the Rubio-Kasich team would have a powerful call on super-delegates at any brokered Republican convention if it already had wins in the nation’s two most important swing states under its belt. It would have demonstrated strength in two states that the GOP nominee will badly want to win in the November election.

Polls show that Kasich is stronger than Rubio in Ohio and Rubio is stronger than Kasich in Florida; both trail Trump in both places. However, their combined tallies match up reasonably well with Trump. Beyond that, the shock effect of this kind of partnership—between an accomplished sitting governor and a bright young senator—could change the race’s dynamics enough to bring them even more votes. It will raise eyebrows and cause many to take a second look at the race. Whatever the risks, it certainly seems more promising than the path either one of them is on now.

The preemptive formation of a Rubio-Kasich presidential team in early March would be a highly unusual step. But it’s already a highly unusual year. Put differently, desperate circumstances call for desperate—or at least dramatic—measures. This kind of a true structural change in the primary process promises a greater likelihood of shaking GOP voters up than big speeches by Mitt Romney or warnings from other parts of the GOP establishment. Kasich and Rubio should consider it.

Nearly three years after the fall of the Qaddafi regime, Libya’s revolution has stalled. Militias continue to run rampant as the government struggles to perform basic functions. Theoretically to protect the revolution, Libya passed its Political Isolation Law (PIL) in May 2013, effectively banning anyone involved in Qaddafi’s regime from the new government. The law has raised serious questions: Does it contribute to effective governance and reconciliation? Does it respect human rights and further transitional justice? Will it undermine Libya’s prospects for a successful democratic transition?

In this Brookings Doha Center-Stanford "Project on Arab Transitions" Paper, Roman David and Houda Mzioudet examine the controversy over Libya’s PIL and the law’s likely effects. Drawing on interviews with key Libyan actors, the authors find that the PIL has been manipulated for political purposes and that its application is actually weakening, not protecting, Libya. They caution that the PIL threatens to deprive Libya of competent leaders, undermine badly needed reconciliation, and perpetuate human rights violations.

David and Mzioudet go on to compare the PIL to the personnel reform approaches of Eastern European states and South Africa. Ultimately, they argue that Libyans would be better served if the PIL were replaced with a law based on inclusion rather than exclusion and on reconciliation rather than revenge. They maintain that Libya’s democratic transition would benefit from an approach that gives exonerated former regime personnel a conditional second chance instead of blindly excluding potentially valuable contributors.

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Few issues are closer to President Obama’s vision of the global future than his convictions about reducing the role of nuclear weapons in U.S. national security strategy. Less than three months after entering office, in a major speech in Prague, he put forward an ambitious nuclear agenda, declaring that the United States (as the only state ever to employ nuclear weapons in warfare) had a “moral responsibility…to seek the peace and security of a world without nuclear weapons.”

Seven years later, despite the administration’s having advanced other goals in non-proliferation policy, the larger vision of a nuclear-free world remains very much unfulfilled. But President Obama apparently hasn’t given up. In late May, he became the first American president to visit Hiroshima, where the United States first employed a nuclear weapon in warfare. In his speech, the president declared that “nations like my own that hold nuclear stockpiles…must have the courage to escape the logic of fear and pursue a world without them.” Moreover, as President Obama approaches his final six months in office, senior officials are purportedly deliberating additional policy changes that they believe could be undertaken without congressional approval. As Deputy National Security Adviser Ben Rhodes said in a June 6 speech at the Arms Control Association, the president remains intent on advancing his “Prague agenda” before leaving office.

According to recent press reports, the policy options under consideration include U.S. enunciation of a nuclear “no first use” doctrine. Such a step would represent a profound shift in U.S. policy. Non-nuclear states living in the shadow of nuclear-armed adversaries have long relied on U.S. security guarantees, specifically the declared commitment to employ nuclear weapons should our allies be subject to aggression with conventional forces. They have based their own national security strategies on that pledge, including their willingness to forego indigenous development of nuclear weapons.

Northeast Asia presents a clear contradiction between President Obama’s non-nuclear aspirations and existing circumstances.

These issues bear directly on the credibility of U.S. guarantees to allies in Europe and Asia, with particular relevance in Northeast Asia. Since the end of the Cold War, the content of the U.S. extended nuclear deterrence pledge has already narrowed. Washington has long deemed any use of nuclear weapons a matter of absolute last resort. Since the early 1990s, Washington has also enunciated an unambiguous distinction between employment of conventional and nuclear weapons, including the unilateral withdrawal of all tactical nuclear weapons deployed on the Korean peninsula. 

The Obama administration itself has also moved closer to limiting nuclear weapons use exclusively to deter another state’s first use of such a weapon against the United States, its allies, and partners—in fact, the 2010 Nuclear Posture Review declared that this was a “fundamental role” of the American nuclear arsenal. At that time, it also pledged to “work to establish conditions” under which it was safe to adopt universally a policy where the “sole purpose” of U.S. nuclear weapons was to deter a nuclear attack by an adversary. The implication of such a “sole purpose” policy would be that North Korea need not fear American nuclear retaliation if it mounted only a conventional attack against South Korea. 

Whether it is “no first use” or “sole purpose use,” Northeast Asia presents a clear contradiction between President Obama’s non-nuclear aspirations and existing circumstances. The Republic of Korea and Japan (the only state ever subject to nuclear attack) confront the reality of a nuclear-armed North Korea. Pyongyang continues to enhance its weapons inventory and the means to deliver them. It also regularly threatens Seoul and Tokyo with missile attack, potentially armed with nuclear weapons. 

[A]ny indications that the United States might be wavering from its nuclear guarantees would trigger worst-case fears that the United States, above all, would not want to stimulate.

Both U.S. allies are therefore strongly opposed to a U.S. "no first use" pledge, and would likely have deep concerns about a sole purpose commitment. Though the United States possesses a wide array of non-nuclear strike options in the event of a North Korean attack directed against South Korea or Japan, any indications that the United States might be wavering from its nuclear guarantees would trigger worst-case fears that the United States, above all, would not want to stimulate. At the same time, choosing not to issue a "no first use" pledge should not in any way suggest that the United States favors nuclear use, which would play directly into North Korean propaganda strategy. Rather, the United States should not preemptively remove the nuclear option, especially when North Korea is in overt defiance of its non-proliferation obligations and is single-mindedly intent on a building a nuclear weapons capability.

The Obama administration must therefore balance its clear desire to advance a non-nuclear legacy with Northeast Asia’s inescapable realities. Enunciating a "no first use" doctrine or a sole purpose commitment in the administration’s waning months in office is a bridge too far. Though the United States can and should engage South Korea and Japan in much deeper consultations about extended deterrence, it cannot put at risk the security of allies directly threatened by attack from a nuclear-armed adversary. 

The next U.S. president will have to square this circle. In the meantime, the Obama administration should do all that it can to plan for the road ahead, even if it means policy pledges that might not be as visionary as it would prefer. 

Bruce Katz focuses on the housing challenges facing Washington state in this presentation at the Housing Washington 2004 conference. In the speech Katz reviews Washington's particular challenges and then outlines a "winning affordable-housing playbook" applicable anywhere.

The metro program hosts and participates in a variety of public forums. To view a complete list of these events, please visit the metro program's Speeches and Events page which provides copies of major speeches, powerpoint presentations, event transcripts, and event summaries.

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From the Arab-Israeli conflict, to the paradigm shift of the Arab Spring, to attacks on U.S. government personnel in Egypt and Libya, to the potentially explosive situation in Syria--events in the greater Middle East region continue to resonate here at home. In a recent study, “Americans on the Middle East,” Nonresident Senior Fellow Shibley Telhami finds that Americans have a great understanding and concern about Middle East events. Learn more about these findings in this episode of @ Brookings.

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• Shibley Telhami: What Americans Think about the Middle East

Despite widespread agreement that the federal budget is on an unsustainable path, there is also widespread disagreement about what should be done. The Hamilton Project asked leading experts from a variety of backgrounds—the policy world, academia, and the private sector, and from both sides of the political aisle—to develop and share their ideas for addressing the deficit. The proposals will be released at two events scheduled for February 22 and February 26. In a dialogue previewing those events, Hamilton Project Director Michael Greenstone and Policy Director Adam Looney discuss some of the key ideas offered by the experts.

Greenstone stresses that the goal of the papers is to move beyond the fights and disagreements between President Obama and Congress and to provide some of the poetry, or some of the details, on how government might run better. The papers will also be featured in a book, 15 Ways to Rethink the Federal Budget, and will take on a wide-ranging set of topics, including immigration, transportation, health care, defense spending, and tax expenditures.

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• Michael Greenstone and Adam Looney: These Authors Have Drafted Policies That Help the Budget and Provide Economic Benefits

The man who drove a truck through packed crowds celebrating Bastille Day, killing more than 80, may have acted alone, according to the early reports. We don't know if he was inspired by a jihadist ideology or linked to any specific group. In any event, these extremist groups are increasingly embracing a "lone wolf" approach, and the West should prepare for more such attacks.

I've argued that such lone wolf" attacks are deadly but often fail in the long-term. Part of the reason is that historically many are poorly prepared and incompetent, bungling the attack or at least not killing as many as a more skilled and trained individual might.

Yet the horrific body count in Nice, along with the 49 dead in recent Orlando nightclub shooting, shows how deadly even an unskilled loser like Omar Mateen can be.

This deadliness is not new – Timothy McVeigh and Terry Nichols, largely acting alone, killed 168 people when they bombed the Alfred P. Murrah Federal Building in Oklahoma City in 1995 – but it suggests the potential lethality of lone wolves.

A Weaker Islamic State

The Islamic State is putting more emphasis on lone wolves out of desperation.

In the past, it urged its sympathizers to go to Syria to help the fledgling state defend itself and expand. However, the United States, France, and other countries and local fighters hitting hard at the Islamic State's core in Iraq and Syria. Other major areas of operations, like the Islamic State's "province" in Libya, are also under siege. The self-proclaimed state is short of funds, and the number of foreign recruits is declining.

Like all terrorist groups, the Islamic State needs victories to inspire new recruits and prevent existing members from losing hope. CIA Director John Brennan foresaw this in testimony and warned, "as the pressure mounts on [ISIS], we judge that it will intensify its global terror campaign to maintain its dominance of the global terrorism agenda."

A silver lining is that lone wolf terrorism, even if lethal, usually fails in a strategic sense. As one IRA terrorist said, "you don't bloody well kill people for the sake of killing them."

Violence with no strategy behind it terrifies, but it can backfire against a group and the cause it embraces. McVeigh and Nichols, for example, discredited other far right movements. McVeigh claimed he was dealing a blow against a tyrannical government, but the death of 19 children and three pregnant women in the bombing made it hard even for anti-government zealots to defend him.

In Nice, the driver killed children out to watch the fireworks, and the dead included innocent Muslims, like the grieving young man asking Allah to accept his mother into heaven may (and should) become the face of the attack, hardly a heroic move in a holy war that would inspire others.

Although the Islamic State's moves smack of desperation, that is no comfort to anyone concerned about terrorism.

Difficult To Prevent

Terrorist groups that draw on foreign fighters or otherwise are organized tend to be more deadly and dangerous in the long-term, but lone wolves are exceptionally hard to stop. The very organizational connections that give most terrorism direction are by definition lacking, and thus it is harder to find and disrupt the attacks. So more attempts, and likely some successful ones, seem inevitable.

One clear recommendation – and the one least likely to be heeded in the aftermath of a terrorist attack – is to ensure community support. If a community has good relations with the police and society in general, it has fewer grievances for terrorists to exploit and is more likely to point out malefactors in their midst.

Even though he was never arrested, Mateen came to the FBI's attention because a local Muslim found him worrisome. In France in particular, however, relations between the Muslim community and the government are often poisonous, and a terrorist attack will probably make this worse as France's already popular far-right movement becomes strong. And this will only mean more lone wolves will slip through in the future.

This piece originally appeared on NPR's Parallels.

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The Brookings Institution and the American Enterprise Institute (AEI) collaborated to ask: if you were to redesign Medicare without spending more money, what would you keep and what would you change? A new report on a Center for Healthcare Decisions program provided insight into the public’s willingness to restructure Medicare in the face of tightening budget constraints. Using an interactive, computer-based system, program participants faced the challenge of making Medicare more responsive to the needs of current and future beneficiaries.

Were participants willing to accept limits on their choice of provider or reduced coverage of low-value medical care? Would they accept the need for greater personal responsibility in their use of health services? Would they agree that Medicare should adopt other policies to promote fiscal responsibility?

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Americans — especially low- and middle-income workers — are simply not saving enough for retirement. The current retirement income deficit—the gap between what Americans will need in retirement and what they will actually have—is well over $6 trillion. This gap will be insurmountable without a significant change to current tax policy to help incentivize more Americans to save for their own retirement.

On September 9, the Retirement Security Project at Brookings hosted a briefing in collaboration with the Senate Special Committee on Aging to examine new ways to help Americans save for retirement without increasing government spending. A panel of experts on tax, retirement and budget policy explored ideas to modify the tax incentives for retirement savings.

After the panel, participants took audience questions.

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• Rethinking Incentives to Save for a Secure Retirement

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• Uncorrected Transcript (.pdf)

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