The Congressional Budget Office (CBO) has issued a report entitled "Reducing the Deficit: Spending and Revenue Options," a compendium of budget options to reduce the federal deficit. Many of the proposals would impact the Medicare and Medicaid programs and health insurance provided under the ACA. Highlights of the options include: adding a “public plan” to the ACA health insurance exchanges; repealing the individual health insurance mandate; limiting medical malpractice torts; converting the federal share of Medicaid’s payments for long-term care services into a block grant; reducing the floor on federal Medicaid matching rates; expanding cost-sharing for beneficiaries receiving SNF and home health services; reducing Medicare rates across the board in high-spending areas; eliminating the Medicare critical access hospital, Medicare-dependent hospital, and sole community hospital programs; and requiring manufacturers to pay a minimum rebate on Medicare Part D drugs for low-income beneficiaries. For each option, the CBO presents the potential fiscal impact and policy ramifications.