By NextBestFitPhase 5: Stabilize & govern · Step 5.1
Set a spending growth target
Annual, starting Year 5 · Payment Rates Board; Congress (veto)Discuss this step
Every concrete action this step requires, who is responsible, and when it happens relative to enactment.
| # | Action | Owner | When | Trade-off |
|---|---|---|---|---|
| 5.1.1 | Compute the target each spring; publish projected spending by sector. | Rates Board | Annual | Annual targets give predictability but can become ceilings that ration care. |
| 5.1.2 | If the projection exceeds the target, recommend fee-update reductions, budget growth limits, or formulary actions, which take effect unless Congress votes them down. | Rates Board | Annual | Recommendations that take effect unless vetoed limit lobbying but reduce democratic control. |
| 5.1.3 | If spending runs below target for 2 years, share savings with providers (half) and lower the household premium (half). | Rates Board / Treasury | Annual | Shared savings reward providers but give up money that could lower taxes further. |