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GOVERNMENT REFORM: ENDING DUPLICATION 

AND HOLDING WASHINGTON ACCOUNTABLE 

HEARING 

BEFORE THE

COMMITTEE ON 

HOMELAND SECURITY AND 

GOVERNMENTAL AFFAIRS 

UNITED STATES SENATE 

ONE HUNDRED FOURTEENTH CONGRESS 

SECOND SESSION 

APRIL 27, 2016 

Available via the World Wide Web: http://www.fdsys.gov/ 

Printed for the use of the 

Committee on Homeland Security and Governmental Affairs 

( 
(II) 

COMMITTEE ON HOMELAND SECURITY AND GOVERNMENTAL AFFAIRS 

RON JOHNSON, Wisconsin Chairman 

JOHN MCCAIN, Arizona 

ROB PORTMAN, Ohio 

RAND PAUL, Kentucky 

JAMES LANKFORD, Oklahoma 

MICHAEL B. ENZI, Wyoming 

KELLY AYOTTE, New Hampshire 

JONI ERNST, Iowa 

BEN SASSE, Nebraska 

THOMAS R. CARPER, Delaware 

CLAIRE MCCASKILL, Missouri 

JON TESTER, Montana 

TAMMY BALDWIN, Wisconsin 

HEIDI HEITKAMP, North Dakota 

CORY A. BOOKER, New Jersey 

GARY C. PETERS, Michigan 

CHRISTOPHER R. HIXON, Staff Director 

PATRICK J. BAILEY Chief Counsel for Governmental Affairs 

DANIEL P. LIPS, Policy Director 

GABRIELLE A. BATKIN, Minority Staff Director 

JOHN P. KILVINGTON, Minority Deputy Staff Director 

BRIAN F. PAPP, JR., Minority Professional Staff Member 

KATHERINE C. SYBENGA, Minority Chief Counsel for Governmental Affairs 

LAURA W. KILBRIDE, Chief Clerk 

BENJAMIN C. GRAZDA, Hearing Clerk 
(III) 

C O N T E N T S 

Opening statements: Page 

Senator Johnson ............................................................................................... 1 

Senator Carper ................................................................................................. 7 

Senator Lankford .............................................................................................. 10 

Prepared statements: 

Senator Johnson ............................................................................................... 25 

Senator Carper ................................................................................................. 27 

WITNESS 

WEDNESDAY, APRIL 27, 2016 

Hon. Eugene L. Dodaro, Comptroller General of the United States, U.S. 

Government Accountability Office ...................................................................... 2 

Hon. Tom Coburn, M.D., Former U.S. Senator from the State of Oklahoma ..... 4 

ALPHABETICAL LIST OF WITNESSES

Coburn, M.D. Hon. Tom: 

Testimony .......................................................................................................... 4 

Prepared statement .......................................................................................... 67 

Dodaro, Hon. Eugene L.: 

Testimony .......................................................................................................... 2 

Prepared statement .......................................................................................... 29 

APPENDIX 

Recommendations submitted by Mr. Dodaro ........................................................ 66 

Statement submitted by Consortium for Citizens with Disabilities (CCD) ........ 71 

Response to post-hearing questions for the Record: 

Mr. Dodaro ........................................................................................................ 77 

(1) 

GOVERNMENT REFORM: ENDING 

DUPLICATION AND HOLDING WASHINGTON 

ACCOUNTABLE 

WEDNESDAY, APRIL 27, 2016 

U.S. SENATE,

COMMITTEE ON HOMELAND SECURITY

AND GOVERNMENTAL AFFAIRS, 

Washington, DC. 

The Committee met, pursuant to notice, at 11:04 a.m., in room 

342, Dirksen Senate Office Building, Hon. Ron Johnson, Chairman 

of the Committee, presiding. 

Present: Senators Johnson, Portman, Lankford, Ayotte, Ernst, 

Carper, Tester, and Heitkamp. 

OPENING STATEMENT OF CHAIRMAN JOHNSON 

Chairman JOHNSON. Good morning. This hearing will come to 

order. 

It is nice to see the reunion of two good friends—two individuals 

who have working together, really done some, pretty extraordinary 

work with a pretty simple concept—a pretty simple idea. Let 

us get some information on the Federal Government. Coming 

from a manufacturing background, certainly, just using what is in 

my deoxyribonucleic acid (DNA): analyzing the root cause, trying to 

find areas of agreement, and striving for continuous improvement. 

And, from my standpoint, that is what this Duplication Report has 

been all about. 

The history of it is really quite interesting. I will let Dr. Coburn 

really tell the history of that. I do not want to steal either of your 

thunder. But, I think it has been remarkable. This simple concept 

that is just basic to business—having information measuring results—was pretty foreign to the Federal Government and, since implemented, it is having some dramatic results. And, of course, it 

was also carried out in a completely bipartisan fashion, which is 

what this Committee is all about. 

But, again, without stealing too much thunder, the Duplication Report has saved the Federal Government about $56 billion over 

the last 5 years. If the programs that are currently being implemented continue, over the next 10 years, you are estimating it will 

save about $69 billion, additionally. Thirty-four of your recommendations have been partially implemented. Twenty percent 

have been unaddressed. So, if those are fully implemented and addressed, who knows how many additional billions of dollars can be 

saved. 
2 

1The prepared statement of Senator Johnson appears in the Appendix on page 25. 

2The prepared statement of Mr. Dodaro appears in the Appendix on page 29. 

I mean, my hat is off to both of you gentlemen for really doing 

the hard work of conducting the oversight, developing the reports, 

and getting the information the government truly needs if we are 

going to really solve these problems. 

I will have some other things to say. I have an opening statement that I will ask to be entered for the record.1

But, what I would rather do, because we are going to be broken 

up—this hearing will be suspended for votes at noon—I would 

rather just get into your testimony and then wait for Senator Carper to give his opening statement and ask questions. 

It is the tradition of this Committee to swear the witnesses in, 

so if you will both rise and raise your right hand. 

Do you swear the testimony you will give before this Committee 

will be the truth, the whole truth, and nothing but the truth, so 

help you, God? 

Dr. COBURN. I do. 

Mr. DODARO. I do. 

Chairman JOHNSON. Please be seated. 

I think we will switch the order of testimony here and we will 

start with Mr. Gene Dodaro, who has been the Comptroller General 

of the U.S. Government Accountability Office (GAO) since 2010. He 

has more than 40 years of experience at the agency, including as 

Acting Comptroller General, Chief Operating Officer (COO), and 

the head of the Accounting and Information Management Division. 

Mr. Dodaro. 

TESTIMONY OF THE HONORABLE EUGENE L. DODARO,2 COMPTROLLER GENERAL OF THE UNITED STATES, U.S. GOVERNMENT ACCOUNTABILITY OFFICE 

Mr. DODARO. Thank you very much, Mr. Chairman. Good morning to you and Senator Ayotte. I am very pleased to be here today 

to discuss GAO’s most recent report on overlap, duplication, and 

fragmentation in the Federal Government and on additional opportunities to achieve other financial benefits. 

I am especially pleased to be here today with Dr. Coburn. I want 

to publicly thank him for his vision and his intense interest in our 

work at the GAO. 

This is our sixth annual report. We have 92 new actions that we 

are suggesting in 37 different areas across the Federal Government. I think they can result in significant savings. 

Some examples include consolidating the Department of Defense’s (DOD’s) fragmented procurement of commercial satellite 

services, which could save tens of millions of dollars. 

Also, streamlining and automating the approximately nine different overlapping systems that the Internal Revenue Service (IRS) 

has to receive tips on noncompliance would result in additional revenues coming to the government and a more streamlined system 

for people to provide input. 

Another example is better managing and overseeing an effort at 

the Department of Homeland Security (DHS) to revamp their 
3 

human resource management systems. Right now, there are over 

400 human resource systems and applications underway at DHS. 

By eliminating the potential for overlapping coverage between individuals moving between Medicaid and the exchanges, the risk of 

potential duplicative payments could be reduced. 

There are also other efforts that we suggest that could have tremendous cost savings. For example, reducing the overpayments in 

disability insurance and the improper waivers that occur could 

save billions of dollars. 

Also, equalizing certain Medicare payments could produce savings. Providers receive Medicare payments at a higher rate for certain services if patients received them at a hospital as opposed to 

at a doctor’s office. We think that, if you could equalize those rates, 

billions could be saved. 

Also, by giving Federal civilian Agencies the opportunity to obtain excess personal property from DOD as well as excess ammunition, which currently goes, in some cases, to State and local governments, first, before Federal civilian Agencies. In addition, DOD 

spends a lot of money—$118 million last year—to dispose of excess 

ammunition, which could be provided to Federal civilian Agencies. 

Raising some of the fees at the National Park Service (NPS) 

would generate additional revenue. One fee in particular has not 

been raised for over 20 years and we need additional funds to provide service to our parks. That could result in millions of additional 

dollars. 

So, with these 92 recommendations, this year, we have a total of 

over 600. There had been 544 previous recommendations. Forty-one 

percent have been implemented, 34 percent have been partially implemented, and 20 percent have not been implemented at all. We 

think there are opportunities, as you mentioned, Mr. Chairman, for 

tens of billions of dollars in additional savings, if those recommendations are fully implemented. 

To provide a service to the Congress, this year, in Appendix 1 of 

my written statement, we have listed all of the 61 areas that require Congress to act in order for our recommendations to take effect. In these cases, we have identified how much money—if we 

know—could be saved. We think, if Congress acted on these areas, 

it could result in significant savings and also improve operations in 

the government. 

We have also listed in our report and testimony all of those actions that still need to be implemented by the Executive Departments and Agencies. 

I would note that, so far, most of the larger savings have come 

from the Congress taking action. I would encourage you to look 

carefully at the recommendations in our Appendix. I think that 

they are very good, sound ways to save money and, therefore, help 

the Federal budget stay under the sequester limits. We have tried 

to identify smart cuts that will not have unintended negative consequences. 

Going forward in doing this work, I have one request of this 

Committee. Senators Sasse and Tester have introduced a bill that 

would give us access to the National Directory of New Hires 

(NDNH), which is a database maintained by the Department of 

Health and Human Services (HHS) that has up-to-date information 
4 

1The prepared statement of Dr. Coburn appears in the Appendix on page 67. 

on employment and wages. This information would help us to 

evaluate means-tested programs across the Federal Government. I 

am sure Dr. Coburn is very familiar with this. He has helped us, 

in the past, to gain some access. We believe we have the authority 

to access it, but HHS does not agree with us—and so, Congress 

clarifying this could save a lot of money. There are hundreds of billions of dollars every year that are spent on these means-tested 

programs and having this information would be extremely helpful. 

So, I look forward to responding to your questions at the appropriate time this morning. Again, I am very pleased to be here with 

Dr. Coburn and I am happy to participate in this hearing. I look 

forward to a good continued relationship with this Committee. 

Chairman JOHNSON. Thank you, General Dodaro. 

By the way, I just cosponsored that piece of legislation and I kind 

of want to wait to talk about a piece of legislation we are trying 

to put together—15 bills that might be a really good addition and 

then, have the 16th to actually get it passed. 

Our next witness is Dr. Coburn. It is great to see you here. It 

is great to see you in good health. Dr. Coburn is a former Senator 

from the State of Oklahoma, who served from 2005 to 2014. Dr. 

Coburn’s time in the Senate was marked by his leadership in the 

fight to reduce wasteful Washington spending as well as to increase accountability and transparency for the taxpayer. Dr. 

Coburn was the Ranking Member of this Committee for 2 years. 

Previously, he represented Oklahoma’s Second Congressional District in the U.S. House of Representatives from 1995 to 2001. Dr. 

Coburn. 

TESTIMONY OF THE HONORABLE TOM COBURN, M.D.,1

FORMER U.S. SENATOR FROM THE STATE OF OKLAHOMA 

Dr. COBURN. Well, thank you, Mr. Chairman—and for Ranking 

Member Carper, I will recognize him when he comes. 

It is a real honor and a privilege to sit next to Gene Dodaro. 

When you see Gene Dodaro, you need to remember all of the people 

behind him, because we have these great investigators—these 

great people who work for GAO that are out there to help us do 

what we need to do. And, you cannot mention GAO without mentioning the Inspectors General (IGs), because they also are out 

there to help us do that. 

And, I think it is great that you are having this hearing. I would 

just like to tell you a little of my background. This last year, in 

2015, I spent my time in 21 different States. I was in Ohio last 

week, by the way. And, America does not trust you anymore—that 

is the truth—because they do not see the actions coming out of 

Congress that should be coming out. And, that does not mean 

that they are right all of the time, but you have lost their confidence—and that is not one party—that is both parties. 

And so, when you have hundreds of billions of dollars that could 

be saved and are not being saved—and they know it—they actually 

read your reports, Gene. They actually get online, and then, they 

use social media to pass them around. 
5 

The important thing is to restore the confidence in the country, 

in terms of what you are doing, why you are doing it, and how you 

are doing it. And, I found this Committee to be one of the best 

Committees in Congress. That is why I stayed here my entire time. 

When I first came, the Republicans were in the Majority and I sat 

on the Subcommittee on Federal Financial Management (FFM). 

This Committee has a broader jurisdiction than any Committee in 

the Senate. You have the capability to change things and to make 

a real difference. And, historically, this Committee has been a bipartisan Committee. It has been one where we have worked together for the best interest and the long-term interest of the country. 

I will just give you a reminder that, right now, the unfunded li- abilities of this country, with its debt, are $142 trillion. That is one 

million dollars per family—or that is one million dollars per taxpayer—either way that you break it down. Nobody knows what a 

trillion is, but, when you are telling a young family with two small 

kids that, ‘‘By the way, here is the debt burden that is coming to 

you over the next 25 years,’’ you had better be prepared for it. 

The other point that I would make to you is that the standard 

of living in this country—although increased—the median family 

income is exactly the same as it was in 1988—and there are reasons for that. And, the reasons for it are too much government, too 

intrusive a government, and too many questions by government. 

I wanted to read for you all something that was written a long 

time ago, but, I think, it is very apropos to where we are 

today—and it is not mine. I am copying this. I am going to quote 

it. But, it is a quote by Alexis de Tocqueville. It is from his ‘‘Democracy in America.’’ Some of you may have read it and some of you 

may not have. But, it tells me where we are, today, in our country. 

And, having been in 21 States last year and 15, already, this year, 

what I am hearing—I am hearing what Tocqueville described back 

in the late 1700s—early 1800s. 

‘‘I think, then, that the species of oppression by which democratic 

nations are menaced is unlike anything ever that before existed in 

the world [. . .] The supreme power then extends its arm over the 

whole community. It covers the surface of society with a network 

of small, complicated rules, minute and uniform, through which the 

most original minds and the most energetic characters cannot penetrate, to rise above the crowd. The will of man is not shattered, 

but softened, bent, and guided. Men are seldom forced by it to act, 

but they are constantly restrained from acting. Such a power does 

not destroy, but it prevents existence. It does not tyrannize, but it 

compresses, enervates, extinguishes, and stupefies a people until 

each nation is reduced to nothing better than a flock of timid and 

industrious animals, of which the government is the shepherd.’’ 

That, to me—in my experience—that is my opinion—is where we 

are, today, in our country. I think that is why you see the kind of 

Presidential race that we are seeing. 

And so, the question is: where is the smart government? And, if 

there is going to be smart government, this Committee is going to 

have to be the one that leads on this. This is the Committee that 

has the authority to do that. This is the Committee that has the 

bipartisan relationships that can do that. 
6 

So, what I would suggest to you is that there is tons to be 

done—even in an election year—that can make a great difference. 

The history with Gene came after my bipartisan work with then 

Senator Barack Obama, Senator Tom Carper, and several others on 

the Federal Funding Accountability and Transparency Act of 2006 

(FFATA). 

And, just to show you how the American people get this, there 

is a little application out there right now that, in another 3 years, 

will show every dollar spent by every State, by every county, and 

by the Federal Government—and you can go to it in an app. It is 

called ‘‘Open the Books.’’ And, I can tell my farmer friends how 

much money they got from the Department of Agriculture (USDA) 

last year and it drives them nuts. 

But, transparency is great for our country—and that is what we 

need. And, we need the transparency. America is interested in 

what is going on with our country. Americans are not just sitting 

back. They want us to proceed to continue to perform and deliver 

freedom and liberty. And, they see that liberty at risk. They also 

see the rule of law at risk. They see more of ‘‘ruler of rulers’’ coming out of Washington than rule of law. 

I think the thing that happened was, we started looking at duplication within my own staff on this Committee—and what we found 

was we really could not do it. So, we went to GAO and they really 

did not want to do it, initially. So, we passed an amendment, in 

2010, on the debt limit increase, which mandated that GAO would 

do this—and they have done a fine job every year. 

What has not happened—even though Gene gives the Congress 

some credit—there are multiple recommendations in there that will 

save billions and billions and billions of dollars every year that you 

have not acted on—that this Committee could act on. And so, he 

is very kind to say that the Congress is better than the Executive 

Branch, but there is still $400 billion that should not be being 

spent by the Federal Government every year, when you include duplication, waste, and fraud. And, most of that falls under the jurisdiction of this Committee. 

So, to have a 4-year plan, where we could knock $100 billion a 

year out of the Federal Government, would go a long way toward 

solving our problems. If you look at the Congressional Budget Office’s (CBO’s) projections and the Office of Management and Budget’s (OMB’s) projections, you are going to be back at trillion-dollar 

deficit levels very soon, right? And, you are adding about $6.5 trillion a year in unfunded liabilities. So, these are real problems that 

you all have the capability to address and I came here to encourage 

you to do that. 

I would also tell you that there is another movement afoot in the 

country and that is to force you to do it—and that is being done 

through a Convention of States—and two have passed this last 

week. We are at ten. And, it will not be long until we meet the 34- 

State requirement—and we will have a Convention of States and 

then we will make recommendations to the States—one on a balanced budget amendment using Generally Accepted Accounting 

Principles (GAAP), with very little wiggle room, which will force 

you to do it. It will give Congress the backbone to do what they 
7 

should be doing in the first place. And, also there will be limitations in scope on jurisdiction. 

And, you are going to see that coming forward. That now has 

1,700,000 activists following it every day—involved in it—there are 

650,000 actually working at State capitols around this country— 

and we will see a change in our country as that gets closer. And, 

one of two things will happen. We will either have a Convention 

of States or you all will change this. But, one of those two things 

is going to happen. And, the American people want it to happen, 

because they actually sense that things are out of control in our 

country. 

This Committee has been a great Committee. You have done 

more work—great work—than many of the other Committees. You 

have the ability to do more and greater things. And, my charge to 

you would be to look at where the opportunities are and to throw 

the politics aside. 

Here is what I have discovered. All of this waste, all of this duplication, and all of this fraud has a constituency—and so, a lot of 

people do not want to take a vote to eliminate it, because it will 

offend a group of voters or a group of contributors. I think you 

ought to offend them all and I think you ought to do what is right. 

I will close by paraphrasing very quickly—and this is a paraphrase, it is not exactly what he said. But, this is the way he said 

it in a way that I can understand it. Martin Luther King said the 

following: Vanity asks the question, ‘‘Is it popular? ’’ Cowardice 

asks the question, ‘‘Is it expedient? ’’ But, conscience asks the question, ‘‘Is it right? ’’ 

You all have the ability to do the right thing and the best thing 

for our country. My hope is that you will do it. Thank you. 

Chairman JOHNSON. Thank you, Dr. Coburn. And, again, we 

know you both well, so it is going to be Tom and Gene from here 

on out—at least from my Chair. 

Senator Carper, would you like to make a statement or should 

we—— 

OPENING STATEMENT OF SENATOR CARPER 

Senator CARPER. I would just like to say welcome. I had a chance 

to visit a little bit with Dr. Coburn before the Committee started. 

I apologize for being late. As you know, I had an emergency caucus 

meeting and I needed to be there. 

I just want to say that two of my favorite people on the planet 

are here—and they are two of the smartest, wisest people that I 

know. And, it is just great to see you and to see you well. And, 

Gene, we are just grateful for your leadership and all that you do 

to help us do our jobs better. Thank you. 

Chairman JOHNSON. So, Tom, let me start by asking some questions, just in terms of the duplication report, which, from my standpoint, started a process. I am from the manufacturing sector. In 

order to have a good product, you have to have a good process. And, 

we can describe that in greater detail, but I want to go back to 

what you were talking about, in terms of forcing change—about a 

constitutional amendment that will force the change. I mean, that 

is a process that we have to put in place before Congress is going 

to act. Try and kind of speak to that point a little bit, if you will. 
8 

Dr. COBURN. Well, I guess that one of the things the American 

people are asking—quite frankly, is that, if you have an oath, why 

do we have to have a constitutional amendment in order for Congress to do what is best for the country? And, they have decided 

that Congress cannot do what is best for the country, so they are 

going to do it, themselves, under the authority of the Constitution. 

In other words, the Constitution, actually, is the powerful tool 

with which to solve the problems of our country. It is big enough 

to solve the problems. And, the partisanship and the politics kind 

of move away when we start asking, ‘‘Why do we want a balanced 

budget? Is there a reason? ’’ In other words, is it impossible to look 

at mandatory spending today—discretionary spending today—and 

what our needs are for the country and get to a balanced budget? 

And, the answer is: absolutely not. It is absolutely not, if you actually go in and look at where things are. 

In my mind, the question is—and my advice to the Committee 

is to look at the roles that the Federal Government has taken over 

that would be better and more efficiently done at the State level, 

because you will find you can get the same results for a whole lot 

less money and have all sorts of different, better results than when 

the Federal Government does it. 

Now, I know I am an advocate for small government and I can 

understand that that can be pooh-poohed up here, but when 

you just test it, look at how things work, and look around the 

States—this is obviously true. 

Chairman JOHNSON. A big part of the problem—and you know 

this—is that two-thirds of the Federal budget is on automatic pilot. 

It is in law. If you qualify for benefits, you get them. We keep expanding the eligibility. And so, unless you are able to pass another 

law—and that is what has been impossible to do here—to actually 

rein in—first of all, put everything on the budget—put it in an appropriation process, so that every year, you have to actually vote 

on all of the appropriations. That is not happening today—— 

Dr. COBURN. Well, I think there are two answers—— 

Chairman JOHNSON [continuing]. And, it is part of the reason 

you need some kind of process constraint to force those laws to be 

changed. 

Dr. COBURN. Well, for example, as a Social Security recipient, I 

get an increase when there is a certain amount of inflation. Where 

are the tax dollars to pay for that? So, what ought to happen is 

that, if we are going to continue to have the kind of benefits that 

we have and we are not going to change the programs, we at least 

ought to provide the revenue source to pay for them. 

The second thing is—and Gene mentioned this in his talk—in 

terms of disability. There is no doubt in my mind—I am a hundred 

percent sure—that one out of every three people collecting disability in this country is not disabled. And yet, when they make an 

error, they forgive the money rather than asking for it back. Or, 

a Congressman goes over and jawbones because he controls the Social Security Administration’s (SSA’s) budget and says, ‘‘No, you 

will keep them on it until you prove they are not eligible.’’ 

But, that just shows you the state that oversight is in, because 

that started, in this Committee, with Senator Carl Levin and myself doing an oversight investigation. The three key actors in that 
9 

have now been indicted by a Federal grand jury and, I presume, 

will go to jail and spend a long time there. 

The question is: did we learn anything from that? Did we change 

Social Security management? No. So, you have done the oversight, 

but, if you do not act on the information gathered during the oversight investigation, then you have not accomplished anything. 

Chairman JOHNSON. And, that is my point. We are going to have 

to put the processes in place to force action. Otherwise, we do not 

act. 

Gene, you talked about some of these things having been implemented. Give us the best example of an implementation of your 

recommendation and how it occurred, so we can learn from that example of best practice. 

Mr. DODARO. In the first year of this report, we identified the 

fact that there was duplication between the ethanol tax credit that 

was in place and the Renewable Fuel Standard (RFS) program. We 

said the ethanol tax credit was duplicative and Congress let that 

expire. That was a big change. People had been advocating that for 

a long time. 

For another example, after the attacks on September 11, 2001 (9/ 

11), the airlines and the traveling public were supposed to pay for 

the increased security, but Congress capped the aviation security 

fees. We had an open recommendation for several years that Congress allow the fees to increase, so that customers, rather 

than taxpayers—and rather than having Congress borrow the 

money—would bear the cost. Congress passed that increase and 

about $128 billion was saved, over 10 years. 

Congress also saved almost $5 billion per year by eliminating direct payments to farmers. 

But, I would just say, in terms of the fiscal condition, we 

are on an unsustainable fiscal path. Every part of the Federal 

budget—mandatory spending and discretionary spending—needs to 

be looked at—as well as the revenue side of government and tax 

expenditures. 

We also have a very ineffective way to control our debt. The debt 

ceiling, as it is designed right now, is totally an after the fact consideration. We have already authorized all of the spending. Raising 

the debt ceiling just authorizes the Department of the Treasury to 

borrow to cover the spending that was already authorized. I have 

recommended we change that by linking decisions about spending 

and revenue to decisions about the debt limit when they are made. 

Congress ought to have some reasonable limit as a percent of the 

Gross Domestic Product (GDP). Unless we do that, you are going 

to have problems, especially if the interest rates continue to climb. 

If that happens, the service costs on that debt are going to skyrocket. The only thing that has been saving us so far are the low 

interest rates on borrowing an incredible amount of money. 

Chairman JOHNSON. So, the lesson I am learning from the examples you threw out there is, first of all, you have to highlight it and 

get the public to be aware of it in order to really force the politicians—the elected officials—to actually act on it, because, if you do 

not shine the light of day on it, nobody is going to know and this 

place is just going to continue on automatic pilot. 
10 

Let me, in my last moments here, talk a little bit about one piece 

of legislation we are trying to put together and that Majority 

Leader McConnell is completely supportive of. It is actually 15 

bills—maybe 16 bills—that have broad bipartisan support, are, 

generally, based on GAO’s recommendations, and are things that 

have been passed through our Committee, unanimously, in a bipartisan fashion. I mean, I could list off the cosponsors, but just 

about—I know every Senator on this Committee has supported 

these. I know a lot of Members of the Senate have supported these 

pieces of legislation. So, hopefully, we can get bipartisan support. 

We have not been able to pass these through unanimous consent 

(UC). Somebody would object. This is something that could actually 

get floor time, so I am certainly hoping that Senator Carper will 

be supportive of this. 

We have not given it a name yet. We do not have the right acronym. But, it is really a group of 15—maybe 16—pieces of legislation that implement the recommendations of GAO. It is good government. It is moving. It is continuous improvement. It is not a ‘‘be 

all, end all.’’ It is not going to solve the entire problem. But, just 

like with the Duplication Report, you start here and you start making progress. And, again, that is just kind of my manufacturing 

background at work. I will work toward continuous improvement. 

If you do it over enough years, pretty soon, you can look back and 

go, ‘‘Hey, we made some real progress.’’ 

With that, Senator Carper. 

Senator CARPER. Let me pass right now. I have delayed this 

hearing long enough. Let me pass. I will ask some questions later. 

Thank you. 

Chairman JOHNSON. Senator Lankford. 

OPENING STATEMENT OF SENATOR LANKFORD 

Senator LANKFORD. Thank you, Mr. Chairman. 

Dr. Coburn and Gene, thank you for being here and thank you 

for all of the work. And, thank you for the legacy that you left, Dr. 

Coburn. I have the opportunity to walk in a long shadow and I am 

glad to be able to walk through that as well. 

For Gene, what you have done as well as the work and your 

team has been remarkable, to say the least—and you have been 

able to pull a lot of things together. 

You and I spoke last year about the possibility of taking the lists 

as they exist—rather than having a large list—and breaking them 

out, in terms of what is Congressional, what are Administrative responsibilities, and so that it can be clearly identified as to who has 

what. You have done that this year and I appreciate that, as well, 

because that does allow us to be able to say, ‘‘This is our list. This 

is our ‘to-do list’.’’ It moves from a big list to a big list that is, specifically, one with our name on it—and so, that is very helpful in 

the process, as well, to help to identify those things. 

Dr. Coburn, I would have to tell you that I get asked often about 

the work that you did while you were here and while you sat on 

this dais. And, people will say to me, ‘‘You did a lot of things, said 

a lot of things, and made a lot of speeches. What really changed? ’’ 

I, typically, take them back to this—to the work on duplication and 

this specific report—to be able to identify, ‘‘Here are the things 
11 

that really made a difference—and it is a difference in the billions 

of dollars.’’ Not only the Administration can see it, the people can 

see it. And, Congress can choose to act on it or choose to be exposed 

when they do not. It does make a tremendous difference in the 

days ahead and I hope we can continue that. 

While you were on the Senate side, I was on the House side. We 

were both working on a bill called the Taxpayers Right-to-Know 

Act. That has moved significantly. It moved through the House 

while I was there. It stalled here in the Senate. It has now moved 

completely through the House again—413 to 0 this time. We have 

a version that we have worked through here, in a bipartisan way, 

and it is being held up by a single member. We feel like that is 

at the behest of OMB. 

It was interesting, Gene, when you brought up a lot of your questions—in your statements to OMB—on why they have not reacted 

to some of the transparency, they referred over and over again to 

the idea that they anticipate the Taxpayers Right to Know Act to 

pass. And, when it passes, then they will actually take on these 

things—but they are not going to do them until it passes. 

We also believe that OMB is helping the charge to not move it 

here, for whatever reason. Part of that may be the program thresholds. Currently, the program threshold is one million dollars. For 

every program that is greater than one million dollars, we have to 

have a list. 

Gene, when you and I, in 2013, had an interchange about this 

same issue, trying to identify—based on the Digital Accountability 

and Transparency Act of 2014 (DATA Act) and other things that 

are out there—what information we do have and what information 

we do not have. We determined, at that time, even in our conversation, a number of things we do not have. We do not have a list of 

every program, how much is spent on a particular program, if a 

program is evaluated at all, what was the evaluation of that program, or how many full-time employees are dedicated to a particular program—just a simple, straightforward list that every 

business in America has. Every one of them has some kind of 

tracking on that. We do not have that in the Federal Government. 

So, we go to GAO to do this large-scale report, when that information should be something that every watchdog group is able to 

have out on a list and also should be on an app that is publicly 

available, so you can clearly see it. But, right now, that cannot be 

done, because we do not have that. 

So, let me just come to a question on that. The $1 million threshold, compared to a $10 million threshold, what does that do for program transparency and uncovering the number of programs that 

may be duplicative that you cannot see? 

Mr. DODARO. I think the one million dollar threshold is a reasonable request by Congress. There could still be some implementation 

problems, largely because OMB has not defined programs. That requirement has been in place for a long time under the Government 

Performance and Results Act (GPRA) Modernization Act. They 

punted that to the DATA Act. They are supposed to do it under the 

DATA Act. That is not being done. 

So, I think there is a lot of confusion right now, because there 

is not a definition of program. I think there are more than one 
12 

thousand programs in the Catalog of Federal Domestic Assistance 

(CFDA) that have budgets that are between $1 million and $10 

million. You need to have that visibility added into those programs. 

You need to have that transparency. Federal Agencies and OMB 

may have some difficulties in implementation, but I think you have 

to move in that direction if you really want to have a clear, transparent, and accountable government. 

Senator LANKFORD. So, you are basically not going to see a thousand programs—or more—unless you have that definitional 

change. 

Mr. DODARO. There is a good possibility of that, yes. 

Senator LANKFORD. OK. Let me ask you about the NDNH. 

Well, actually, let me pause before we do that. Dr. Coburn, do 

you have any comments you want to make on the Taxpayers Right 

to Know Act? You worked very hard on this for the Senate for a 

long time. 

Dr. COBURN. I would just say that if, in fact, OMB is the holdup with it, it is the same thing we heard on the DATA Act—that 

it is too hard to implement. 

Senator LANKFORD. Right. 

Dr. COBURN. It costs too much money. Well, what they found out 

was that it was a little hard to implement, but it did not cost nearly as much money. They bought a program from a nonprofit, Sunlight Foundation, and implemented it—and the same thing could 

happen on this. It is not hard. 

People—if they are not being held accountable, they do not want 

to be held accountable—and transparency is what holds them accountable. So, the Taxpayers Right to Know Act is just as essential 

as any other thing we have done, in terms of transparency, so the 

American people can know. 

So, what you are really doing is fighting a dark force that does 

not want the American people to know what is going on up here. 

And, the American people are saying, ‘‘Hey, we kind of get it. We 

kind of get it.’’ And, that is why your approval rating is low and 

that is why you are seeing the politics of America today. And, everybody is responsible for that. That is not partisan. That is just 

due to the fact that there is not a commitment to reconciliation and 

working together to get things done. 

Senator LANKFORD. Right. Gene, talk to me about the NDNH. 

Why is that needed? You mentioned that earlier in your opening 

testimony. It is something that all of us support here. Why is that 

needed? 

Mr. DODARO. There are a lot of Federal programs where benefits 

are based on means testing of income. The NDNH, which was initially created to help with child support enforcement, is the authoritative database on new employment and has the most up-to-date 

wage information. And so, that information could be compared 

against benefit decisions to test for possible improper payments. In 

a lot of means tested programs, people self-report their income. 

And so, Agencies do not always have a means of checking, through 

third-party information, whether what is being self-reported is 

right and whether it is up to date. 

So, this database is essential. It is easy to use—once GAO has 

access to it—but OMB, initially, objected to our use. So, we went 
13 

to the States that report the data and had to get it from them. 

That is a very time consuming and labor intensive process—and 

the information quickly becomes out of date. We believe we have 

the authority to obtain and use the data, but Congress needs to 

clarify that. This will help us to do this work on overlap, duplication, and fragmentation in a much more efficient and effective way. 

Senator LANKFORD. OK, thank you. Gentlemen, again, thank you 

for being here and for the ongoing work. 

I yield back my time. 

Chairman JOHNSON. Senator Lankford, first of all, I agree that 

you have some big shoes to fill, but you are doing a pretty good job. 

You are doing an excellent job as the Chairman of the Subcommittee on Regulatory Affairs and Federal Management 

(RAFM), working in a very bipartisan fashion with Senator 

Heitkamp. I truly appreciate that. 

And, your Taxpayers Right to Know Act is part of this package 

and was introduced, first, in 2011. Let me just list the cosponsors 

right now. It is: Lankford, McCaskill, Johnson, Ayotte, Heitkamp, 

Enzi, McCain, Portman, Peters, Paul, and Fischer. That is what we 

are trying to put together here—and I truly appreciate your participation in that. Senator Carper. 

Senator CARPER. Thank you. Thank you so much. 

Several times, we have heard it mentioned that the American 

people have a pretty good idea of what needs to be done—and we 

need to remember that. Jefferson used to say, ‘‘If the people know 

the truth, they will not make a mistake.’’ 

And, when you think about the way we spend money in the Federal Government—not everybody knows this—but I think it was in 

a pie chart. About half of the money that we spend, through the 

Federal Government, is from programs like—they are entitlements—things that people are entitled to—you folks know this— 

Social Security, Medicare, Medicaid, and veterans benefits—some 

of the veterans benefits—things that people are entitled to by virtue of their age, their service, or their health. This accounts for 

about 50 percent—and it is growing, not shrinking. 

Another 5 or 10 percent is the interest on the national debt. If 

interest rates ever go up, heaven help us, because that one has not 

been growing that much, given the size of our debt. But, 5 to 10 

percent is the interest on the national debt. 

The other 40 percent, as you know, is discretionary spending. 

That is where we actually appropriate, in our dozen or so appropriations bills, which we are actually taking up on the floor today, 

tomorrow, and in the weeks to come. When—and that 40 percent— 

most of that is defense. The majority of it is defense, but the rest 

of it is the whole rest of the Federal Government. 

The idea—to assume that we can get where we need to go, in a 

fiscally responsible way, by ignoring, really, any of those pieces— 

I think we make a mistake. 

Dr. Coburn was one of the members of the National Commission 

on Fiscal Responsibility and Reform (NCFRR), or the Bowles-Simpson Commission, which came together with a plan about a halfdozen years ago. It was convened, by President Obama, to put us 

on the right track—and it involved everything. It involved revenues. It involved entitlements. I thought the way they did entitle-
14 

ments was—I call it consistent with Matthew 25: ‘‘the least of 

these.’’ It says we have a moral obligation to the least of these: 

when I was hungry, when I was naked, and when I was thirsty— 

what did you do? And, I think we have a moral obligation to the 

least of these in our society. But, we have a fiscal imperative— 

since we have a large budget deficit—to meet that moral obligation 

in a fiscally sustainable way. 

Dr. Coburn and I used to use GAO’s ‘‘High-Risk List’’ almost as 

our ‘‘to-do list,’’ when we were working together on this Committee. 

One of the things that befuddled me is that we worked very hard 

on improper payments—and we passed legislation that initially 

said, ‘‘Agencies, you have to figure out what your improper payments are.’’ Well, they were not doing that, so they did it. OK. And, 

we said, ‘‘Second, you have to stop making improper payments.’’ 

And, OK. And, next, ‘‘You have to report that. And, you also have 

to promote people, and consider in promotion whether the supervisors of an Agency—the heads of Agencies are doing anything 

about improper payments.’’ It is huge. It is, like, over $100 billion 

a year. And, some of the reports on improper payments have come 

out. Medicare, to my amazement, jumped by $15 billion. 

So, I would just say—let me just start there. To the Comptroller 

General, do you have any idea why that happened, despite our best 

efforts? That is a lot of money. 

Mr. DODARO. Yes. Since Congress required Aagencies to report 

improper payment estimates in 2003, the cumulative number of 

improper payments that has been reported is over one trillion dollars—and, this last year, it was $136 trillion. The reason that—— 

Senator CARPER. Billion. One hundred-and-thirty-six billion dollars. 

Mr. DODARO. Billion. I am sorry. Thank you. The reason it 

jumped, in Medicaid, from my understanding, is that the States 

have not yet put in all of the systems necessary to check eligibility 

under the Affordable Care Act (ACA)—and so, they need to do that. 

The one thing I would point out, Senator Carper, with Medicaid—that concerns me even more than these estimates—is the 

managed care portion of Medicaid. None of these improper payment estimates are covering the managed care portion of Medicaid, 

which is the fastest growing portion in States. All that the States 

are checking is whether they are paying the contractors properly— 

not whether the contractors are actually making the payments 

properly. That is going to change under a new rule, based on a recommendation we made to the Medicaid area. 

I believe the improper payments, both in Medicare and Medicaid, 

account for over 50 percent of the improper payments for those 

agencies that estimate improper payments. They are two of the 

fastest growing programs in the Federal Government—estimated 

by CBO to grow at a rate of 6 to 8 percent over the next 2 years. 

Unless the agencies get on top of this situation, in my opinion, it 

could quite likely get worse before it gets better. There are a number of recommendations we have made. They need to implement 

them. And, they need to change the culture to one of making sure 

we prevent these payments from occurring in the first place. 

Senator CARPER. What was the name of the guy that used to say, 

‘‘So-and-so, why do you rob banks? ’’ And, he would say, ‘‘That is 
15 

because that is where the money is.’’ Who was that guy? Does anybody remember? 

Mr. DODARO. Willie Sutton. 

Senator CARPER. Willie Sutton. ‘‘Willie Sutton, why do you rob 

banks? ’’ He says, ‘‘Well, that is where the money is.’’ Well, there 

is a lot of money in improper payments that are outside of Medicaid and Medicare, but there is a huge amount of money there and 

we just need to continue to focus on that. 

I just want to say that some people think of entitlement reform 

as a way to save money. I think that what we need to do is save 

the programs for our kids and grandchildren. We do need to save 

some money—and we need to do so in a way that does not savage 

the least of these. Those are the three guidelines that I would give. 

Dr. Coburn, you served on the Bowles-Simpson Commission, 

where you guys came up with, I thought, an excellent game plan. 

I want to applaud your courage—political courage—for supporting 

it and for being very vocal about it. 

One of my great disappointments was that our friend—mutual 

friend—President Obama—because he created the Bowles-Simpson 

Commission—when you all came out with your report, he did not 

embrace it. And, I talked to him any number of times, privately, 

about it and he would say, ‘‘I do not want to negotiate against myself. I need someone to negotiate with on the Republican side.’’ 

Some people said, several years later, that he and Speaker of the 

House John Boehner, as you may recall, did negotiate—not once, 

but twice—to try to get a Bowles-Simpson-like agreement. And, my 

understanding is that, when the Speaker went back to his caucus 

and said, ‘‘Well, what do you all think? ’’ they said, ‘‘If you do this, 

you may not be Speaker much longer.’’ So, there was finally an effort—belated—but there was an effort to do it. 

I think, if the President had run with this when you guys said, 

‘‘This is what we recommend,’’ we would not be having this hearing 

today. That would have been a huge game changer. 

Let me just ask—without something like that—a Bowles-Simpson-like structure with the recommendations—comprehensive recommendations—we can do the piecemeal stuff—and we will, but do 

we need the overreaching structure that a Bowles-Simpson approach provides—that provides the balance? 

Dr. COBURN. Well, the Bowles-Simpson approach was that we all 

jumped off of the bridge together—— 

Senator CARPER. Yes. 

Dr. COBURN [continuing]. And, actually solved the problem. But, 

you can do it unilaterally. There are a couple of problems. We keep 

making the same mistake. If we create a new program or if we enhance a program, we do not create a revenue stream to pay for it— 

and the Republicans are guilty of that with Medicare Part D and 

Democrats are guilty of that too. Everybody that voted for the last 

omnibus—you stole the money from Social Security to re-up Social 

Security Disability Insurance (SSDI), which was totally out of 

money. And, what fixed Social Security Disability Insurance? Nothing. So, what is going to happen? You are going to do the same 

thing—except the next time you go to Social Security, there is not 

going to be any money in it to take. 
16 

So, what has happened is that you have delayed fixing the real 

problem. You have done a patchwork fix, so you do not have to deal 

with the real problem. And, it is hard work. I am not saying it is 

not. But, some major changes in Social Security Disability Insurance would be amazingly helpful for the disabled community and 

would get rid of the fraud. And, you would extend the life of the 

Disability Insurance Trust Fund by 20 years. But, not doing that— 

it is expedient to take the money from Social Security and to not 

fix Social Security Disability Insurance. 

So, I would just say, these are the kinds of examples of what we 

continue to do because it is convenient and expedient—but we do 

not actually fix the real problem. And, that is the Senate Finance 

Committee’s jurisdiction, I think. That is not this Committee’s jurisdiction. But, anyhow, it needs to be fixed. 

And, the other thing is the rule—if you are going to start a new 

program—and we may need to—we are our brother’s keeper—we 

need to have a tax revenue stream that pays for it rather than— 

and then, we do not increase benefits without increasing the revenues to pay for them. 

Senator CARPER. OK. Mr. Chairman, I know I am over my time. 

Could I just ask for one more minute and then I will stop? 

We are not very good at paying for things that we know we need. 

A good example is our approach to roads, highways, and bridges. 

We have a history of saying that businesses and the people who 

use our roads, highways, and bridges should pay for them—and instead of doing that this last time, we have, literally, pilfered money 

from the Federal Reserve. We take oil out of the Strategic Petroleum Reserve (SPR) that we paid $80 or $90 a barrel for and we 

say we are going to sell it for half of that and use that. There was 

an effort to raise Transportation Security Administration (TSA) 

fees and, instead of putting that money toward aviation security— 

to actually use it for roads, highways, and bridges—we beat that 

back. There was an increase in U.S. Customs fees. Instead of providing for better border security, we were going to use that for 

roads, highways, and bridges. It is shameful. I think it is shameful. 

But, on a positive note, we took a program—the Earned Income 

Tax Credit (EITC), which Ronald Reagan said was the best antipoverty program ever—but we knew that it was flawed. We knew 

that it was flawed and that it needed to be cleaned up. And, when 

we put it in that big package that Dr. Coburn referred to, from last 

year, we actually made program integrity changes—and they were 

still trying to do that for the U.S. Postal Service (USPS) with respect to Workers’ Compensation, which is another thing that needs 

to be done. 

So, I think we just have to stay with this stuff. And, you are 

right, this Committee—as much as anybody else—has the obligation—and, frankly, the history of working together—that shows we 

can get stuff done. 

The three Cs—I like to talk about the three Cs. Communicate 

and compromise, those are the secrets for a vibrant democracy. Add 

a third C—that would be collaboration—and that is really in our 

DNA in this Committee—and we just can never lose that. 

It is just great to see you both. And, thank you so much for being 

here. God bless you. And, I want to second the motion of the Chair-
17 

man of the Committee about James Lankford. He is a worthy successor—a very worthy successor. 

Dr. COBURN. I agree. 

Chairman JOHNSON. Also, by the way, they are big boots he is 

filling—not shoes. [Laughter.] 

So, let me be one of the two accountants in the room here and 

talk a little bit about some of the numbers, because, the fact of the 

matter is, we have actually reduced the national debt by more than 

80 percent of what the Bowles-Simpson Commission’s recommendations would have done. It is not the way the Bowles-Simpson Commission really laid it out, but, in the Budget Control Act of 2011, 

we had about $2.1 trillion of spending restraint. In the American 

Taxpayer Relief Act of 2012 (ATRA), we had about $700 billion of 

revenue raised. So, that is about $3.8 trillion. That reduced the national debt by about 81 percent of what it would have been reduced 

to under the Bowles-Simpson Commission’s Plan. We did zero mandatory spending, whatsoever. 

But, it, unfortunately, barely made a dent, because, according to 

the Congressional Budget Office, the projected deficit, over the next 

30 years, which is a concept I kind of came up with in working 

with the White House right after President Obama got reelected— 

the total deficit, over the next 30 years, which really is the definition of the problem—the demographic bubble—all of the ‘‘Baby 

Boomer’’ generation retiring—all of these promises made—and we 

have no way to pay for them—is $103 trillion. 

Dr. COBURN. More. 

Chairman JOHNSON. One hundred-and-three trillion dollars. This 

is with what we have already done, reduced the national debt by 

80-some percent of what the Bowles-Simpson Commission’s recommendation would have done—$10 trillion the first decade, $28 

trillion in the second, and $65 trillion in the third. 

Now, here is the problem. I was in the White House. President 

Obama joined us for the second half of a 2-hour meeting. And, I 

slid my 30-year deficit chart under his nose and I said, ‘‘Mr. President, I have given my PowerPoint presentation to 17,000 Wisconsinites in audiences about this large. But, you are the President. 

You have the bully pulpit. Please use it. Tell the American public 

the truth. Show them the depth of the problem, so that, collectively, we can take the first step to solving any problem.’’ 

Do you know what he said to me? He said, ‘‘Ron, we cannot show 

the American public numbers this big. If we do, they will become 

scared and give up hope.’’ He said, ‘‘Besides, Ron, we cannot do all 

of the work. We have to leave some work for future Presidents and 

future Congresses.’’ So, it is that denying of the reality, that lack 

of willingness to tell the American people the truth, and that lack 

of transparency that is preventing us from really addressing these 

very serious problems. 

I have two quotes. We talked about Thomas Jefferson. Let me 

paraphrase, instead of giving quotes, because I do not have the 

quotes in front of me. Thomas Jefferson said that a Nation that expects to be free and ignorant living in a state of civilization expects 

what never was and what never will be. And, he also said that a 

government big enough to give you everything you want is big 
18 

enough to take away everything you have. And, those are the realities that we are dealing with. 

Gene, I want to talk to you a little bit about fraud. We talked 

about waste, which is really kind of the category I put the duplicated programs in—just waste. If we are doing the same things in 

different agencies, not doing them well, and not measuring the results, that is waste. Let us talk about fraud. 

The Earned Income Tax Credit—we have excellent Inspectors 

General doing reports, which show that 23.8 percent is the most recent figure of fraud with the Earned Income Tax Credit. We do not 

have very good information on fraud in other programs. I know 

people estimate. I have gotten in trouble kind of estimating it. We 

need that information. 

Can you just kind of talk a little bit about what GAO and what 

the Inspectors General can do to really ferret out fraud in—you 

pick the program. 

Mr. DODARO. Well, first, one of the things that we found lacking 

was attention to the fraud issue and the building of it into the program management. So, we created a fraud risk-management framework—or fraud-prevention framework—that Agencies should use to 

focus on what the risks of fraud are, what they can do about it, and 

how they can measure it. It is a similar concept to improper payments. Before we started doing financial audits in the Federal Government, nobody was measuring improper payments. So, Congressional Agencies need to focus on this the same way we did with the 

improper payments. Congress passing legislation on the improper 

payments problem was key. GAO first worked with the IGs and we 

were the first ones to estimate improper payments in the Agencies. 

I am pleased to see that our fraud-risk framework—it is part of 

the legislative package that you are talking about passing. So, I 

would encourage you to pass that to put that framework in place 

at the Agencies. 

Then, we need to work with the Agencies to have better controls 

in place. We looked at health care fraud cases where convictions 

were made by the courts. And, we found, in 40 percent of the cases, 

it was people billing for services that were never provided. 

We see that as a frequent aspect of improper payments—poor 

documentation. I am concerned that Agencies do not take these 

problems seriously. When Agencies have programs vulnerable to 

fraud and there is missing documentation—and they have asked 

for it four or five times before determining it is not there—we believe it is important to further investigate. 

So, there needs to be more attention to it. You need a framework 

in place. Congress has that, now, in the proposed legislation based 

on our framework. If you pass that—put it in legislation, I think 

you will see a lot of changes. 

But, we need the Agencies’ participation. The problem is too difficult for just GAO and the IGs to work on. So, we need Congress 

to hold their feet to the fire as well. 

Chairman JOHNSON. Can you talk, specifically, though—so, you 

have the Inspector General of the IRS, basically, doing a pretty 

good study showing—and giving us a macro number for the Earned 

Income Tax Credit, which is a powerful piece of information we can 
19 

use to prompt reform. The problem is that these other instances of 

fraud are anecdotal. 

Mr. DODARO. Yes. 

Chairman JOHNSON. And so, certainly, when I have used the 

anecdotes—I hear ‘‘Well, yes, that is—but it is nowhere near 20 

percent or whatever.’’ How do we turn those micro anecdotes into 

the macro numbers that really will drive action—that will actually 

force action—that will create the political will to force action here 

in Congress? Either you or Tom could answer that one—or if you 

have any thoughts on it. 

Dr. COBURN. Well, I would comment first on Medicare and Medicaid fraud. They are designed to be defrauded. I mean, think about 

it. You are fixing the wrong problem. What you have to do is 

change the design of the Medicare and Medicaid programs so that 

they are not susceptible to fraud. Otherwise, you are going to end 

up with a bureaucrat in every office in every medical facility. If you 

really want to get it right—because the program is based on the 

integrity of doing the right thing—and now we are spending all of 

this money to try to find those who are not doing the right thing. 

So, you could spend more money trying to prevent spending wrong 

money than you would ever save. So, you end up spending more 

money. 

So, my first answer is that you always try to fix the real disease—not the symptoms. The fraud on Medicare is because of the 

way the system is set up. It is designed to be defrauded. 

Chairman JOHNSON. So, being a doctor, yourself—being a provider—describe the difference between private sector health care, 

in terms of the level of fraud and what controls are in place there 

as opposed to Medicare. 

Dr. COBURN. Really easy. Blue Cross Blue Shield (BCBS) knows 

everything about every patient I see. They know my practice patterns. They know my reimbursement patterns. They know when I 

see a patient. They have computer algorithms. They know what is 

going on. Medicare does not have that. They have no idea. 

So, Blue Cross Blue Shield and the rest of the insurance companies—every provider—they know what their parameters are and, 

when they see something pop out of the parameter, do you know 

what the first thing they say is? They say, ‘‘We are not paying this. 

Send us information.’’ And, no human touches that. That is a computer program that sends an e-mail to my office that says, ‘‘We are 

not paying this because this does not smell right.’’ 

Chairman JOHNSON. So, these solutions exist. 

Dr. COBURN. Yes. 

Chairman JOHNSON. And, so many of these problems—I mean, 

this is just one example—using that as an example—these solutions exist in the private sector. They are just table stakes. In the 

private sector, this is how things operate. But, it has just been impossible to implement these things that already exist and have 

them implemented in the government. And, as a result, we are 

paying billions of dollars in fraudulent payments. 

Mr. DODARO. What Dr. Coburn just mentioned is similar to one 

of our outstanding recommendations, based on this work. Physician 

profiling, which is what Dr. Coburn is talking about—and the Centers for Medicare and Medicaid Services (CMS) is beginning to 
20 

1The recommendations submitted by Mr. Dodaro appears in the Appendix on page 66. 

have something in place. They have started down that path, but 

they need to do much more. 

So, our recommendation is to try to take some of the private sector best practices and have them implemented in the government 

setting. But, CMS is too slow to put them in place. 

Chairman JOHNSON. So, I am over my time, but I will just ask 

a rhetorical question. So, why does the head of HHS or Medicare 

not go to the private sector and say, ‘‘Just implement this here? ’’ 

It drives me nuts. Senator Lankford. 

Dr. COBURN. Just as an aside, it was offered to them for free. 

They did not take it. Just to let you know that. 

Senator LANKFORD. I know we are about to be called for votes, 

so let me cut to the chase. I have several things I would love to 

be able to talk about—both with the Federal fleets, the management of that, and several recommendations you have on that—and 

quite a few other areas—on Social Security Disability Insurance, 

things that we have worked on together in the past and things that 

are very obvious. 

I was just as frustrated last October, when that budget piece 

passed that included an incredible punt on Social Security Disability Insurance. And, the frustration is that we never seem to fix 

anything here until we have a deadline. We finally had a deadline 

to do something and it was punted for 7 years instead of actually 

faced. So, we will have to deal with that in the days ahead. 

The issue I want to be able to bring up and be able to drive 

home, though, deals with emergency spending and recisions. There 

is some conversation moving around Congress, right now, that 

there are some important things that are happening right now with 

Zika, with opioids, with the Flint, Michigan water crisis, and with 

other things—and the conversation involves people saying, ‘‘These 

are emergencies. We need to break the caps. We need to have 

something uniquely different on this because it is very important.’’ 

Your report also details things like the Home Affordable Refinance Program (HARP) and multiple other areas where there are 

recisions and de-obligated balances—where there are billions of dollars that are still sitting there, basically, because they are obligated 

to programs that are not functioning anymore. Can you give me a 

little bit of detail about that? 

Mr. DODARO. Yes. We have several recommendations that focus 

on suggested recisions. This is an area Dr. Coburn and I talked 

about early on. It is hard to identify specific recisions, but we have 

three examples of areas where there is money that could be rescinded—and I will provide those for the record.1 They are in our 

recommendations to Congress. 

One is the Advanced Technology Vehicles Manufacturing (ATVM) 

Program. We think there is about $4 billion there. There are unobligated balances at the Department of Energy (DOE) and the Department of State (DOS) totaling several hundred million dollars. 

HARP as you mentioned—we think there is the potential there for 

$2 or $3 billion in recisions to take place. So, we have highlighted 

those in the report—and I would encourage Congress to act on 

them. 
21 

Senator LANKFORD. OK, thank you. I will yield back my time, because we are getting close to voting time. 

Chairman JOHNSON. Senator Carper. 

Dr. COBURN. Can I just make one comment? In my 16 years of 

service up here, I have never heard of an Agency that said it had 

more than enough money. I mean, truly. And, that is not to be critical of the Agencies, because they are going to protect their turf. 

But, I would put forward to you that there is not an Agency in the 

Federal Government that you cannot find 10 percent waste in— 

minimum. So, if you take the discretionary and the management 

side of the mandatory spending, you can find, easily, one hundred 

billion dollars a year in our budget that could be put toward health 

care for our seniors and veterans care for our veterans. You could, 

actually, do that if you had the willingness to actually do the hard 

work. 

And, what I found is that, on this Committee, we had a lot of 

people willing to do the hard work, but, in the rest of Congress, I 

did not find it. In other words, when you talked about it, there was 

kind of a blank stare. ‘‘I do not want to listen to this, because I 

do not want to do that,’’ and, I think that part of your job is to go 

out and sell everybody. We have ways to solve these problems. We 

know. We have actually done the oversight. Oversight is the most 

effective tool that we have, in Congress, to actually make changes 

that positively impact America. 

Senator CARPER. When the President submitted his budget for 

2017, Gene, I think, he recommended a very small increase for 

GAO. I think under some of our cuts in recent years, the resources 

for GAO have been diminished—and it is only a couple of percentage points, but it is something, after having several years of freezes 

or cuts—and my hope is that we will do that. 

You have testified before, in this Committee, on the revenue side, 

as opposed to the spending side—and what we can do that would 

be smart, in terms of resources for the IRS and changes, in terms 

of, like, allowing folks who are, really, anywhere from incompetent 

to corrupt to continue to prepare tax forms and tax returns. Could 

you just talk about some of the things we might do—or ought to 

do—that actually would enable the IRS to do a better job, including 

the last piece that I talked about? 

Mr. DODARO. Yes. We have had a recommendation that Congress 

give the IRS the authority to regulate paid tax preparers. We did 

an undercover investigation a while back. We sent teams out to 19 

paid tax preparers and we worked out different scenarios of what 

the tax should be and ran it by the IRS. Only two of the 19 paid 

tax preparers gave us the right answers. And, some gave—— 

Senator CARPER. Say that again. How many out of 19? 

Mr. DODARO. Two. Two of 19. Only 2 of 19. And, some of the ones 

that gave us answers were off by so much that it would have cost 

penalties and increased interest—both to themselves as well as to 

the taxpayers. 

We also looked at the IRS’s records and the data that they had. 

And, we found that returns that were prepared by tax preparers 

had a 60 percent rate of errors in them compared to a 50 percent 

rate of errors in the tax returns of people who prepared their own 
22 

taxes. Over half of the returns with problems in the Earned Income 

Tax Credit were the result of paid tax preparers as well. 

Oregon has had a State program for a number of years that regulates preparers. Oregon taxpayers using preparers are more likely 

to get an accurate return—it is 72 percent more likely, in Oregon, 

than any other place in the country. So, some of the States have 

this. The IRS tried to do it. The court ruled they did not have the 

legal authority. And so, Congress needs to act, if you want the IRS 

to proceed. 

Simple math authority. For some errors, the IRS could use administrative records to fix the returns right away. They would not 

have to do an audit, which burdens the taxpayers and others. It is 

possible to do this with due process. We think that should be put 

in place. 

Allowing—or requiring—more electronic filing of information 

from employees to the IRS, specifically, to bring the threshold from 

250 employees down to about 5 or 10, using electronic means—that 

would be an improvement. 

I would compliment Congress that they did act on our recommendation last year to move up the date for W–2 information 

to be sent so the IRS has it now at the end of January, rather than 

in April. This will allow the IRS to match it with filed returns. This 

will help prevent identity theft refund fraud as well as improve the 

administration of the current tax system. 

Those are a few of the things that we have—— 

Senator CARPER. That is great. One of the things that Dr. 

Coburn and I worked on for some time was—no, I am not going to 

go there. That is going to take too long. 

Let me just conclude by saying—go ahead. 

Dr. COBURN. I just want to comment on it. Before I came to the 

Senate—and you were here, Tom—the Senate Finance Committee 

actually did a study that Senator Trent Lott authored on the IRS 

and professional preparers. And, what it showed was that, of the 

10 regional branches of the IRS, where they went to them with this 

tax data, they got a different answer at every IRS location. So, that 

tells you something. Then, when they went to the formal tax preparers—and I am talking about the big firms, not the small ones— 

they got a different answer. So, the question is: who is right? 

So, again, it is about going back to fixing the real disease, instead of the symptoms. What we need is a simpler, fairer, and flatter tax code, so that everybody pays something, everybody knows 

when they pay it, they pay the right amount, and they are not in 

jeopardy. People worry to death about hearing from the IRS, thinking, ‘‘Maybe my taxes were not right.’’ So, this means fixing the 

real disease: changing the tax code. 

And, if you changed it properly, you could save 90,000 Federal 

employees—90,000—who, by the way, make 77 percent more than 

the average American—77 percent. That is according to the U.S. 

Bureau of Economic Analysis (BEA). So, the average Federal employee is making 77 percent more—and then, when we are doing 

our taxes—trying to do it right at each place—if you send it to 10 

different places, you get a different answer each place. 

Senator CARPER. Yes. Let me conclude with this. One of the requests by John Koskinen, the Commissioner of the IRS, to us, the 
23 

other day, was—you know what we did for DHS. They were having 

a hard time hiring and retaining their cyber warriors, so we made 

some modifications. We gave them some flexibility there, which 

they are beginning to use now. 

One of the things that the IRS has asked us for is to restore 

what they call streamlining compensation. It is like a million dollars a year, but they use it for information technology (IT). They 

hire IT people. They train them, they get to be good, and they get 

hired away. And, we have gone, I think, 3 years without restoring 

that. That was just an example of somewhere we can actually 

spend some money to save money. 

I will close with this thought. It is hard to believe when I tell 

younger people, but it was not all that long ago that we actually 

had a balanced Federal budget. We had not one, not two, not three, 

but, actually, four—if you will recall, the last 4 years of President 

Clinton’s Administration and going into President Bush’s Administration. 

And, if you look at the percentage of the GDP that we spent, it 

was about 20 percent in each of those 4 years. If you look at the 

percentage of the GDP that revenues accounted for, it was about 

20 percent. And, today, I think we are spending about 22 to 23 percent of the GDP—— 

Dr. COBURN. Twenty-four. 

Senator CARPER [continuing]. Twenty-four. And, our revenues are 

17 or 18 percent. And, clearly, we need to do something on—just 

like the Bowles-Simpson Commission. We need to do something on 

the spending side. It cannot just be all discretionary spending, or 

defense spending, or entitlement spending. There has to be a combination thereof. And, we need to do something on the revenue side 

as well. 

Dr. COBURN. If I could gently challenge you—— 

Senator CARPER. Please. 

Dr. COBURN [continuing]. On the 4-years of balanced budgets, 

under GAAP, you had one year—and it was $14 billion. That did 

not have anything to do with Congress. It had everything to do 

with the year 2000 (Y2K) and the additional forward purchasing. 

So, it was nice to say we had a balanced budget, but, on GAAP 

terms, you only had one year. 

Senator CARPER. Yes. The other thing we had going in force then 

was a very strong economy—— 

Dr. COBURN. Yes. 

Senator CARPER [continuing]. And, one of the best ways we could 

strengthen the economy would be to show that we have the discipline here, the wherewithal, and the willingness to work together 

to do some of the things that we are talking about. And, the spirit 

that you really demonstrated here, Tom, for all of those years— 

and, frankly, the spirit that Gene and his troops have, as well, I 

think is still alive—and our job is to make sure that we do not let 

that flame die. Thank you. 

Chairman JOHNSON. Thank you, Senator Carper. 

By the way, we are also 15, 16, and 17 years further away from 

this ‘‘Baby Boomer’’ bubble with all of these entitlements, which 

has been pretty obvious and people just ignored it. 
24 

By the way, Senator Coburn, I like your root cause analysis of 

the tax system. Rather than try and fix the symptom, which is a 

complex system, and rather than trying to figure out how to get 

people to prepare taxes properly in a complex system—just simplify 

the system. Scrap it and set up something, I always say, elegantly 

simple. Two basic principles: Raise the revenue we need and do no 

economic harm. Stop trying to socially and economically engineer 

through the tax code. We do a terrible job. But, anyway, there is 

my pontificating, I guess. 

I want to thank both of you. I mean, you have laid the groundwork, through your efforts, for this Committee to actually take 

some action and enact that continuous improvement. And, by the 

way, we are getting some results. People do not realize that, but, 

using an approach that, certainly, Tom, you were, certainly, engaged in—trying to find areas of agreement that unify us—you can 

actually get results. 

We have passed 69 pieces of legislation through this Committee—most of them unanimously. Twenty-four bills now have 

been signed into law. There is another piece of legislation that is 

waiting on the President’s desk. In some way, shape, or form we 

have gotten it to the President’s desk—gotten the result. And, I 

really do hope that Senator Carper will join me on this piece of legislation that we would like to get on the floor, because nobody 

can—again, not one Senator can hold it up if we get it to the floor. 

Leader McConnell is committed to doing so. So, we can actually implement some of these great recommendations from GAO. So, I 

hope you join us on that. 

Senator CARPER. Let me just say, if I could, Mr. Chairman, I 

think we have done good work. I am proud of what we have done, 

building on the record that Dr. Coburn helped to create. And, I am 

very much interested in the package that puts together a lot of the 

stuff that I helped to write or authored. 

The other thing I am really interested in doing, as you know, is 

taking up and legislating on USPS reform—and I want to get that 

done. We need to get that done. It is eminently fixable. Dr. Coburn 

and I tried very hard to fix it—and that is something we should 

do. But, I think we can do both and we need to. 

Chairman JOHNSON. And, we are working with you and the 

House of Representatives to try and accomplish something there. 

But, again, gentlemen, thank you for everything you have done 

for your country and for this Committee. Thank you for coming 

here today and for testifying. You are great Americans. 

And, with that, I think I have to read the magic words here. This 

hearing record will remain open for 15 days, until May 12 at 5 

p.m., for the submission of statements and questions for the record. 

This hearing is adjourned. 

[Whereupon, at 12:14 p.m., the Committee was adjourned.] 
(25) 

A P P E N D I X 
26 

reforms. I've heard from the majority leader that he is very supportive of moving bipartisan 

government reform legislation through the Senate. 

By focusing on these areas of agreement, we can pass legislation that makes a real difference in 

addressing government waste. I look forward to discussing this bill further with my colleagues. 

I am grateful for Senator Coburn being here today to call attention to duplication and waste, and 

I look f(Jrward to hearing from him and the Comptroller General about what more we can do. 
27 

Statement of Ranking Member Tom Carper 

"Government Reform: Ending Duplication and Holding Washington Accountable" 

Wednesday, April27, 2016 

As prepared for delivery: 

I want to thank Chairman Johnson for holding this hearing today. I also want to thank our 

witnesses, Mr. Gene Dodaro, and our friend Dr. Coburn for joining us to examine the GAO's 

annual 'duplication' report. 

Let me start off my statement by saying a word about our former colleague. Most people 

probably don't know this, but we actually have Dr. Coburn to thank for this hearing and for the 

attention that GAO and Congress are now giving to duplication and inefficiency in government. 

In 2010, Dr. Coburn offered an amendment to require GAO to conduct this annual report. That 

amendment was approved by a vote of94 to 0, illustrating the bipartisan desire to look in every 

nook and cranny of the government for ways to save money. 

I had the privilege of working with Dr. Coburn on this committee over the years to do just that. 

In fact, we spent some time working on many issues highlighted in GAO's report. By taking on 

these issues, we tried to find a bipartisan way forward to improve the functioning of government 

and save taxpayer dollars. So I'm pleased that Dr. Coburn is with us today to provide us with his 

thoughts on Congress' role in overseeing the federal government, legislation to improve 

transparency, accountability, and efficiency in the Executive branch, and also his history and 

experience with this report. This report continues GAO's now 6-year examination of the federal 

government to identify major instances of fragmentation, overlap, and duplication. Throughout 

each of the reports issued in that time, GAO has provided a number of recommendations for 

Congress and the Executive branch that, if implemented, have the potential to save money and 

make our government more efficient. 

Some of the issues we will have the opportunity to discuss today have long been of interest to 

members of this Committee. They include real property management, the root causes of 

improper payments in Medicare and Medicaid, the functioning of the Internal Revenue Service, 

and problems with the Post 9/11 G.!. bill overpayments to name a few. We have seen progress on 

some of these issues and should recognize the work that has been done by agencies and by the 

Congress. For example, GAO estimates that through addressing its recommendations over the 

past five years agencies and Congress have realized roughly $56 billion in financial benefits in 

fiscal years 2010-2015. And GAO estimates an additional $69 billion in benefits through 2025 

for a grand total of approximately $125 billion in financial benefits from 2010 through 2025. 

However, we are seeing some troubling trends, such as increases in the number of improper 

payments government-wide and a lack of progress in vital programs such as Medicare and 

Medicaid. In fact, just over the past year or so we've seen an increase in improper payments in 

the Medicaid program alone by just under $10 billion dollars. 

Simply put, there is more work that needs to be done. But in saying that, I should note that many 

of the challenges discussed in GAO's reports arc complex and dit1icult to solve. They cut across 
28 

various departments and involve programs that each have their own constituencies and, in many 

cases, provide the public with services they need and rely on. So what GAO does by shining a 

spotlight on these challenges is call on those of us here in Congress and our partners in the 

executive branch to show leadership and exercise oversight to determine where unnecessary 

duplication exists, where it can be eliminated, and where we need better coordination among 

government programs with similar missions. 

With that in mind I would like to highlight a bipartisan, bicameral bill that I introduced with our 

Chairman and a number of my colleagues that builds on longstanding management efforts to 

increase the efficiency and effectiveness of the federal government and enhance its ability to 

address many of these issues. This bill, the Getting Results through Enhanced Accountability and 

Transparency Act, would update the decades-old statutes that govern how agencies manage and 

review their operations to help them identify opportunities for efficiency and economy in all of 

their functions, and activities. It would also ensure that agencies address issues of duplication in 

their strategic planning, including in their annual perfonnance plans they send us along with their 

budget submissions to Congress. Other provisions would enhance collaboration among agencies 

through existing management and performance structures, such as the Performance Improvement 

Council (PIC) and efforts like the cross-agency federal priority goals monitored by OMB. I look 

forward to working with the GAO, OMB, and members of this Committee to move this bill 

forward in the near future. 

Finally, I want to close by thanking Mr. Dodaro and his team at GAO for the hard work that 

went into putting this report together. My colleagues have heard me say many times that I think 

of this report and GAO's High Risk List as our to do lists here on this Committee and in 

Congress. GAO consistently provides us with information we can use to help get better results 

for less money so all of us are very thankful for your service. My thanks again to both of you for 

joining us to discuss these important issues today. I look forward to your testimony. 
29 

For Release on Delivery 

Expected at 10:00 a.m. ET 

Wednesday, April27, 2016 

GA0-16-580T 

United States Government Accountability Office 

Testimony 

Before the Committee on Homeland 

Security and Governmental Affairs, 

U.S. Senate 

GOVERNMENT 

EFFICIENCY AND 

EFFECTIVENESS 

Opportunities to 

Reduce 

Fragmentation, 

Overlap, and 

Duplication and 

Achieve Other 

Financial Benefits 

Statement of Gene L. Dodaro 

Comptroller General of the United States 
30 

GAO 

Highlights 

Hlghil!l~tsiit{l'Aq;,~~~o;, al~otioiQny 

~~~~~~~~~~~~~&~~~!!,c~fny, 

wtiyJi~~~J~bisS~~t·· Thefed~ral govern,hell~ ~pit~u~ato face. an unsustainable id~!l:l~rljl.fiscal· 

path 6a~ed on'thelmbalan~e between 

To bting these; o.PR?rtunities tQ light,> 

Congress inciU<!ed ,a provision in 

statute f~r GAO.to annually identify 

federat,prqgr~ms~ ~,~~~J~~ieS,,,'9ffjc~s( 

and initiative,s.(t:>otH within departlt)ents 

and govemml!hl'W.lde).tha{ are 

duplipatiVe, .As)liui of.thi.s work, GAO 

also idef\lifles areas that.are .• 

fragmented ?i•oveti~~Ping as well as . addtliqnaloppettunltles to achieve cost 

sa~ings ~r,Em~a,~pe~, re:y~~~e , , ,\, collection,cG,AO:s'i<016 imnual.rel)oft is Its si)lth in.lhis s<>rtes (GA0-16-375SP) •• 

This state merit discusses 

new issues' GAO ldentlfles. in its 

2016 report; • 

the st~tus of actions Congtess and, 

executiVe btanc.h .~9~!1~ies haVe takento·adi:lresslSsu'esGI\0 

ideritifi~d'inlt~ 2011,2015reports;., and ·· · · 

opportunities to ach)eve siQniltcant ·. 

benefits from selected areas 

included in this year's and. PaSt 

~nnu~l reppf1:S. ' 

To identify .wilat.actions exist to 

a~d.dre,ss ti!~,~e ,l~$U~~ a~~, ~1:1~~, adyantaga:O'topportunltieS:foc <;Ost 

saving'! anq enhartcect'f<!venues, Gl\q 

reviewed and updateo prtor work, · 

includlnfj recomljlendatioils Jor 

executive act(~n and.rpatters lor 

congressional consideration, . 

View GA0-16-580T. Pof more information, 

contact Ortce William~ Brown at 202·512-8678 

orwillf~mio@~aO-,go~ or'A f'.llcOie,Ciowers at clowersa'@gao,gov 'or (202) 5i2~7114. 

GOVERNMENT EFFICIENCY AND 

EFFECTIVENESS 

Opportunities to Reduce Fragmentation, Overlap, and 

Duplication and Achieve Other Financial Benefits 

What GAO Found 

GAO's 2016 annual report identifies 92 new actions that Congress and executive 

branch agencies could take to improve the efficiency and effectiveness of 

government in 37 areas. GAO identifies 12 areas in which there is evidence of 

fragmentation, overlap, or duplication. For exam pte, GAO found that the Internal 

Revenue Service could potentially collect billions of dollars in taxes owed and 

save resources by better managing fragmentation and overlap, improving 

communication, and streamlining processes within its nine public referral 

programs. GAO also identifies 25 areas where opportunities exist to reduce the 

cost of government operations or enhance revenue collections. For example, 

GAO found that Medicare could save billions of dollars if Congress were to 

equalize the rates Medicare pays for certain health care services, which often 

vary depending on where the service is performed. 

Congress and executive branch agencies have made progress in addressing the 

544 actions government-wide that GAO identified in its past annual reports. As of 

March 2, 2016,41 percent of these actions were addressed, 34 percent were 

partially addressed, and 20 percent were not addressed. Congressional and 

executive branch efforts to address these actions over the past 5 years have 

resulted in roughly $56 billion in financial benefits, with at least an additional $69 

billion in estimated benefits projected to be accrued through 2025. These 

estimates are based on a variety of sources that considered different time 

periods, assumptions, and methodologies. 

Status of 2011~2015 Actions Directed to Congress and the Executive Branch, as of March 2, 

2016 

While Congress and executive branch agencies have made progress toward 

addressing the actions GAO has identified, further steps are needed to fully 

address the remaining actions. GAO estimates that tens of billions of additional 

dollars would be saved should Congress and executive branch agencies fully 

address actions that are currently partially addressed or not addressed, including 

the new actions GAO identified in 2016. A substantial number of GAO's actions 

from the 2011-2016 annual reports fall within the areas of health care, defense, 

and revenues, and these areas have significant opportunities for cost savings or 

other financial benefits. For example, in the 2015 annual report, GAO reported 

that DOD could potentially achieve hundreds of millions of dollars in cost savings 

by re·evaluating its headquarters reductions efforts and conducting periodic 

reassessments of workforce requirements. 

-------------United States Government Accountability Office 
31 

Chairman Johnson, Ranking Member Carper, and Members of the 

Committee: 

I appreciate the opportunity to discuss our 2016 annual report, which 

presents 92 new actions for Congress or executive branch agencies to 

reduce, eliminate, or better manage fragmentation, overlap, and 

duplication and achieve other financial benefits. 1 My testimony today 

describes (1) new issues identified in our 2016 annual report; (2) the 

status of actions taken by Congress and executive branch agencies to 

address the issues identified in our past annual reports;' and (3) 

opportunities to achieve significant benefits from selected areas included 

in this year's and past annual reports. 

My comments are based upon our 2016 annual report, which was 

released on April 13, 2016, as well as our update on the progress made 

in implementing actions that we have suggested in our previous annual 

reports. 3 These efforts are based upon work GAO conducted in 

accordance with generally accepted government auditing standards. 4 

1

GAO, 2016 Annual Report: Additional Opportunities to Reduce Fragmentation, Overlap, 

and Duplication and Achieve Other Financial Benefits, GA0-16-375SP (Washington, D.C 

Apr. 13, 2016) 

2

GAO, Opportunities to Reduce Potential Duplication in Government Programs, Save Tax 

Dollars, and Enhance Revenue, GA0-11-318SP (Washington, D.C .. Mar. 1, 2011 ); 2012 

Annual Report: Opportunities to Reduce Duplication, Overlap and Fragmentation, Achieve 

Savings, and Enhance Revenue, GA0-12-342SP (Washington. D.C .. Feb. 28, 2012); 

2013 Annual Report: Actions Needed to Reduce Fragmentation, Overlap, and Duplication 

and Achieve Other Financial Benefits, GA0-13-279SP (Washington, D.C.: Apr. 9, 2013); 

2014 Annual Report: Additional Opportunities to Reduce Fragmentation, Overlap, and 

Duplication and Achieve Other Financial Benefits, GA0-14-343SP (Washington, D.C 

Apr. 8, 2014); and 2015 Annual Report: Additional Opportunities to Reduce 

Fragmentation, Overlap, and Duplication and Achieve Other Financial Benefits, 

GA0-15A04SP (Washington, D.C.: Apr. 14, 2015). 

3

See GAO's Action Tracker, a publicly available website that includes progress updates 

and assessments of the actions from this series of reports. 

4Because our 2016 annual report is based on previously issued GAO products, in many 

cases we cite November 1999 internal control standards as criteria; see GAO, Standards 

for Internal Control in the Federal Government, GAOJA!MD-00-21 3 1 (Washington, D.C.· 

November 1999). When cited, these criteria were effective at the time of our review 

However, new internal control standards for the federal government became effective 

beginning October 1, 2015; see GAO, Standards for Internal Control in the Federal 

Government, GA0-14-704G (Washington, D.C .. September 2014). Any correct1ve action 

that agencies p!an to take should be in accordance with the new standards 

Page 1 GA0~16-580T 
32 

Ninety-Two New 

Actions Identified to 

Improve Efficiency 

and Effectiveness 

across the Federal 

Government 

More details on our scope and methodology can be found in the full 

report. 

Of the 92 new actions we identified in our 2016 annual report, 33 are 

directed at the 12 areas in which we found evidence of fragmentation, 

overlap, or duplication in government missions such as defense, 

economic development, health, homeland security, and information 

technology.' As described in table 1, these 12 areas span a wide range of 

federal functions or missions. 

Table 1. Fragmentation, Overlap, and Duplication Areas Identified in GAO's 2016 Report, by Mission 

Mission 

Defense 

Economic development 

Areas identified 

DOD Commercial Satellite Communication Procurements: Enforcing existing 

acquisition policy and identifying opportunities to centralize the Department of Defense's 

procurement of commercia! sate!Hte communications services could create opportunities 

to potentially save tens of millions of dollars annually 

DOD's Storage of Occupational and Environmental Health Surveillance Data: 

Inconsistencies among the policies of the Department of Defense and the military 

services have contributed to fragmented and duplicative efforts to store occupational and 

environmental health surveillance data needed to track and assess service~related 

_health conditions of retuming servicemembers and veterans 

Weapon System Portfolio Management: By using portfolio management more 

effectively, the Department of Defense could help ensure that the more than $100 billion 

it spends annually on weapon system acquisitions contributes to its strategic goals and 

could reduce the potential for overlapping and unnecessarily duplicative investments. 

Manufacturing Loan Guarantees: The Economic Development Administration could 

better ensure that the activities carried out under the Innovative Technologies m 

Manufacturing program do not duplicate the efforts of other federal loan guarantee 

programs by working with other agencies to identify and target capital access gaps not 

filled by other programs. 

Page2 

not include the six new actions that were added to existing areas we previously 

in our 2011-2015 annual reports 

GA0-16-SSOT 
33 

General government 

Health 

Homeland securityllaw enforcement 

Financial Regulatory Structure: To reduce or better manage fragmentation and 

overlap, Congress should consider changes to the financial regulatory structure, and the 

Board of Governors of the Federal Reserve System and the Office of Financial Research 

should take steps to improve collaboration in monitoring systemic risk 

IRS's Public Referral Programs: The Internal Revenue Service could potentially collect 

billions of dollars in tax underpayments through Its nine public referral programs and 

save resources by better managing fragmentation and overlap, improving 

communication, and streamllning processes. 

Medicaid and Exchange Coordination: The Centers for Medicare & Medicaid Services 

should take actions to minimize the risk of duplicative federal spending on health 

insurance coverage for individuals transitioning between Medicaid and exchange 

coverage. 

Department of Homeland Security's Human Resources Systems: To address issues 

related to fragmented systems and duplicative processes, the Department of Homeland 

Security should take steps to (1) ensure that its Human Resources Information 

Technology investment receives necessary oversight and attention from its steering 

committee and (2) evaluate and update the investment's strategic planning document. 

Security of Federal Facilities: The Federal ProtectiVe Service and General Services 

Administration need to improve collaboration in key areas to better manage 

fragmentatiOn and enhance the agencies' ability to protect federal facilities. 

-;l-nf;-o-nn-a-:ti-,-.o-n-:te-c-;h-n-o;-lo_g_y ______ "'Tr"ibc-a-;17

1nc;te-r-n-:et-:A;-c-c-es-s,--:-;oG:-re"a7te._r coordination among the Federal Communications 

Commission's Universal Service Fund subsidy programs and the U.S. Department of 

Agriculture's Rural Utilities Service grant programs could result in more efficient and 

effective support of Internet access for tribal communities. 

International affairs 

S(>l.Jrce GAO I GA0.16-580T 

U.S. Embassy Kabul Construction: A strategic facilities plan for construction projects 

in Kabul, Afghanistan, could enhance the planning and coordination among Department 

of State bureaus and reduce the likelihood of fragmented construction efforts and 

duplicative facilities 

U.S.~Funded Development Innovation Programs: The U.S. Agency for International 

Development should establish a joint approach to collaboration among its Development 

Innovation Ventures program and other similar U.SAunded programs in India to better 

manage overlap. 

We consider programs or activities to be fragmented when more than one 

federal agency (or more than one organization within an agency) is 

involved in the same broad area of national need and there may be 

opportunities to improve how the government delivers services. We 

identified fragmentation in multiple programs we reviewed. For example. 

in our 2016 annual report, we reported fragmentation in the Department 

of Defense's (DOD) procurement of commercial satellite communications 

services. We found that approximately 34 percent (about $290 million) of 

fixed commercial satellite communications was procured outside the 

Defense Information System Agency, contrary to DOD policy, and that 

DOD had not performed an analysis to identify inefficiencies and 

opportunities to consolidate purchases. Among other things, we 

recommended that DOD conduct a spend analysis that identifies 

procurement inefficiencies and opportunities to consolidate purchases in 

Page3 GA0-16-SSOT 
34 

order to potentially save tens of millions of dollars annually. DOD agreed 

with our recommendations but had yet to fully address them as of March 

2016. 

Fragmentation can also be a harbinger for overlap or duplication. Overlap 

occurs when multiple agencies or programs have similar goals, engage in 

similar activities or strategies to achieve them, or target similar 

beneficiaries. We found overlap among federal programs or initiatives in a 

variety of areas, such as the Internal Revenue Service's (IRS) nine public 

referral programs. We found that IRS could potentially collect billions of 

additional dollars in taxes owed through these programs and save 

resources by better managing fragmentation and overlap, improving 

communication, and streamlining processes. We made several 

recommendations to IRS, including that it establish a coordination 

mechanism to communicate across the multiple referral programs, 

develop an online referral submission process, streamline the review 

process, and improve external communication. IRS agreed with our 

recommendations and plans to implement some of them by October 

2016; however, it had not provided an action plan or time frames for other 

referral program recommendations as of March 2016. 

In other aspects of our work, we found evidence of duplication or risk of 

duplication, which occurs when two or more agencies or programs are 

engaged in the same activities or provide the same services to the same 

beneficiaries. An example of potentially duplicative federal efforts involves 

coordination between Medicaid and federally subsidized health insurance 

purchased through the exchanges created under the Patient Protection 

and Affordable Care Act. 6 Although a limited amount of duplicate 

coverage may be expected-and is permitted under federal law-for 

individuals completing the transition from subsidized exchange to 

Medicaid coverage, we found that duplicate coverage was also occurring 

outside of this transitional period. While the Centers for Medicare & 

Medicaid Services (CMS)-within the Department of Health and Human 

Services (HHS)-has taken some steps to minimize the potential for 

duplicate coverage in states with federally facilitated exchanges, we 

found that its policies and procedures were not sufficient based on federal 

standards for internal control. 

L. No. 111-148, 124 Stat 119 (2010), as amended by the Health Care and 

Education Reconciliation Act of 2010 (HCERA), Pub. L No. 111-152, 124 Stat. 1029 

(2010). for the purposes of this statement, references to the Patient Protection and 

Affordable Care Act include the amendments made by HCERA. 

Page 4 GA0-16·580T 
35 

We recommended that CMS establish a schedule for regular checks for 

duplicate coverage in states with federally facilitated exchanges and 

develop a plan to routinely monitor the effectiveness of the checks and 

other planned procedures to minimize duplicate coverage. HHS agreed 

with our recommendations and as of March 2016, was in the process of 

refining these checks, but had not established a schedule for doing so. By 

implementing our recommendation, HHS could ultimately help protect the 

federal government from unnecessary and duplicative expenditures. 

In addition to areas of fragmentation, overlap, and duplication, our 2016 

report suggested 59 new actions in 25 areas that Congress and executive 

branch agencies can take to reduce the cost of government operations or 

enhance revenue collections for the U.S. Treasury. These 25 areas exist 

in a wide range of federal government missions (see table 2). 

Table 2. Cost Savings and Revenue Enhancement Opportunities Identified in GAO's 2016 Report, by Mission 

Mission 

Defense 

Economic development 

Areas identified 

Defense Excess Property Disposal: Federal civilian agencies could potentially achieve 

millions of dollars in cost savings if they were able to obtain more of the Department of 

Defense's available excess personal property through the disposal process rather than 

purchasing similar property through a private sector supplier. 

DOD's Eligibility Determinations for Living Quarters Allowance: The Department of 

Defense (DOD) could potentially achieve cost savings by monitoring its components' 

reviews of eligibility detenninations for the over $500 mH!ion spent annually on living 

quarters allowance for civilian employees to better ensure that DOD components are not 

improperly providing this allowance. 

DOD Excess Ammunition: The Department of Defense could potentially reduce 1ts 

storage, demH!tarization, and disposal costs by hundreds of thousands of dollars by 

transferring excess serviceable conventional ammunition, including small arms 

ammunition, to federal, state, and local government agencies. 

DOD Leases and Use of Underutilized Space at Military Installations: The 

Department of Defense could potentially achieve millions of dollars in savings by 

identifying and implementing actions to increase use of underuti!ized facilities at its 

military insta!!ations, such as identifying opportunities to relocate some of its 

organizations currently in leased space to installations, communicating the availability of 

underutilized space to potential tenants, and seeking use by other federal agencies 

Treasury's Foreclosure Prevention Efforts: The Department of the Treasury could 

potentially achieve biHions in financial benefits by reviewing the potential for unexpended 

balances for the Making Home Affordable Program and deob!igating excess funds, which 

Congress could rescind and direct to other priorities. 

Page 5 GA0-16-580T 
36 

General government 

Health 

Bridge Contracts: When bridge contracts-which include extensions to existing 

contracts and short-term noncompetitive contracts to avoid a gap in service-are used 

frequently or for prolonged periods of time, the government is at risk of paying more than 

it should for goods and services. 

Federal Supply Schedules: Agencies are paying insufficient attention to prices when 

using the Federal Supply Schedules program and may be missing opportunities for cost 

savings. 

Federally Leased Vehicles: The General Services Administration and selected 

agencies could potentially reduce costs by improving the processes for justifying the use 

of vehicles in the federal fleet and taking actions for any vehicles that may be 

underutilized. 

Financing of Improvements of Federally Leased Space: In order to achieve millions 

in potential cost savings, the General Services Administration should explore the benefits 

and risks of loaning unobligated Federal Buildings Fund balances to tenant agencies to 

cover the costs of improving newly leased space, which would otheJWise be financed by 

private lessors at private-sector interest rates. 

Identity Theft Refund Fraud: The Internal Revenue Service and Congress could 

potentially save billions of dollars in fraudulent refunds by improving the agency's efforts 

to prevent refund fraud associated with identity theft. 

National Park Service Fees: The National Park Service could potentially increase 

revenues from the recreation fees it collects by milfions of dollars annually if Congress 

were to amend the authorizing legislation for this program and if the agency required 

park units to periodically review these fees. 

Unobligated Balances: To help ensure effective use of federal funds, the Departments 

of Energy and State should develop and finalize strategies for reducmg tens and 

hundreds of millions of dollars of excess unobligated balances. respectively, in two 

budget accounts 

Distribution of Medicaid Supplemental Payments: The Centers for Medicare & 

Medicaid Services should provide written guidance to state Medicaid programs clarifying 

its policies that the distribution of Medicaid supplemental payments be linked to the 

provision of Medicaid-covered services, and that such payments not be made contingent 

on the availabiHty of local funding for the non federal share-actions that could result in 

substantial cost savings 

Eligibility of Medicare Providers and Suppliers: The Centers for Medicare & Medica1d 

Services could use better information to help prevent ineligible providers and suppliers 

from enrolling in the Medicare program and improperly obtaining Medicare funds, 

potentially reducing the billions of dollars in improper payments that the program has 

paid out in recent years. 

Medicaid Demonstration Approved Spending: The Secretary of Health and Human 

Services could potentially curtail spending growth of Medicaid demonstrations, which 

have resulted in the authorization of bi!Hons of dollars in federal spending, by 

establishing specific criteria for assessing whether demonstration spending furthers 

Medicaid objectives and taking other steps to improve the transparency and 

accountability of the approval process 

Medicaid Eligibility Determinations: The Centers for Medicare & Medicaid Services 

shoutd assess the accuracy of federal Medicaid eligibility determinations to minimize the 

PageS GA0-16-SBOT 
37 

Health 

Income security 

Information technology 

International affairs 

Training, employment, and education 

Source GAO !GA0-16-SSOT 

Medicaid Payments to Institutional Providers: The Centers for Medicare & Medicaid 

Services should take steps to improve the oversight of state Medicaid payments to 

institutional providers and better ensure that the federal government does not provide 

funds for excessive state payments made to certain providers, which could result in 

savings of hundreds of mtHions of dollars. 

Medicare Payments by Place of Service: Medicare could save billions of dollars if 

Congress were to equalize the rates Medicare pays for certain health care services, 

which often vary depending on where the service is performed. 

Disability Insurance and Federal Workers' Compensation: The Social Security 

Administration should take steps to minimize overpayments from the Socia! Security 

Disability Insurance program to individuals who also received federal workers' 

compensation, which could help to achieve potentla! cost savings associated with 

millions of dollars of overpayments from the Social Security Disability Insurance 

program. 

Disability Insurance Overpayments: To help prevent the loss of bi!!ions of dollars. the 

Social Security Administration should take steps to prevent overpayments to 

beneficlaries of the Disability Insurance program and improper waivers of beneficiaries' 

overpayment debt. 

Disability Reviews: The Social Security Administration may increase federal savings 

realized as a result of disability reviews by further considering factors that affect 

individuals' lifetime benefits when prioritizing its reviews of Disability Insurance 

VA's Individual Unemployability Benefit: To potentia!!y achieve cost savings, the 

Department of Veterans Affairs should develop a plan to study whether age should be 

considered when deciding If veterans are unemployable due to service-connected 

disabilities. By comparison, other benefit programs, such as Social Security Disability 

Insurance, consider retirement age a cause for ineligibility and convert benefits for those 

reaching their retirement age to a Social Security retirement benefit. If the department 

were to determine that Total Disability Individual Unemployabmty benefits should be 

provided only to veterans younger than their full Social Security retirement age, it could 

achieve an estimated $15 billlon in savings from 2015 through 2023, according to the 

Congressional Budget Office. 

Federal Mobile Telecommunications: In order to achieve substantial government-wide 

savings, federal agencies should establish better controls on mobile device spending, 

and the Office of Management and Budget should monitor progress in achieving these 

savings. 

Cargo Preference for Food Aid: A clearer definition of "geographic area" in legislatiOnon cargo preference forfood aid could allow the U.S. Department of Agriculture to 

achieve financial savings by more fully utilizing the flexibility Congress granted when it 

lowered the statutory cargo preference requirement 

Post 9/11 GIS ill Overpayments: The Department of Veterans Affairs could achieve 

substantial savings by developing guidance and controls to reduce the volume of annual 

Post-9/11 Gl Bill overpayments-which amounted to over $400 mi!!ion in fiscal year 

2014-and to improve the collection of overpayment debts, of which $262 million was 

still outstanding as of November 2014. 

Page 7 GA0-16-5BOT 
38 

Examples of areas with opportunities to reduce costs or enhance revenue 

collections from our 2016 annual report include Medicare Payments by 

Place of Service, Disability Insurance Overpayments, and National Park 

Service Fees. 

PageS 

Medicare Payments by Place of Service: In fiscal year 2015, 

Medicare served about 55 million beneficiaries at a cost of $634 

billion. In December 2015, we found that the program could save 

billions of dollars annually if Congress were to equalize the rates 

Medicare pays for certain health care services, which often vary 

depending on where the service is performed. For example, 

Medicare spending on hospital outpatient department services 

was over $40 billion in 2013 and is growing, in part because 

services that were typically performed in physician offices have 

shifted to more costly hospital settings. Following this shift, 

services once reimbursed at a lower total payment rate can be 

classified as hospital outpatient department services and 

reimbursed by Medicare at a higher rate, increasing program 

costs. 

We recommended that Congress equalize payment rates between 

physician offices and hospital outpatient departments for certain 

services. While the Bipartisan Budget Act of 2015 addresses this 

payment differential for some new providers, many providers will 

continue to be paid more than necessary for certain services, such 

as office visits. 

Disability Insurance Overpayments: In fiscal year 2014, about 11 

million individuals with disabilities and their dependents received 

approximately $143 billion in Disability Insurance (01) benefits, 

$1.3 billion of which the Social Security Administration (SSA) 

identified as overpayments. Additionally, SSA permanently waived 

over $2.4 billion in overpayment debt over the past 10 years. In 

our October 2015 report, we found that SSA's process for 

handling work reports by beneficiaries has internal control and 

other weaknesses that increase the risk of overpayments, even 

when Dl beneficiaries follow program rules and report work and 

earnings. In addition, SSA's process for handling requests to 

waive overpayments lacks sufficient controls to help ensure 

appropriate decisions are made. 

We made several recommendations to improve SSA's handling of 

overpayments, work reports, and waivers, including that SSA 

study automated reporting options and improve oversight of work 

GA0·16-580T 
39 

reports and waivers. SSA agreed with all of these except the 

recommendation to improve oversight of work reports. We clarified 

that oversight should help to ensure that staff are following proper 

procedures. As of March 2016, SSA has not fully addressed these 

recommendations. Until SSA takes these actions, it will likely 

continue to overpay beneficiaries and improperly waive 

overpayment debt, costing the federal government billions of 

dollars. 

National Park Service Fees: The Federal Lands Recreation 

Enhancement Act (FLREA) does not give the National Park 

Service (Park Service) and other agencies that charge recreation 

fees the authority to adjust the price of a lifetime senior pass, 

which has been $10 since 1993. 7 Without this authority, the Park 

Service is limited in its ability to increase revenue from this fee. In 

addition, the Park Service does not call for periodic reviews of 

recreation fees, even though federal policy on user fees instructs 

agencies to seek authority, if needed, to make changes warranted 

by their reviews' and our guide on user fees states that federal 

agencies should regularly review fees and make changes if 

warranted.' 

We suggested that Congress consider amending FLREA to give 

the agencies authority to adjust the price of a lifetime senior pass. 

A bill was introduced in September 2015 to increase the price of 

the senior pass to a one-time amount matching the price of the 

annual interagency pass, which is $80, as of November 2015. 10 If 

passed, this could generate millions of dollars in revenue annually. 

We also made recommendations to improve the Park Service's 

management of recreation fees. The Department of the Interior, 

Lands Recreation Enhancement Act, Pub. L. No. 108-447, div. J. tit VI! I, 118 

Stat. 3377 (2004) (codified as amended at 16 U.S. C.§§ 6801-6814 (2015)) 

8

0ffice of Management and Budget, OMB Circular A-25, User Charges ( 1993) 

9

GAO, Federal User Fees: A Design Guide, GA0-08-386SP (Washington, D.C May 29, 

2008). 

10National Park SeNice Centennial Act, H.R. 3556, 1141

h Gong. § 602 (2015). The annual 

interagency pass covers entrance fees and certain amenity fees for all federal recreational 

lands. The amount of additional revenue generated by adjusting the price of the senior 

pass could be lower if the amount of the price increase deters seniors from purchasing the 

pass 

Page 9 GA0-16-SSOT 
40 

Congress and 

Executive Branch 

Agencies Continue to 

Address Actions That 

Span the Federal 

Government 

Progress toward 

Addressing Actions 

which administers the Park Service, agreed with our 

recommendations and plans to begin addressing them in 2016. 

Improving the management of recreation fees could help the Park 

Service to better ensure that these fees are set at a reasonable 

leveL 

In addition to the new actions identified in this year's annual report, we 

have continued to monitor the progress that Congress and executive 

branch agencies have made in addressing the issues we identified in our 

2011-2015 reports. In response to our 2011-2015 annual reports, 

Congress and executive branch agencies have addressed a total of 224 

actions, including 55 actions since April 2015. 11 We found that these 

efforts have resulted in roughly $56 billion in financial benefits from fiscal 

years 2010 through 2015, with at least an additional $69 billion in 

estimated benefits projected to be accrued through 2025. 12 

Congress and executive branch agencies have addressed a total of 55 

actions since our last report. Of these 55 addressed actions, 44 were 

identified in our 2011-2014 annual reports, bringing the total number of 

addressed actions for the 2011-2014 annual reports to 213 actions-47 

percent of the 458 actions identified over that period (see fig. 1 ), 

11Actions were assessed as of March 2, 2016, the date we completed our aud1t work In 

assessing actions suggested for Congress, we applied the following criteria: "addressed" 

means relevant legislation has been enacted and addresses a!! aspects of the act1on 

needed; "partially addressed" means a relevant bill has passed a committee. the House of 

Representatives, or the Senate, or relevant legislation has been enacted but only 

addressed part of the action needed; and "not addressedn means a bill may have been 

introduced but did not pass out of a committee, or no relevant legislation has been 

introduced. In assessing actions suggested for the executive branch, we applied the 

following criteria: "addressed" means implementation of the action needed has been 

completed; ~partially addressed" means the action needed is in development, or started 

but not yet completed; and "not addressed" means the administration, the agencies, or 

both have made minimal or no progress toward implementing the action needed 

12!n calculating these totals, we relied on individual estimates from a variety of sources, 

which considered different time periods and utilized different data sources, assumptions, 

and methodologies. They represent a rough estimate of financial benefits and have been 

rounded down to the nearest $1 billion. 

Page 10 GA0·16·580T 
41 

Figure 1. Status of 2011~2014 Actions, as of 2015 and 2016 

2015 Status 2016 Status Change 2015 

to 2016 

Congressional 

Addressed U'' Partially 

Addressed ~ 10 

Not 8 Addressed 

Consolidated 

or Other ~ 5 

0 50 100 150 200 250 

Source GAO analysES i GA0·10.5130T 

Total Congressional 

169 0" 213 

178 ~10 

91 8 69 

liS 20 ~ 5 24 

• so 100 150 200 250 0 50 100 150 200 250 

Overall totals Overa!ltotal~; 

Note: Actions categorized as "consolidated or other" are no longer assessed. In most cases, the 

acUons were replaced or subsumed by new actions based on additional audit work or other relevant 

information. For example, actions categorized as "consolidated or other" may have been consolidated 

into other actions that we track. based on subsequent audit work. or significant changes in agency 

circumstances, or they may have been redirected from a congressional to an executive branch action, 

or vice versa. 

In our 2015 annual report, we identified 86 new actions for congressional 

or executive branch agency attention. 13 As of March 2, 2016, we found 

that 11 (13 percent) of the new 2015 actions had been addressed and 33 

(38 percent) had been partially addressed. 

In total, of the 544 total actions we identified in our 2011-2015 annual 

reports, we found that 224 (41 percent) were addressed, 185 (34 percent) 

were partially addressed, and 111 (20 percent) were not addressed. 14 As 

13Jn addition to the new actions identified in our 2015 annual report, we also added 19 

new actions to existing areas that we previously identified in our 2011-2014 reports 

14Percentages do not add to 100 due to rounding. ln addition, this year, 4 actions were 

categorized as "consolidated or other" for a total of 24 actions (4 percent) in this category 

from 2011-2015_ Actions categorized as "consolidated or other" are no longer assessed 

!n most cases, the actions were replaced or subsumed by new actions based on 

additional audit work or other relevant information. For example, actions categorized as 

"consolidated or other" may have been consolidated into other actions that we track based 

on subsequent audit work or significant changes in agency circumstances. or they may 

have been redirected from a congressional to an executive branch action, or vice versa 

Page 11 GA0-16-580T 
42 

figure 2 shows, many of the actions that have been addressed were 

identified in our 2013 or earlier reports-which that it frequently 

takes multiple years for actions to be fully ,rl,;rp•••·rl 

Figure 2. Progress in Addressing 2011~2015 Actions, as of 2015 and 2016 

2016 2016 

Actions 

identified 

in 2014 

Number of actions Number of actions 

100 100 

2016 

Assessment year Assessment year Assessment year Assessment year Assessment year 

i GAQ,1fl58GT 

Page 12 

Number of actions 

600 

Assessment year 

GA0·16·580T 
43 

Financial Benefits Related 

to Actions Taken by 

Congress and Executive 

Branch Agencies 

The progress Congress and executive branch agencies have made as of 

March 2, 2016, to address the actions we identified will result in 

approximately $125 billion in financial benefits from 2010 through 2025. 15 

Table 3 outlines examples of our addressed actions that have resulted in 

or are expected to result in cost savings or enhanced revenue. 

Table 3: Examples of Addressed Actions with Associated Cost Savings and Revenue Enhancements, 2010-2025 

Annual report 

2011 

2011 

2014 

2015 

2013 

2011 

2012 

2011 

Area identified 

Domestic Ethanol Production (Area 13): Congress allowed the Volumetric Ethanol Excise Tax Credit to 

expire at the end of 2011, which eliminated duplicative federal efforts directed at increasing domestic 

ethanol production and reduced revenue losses by $29 billion in fiscal year 2012 to fiscal year 2016. 

Farm Program Payments (Area 35): The Agricultural Act of 2014 eliminated direct payments to farmers 

and should save approximately $44 billion from fiscal year 2015 through fiscal year 2023, of which $5 

billion has accrued and $39 billion is expected to accrue in fiscal year 2016 or later, according to the 

Congressional Budget Office. 

Real Estate~Owned Properties (Area 18}: GAO estimated that the Department of Housing and Urban 

Development saved as much as $2.8 billion from July 2013 through June 2015 by implementing 

improvements to its property custody approach including reducing the number of foreclosed properties that 

it acquires by using other means of resolving troubled mortgages 

Tax Policies and Enforcement (Area 17): Congress amended the audit procedures applicable to certain 

large partnerships to require that they pay audit adjustments at the partnership level. This should raise 

$9.3 billion from fiscal years 2019 to 2025, according to the Joint Committee on Taxation. 

Combat Uniforms {Area 2): Consistent with our recommendation to avoid fragmentation, the Army chose 

not to introduce a new family of camouflage uniforms into its inventory, resulting in a cost avoidance of 

about $4.2 billion over 5 years, of which $1.7 billion has accrued since fiscal year 2014 and $2.5 billion is 

expected to accrue in fiscal year 2016 or later. 

Federal Emergency Management Agency (FEMA) Grants (Area 26): GAO estimated savings of $2.55 

billion from fiscal years 2011 through 2013 due to Congress limiting preparedness grant funding until 

FEMA completes a national preparedness assessment of capability gaps. 

Overseas Defense Posture (Area 37): The United States Forces Korea conducted a series of 

consultations with the military services to evaluate the costs and benefits associated with tour 

normalization and decided not to move forward with the full tour normalization initiative because it was not 

affordable. The Department of Defense's (DOD} decision to not move forward with this Initiative saved an 

estimated $3.1 billion from fiscal years 2012 through 2016, of which $2.5 billion has accrued through fiscal 

year 2015 and $615 mH!1on is expected to accrue m fiscal year 2016. 

Overseas Military Presence (Area 36): In January 2015, DOD estimated that it would save $1,2 billion 

annually by closing, consolidating, or realigning European installations after a comprehensive study of 

----------------·~po_s_tu_re_._a_s_w_e_h_ad._r_ec_o_m_m_e_n_de_d_. __________________________________________ __ 

15!n calculating these totals, we relied on individual estimates from a variety of sources, 

which considered different time periods and utilized different data sources, assumptions, 

and methodologies. These totals represent a rough estimate of financial benefits and have 

been rounded down to the nearest $1 bi!!ion. 

Page 13 GA0~16·580T 
44 

Annual report 

2011 

Source GAO iGA0-16·560T 

Area identified 

Medicare Health Care Payments (Area 74): Congress and the Centers for Medicare & Medicaid Services 

took several actions to improve the effic1encies of some Medicare payments for health care services, 

resulting in significant savings 

Note: The estimates in our 2016 annual report, GA0-16-375SP, are from a range of sources, 

including GAO, executive branch agencies, the Congressional Budget Office, and the Joint 

Committee on Taxation. The Tax Policies and Enforcement action (area 17) is newly addressed since 

GAO's 2015 report Some estimates have been updated to reflect more recent analysis. 

Congress also has taken a number of additional steps to address actions 

we have identified to achieve financial benefits or improve efficiency and 

effectiveness. For example, in our 2015 report we found the Department 

of Energy (DOE) could potentially realize savings by re-examining the 

appropriate size of the Strategic Petroleum Reserve (SPR)-which was 

valued at about $22 billion as of January 2016-and depending on the 

outcome of the analysis, selling crude oil from the reserve and using the 

proceeds to fund other national priorities. In 2015, Congress required 

DOE to complete a long-range strategic review of the SPR and also 

authorized the sale of 124 million barrels of SPR oil. The Congressional 

Budget Office estimated potential savings to be $8 billion from 2018 

through 2025. 

In another example, in our 2011 annual report we found that a 

proliferation of programs to improve teacher quality complicated federal 

efforts to invest dollars effectively. Specifically, we identified 82 distinct 

programs designed to improve teacher quality. Separately, we verified 

that legislation passed by Congress in December 2015 did not include 

authorization for 19 programs that were potentially overlapping. 16 Using 

Department of Education (Education) data, GAO estimated the decision 

to not reauthorize saved approximately $800 million based on fiscal year 

2016 appropriations for these programs. In addition, Congress included 

language in appropriations acts that eliminated some barriers to 

educational program alignment and passed legislation to give Education 

broader discretion to realign program resources. 

In other instances, Congress and executive branch agencies took steps 

to address issues that we identified during the course of our work that 

could also result in financial benefits. For example, in August 2014, we 

reported that the wage information that employers report on Form W-2 

16Every Student Succeeds Act, Pub. L No. 114-95 (Dec. 10, 2015) 

Page 14 GA0-16-580T 
45 

Action in Several 

Remaining Areas 

Could Yield 

Significant Additional 

Benefits 

was not available to IRS until after it issued most refunds. We found that if 

IRS had access to W-2 data earlier, it could match such information to 

taxpayers' returns and identify discrepancies before issuing billions of 

dollars of fraudulent identity theft refunds. The Consolidated 

Appropriations Act, 2016, enacted in December 2015, amended the tax 

code to accelerate W-2 filing deadlines to January 31. 17 According to IRS, 

a program that would match W-2 data to tax returns before refunds are 

issued would save revenue by protecting a substantial part of the billions 

currently paid to fraudsters. 

Also in August 2014, we reported that IRS had not fully assessed the 

costs and benefits of having available W-2 information for pre-refund 

matching, which could involve challenges such as a potential increase in 

W-2s that need to be corrected and required upgrades to IRS's 

information technology systems, among others. In response to our 

recommendation, in September 2015, IRS provided us with a report 

discussing (1) adjustments to IRS systems and work processes needed 

to use accelerated W-2 information, (2) potential impacts on internal and 

external stakeholders, and (3) other changes needed to match Form W-2 

data to tax returns prior to issuing refunds. This report should help IRS 

determine how best to implement pre-refund W-2 matching, given the 

new January 31 deadline for filing W-2s. 

While Congress and executive branch agencies have made progress 

toward addressing the actions we have identified, further steps are 

needed to fully address the remaining actions, as shown in table 4. More 

specifically, 53 percent of the actions (243 of 459) directed to executive 

branch agencies and 62 percent of the actions (53 of 85) directed to 

Congress that were identified in our 2011-2015 reports remain partially or 

not addressed. In addition, we identified 92 new actions in 2016. We 

estimate that tens of billions of additional dollars would be saved should 

Congress and executive branch agencies address our actions that are 

L. No. 114-113, div. Q, § 201, 129 Stat. 2242 (Dec. 18, 2015). This change goes 

into effect forW-2s reporting payments made in 2016 and filed in 2017 

Page 15 GA0-16-SBOT 
46 

partially addressed and not addressed, including the new ones we 

identified in 2016. 18 

Table 4: Status of 2011-2015 Actions Directed to Congress and the Executive Branch, as of March 2, 2016 

Status 

Source GAO Analysts iGA0-16-580T 

Executive branch3 Congress Grand totals 

Number Number Total number Overall 

of actions Percentage of actions Percentage of actions percentagee 

Notes: This year, 4 actions were categorized as "consolidated or other'' for a total of 24 actions in this 

category from 2011-2015. Actions categorized as "consolidated or other" are no longer assessed. In 

most cases, these actions were replaced or subsumed by new actions based on addJ!ional audit work 

or other relevant information. For example, actions categorized as "consolidated or other'' may have 

been consolidated into other actions thai we track based on subsequent audit work or significant 

changes in agency circumstances, or they may have been redirected from a congressional to an 

executive branch action, or vice versa. 

aExecutive branch agencies took steps that addressed five actions directed to Congress. 

bCongress took steps that fully addressed one action and partially addressed another action directed 

to executive branch agenc1es 

cNumbers do not add to 100 percent due to rounding. 

Our suggested actions that remain open include actions for both 

Congress and executive branch agencies, and span the government.'' 

The open actions directed to Congress are detailed in appendix I. We 

have directed actions to all 15 cabinet-level executive departments and at 

least 17 other federal entities. In particular, a substantial number of our 

actions are directed to three departments that make up 55 percent of 

federal obligations in fiscal year 2015-HHS, DOD, and the Department 

181n calculating this estrmate, we relred on individual estimates from a variety of sources, 

which considered different time periods, and utmzed different data sources, assumptions, 

and methodologies. These individual estimates are subject to increased uncertainty, 

depending on whether, how, and when they are addressed. This amount represents a 

rough estimate of financial benefits. 

19ln some cases, these actions may be included in areas that have other actions with no 

associated cost savings or revenue enhancements. 

Page 16 GA0-16-SSOT 
47 

Improving the Efficiency of 

Health Care Programs 

of the Treasury (Treasury). 20 Specifically, we have directed a total of 82 

actions to HHS, 152 actions to DOD, and 112 actions to Treasury since 

2011. Given the amount of federal dollars represented and number of 

unaddressed actions in the health care, defense, and tax areas, 

significant opportunities for cost savings and revenue enhancement exist 

in these three areas. 

According to CBO, gross federal outlays for Medicare, Medicaid, and 

other major health care programs totaled $1 trillion in 2015, equaling 5.8 

percent of the gross domestic product (GOP). 21 CBO estimates that gross 

federal outlays for those programs will jump to $1.1 trillion, or 6.2 percent 

of GOP, in 2016. 22 CBO further estimates that such spending will grow 

robustly, nearly doubling in dollar terms between 2016 and 2026, 

reaching $2.0 trillion, or 7.4 percent of GOP, by the end of that period. 

This level of spending contributes to the fiscal challenges facing the 

nation. 

In our 2011-2015 annual reports, we directed 64 actions to HHS to 

improve the efficiency and effectiveness of health care programs, among 

other areas. In addition, we directed 18 new actions to HHS in this year's 

annual report. Fifty-five of the 82 (67 percent) total actions we directed to 

HHS remain partially addressed or not addressed. 23 Many of these 

actions are directed at the Medicare and Medicaid programs, which had a 

combined total of over $900 billion in federal outlays in 2015, representing 

27 percent of total federal outlays. 24 Effectively implementing these 

20HHS includes Medicaid and Medicare_ DOD includes the Office of the Secretary of 

Defense, m1l1tary services, and defense agencies. Treasury consists of 10 bureaus, the 

largest of which is IRS. 

21Due to their size, complexity, and susceptibility to mismanagement and improper 

payments, we designated Medicare and Medicaid as high-risk programs in 1990 and 

2003, respectively. See GAO, High-Risk Series: An Update, GA0-15-290 (Feb. 11, 2015) 

22Congressional Budget Office, The Budget and Economic Outlook: 2016 to 2026 

{Washington, D.C.: January 2016). 

2

3-rhis includes new actions identified in our 2016 annual report. In addition, actions 

directed to multiple agencies are not assessed as addressed until all agencies have made 

necessary progress 

24Th is figure represents gross Medicare and Medicaid outlays. Net Medicare and 

Medicaid outlays represent 24 percent of total federal outlays. 

Page 17 GA0-16-580T 
48 

2012 

2015 

2016 

2016 

2013/2016 

2014/2016 

2015 

2016 

actions would result in significant cost savings or revenue enhancement, 

including the examples shown in table 5. 

Program Integrity (Areas 73/25): To help prevent billions of dollars in improper payments, the Centers for 

Medicare & Medicaid Services (CMS) should better target its claims review by requiring its contractors to 

develop thresholds for unexplained increases in billing and use them to develop automated prepayment 

controls, and by requiring that physicians receive a statement of home health services that beneficiaries 

received based on the physicians' certification. 

Medicare Advantage Payments (Area 45): To help ensure appropriate payments to Medicare Advantage 

plans, CMS should take steps to improve the accuracy of the adjustment made for differences in diagnostic 

coding practices between Medicare Advantage plans and traditional Medicare providers. We previously 

reported that these shortcomings in CMS's adjustment resulted in excess payments to Medicare Advantage 

plans totaling an estimated $3.2 billion to $5.1 billion over a 3-year period from 2010 through 2012 

Medicare Payments to Certain Cancer Hospitals (Area 19): To achieve almost $500 million per year in 

program savings, Congress should consider modifying how Medicare pays certain cancer hospitals 

Medicare Payments by Place of Service (Area 30}: Medicare cou!d save billions of dollars if Congress 

were to equalize the rates Medicare pays for certain health care services, which often vary depending on 

where the service is perfonned. 

Eligibility of Medicare Providers and Suppliers (Area 26): CMS could use better information to help prevent 

ineligible providers and suppliers from enrolling in the Medicare program and improperly obtaining Medicare 

funds, potentially reducing the billions of dollars in improper payments that the program has paid out in 

recent years 

Medicaid 

Supplemental Payments (Areas 26/25)· To save Medicaid hundreds of millions of dollars, (1) Congress 

should consider requiring CMS to take steps that would facilitate the agency's ability to oversee these 

payments, including identifying payments that are not used for Medicaid purposes or are otherwise 

inconsistent with Medicaid payment principles. and (2) CMS should clarify its requirement that supplemental 

payments be linked to the provision of Medicaid-covered services, and that such payments not be made 

contingent on the availability of local funding for the nonfederal share 

Demonstration Spending (Areas 21/27)· To save billions of dollars. (1) Congress should consider requiring 

the Department of Health and Human Services (HHS) to improve the process for reviewing, approving, and 

making transparent the basis for approving spending limits, including ensuring that valid methods are used to 

demonstrate budget neutrality and (2) HHS should establish specific criteria for assessing whether 

demonstration spending furthers Medicaid objectives and take other steps to improve the transparency and 

accountability of the approval process. 

State Sources of Funds (Area 20). To potentially save hundreds of millions of dollars, CMS should ensure 

that states report accurate and complete data on state Medicaid sources of funds so that it may better oversee 

states' financing arrangements that can increase costs for the federal government. 

Medicaid and Exchange Coordination (Area 7). CMS should take actions to minimize the risk of dupl!cative 

federal spending on health insurance coverage for individuals transitioning between Medicaid and exchange 

coverage. 

Page 18 GA0·16-580T 
49 

Annual report 

2016 

2016 

Source GAO j GA0-16-580T 

Area identified (Click area name for more information) 

Payments to Institutional Providers (Area 29)· CMS should take steps to improve the oversight of state 

Medicaid payments to institutional providers and better ensure that the federal government does not provide 

funds for excessive state payments made to certain providers, which could result in savmgs of hundreds of 

millions of dollars. 

Medicaid Eligibility Determinations (Area 28): CMS should assess the accuracy of federal Medicaid 

eligibility determinations to minimize the risk of improper payments 

Note: The estimates in our 2016 annual report, GA0-16-375SP. are from a range of sources, 

including GAO, executive branch agencies, the Congressional Budget Office. and the Joint 

Committee on Taxation. Some estimates have been updated to reflect more recent analysis 

More Effectively Targeting 

Defense Resources 

Defense outlays represented about 17 percent25 of the government's 

2015 total outlays and were the largest component-almost half-of the 

federal government's $1.2 trillion discretionary spending in that year. 26 

Avoiding fragmented, overlapping, and duplicative investments could help 

ensure more efficient and effective use of resources. 

In our 2011-2015 annual reports, we directed 130 actions to DOD, and in 

this year's annual report, we direct an additional 22 actions-" Ninety-five 

of the 152 (63 percent) total actions we identified remain partially 

addressed or not addressed. 28 Many of the actions fall within a few key 

areas, including acquisitions and contract management, support 

infrastructure, and headquarters management. Our work suggests that 

effectively implementing these actions, such as the examples in table 6, 

would yield significant financial benefits. 

25Th is figure represents net defense outlays from which offsetting conections have been 

deducted. 

26Discretionary spending refers to outlays from budget authority that is provided '1n and 

controlled by appropriations acts. The Department of Defense program management has 

been on our High Risk List since 1990. See GA0-15-290. 

27The 22 new actions include 19 actions in new defense-related areas and 3 actions 

added to an existing area from our 2013 annual report. See appendix!!! of 

GA0-16~375SP for more information on actions added to existing areas in 2016. 

28This includes new actions identified in our 2016 annual report. In addition, actions 

directed to multiple agencies are not assessed as addressed until aU agencies have made 

necessary progress 

Page 19 GA0-16-SSOT 
50 

Table 6: Examples of Defense Areas in 2011~2016 Annual Reports with Actions Remaining to Be Addressed 

Annual report 

2013 

2013 

2015 

2015 

2015 

2016 

2016 

2016 

2016 

2016 

Area identified (Click area name for more information) 

Agencies' Use of Strategic Sourcing {Area 23). The Department of Defense (DOD) and other selected 

agencies could better leverage their buying power and achieve additional savings by directing more 

procurement spending to existing strategically sourced contracts and further expanding strategic sourcing 

practices to their highest~spending procurement categories. GAO estimated that savings of 1 percent from 

selected agencies' procurement spending alone would equate to over $4 billion. 

Joint Basing (Area 20): DOD needs an implementation plan to guide joint bases to achieve $2.3 billion 

dollars in cost savings over a 20~year period and efficiencies anticipated from combining support services at 

26 installations located close to one another 

Defense Facilities Consolidation and Disposal (Area 13). DOD should ensure that data on the utilization of 

DOD facilities-which were collectively valued at around $880 billion in fiscal year 2014-are complete and 

accurate in order to identify opportunities for saving costs by consolidating or disposing of unuti!ized or 

underutilized facilities 

DOD Headquarters Reductions (Area 14). DOD could potentially achieve hundreds of millions of dollars 

in cost savings and help ensure that headquarters organizations are sized properly to meet their assigned 

mission by re-evaluating its headquarters reductions efforts and conducting periodic reassessments of 

workforce requirements< 

Department of Defense US Family Health Plan (Area 6): To potentially save millions of dollars and eliminate 

duplication within DOD's health care system, Congress should terminate the statutorily required US Fam1ly 

Health Plan because it offers military beneficiaries the same health care benefit offered by other DOD health 

care contractors. GAO estimates this action could save $189 million from fiscal years 2017 to 2022 

DOD Commercial Satellite Communication Procurement (Area 1 )· Enforcing existing acquisition policy and 

identifying opportunities to centralize DOD's procurement of commercial satellite communications services 

could create opportunities to potentially save tens of millions of dollars annuall'-y.-cc.,-c-c--c-c---,-

000 Excess Ammunition (Area 15): DOD could potentially reduce 1ts storage, demilitarization, and disposal 

costs by hundreds of thousands of dollars by transferring excess serviceable conventional ammunition, 

including small arms ammunition, to federal, state, and focal government agencies. 

DOD leases and Use of Underutilized Space at Military Installations (Area 16)· DOD could potentially 

achieve millions of dollars in savings by identifying and implementing actions to increase use of 

underutilized facilities at its military installations, such as identifying opportunities to relocate some of its 

organizations currently in !eased space to msta!lations, communicating the availability of underutmzed space 

to potential tenants, and seeking use by other federal agencies 

Defense Excess Property Disposal (Area 13) Federal civilian agencies could potentially achieve milfions 

of dollars in cost savings if they were able to obtain more of DOD's available excess personal property 

through the disposal process rather than purchasing similar property through a private sector supplier. 

DOD's Eligibility Determinations for living Quarters Allowance (Area 14): DOD could potentially achieve 

cost savings by monitoring its components' reviews of eligibility determinations for the over $500 million spent 

annually on living quarters allowance for civilian employees to better ensure that DOD components are not 

improperly providing this allowance 

Source GAO analys•s 1 GAQ.16-560T 

Note: The estimates in our 2016 annual report. GAO~ 16-375SP, are from a range of sources, 

includmg GAO, executive branch agencies, the Congressional Budget Office, and 1he Joint 

Committee on Taxation Some estimates have been updated to reflect more recent analysis 

Page 20 GA0-16-SSOT 
51 

Addressing Challenges in 

Collecting Tax Revenue 

and Reducing the Tax Gap 

IRS collected $3.3 trillion in gross taxes, or 93 percent of federal receipts, 

in fiscal year 2015. Among the challenges IRS faces in collecting this 

money are combatting tax refund fraud associated with identity theft, 

addressing factors that contribute to the $385 billion net tax gap (the 

difference between taxes owed and those ultimately collected), and 

reducing the causes of Earned Income Tax Credit improper payments. 29 

In our 2011-2015 annual reports, we directed 99 actions to the 

Department of the Treasury, and we include 13 additional actions in this 

year's report. Seventy of the 112 (63 percent) total actions we identified 

remain open. 30 Effectively implementing our open recommendations, 

including the examples in table 7, would increase revenues or reduce 

costs. 

Table 7: Examples of Tax Areas in 2011w2016 Annual Reports with Actions Remaining to Be Addressed 

Annual report 

2011 

2011 

201312015 

2014 

2016 

Area identified (Click area name for more information) 

Real Estate Tax Deductions (Area 59). Better information and outreach could help increase revenues by 

tens or hundreds of millions of dollars annually by addressing overstated real estate tax deductions. a 

Simple Tax Return Errors (Area 56)' Broadening the Internal Revenue Service's {IRS) authority to correct 

simple tax return errors could facilitate correct tax payments and help IRS avoid costly, burdensome audits. 

The Joint Committee on Taxation estimated this action could raise $274 million from fiscal years 2018 

through 2026. 

Tax Policy and Enforcement (Areas 22/17): By using more rigorous analyses to allocate enforcement 

resources and using data to improve management of enforcement programs such as large partnership and 

correspondence audits, among other things, IRS can increase revenue collections by billions of dollars. 

Online Taxpayer Services (Area 17) IRS could potentially realize hundreds of millions of dollars in cost 

savings and increased revenues by enhancing its online services, which would improve service to taxpayers 

and encourage greater tax law compliance. 

IRS's Public Referral Programs (Area 6}: IRS could potentially collect billions of dollars in tax 

underpayments through its nine public referral programs and save resources by better managing 

_____ fragmentation and overlap, improving communication, and streamlining processes _::....._ ·~~~··~------

29The tax gap does not include taxes due from illegally derived income or various forms of 

fraud. For example, in genera!, refund fraud related to identity theft would not be included 

in the tax gap estimate because it does not invotve evading a tax liability. In 2012, IRS 

estimated the net tax gap to be $385 billion and the gross tax gap-the difference 

between taxes owed and taxes paid on time-to be $450 billion based on data from tax 

year 2006. IRS plans to release an updated tax gap estimate in 2016, which will be based 

on tax years 2008, 2009, and 2010. 

30Th is includes new actions identified in our 2016 annual report. Actions directed to 

multiple agencies are not assessed as addressed until all agencies have made necessary 

progress 

Page 21 GA0-16-SBOT 
52 

Annual report 

2016 

Area identified (Click area name for more infonnation) 

Identity Theft Refund Fraud (Area 22): IRS and Congress could potentially save billions of dollars in 

fraudulent refunds by Improving the agency's efforts to prevent refund fraud associated with identity theft 

Source GAOana!ySJs !GA0-16-580T 

Note: The estimates in our 2016 annual report, GA0-16-375SP, are from a range of sources, 

including GAO, executive branch agencies, the Congressional Budget Office, and the Joint 

Committee on Taxation. Some estimates have been updated to reflect more recent analysis. 

"As part of its outreach efforts to date, !RS has distributed guidance to local jurisdictions that provides 

examples of what is and is not deductible 

Additional Areas with 

Significant Open Actions 

In addition to the health care, defense, and tax areas, we have suggested 

a number of other actions that, if addressed, would result in significant 

cost savings or revenue enhancement across the government31 Table 8 

summarizes examples where additional leadership attention could 

promote progress. 

Table 8: Examples of Areas in 2011-2016 Annual Reports with Actions Remaining to Be Addressed 

Annual report Area identified (Click area name for more information) 

Energy and agriculture 

2011 Oil and Gas Resources (Area 45). Improved management of federal oil and gas resources could result in $1.7 

billion of additional revenue over 10 years, according to the Department of the Interior. 

2012 

2013 

2015 

Excess Uranium Inventories (Area 40): Marketing the Department of Energy's excess uranium could provide 

substantial revenue for the government. In 2014, GAO estimated that actions in this area could increase revenue 

by about $1 billion. 

Crop Insurance (Area 19): To achieve up to $2 billion annually in cost savings in the crop insurance program, 

Congress could consider limiting the subsidy for premiums that are provided on behalf of individual farmers, 

reducing the subsidy. or some combination of limiting and reducing these subsidies. 

U.S. Enrichment Corpor"ation (USEC) Fund (Area 16): Congress m"ay"Cw-ci;::sh=to---=pc:e-=rm=-a=-=nc:e-=-nt"'ly---=r-=-es=-=cc-:in3d-;;th:-:e--:e-=n"tir=-e· 

$1,6 billion balance of the USEC fund-a revolving fund in the U.S. Treasury-because its purposes have been 

fulfilled. 

311n some cases, these actions may be included in areas that have other actions with no 

associated cost savings or revenue enhancements 

Page 22 GA0-16-SSOT 
53 

Annual report 

2016 

Area identified (Click area name for more information) 

Unobligated Balances {Area 24): To help ensure effective use of federal funds, the Departments of Energy and 

State should develop and finalize strategies for reducing tens and hundreds of millions of dollars of excess 

unobligated balances, respectively, in two budget accounts 

Homeland security/law enforcement 

2012 

2013 

Income security 

2011 

2014 

2014 

2015 

2016 

2016 

Immigration Inspection Fee (Area 49): The air passenger immigration inspection user fee should be reviewed 

and adjusted to fully recover the cost of the air passenger immigration inspection activities conducted by the 

Department of Homeland Security's U.S. Immigration and Customs Enforcement and U.S. Customs and Border 

Protection rather than using general fund appropriations. GAO estimated this action could increase revenue by 

almost $175 million. 

Checked Baggage Screening (Area 28) By reviewing the appropriateness of the federal cost share the 

Transportation Security Administration applies to agreements financing airport facility modification projects related 

to the installation of checked baggage screening systems, the Transportation Security Administration could, if a reduced cost share was deemed appropriate, achieve cost efficiencies and be positioned to install a greater 

number of optimal baggage screening systems than it currently anticipates. More efficient baggage screening 

systems could result in roughly $234 million in cost savings from 2015 through 2027, according to the 

Transportation Security Agency. 

Social Security Offsets (Area 80): Social Security needs data on pensions from noncovered earnings to better 

enforce offsets and ensure benefit fairness. This action could result in estimated savings of $2.4 billion to $7.9 

billion over 10 years if enforced both retrospectively and prospectively, according to the Congressional Budget 

Office and the Socia! Security Administration. If Social Security only enforced the offsets prospectively, the overall 

savings would be less as it would not reduce benefits already received. 

Veterans' and Survivors' Benefits (Area 23): The Department of Veterans Affairs' direct spending could be 

reduced-by an average of about $4 million annually, according to the Congressional Budget Office-if new 

statutory provisions were enacted, namely, a look~back review and penalty period for claimants who transfer 

assets for less than fair market value before applying for pension benefits that are available to low-income wartime 

veterans who are at least 65 years old or have disabilities unrelated to their military service 

Disability and Unemployment Benefits (Area 8): Congress should consider passing legislation to prevent 

individuals from collecting both full Disability Insurance benefits and Unemployment Insurance benefits that cover 

the same period, which could save $1.9 billion from fiscal years 2016 through 2025, according to the 

Congressional Budget Office. 

Children's Disability Reviews (Area 21). To prevent an estimated $3.1 billion in potential overpayments over 5 

years, the Social Security Administration needs to conduct timely disability reviews to better ensure that only 

eligible children receive cash benefits from the Supplemental Security Income program. 

VA's Individual Unemployability Benefit (Area 34): To potentially achieve cost savings, the Department of 

Veterans Affairs should develop a plan to study whether age should be considered when deciding if veterans are 

unemployable due to service-connected disabilities. By comparison, other benefit programs, such as Socia! 

Security Disability Insurance, consider retirement age a cause for ineligibility and convert benefits for those 

reaching their retirement age to a Socia! Security retirement benefit. If the department were to determine that Total 

Disability Individual Unemployability benefits should be provided only to veterans younger than their full Social 

Security retirement age, it could achieve an estimated $15 billion in savings from 2015 through 2023, according to 

the Congressional Budget Office. 

Disability Insurance and Federal Workers' Compensation (Area 31). The Social Security Administration should 

take steps to minimize overpayments from the Social Security Disability Insurance program to individuals who also 

received federal workers' compensation, which could help to achieve potential cost savings associated with 

mi!!ions of dollars of overpayments from the Social Security DisabiHty Insurance program 

Page 23 GA0-16-SBOT 
54 

Annual report Area identified {Click area name for more information) 

2016 Disability Insurance Overpayments (Area 32): To help prevent the loss of billions of dollars, the Social Security 

Administration should take steps to prevent overpayments to beneficiaries of the Disability Insurance program and 

improper waivers of beneficiaries' overpayment debt 

-;2:::0 16=-----=o""is-a~bi"'li:-ty-:R:ce-v,-iew.s (Area 33): The Soda! Security Administration may increase federal savings realized as a 

result of disability reviews by further considering factors that affect individuals' expected lifetime benefits when 

prioritizing Its reviews of Disability Insurance and Supplemental Security Income cases 

Information technology 

2011 Federal Data Centers (Area 15)' Consolidating federal data centers would provide an opportunity to improve 

government efficiency. Action in this area could potentially achieve cost savings and avoidances of$8.2 billion 

through fiscal year 2019, of which $2.8 billion has accrued from actions already taken and $5A billion could 

potentially accrue if further action is taken, according to GAO's analysis of data from 24 agencies involved in the 

Federal Data Center ConsoHdation Initiative 

2013 

2013 

2014 

Cloud Computing (Area 29): Better planning of cloud-based computing solutions provides an opportunity for 

potential savings of millions of dollars. 

Information Technology Operations and Maintenance {Area 30): Strengthening oversight of key federal 

agencies' major information technology investments in operations and maintenance would provide an opportunity 

for savings on blllions in information technology investments. 

Information Technology Investment Portfolio Management {Area 24): The Office of Management and Budget 

and multiple agencies could help the federal government realize billions of dollars in savings by taking steps to 

better implement Portfo!ioStat, a process to help agencies manage their information technology investments 

International affairs 

2016 Cargo Preference for Food Aid (Area 36): A clearer definition of "geographic area" in legislation on cargo 

preference for food aid could allow the U.S. Department of Agriculture to achieve financial savings by more fully 

utilizing the flexibility Congress granted when it lowered the statutory cargo preference requirement 

Training, employment, and education 

2016 Post 9/11 Gl Bill Overpayments (Area 37) The Department of Veterans Affairs could achieve substantial savings 

by developing guidance and controls to reduce the volume of annual Post-9/11 Gl Bill overpayments-which 

amounted to over $400 million in fiscal year 2014-and to improve the collection of overpayment debts, of which 

$262 million was still outstanding as of November 2014. 

Source GAO analySis I GAQ..16·580T 

Note: The estimates in our 2016 annual report, GA0-16-375SP, are from a range of sources. mcludmg GAO, executiVe branch agenc1es, the Congressional Budget Office, and the Joint 

Committee on Taxation. Some estimates have been updated to reflect more recent analysis 

We will continue to conduct further analysis to look for additional or 

emerging instances of fragmentation, overlap, and duplication and 

opportunities for cost savings or revenue enhancement. Likewise, 

we will continue to monitor developments in the areas we have 

already identified in this series. We stand ready to assist this and 

other committees in further analyzing the issues we have identified 

and evaluating potential solutions. 

Page 24 GA0·16·580T 
55 

GAO Contacts 

Chairman Johnson, Ranking Member Carper, and Members of the 

Committee, this concludes my prepared statement. I would be 

pleased to answer questions. 

For further information on this testimony or our April13, 2016, 

report, please contact Orice Williams Brown, Managing Director, 

Financial Markets and Community Investment, who may be 

reached at (202) 512-8678 or williamso@gao.gov, and A. Nicole 

Clowers, Managing Director, Health Care, who may be reached at 

(202) 512-7114 or clowersa@gao.gov. Contact points for the 

individual areas listed in our 2016 annual report can be found at the 

end of each area at GA0-16-375SP. Contact points for our 

Congressional Relations and Public Affairs offices may be found on 

the last page of this statement. 

Page 25 GA0-16-SSOT 
56 

Appendix 1: Open Congressional Actions, by 

Mission 

In our 2011-2015 annual reports, we directed 85 actions to Congress, of 

which 53 remain open. Of the 53 open congressional actions, 1 0 are 

partially addressed and 43 are not addressed, as of March 2, 2016. In 

addition, we identified 8 new congressional actions in our 2016 annual 

report. 

Table 1: GAO~Identified Open Congressional Actions Related to Fragmentation, Overlap, Duplication, Cost Savings, or 

Revenue Enhancement, 2011-2016 

Mission 

Agriculture 

Defense 

Annual 

report 

2011 

2013 

2012 

Area 

Area 1 Food 

Safety 

Area 1- Catfish 

Inspection 

Action summary 

Action 2: Congress should consider commissioning the National Academy of 

Sciences or a blue ribbon panel to conduct a detailed analysis of alternative 

food safety organizational structures 

Action 4: Congress should consider formalizing the Food Safety Working Group 

through statute to help ensure sustained leadership across food safety 

agencies over time 

Action 1: Congress should consider repeating provisions of the 2008 Farm Bill 

assigning the U.S. Department of Agriculture {USDA) responsibility for 

examining and inspecting catfish and for creating a catfish inspection program 

This action could save $14 million annually based on the agency's estimate of 

the additional cost to the federal government and industry to implement the 

program 

Area 18. Agricultural Action 5: Congress should consider taklng steps to allow the Secretary of 

Quarantine Agriculture to set fee rates to recover the full costs of the Agricultural 

Inspection Fees Quarantine Inspection program. 

Area 19: Crop 

Insurance 

Area 6 

Stabilization, 

Reconstruction, 

and Humanitarian 

Assistance Efforts 

GAO estimated this action could result in savings of $93 million. 

Action 1. Congress may wish to consider either limiting the amount of premium 

subsidies that an individual farmer can receive each year-as it limits the 

amount of payments to individual farmers in many farm programs-or reducing 

premium subsidy rates, or both limiting premium subsidies and reducing 

premium subsidy rates. 

GAO estimated that this action could result in up to $2 billion per year in cost 

savings 

Action 3: Congress should consider amending the legislation that supports the 

Overseas Humanitarian. Disaster, and C1vicAid-funded human1tarian 

assistance program-the Department of Defense's (DOD) largest humanitarian 

assistance program-to more specifically define DOD's role in humanitarian 

assistance, taking into account the roles and similar types of efforts performed 

_________________ b_:_y_th_e_c_ivi!Jan agencies. 

Page 26 GA0-16-580T 
57 

Appendix 1: 

Mission 

Mission report Area Action summary 

----------~2~0 13~----~A~ffi~a~2~o~.~Jo~in-,-t A·ct~~~o~n~4~•T~o~h~e 1p~e~n~s~ur~e~D~O~D~'s~a~p~p~ro~a~ch~t~o~jo~in~t~b~as~in~g~a~c~h~ie~ve~s~th~e~g~o~a~ls~a~sEconomic 2011 

development 

2016 

Basing outlined by DOD in its justification for the 2005 base realignment and closure 

(BRAG) recommendation and leverages additional opportunities to reduce 

duplication of effort that could in turn generate cost savings and increased 

efficiencies, Congress should consider directing the Deputy Under Secretary of 

Defense (Installations and Environment), in collaboration with the military 

services and joint bases, to evaluate the purpose of the program and determine 

whether the current goals, as stated in the 2005 BRAG Commission 

recommendation, are still appropriate, or whether goals should be revised; 

communicate these goals to the military services and joint bases, and adjust 

program activities accordingly; provide direction to the joint bases on 

requirements for meeting program goals, including determining reporting 

requirements and milestones; and determine any next steps for joint basing, 

including whether to expand it to other installations 

Area 42: Essential Action 2:"' Congress may wish to consider revising the program's operating 

Air Service requirements for providing air service to communities to improve efficiency and 

to better match capacity with community use. 

Area 17: Treasury's 

Foreclosure 

Prevention Efforts 

While not fully addressing our action, Congress passed the Consolidated and 

Further Continuing Appropriations Act, 2012, the Consolidated Appropriations 

Act, 2016, and the FAA Modernization and Reform Act, which revised the 

program's operating requirements<b Opportunities still exist to address this 

action, such as allowing flexibility in the number of flights provided 

Action 3: Congress may wish to consider assessing mu!timoda! solutions, such 

as more cost-effective bus service to hub airports or air taxi service, to provide 

communities alternatives to Essential Air Service 

Action 1: Congress should consider rescinding any Treasury~deobl1gated 

excess Making Home Affordable {MHA) balances that the Department of the 

Treasury does not move into the Hardest Hit Fund 

The agency estimated $4 7 billion reduction in total outlays for the MHA 

program. Treasury deobligated $2 billion of the $4.7 billion on February 25, 

2016, which it planned to obligate to the Hardest Hit Fund. It could potentially 

deob!igate an additional $2.7 billion or more once the program ends or sooner 

-;;Ec:n-ce-:crg:.-y------~2"0:c11~------;;A-.crec:a-:1"'2:-• "'Fe-d;-e-ra 1---;;:-::-:cti~:c~-:;:-.ffi-;;ca""o~-:-~c'r~ecc:cc:--:~c-~::-~ccc~;, ~~~:~:;:~:~~:~~::~:t~~ ~:~:ct:~t~=~:~i~i:u;~: 

2012 

Fleet Energy Goals requirements and provide fleet managers with more flexibility in meeting goals. 

Area 45. Oil and 

Gas Resources 

Area 40: Excess 

Uranium 

Inventories 

Page 27 

Action 2: Congress may need to take action to authorize or encourage the 

Department of the Interior {Interior) to revise its rental fee structure in ways that 

are beyond what is specifically authorized to increase rental payments for 

nonproducing !eases 

Action 4: Depending on the results of the study we recommended Interior 

conduct, in Action 3, Congress may wish to provide additional guidance or take 

additional actions to enable Interior to change how it oversees federal lands 

and waters and the revenues derived from production of oil and gas there. 

Action 1: To pursue potential options for depleted uran1um, Congress may wish 

to clarify the Department of Energy's {DOE) statutory authority regarding 

depleted uranium, explicitly providing direction about whether and how DOE 

may sell or transfer the tails in their current form. Depending on the terms of the 

legislation, and given the significant amount of tails 10 inventory, the 

government could gamer substantial revenue as a result 

GA0·16·580T 
58 

Mission 

General 

government 

report 

2014 

2015 

2011 

Appendix 1: Open Congressional Actions, by 

Mission 

Area 

Area 13: Advanced 

Technology 

Vehicles 

Manufacturing Loan 

Program 

Area 16: US 

Enrichment 

Corporation Fund 

Area 56: Simple 

Tax Return Errors 

Action summary 

Action 2· If Congress sees merit in using the proceeds from the barter, transfer, 

or safe of federal uranium assets to pay for environmental cleanup of uranium 

enrichment plants, it could consider providing DOE with explicit authority to 

barter excess uranium and to retain the proceeds from all three types of 

uranium transactions (barter, transfer, and sale). Likewise, Congress could 

direct DOE to sell uranium for cash and make those proceeds available by 

appropriation for decontamination and decommissioning expenses at DOE's 

uranium enrichment plants. 

In 2014, GAO estimated that these actions could lead to revenue increases of 

about $1 bUlon 

Action 1: Unless DOE can demonstrate a demand for new Advanced 

Technology Vehicles Manufacturing loans and viable applications, Congress 

may wish to consider rescinding all or part of the remaining $4.2 billion in credit 

subsidy appropriations. 

GAO estimated that this action could result ln a one-time savings of 

$4.2 billion. 

Action 1: Congress may wish to permanently rescind the entire $1.6 billion 

balance of the U.S. Enrichment Corporation Fund. 

Action 1 ;a Congress may want to consider granting the Internal Revenue 

Se!Vice {IRS) broader math error authority, with appropriate safeguards against 

misuse of that authority, to correct errors during tax return processing. 

The Joint Committee on Taxation estimated this action could raise $274 million 

from fiscal years 2018 through 2026. 

The Consolidated Appropriations Act, 2016 gave IRS additional math error 

authority, but limited to certain circumstances.c Giving IRS broader math error 

authority with appropriate controls would enable IRS to correct obvious 

noncompliance, would be less intrusive and burdensome to taxpayers than 

audits, and would potentially help taxpayers who underc!aim tax benefits to 

which they are entitled. 

Area 63: S Action 1: Congress could require S corporations to use infonnation already 

Corporations available to them to calculate shareholders' basis as completely as possible 

and report it to shareholders and IRS 

Area 65: Research Action 1: Congress could elimmate the regular credit and add a mimmum base 

Tax Credit amount (equal to 50 percent of a taxpayer's current spending) to the method for 

computing the alternative simplified credit 

Area 66: New Action 1: Congress should consider offering grants in lieu of credits to 

Markets Tax Credit Commun1ty Development Entities (CDE) if it extends the program again. Jf it 

does so, Congress should require the Department of the Treasury to gather 

appropriate data to assess whether and to what extent the grant program 

increases the amount of federal subsidy provided to !ow-income community 

businesses compared to the New Markets Tax Credit (NMTC}; how costs for 

administering the program incurred by the Community Development Financial 

Institutions (CDFI) Fund, GOEs, and investors would change; and whether the 

grant program otherwise affects the success of efforts to assist low-income 

communities. One option would be for Congress to set aside a portion of funds 

to be used as grants and a portion to be used as tax credit allocation authority 

under the current structure of the program to fact!itate comparison of the two 

program structures. 

Page 28 GA0-16-580T 
59 

Mission report 

Appendix 1: Open Congressional Actions, by 

Mission 

Area Action summary 

Area 67 Action 1: Congress should consider whether facilities, including hotels and golf 

Governmental courses, that are privately used should be financed with tax-exempt 

~-=---B"~o_n_ds-,_.,-,-..,-- government bond7s_" ----,-----,---:::------,-

2012 Area 44. !nterna! Action 1: To help improve taxpayer compliance, Congress may wish to make 

2013 

2015 

2015 

Revenue Service owners of rental real estate subject to the same payment reporting 

Enforcement Efforts requirements regardless of whether they engaged in a trade or business under 

current law. 

Area 24: 

Opportunities to 

Help Reduce 

Government 

Satellite Program 

Costs 

Area 4: Consumer 

Product Safety 

Oversight 

Area 17: Tax 

Policies and 

Enforcement 

Page 29 

The Joint Committee on Taxation estimated that this action could result in tax 

revenues of about $2.5 billion from fiscal years 2011 to 2020. 

Action 2: To help improve taxpayer compliance, Congress may wish to require 

payers to report service payments to corporations, thereby reducing payers' 

burden to detennine which payments require reporting 

Action 1 :a Congress may wish to conside::,-=a-=ut"'h:cor=iz=inc::g-::a:cge:cn:ccc:ie-cs-ceccnh:ca-cnc-ce:cd;--

flexibi!ity to acquire certain satellite services related to hosted payload and ride 

sharing arrangements. when appropriately planned and justified, 

Selected agencies have reported saving hundreds of millions of dollars to 

date from using these innovative mechanisms_ 

The National Defense Authorization Act for Fiscal Year 2014 required DOD to 

study low cost and innovative methods for acquiring certain satellite services_d 

The House of Representatives has passed two other bills, but as of March 

2016, neither bill has been enacted.e 

Action 1: Congress should consider transferring the oversight of the markings of 

toy and imitation fireanns in section 5001 of title 15 of the U.S. Code from the 

Department of Commerce's National Institute of Standards and Technology to 

the Consumer Product Safety Commission. 

Action 2: Congress should consider establishing a forma! comprehensive 

oversight mechanism for consumer product safety agencies to address 

crosscutting issues as we!! as inefficiencies related to fragmentation and 

overlap such as communication and coordination chal!enges and jurisdictional 

questions between agencies. Different types of formal mechanisms could 

include, for example. creating a memorandum of understanding to formalize 

relationships and agreements or estab!!shing a task force or interagency work group. As a starting point, Congress may wish to obtam agency input on options 

for establishing more formal coordination. 

Action 1: Congress should consider revisiting the use of indivtdual retirement 

accounts (IRA) to accumulate large balances and considering ways to improve 

the equity of the existing tax expenditure on IRAs. Options could include limits 

on (1) the types of assets permitted in IRAs, (2) the minimum valuation for an 

asset purchased in an IRA, or {3) the amount of assets that can be 

accumulated in !RAs and employer-sponsored plans that get preferential tax 

treatment 

Action 2: Congress should consider expanding the mandate that partnerships 

and S corporations electronically file their tax returns in order to cover a greater 

share of filed returns. 

These congressional actions could enable IRS to potentially collect hundreds 

of millions of dollars in additional revenue. 
60 

Mission 

Health 

report 

2016 

Appendlx t: Open Congressional Actions, by 

Mission 

Area 

Area 5: Financial 

Regulatory 

Structure 

Action summary 

Action 1: Congress should consider whether additional changes to the financial 

regulatory structure are needed to improve (1) the efficiency and effectiveness 

of oversight; (2) the consistency of consumer and investor protections; and (3) 

the consistency of financial oversight for similar institutions, products, risks, and 

services. 

Action 2: Congress should consider whether legislative changes are necessary 

to align the Financial Stability Oversight Council's authorities with its mission to 

respond to systemic risks. 

2016 Area 22: Identity Action 1: Congress should consider providing the Secretary of the Treasury with 

Theft Refund Fraud the regulatory authority to !ower the threshold for electronic filing ofW-2s from 

250 returns annually to between 5 to 10 returns, as appropriate. 

GAO estimated this action could result in savings of billions of dollars. 

2016 Area 23: National Action 1: To increase the flexibility that the National Park Service has to change 

2011 

2013 

Park Service Fees entrance fees, Congress should consider amending Federal Lands Recreat1on 

Enhancement Act to give authority to the Park Service and the other four 

agencies that implement the recreation fee program-Bureau of Reclamation, 

Bureau of Land Management, the U,S. Fish and Wildlife Service, and the U.S. 

Forest Service-to adjust the price of a lifetime senior pass. 

Area 74· 

Medicare's Health 

Care Payments 

Area 26: Medicaid 

Supplemental 

Payments 

GAO estimated this action could result in additional revenue of $35 million 

annually. 

Action 7:a Congress could exempt from the budget neutrality requirement 

savings attributable to policies that reflect efficiencies occurring when services 

are furnished together. 

While Congress has exempted certain savings from the budget neutrality 

requirement. other services remain subject to this requirement.1 

Action 1 :a.l} Congress should consider requiring the Administrator of the Centers 

for Medicare & Medicaid Services (CMS) to improve state reporting of non~ 

disproportionate share hospital (DSH) supplemental payments, including 

requiring annual reporting of payments made to individual facilities and other 

infonnatlon that the agency determines is necessary to oversee non-DSH 

payme.n~t 07----~--~--~----~~~~~~--~~----­ Action 2."'11 Congress should consider requiring the Administrator of CMS to 

clarify permissible methods of calculating non-DSH supplemental payments 

Action 3: Congress should consider requiring the Administrator of CMS to 

require states to submit an annual independent certified audit verifying state 

compliance with permissible methods for calculating non-OSH supplemental 

payments. 

GAO estimated that these three actions could result in savings in the hundreds 

of millions of dollars. 

2014 Area 21: Medicaid Action 1; Congress could consider requiring the Secretary of Health and Human 

Demonstration Services to improve the Medicaid demonstration review process, through steps 

Waivers such as improving the review criteria, better ensuring that valid methods are 

used to demonstrate budget neutrality, and documenting and making clear the 

basis for the approved limits 

Page 30 

GAO estimated that this action could result in savings in the hundreds of 

millions of dollars. 

GA0-16-580T 
61 

Appendix 1: Open Congressional Actions, by 

Mission 

Mission report Area Action summary 

------~20~1~5~----A-re-a~6~:=oo==o U~S~~A-ct~io-n~1-:T~o-e~l~im~in-a re_u_n~n-ec~e-ss~a~~-p-r~og~r~am~d~u~pl~i~~~~~o~n~a~nd~ac~h ie~v~e~in~cr=e~as~ed' 

2015 

2016 

Family Health Plan efficiencies and potential savings within the integrated Military Health System, 

Congress should terminate the Secretary of Defense's authority to contract with 

the US Family Health Plan (USFHP) designated providers in a manner 

consistent with a reasonable transition of affected enrollees into TR!CARE's 

USFHP regional managed care program or other health care programs, as 

appropriate. 

Area 19: Medicare 

Payments to 

Certain Cancer 

Hospitals 

Area 30: Medicare 

Payments by Place 

of Service 

GAO estimated this action could save $189 million from fiscal years 2017 to 

2022. 

Action 1: To help the Department of Health and Human Services better control 

Medicare spending and encourage efficient delivery of care, and to generate 

cost savings from any reductions in payments to cancer hospitals that are 

exempted from the prospective payment system (PPS), Congress should 

consider requiring Medicare to pay these PPS-exempt cancer hospitals (PCH) 

as it pays PPS teaching hospitals, or provide the Secretary of Health and 

Human Services with the authority to otherwise modify how Medicare pays 

PCHs, and provide that aU forgone payment adjustment amounts be returned to 

the Supplementary Medical Insurance Trust Fund" 

GAO estimated this action could result in savings of almost $500 million per 

year. 

Action 1: To prevent the shift of services from physician offices to hospital 

outpatient departments from increasing costs for the Medicare program and Its 

beneficiaries. Congress should consider directing the Secretary of Health and 

Human Services to equalize payment rates between settings for evaluation and 

management office visits-and other services that the Secretary deems 

appropriate-and return the associated savings to the Medicare program. 

According to estimates by the Medicare Payment Advisory Commission and 

others, this action could result in savings of billions of dollars annually. 

Homeland 2011 Area 26 FEMA Action 4: Once the Federal Emergency Management Agency has completed a 

national preparedness assessment of capabl!ity gaps, as recommended in 

Action 3, Congress may wish to consider limiting the use of federal 

security/law 

enforcement 

Grants 

preparedness grant programs to fund only projects to fill identified, validated, 

and documented capability gaps that may (or may not) include maintaining 

-::-:=-------cc--:c:-:cc--:---:--•~x-:cis_tin_,g::-c~ac-pa_biltties developed. 

2012 Area 17. Homeland Action 3: Congress may want to consider requinng the Department of 

Security Grants Homeland Security to report on the results of its efforts to identify and prevent 

unnecessary duplication within and across the State Homeland Security Grant 

Program, Urban Areas Security Initiative, Port Security Grant Program, and 

Transit Secunty Grant Program, and consider these results when making future 

funding decisions for these programs. 

Area 49: Action 2:a9 Congress may wish to require the Secretary of the Department of 

Immigration Homeland Security to adjust the air passenger immigration inspection fee as 

Inspection Fee needed so that collections are aligned with total inspection costs, if it is 

determined that total immigration fee collections do not cover total immigration 

mspectlon costs. 

GAO estimated this action increase annual fee revenue by almost $175 

million based on fiscal data 

Page 31 GA0-16·580T 
62 

Mission 

Income 

security 

report Area 

Appendix 1: Open Congressional Actions, by 

Mission 

Action summary 

Action 4: To determine the extent to which air passenger immigration Inspection 

fees are aligned with the costs of inspection activities, which could enable fee 

adj'ustments to reduce reliance on genera! fund appropriations, Congress may 

wish to require the Secretary of Homeland Security to direct ICE and CBP to 

establish a regular schedule to review and coordinate on the costs of their 

respective air passenger immigration inspection activities, and revise the 

proportion of the fee received by each agency accordingly. 

2013 Area 28· Checked Action 1: Congress may wish to consider directing the Transportation Security 

2011 

2014 

Baggage Screening Administration (TSA) to study, in consultation with relevant industry 

stakeholders, whether the 90 percent federal cost share that TSA generalty 

applies to cost sharing agreements for eHgibly airport facility modification 

projects related to the installation of checked baggage screening systems is 

appropriate or should be adjusted. 

Area 80: Social 

Security Offsets 

Area 8: DisabHity 

and Unemployment 

Benefits 

Area 9· Federal 

Employees' 

Compensation and 

Unemployment 

Benefits 

Area 23: Veterans' 

and Survivors' 

Benefits 

Page 32 

Action 2: Congress may wish to consider whether an amendment to current 

legislation, or enactment of new legislation, is necessary and warranted if it is 

determined that a change in the current federal cost share that TSA generally 

applies to these cost sharing agreements is appropriate. 

The agency estimated 1hese actions could result in roughly $234 million in cost 

savings from 2015 through 2027. 

Action 1: Congress could consider giving IRS the authority to collect the 

information that the Social Security Administration (SSA) needs on government 

pension income to administer the Government Pension Offset and the Windfall 

Elimination Provision accurately and fairly. 

The Congressional Budget Office and SSA estimate that this action could result 

in savings of$2.4 billion to $7.9 billion over 10 years if enforced both 

retrospectively and prospectively. 

Action 1: Congress should consider passing legislation to require the Social 

Security Administration to offset DisabiHty Insurance benefits for any 

Unemployment Insurance benefits received in the same period. 

The Congressional Budget Office estimated that this action could save about 

$1.9 billion from fiscal years 2016 to 2025. 

Action 2: To help verify claimants' reported income and help ensure the proper 

payment of benefits, Congress should consider granting the Department of 

Labor the additional authority to access wage data. 

Action 1 ;ss Congress should consider passing !egis!at!on that would establish a 

look-back and penalty period for claimants who transfer assets for less than fair 

market value prior to applying for pension benefits. 

The Congressional Budget Office estimated that this action could save about 

$4 million annually. 

The House of Representatives passed HR. 2189, which contained language to 

establish a 3-year look-back and penalty period for the VA pension program.h 

However, the bill was not ultimately enacted. 

GA0-16-SSOT 
63 

Appendix 1: Open Congressional Actions, by 

Mission 

~M_I~ss~i~on~~--~r~ep o~rt ____ ~A~m~a~~------~A~c"'tionsumm_a~~~----~~--~----~~~· Information 2013 Area 10· Action 1 :

11 Congress may wish to consider examining the appropriateness and 

technology Dissemination of viability of the fee-based mode! under which the National Technical Information 

Technical Research Service currently operates for disseminating technical information to determine 

2014 

Reports whether the use of this model should be continued. 

Several biHs have been introduced that have the potential to address this 

action, including H.R. 443, S.787, S.1636.1 Additionally, the Consolidated and 

Further Continuing Appropriations Act of 2015 limited instances where NTIS 

could charge customers fees for reports.! 

Area 11 Geospatial Action 14: To increase coordination between various levels of govemment and 

Investments reduce duplication of effort, resources, and costs associated with collecting and 

maintaining accurate address data, Congress should consider assessing the 

impact of the disclosure restrictions of Section 9 of Title 13 and Section 412 of 

Title 39 of the U.S. Code in moving toward a national geospatia! address 

database. If warranted, Congress should consider revising those statutes to 

authorize the limited release of addresses, without any personally identifiable 

information, specifically for geospatia! purposes. Such a change, if deemed 

appropriate, could potentially result in significant savings across federal, state, 

and local governments. 

Area 10: 

Interoperable Radio 

Communications 

Systems 

Action 1 :a Congress should consider requiring the Departments of Homeland 

Security (DHS), Justice, and the Treasury to collaborate on the development 

and implementation of a joint radio communications solution that specifically 

requires the departments to establish an effective governance structure that 

includes a formal process for making decisions and resolving disputes, define 

and articulate a common outcome for this joint effort, and develop a jomt 

strategy for improving radio communications. 

legislation has been enacted that is aimed at improving interoperable 

communications solely at DHS, and it does not require coordination across 

DHS, Justice, and Treasury as we recommended.~ Additionally, in July 2015, 

the House of Representatives passed a bill that would further address this 

action.1 

International 2011 Area81: Action 1: Congress could eliminate the retrospective component of the U.S. 

antidumping and counteNaiHng duty system and, instead, treat the antidumping 

and countervailing duties assessed at the time the product enters the country 

as final 

affairs Antidumping and 

Countervailing 

Duties 

2012 Area 20: Overseas Act1on 1: To contain costs and reduce duplication of administrative support 

AdmimstratiVe services overseas, Congress may wish to consider requiring agencies to 

Services participate in International Cooperative Administrative Support Services 

(ICASS) unless they provide a business case to show that they can obtain 

these services outside of ICASS without increasing overall costs to the U.S 

government or that their mission cannot be achieved within !CASS. 

2013 Area 31 Tobacco Action 1: Congress, as it continues oversight of the Children's Health Insurance 

Taxes Program Reauthorization Act (CHIPRA), may wish to consider equalizing tax 

rates on ro!l~your-own and pipe tobacco. 

Action 2: Corigress, as it continues oversight of CHIPRA, may wish to consider, 

in consultation with the Department of the Treasury, options for reducing tax 

_________________________________ avoidance due to tax differentials be~~e~e_n :_~~~~a_nd __ la_rg~e ~~~~ar~s·-~-

Page 33 GA0-16·580T 
64 

Mission report 

2016 

Social 2012 

services 

Training, 2016 

employment, 

and education 

Source GAO.jGA0·16·580T 

Area 

Appendix 1: Open Congressional Actions, by 

Mission 

Action summary 

Area 36: Cargo 

Preference for 

Food Aid 

Act1on 1: While recognizing that cargo preference serves policy goals 

established by Congress with respect to the U.S. merchant marine, including 

maintenance of a fleet capable of serving as a naval and military auxiliary in 

time of war or national emergency, Congress should consider clarifying cargo 

preference legislation regarding the definition of "geographic area~ to ensure 

that agencies can fully utilize the flexibility Congress granted to them when it 

lowered the cargo preference for food aid requirement. 

Area 28. Housing 

Assistance 

Area 37; Post9/11GI Bill 

Overpayments 

GAO estimated that this action could potentially result in millions of dollars in 

savings. 

Action 1: To optimize the federal role in rural housing, the Congress may wish 

to consider requiring USDA and the Department of Housing and Urban 

Development (HUD) to examine the benefits and costs of merging those 

programs that serve similar markets and provide similar products. As a first 

step, the Congress could consider requiring USDA and HUD to explore merging 

their single-family insured lending programs and multifamily portfolio 

management programs, taking advantage of the best practices of each and 

ensuring that targeted populations are not adversely affected. 

Action 1: Congress should consider granting the Department of Veterans Affairs 

explicit authority to require a minimum level of training for appropriate school 

officials. 

Note: This table provides estimates of cost savings or increased revenue where such information was 

available. In addition, it provides information on steps Congress took for actions that are considered 

partially addressed. 

"These actions are partially addressed. Partially addressed means a relevant bill has passed a 

committee, the House of Representatives, or the Senate, or relevant legislation has been enacted but 

only addressed part of the action needed. AU other items are not addressed, which means that a bill 

may have been introduced, but did not pass out of a committee. or no relevant legislation has been 

introduced. 

~>Pub. L. No. 112-55 (2011); Pub. L. No. 114-113 {2015); Pub. L. No. 112-95 (2012). 

~Pub. L. No. 114-113 (2015} 

4

Nationa! Defense Authorization Act for Fiscal Year 2014, Pub. L No. 113-66 {2013}. 

~National Aeronautics and Space Administration Authorization Act of 2015, H R 810, 114th Gong 

(2015); Weather Research and Forecasting Innovation Act of 2015, H.R 1561, 114th Cong. (2015) 

1

Protection and Affordable Care Act, Pub. L. No. 111-148, § 3135(b), 124 Stat. 119, 437 (2010) 

(codified, as amended. at 42 U.S.C. § 1395w-4(c}(2)(B)(v)(VI)): The Physician Payment and Therapy 

Relief Act of 2010, Pub. l. No. 111-286 § 3(b), 124 Stat. 3056 (2010) (codified, as amended, at 42 

U.S.C. § 1395w-4(c){2}(B){v)(VII}); Pub. L No. 114-113, div. 0, § 502(a)(2), 129 Stat. 2242, 3020 

(codified at 42 U.S.G. §§ 1395w-4(b)(10), (c)(2)(8)(v)(X!)). 

11"Thls action is partially addressed as a result of actions taken by the agency 

nH.R. 2189 (2013). 

'H.R. 443, 114th Gong. (2015); NTIS Elimination Act, $.787, 114th Cong. (2015); Just Goog!e lt Act, 

S.1636, 114th Cong. {2015). Additionally, bills have been previously introduced but were not enacted 

See Let Me Google That For You Act, S. 2206, 113th Cong. (2014); and H.R. 4382, 113th Gong 

(2014) 

1

Pub. L No. 113·235. div. 6, title I,§ 109 (2014). 

kDepartment of Homeland Security Interoperable Communications Act, Pub. L No. 114·29 (2015) 

Page 34 GA0-16-SSOT 
65 

(100756) 

Appendix 1: Open Congressional Actions, by 

Mission 

1

State Wide Interoperable Communications Enhancement Act. H.R. 2206, 114th Cong. (2015). Also, 

in September 2015, a bill was introduced that would address this action. See PREPARE Act, H.R 

3583, 114th Gong. (2015). 

Page 35 GA0-16-580T 
66 

Insert. p. 49 of transcript 

Over the past 6 years, GAO has recommended specific rescissions-one of Congress's targeted policy 

tools to achieve possible cost savings, and one that requires specific information and targeted 

legislation-whenever there has been sufficient cost and program information to do so. We've identified a 

total of $8.5 billion in possible rescissions so far: 

Treasury's Foreclosure Prevention Efforts (2016): We suggested Congress rescind any Treasurydeobligated excess Making Home Affordable program balances that Treasury doesn't move into 

the Hardest Hit Fund. Based on current information, there's atleast $2.7 billion more that 

Treasury could deobligate, which could Increase as the program closes. For now, we think 

Congress should conduct regular oversight to ensure Treasury continues to identify and 

deobligate excess funds and when this occurs, Congress should consider rescinding those funds. 

U.S. Enrichment Corporation Fund (2015): We suggested Congress permanently rescind the 

entire $1.6 billion balance of the U.S. Enrichment Corporation (USEC) Fund because all of the 

authorized purposes of that Fund (relating to environmental cleanup and USEC privatization) 

have been fulfilled. Two bills that would rescind these funds were introduced last December, but 

they haven't been enacted yet (S. 2354, Strong Families Act, and H.R. 4140 (Saving the Earnings 

and Noting the Investment of Our Retired Seniors Act of 2015). 

l 

Advanced Technology Vehicles Manufacturing Loan Program {2014): We suggested Congress 

rescind some or all of the remaining $4.2 billion in credit subsidy appropriations for DOE's A TVM 

loan program, unless the agency can show a demand for new loans and viable applications. 

There's been some legislative activity the last few months involving possible rescission of the 

ATVM funds, in connection with the Flint, Michigan drinking water situation, but nothing's been 

enacted so far. 

GAO has also identified areas where Congress could use some of its other appropriations-related tools 

beyond rescission-such as budget reductions and program cancellations-to achieve cost savings in the 

short term. Examples: 

Open GAO recommendations: 

Unobligated Balances 12016): We recommended the Department of State finalize Consular 

Affair's strategy for the management of its unobligated balances, and continue its efforts to 

reduce excess unobligated balances allocated to the Consular and Border Security Programs in 

the Diplomatic and Consular Programs account ($440 million). We also recommended DOE 

finalize and implement a strategy to reduce excess unobligated balances within the Construction, 

Rehabilitation, Operation and Maintenance account ($40 million). 

DOD US.Family Health Plans (2015): We recommended Congress terminate Defense's authority 

to contract with US Family Health Plan {USFHP)-designated providers in a manner consistent 

with a reasonable transition of affected USFHP enrollees into TRICARE's regional managed care 

program or other health care programs, as appropriate. This could potentially save millions of 

dollars. 

Crop Insurance (2013): We recommended Congress consider limiting the crop insurance subsidy 

for all farmers or at least high-income farmers. This could save up to $2 billion annually. 
67 

Written Statement of Dr. Tom Coburn 

April27, 2016 

Good morning. Thank you, Chairman Johnson, Ranking Member Carper and members 

of the Committee. It is good to see you. It's good to be back with the Committee. 

Since leaving the Senate last January, I have kept busy. I am supporting the Convention 

of the States Project to restore Washington's accountability to the states and the American 

people. I have been active working on the Manhattan Institute's Project FDA to improve patient 

treatments and innovation. I also recently formed a new group The Foundation to Restore 

Accountability to continue my work investigating and conducting oversight of wasteful 

spending in the federal government. 

Most importantly, I have been enjoying spending time in Oklahoma with Carolyn and our 

children's families, including our beautiful grandchildren. 

As I spend time away from Washington and travel across the country, I am more 

convinced than ever that our nation faces a crisis. Our national debt has grown to more than $19 

trillion. The federal government's obligations continue to expand at a time when our nation's 

challenges-including serious threats to national security-arc increasing and threaten our way 

of life. 

All the while, the American people have lost faith in their government. They do not see 

leadership coming from Washington because there is none. They do not believe that Congress 

and the Administration are able to fix our nation's problems. I agree. 

Recognizing these serious problems, my purpose for visiting with you today is to share 

my thoughts about what lessons I learned from serving on this important committee. I am proud 

of the work that we did together. But so much remains unfinished. 

One important lesson that I learned was the importance of oversight. Without knowing 

where you are, you can't get to where you need to go. 

Consider the Duplication Report that we are talking about today. The Duplication Report 

started with a request that I made to my staff. I asked them to identifY all of the areas of overlap 

and waste in the federal government. They thought I was nuts. My staff spent several weeks 

and found waste and duplication all across the federal government. I then asked for GAO to 

effectively compare all of the departments, agencies, offices, and programs across the federal 

government. 

Gene, I am sincerely grateful for all of the work that you and your dedicated staff have 

done over the years. But even your team was reluctant to volunteer for such a daunting project. 

So we passed an amendment to the 20 I 0 bill to raise the debt ceiling to make it happen. The 

amendment passed 94-0. 
68 

GAO has now completed six duplication reports, which have identified 237 areas where 

federal agencies' programs are overlapping or duplicative, and where we can achieve savings. 

My gut is there are even more. There are real savings here. 

GAO says in this year's report that we've saved $56 billion already and will save another 

$69 billion over the next I 0 years. And those savings are achieved after Congress and federal 

agencies have implemented less than half of GAO's recommendations. To put that in context, the 

current fight over funding to fight the Zika outbreak comes in at less than $2 billion. 

This year's report highlights duplicative payments by the federal government for the 

health care of low-income individuals. The government is often reimbursing the states for 

Medicaid and paying subsidies to their Obamacare exchanges for the same low income people. 

The goal of President Obama's health care plan was universal coverage. The goal was not to pay 

twice for the same coverage. 

GAO also highlighted this year that the Social Security Administration is losing billions 

by overpaying disability insurance recipients, and, rather than requiring them to pay back those 

overpayments, simply waives them. The disability program has many problems, and for SSA to 

simply write-off the mistakes it makes is a disservice to disabled Americans. 

In another example, the Dodd-Frank law created a structure where there are now as many 

as J 5 federal and state regulatory agencies overseeing financial institutions. GAO reports this is 

bad for institutions, bad for the regulators, and bad for the consumers, who are poorly protected 

by this inefficient structure of confusing responsibility. 

Finally, the Department of Defense is so fundamentally bad at procuring what it needs, 

that it now has a stockpile of 529,373 tons of excess ammunition awaiting disposal. which is 

expected to double over the next five years. DOD spends about $118 million each year just 

disposing of extra ammunition that could be transferred to other federal agencies, reducing their 

need to spend money on ammo. 

And the Duplication Report is just the tip off the iceberg of where we can find savings in 

the federal budget. Look at what we found in our annual Wastebook reports. Wastebook 

highlighted a million dollar federal grant for a website about romance novels, hundreds of 

thousands for Swedish massages for rabbits, and a federally-funded project to study shrimp on a 

treadmill. 

This work did have some success through oversight and persistence. The bridge to 

nowhere is finally dead. The NFL tax loophole is closed. Taxpayers no longer fund political 

party conventions. The federal government is no longer funding the Woodstock museum. And 

we actually let the ethanol tax credit expire, which was a recommendation in GAO's very first 

Duplication Report. 

These reports were just a few in addition to the 4 7 oversight reports that my office 

released during my time in Congress. Beyond just the waste, we identified serious problems at 

critical agencies like the Department of Veterans Affairs where mismanagement leads to poor 
69 

care and even lost lives of American heroes. Or at the Department of Homeland Security, where 

failure to achieve its missions like border security and immigration enforcement puts our nation 

and the American people at risk. 

I am also proud of the bipartisan oversight and investigative work that we did at this 

Committee, including my work with Carl Levin at the Permanent Subcommittee on 

Investigations. 

For example, I am pleased to report that the Department of Justice has finally indicted 

several of the subjects of our bipartisan investigation of the fraud and corruption in the Social 

Security disability program. Our report found Eric Conn, a disability attorney in Kentucky, was 

paying doctors to manufacture fraudulent medical records to support Social Security disability 

claims. Mr. Conn then directed those claims to an Administrative Law Judge, David Daugherty, 

who would approve them on the record, without a hearing. 

Just a few weeks ago, Mr. Conn, former Judge Daugherty, and one of Mr. Conn's doctors 

were all indicted on a number of charges, including mail fraud, wire fraud, and money 

laundering, all ofwhieh were outlined in this Committee's 2013 report and hearing. 

Senator Levin and I didn't always agree on matters of policy and how to reform our 

government. But we did agree that the Congress and the American public deserve the facts and 

to know the truth. 

Bipartisanship wasn'tjust about doing oversight work. It has been the basic culture of 

this Committee since !joined it in 2005. And it was through that bipartisan work that we 

succeeded in passing legislation on issues where we could find basic agreement. I am proud to 

have worked with then-Senator Obama to pass the Federal Funding Accountability and 

Transparency Act of2006 to create the USASpending.Gov, which was a key step in making our 

government more transparent. 

Senator Carper, I am proud of the all of the work we did together all those yearsstarting back at the Federal Financial Management subcommittee and continuing through the last 

days of the last Congress with the full Committee. We sat together for more hearings than I can 

remember. We worked together to co-sponsor more bills than I can count. I am particularly 

proud of our record enacting bipartisan legislation, from improving federal cybersecurity, IT 

management, and curbing improper payments. 

We didn't always succeed. Take our legislation together to reform the federal real 

property system, our bill to stop improper payments to dead people, and the Taxpayer Right to 

Know Act, which would have required an online database of all federal programs. All of these 

were good-government bills that would have made a difference but were held up by just one or 

two objections and could not pass by unanimous consent. 

But we did our best to work together to solve problems where we had agreement and 

there was a window of opportunity. And together you and l-and our Committee-became a 

model of bipartisanship in the process. 
70 

Chairman Johnson, I applaud your leadership of this Committee. I appreciate that you 

continue to focus on the major problems facing our nation, and that you and Senator Carper are 

continuing to carry forward the tradition of bipartisanship, including passing 68 bipartisan bills 

through the Committee so far. I am particularly thankful that you are continuing to champion 

some of the reforms that Senator Carper and I were working on all those years, from real 

property reform and identifYing and reducing improper payments, to protecting whistleblowers 

and strengthening watchdogs. I am optimistic that you two and the Committee will succeed in 

getting those reforms across the finish line this year. 

I will close with one final thought for each of you. I think back to my time spent in your 

position. I now fully appreciate the limited time that we have serving the American people as 

members of the Senate. As a private citizen again, I encourage each of you to approach each day 

asking what you and your staff can do to help address the big challenges facing our nation. 

Whether it is implementing GAO's recommendations, working together on bipartisan 

legislation or just doing basic oversight, each of you-both individually and collectively as a 

Committee-has an opportunity to make a difference and to begin to win back the American 

people's trust. 
71 

CONSORTIUM FOR CITIZENS 

WITH DISABILITIES 

STATEMENT FOR THE RECORD 

Hearing before the 

Senate Committee on Homeland Security and Government Affairs 

Government Reform: Ending Duplication and 

Holding Washington Accountable 

April 27, 2016 

Statement submitted by the Co-Chairs of the 

Social Security Task Force, 

Consortium for Citizens with Disabilities 

Submitted May 9, 2016 via email on behalf of the Co-Chairs oftbe Social Security Task 

Force, Consortium for Citizens with Disabilities: 

Lisa Ekman, National Organization of Social Security Claimants' Representatives 

Kate Lang, Justice in Aging 

Jeanne Morin, National Association of Disability Representatives 

Webster Phillips, National Committee to Preserve Social Security and Medicare 

T.J. Sutcliffe, The Arc of the United States 

Chairman Johnson, Ranking Member Carper, and Members of the Committee, thank you for the 

opportunity to submit this Statement for the Record as Co-Chairs of the Consortium for Citizens 

with Disabilities (CCD) Social Security Task Force, on "Government Reform: Ending 

Duplication and Holding Washington Accountable." 

CCD is a working coalition of national consumer, advocacy, provider, and professional 

organizations working together with and on behalf of the approximately 57 million children and 

adults with disabilities and their families living in the United States. The CCD Social Security 

Task Force focuses on disability policy issues in the Title II disability programs and the Title 

XVI Supplemental Security Income (SSI) program. 

At the April 27 hearing, Eugene L. Dodaro, Comptroller General of the Government 

Accountability Office (GAO), noted that the GAO's "2016 Annual Report: Additional 

Opportunities to Reduce Fragmentation, Overlap, and Duplication and Achieve Other Financial 

1825 K Street, NW. Suite 1200 • Washington. DC 20006 • PH 202-783-2229 • FAX 202-783-8250 • lnfo@c-c-d.org • www.c-c-d.org 
72 

Benefits" includes a recommendation for Congress to" ... consider passing legislation to prevent 

individuals from collecting both full Disability Insurance benefits and Unemployment Insurance 

benefits that cover the same period ... " (GAO 2016 Annual Report, p. 33). 

We urge the Committee to reject this proposal. 

Last year, over 70 national organizations including members of CCD, the Coalition on Human 

Needs, and the Strengthen Social Security Coalition highlighted their opposition to cuts to 

concurrent Social Security Disability Insurance (SSDI) and Unemployment Insurance (UI) 

benefits in a letter to Congress. A copy of that letter is enclosed and is available at: 

http://www.c-c-d.org/fichiers/CCD-Letter-DI-UI-03-17-l5F!NAL.pdf 

As highlighted in the letter, SSDI and UI are vital insurance systems established for different 

purposes, paid for by workers and their employers. Receiving UI and SSDI concurrently is legal 

and appropriate. This has been the long-standing position of the Social Security Administration 

and of the courts. 

Individuals qualify for SSDI because they have disabilities that meet the Social Security Acfs 

stringent standard, preventing work at or above Social Security's Substantial Gainful Activity 

level (earnings of $1,130 per month in 2016 for non-blind beneficiaries with disabilities). At the 

same time, Congress has on a bipartisan basis designed the Social Security Act to encourage 

SSDI beneficiaries to attempt to work. Beneficiaries who have done so at a low level of earnings 

but have lost their job through no fault of their own may qualify for Ul at the same time that they 

continue to be eligible for SSD!. As highlighted in a 2012 GAO report, less than one percent of 

individuals served by SSDI and UI receive concurrent benefits. The average quarterly concurrent 

benefit in fiscal year 2010 totaled only about $3,300 tl·om both SSDI and Ul, combined (or an 

average of$1,100 per month from both SSD! and UJ). 

The CCD Social Security Task Force believes that cutting concurrent SSDI and UI benefits 

would harm the economic security ofSSDI beneficiaries and their families, who rely on these 

modest but vital benefits to get by. 

Proposed cuts would also single out SSDI beneficiaries and treat them differently from other 

workers under UI, denying them the benefits that they and their employers have paid for. 

Finally, proposed cuts would create a new work disincentive in the SSD! program, by penalizing 

SSDI beneficiaries who attempt to work and sending the message to beneficiaries who are 

considering a work attempt that if they lose a job through no fault of their own, their benefits will 

be at risk. This would run directly counter to decades of bipartisan Congressional efTorts to 

encourage work by SSDI beneficiaries. 

For these reasons, we strongly urge the Committee and Congress to reject proposals to 

reduce or eliminate these concurrent earned insurance benefits. 

Please contact T.J. Sutcliffe, sutcliffe@thearc.org. if you have any questions or would like more 

information about the impact of these proposed cuts on SSDI beneficiaries and their families. 

2 
73 

CONSORTIUM FOR CITIZENS 

WITH DISABILITIES 

March 17, 2015 

The Honorable Orrin Hatch 

Chair, Committee on Finance 

U.S. Senate 

219 Dirksen Senate Office Building 

Washington, DC 20510 

The Honorable Sam Johnson 

Chair, Subcommittee on Social Security 

Committee on Ways and Means 

U.S. House of Representatives 

B317 Rayburn House Office Building 

Washington, DC 20515 

The Honorable Paul Ryan 

Chair, Committee on Ways and Means 

U.S. House of Representatives 

1102 Longworth House Office Building 

Washington, DC 20515 

The Honorable Jeff Flake 

U.S. Senate 

368 Russell Senate Office Building 

Washington, DC 20510 

The Honorable Joe Manchin 

U.S. Senate 

306 Hart Senate Office Building 

Washington, DC 20510 

RE: Opposition to proposals to eliminate or reduce concurrent Social Security 

Disability Insurance (SSDI) and Unemployment Insurance (UI) benefits 

Dear Chairman Hatch, Chairman Johnson, Chairman Ryan, Senator Flake, and Senator 

Manchin: 

The undersigned members of the Consortium for Citizens with Disabilities (CCD), the 

Coalition on Human Needs, and the Strengthen Social Security Coalition write to 

express our opposition to proposals to eliminate or reduce concurrent Social Security 

Disability Insurance (SSDI) and Unemployment Insurance (UI) benefits, including the 

"Social Security Disability Insurance and Unemployment Benefits Double Dip 

Elimination Act of 2015" (S. 499; H.R. 918) and the "Reducing Overlapping Payments 

Act of 2015" (S. 343). 

SSDI and Ul are vital insurance systems established for different purposes. Receiving 

Ul and SSDI concurrently is legal and appropriate. This has been the long-standing 

position of the Social Security Administration and of the courts. Individuals qualify for 

SSDI because they have significant disabilities that prevent work at or above Social 

Security's Substantial Gainful Activity level (earnings of $1,090 per month, in 2015). At 

1825 K Street, NW. Suite 1200 • Washington. DC 20006 • PH 202-783-2229 • FAX 202-783-8250 • lnfo@c-c-d.org • www.c-c-d.org 
74 

the same time, the Social Security Act encourages SSDI beneficiaries to attempt to 

work, and those who have done so at a low level of earnings but have lost their job 

through no fault of their own may qualify for Ul. As highlighted in a 2012 Government 

Accountability Office report, less than one percent of individuals served by SSDI and Ul 

receive concurrent benefits, and the average quarterly concurrent benefit in fiscal year 

2010 totaled only about $3,300 (or an average of $1,100 per month). 

These extremely modest benefits can be a lifeline to workers with disabilities who 

receive them, and their families- and as permitted by law are neither "double-dipping" 

nor improper payments. We are deeply concerned by any prospect of worsening the 

economic security of workers with disabilities and their families. 

In addition, proposed cuts to concurrent benefits single out SSDI beneficiaries with 

disabilities, treating them differently from other workers under the Ul program. 

Finally, proposed cuts to concurrent benefits create new disincentives to work for SSDI 

beneficiaries, by penalizing individuals who qualify for both SSDI and Ul because they 

have attempted to work, as encouraged by law. The creation of a new work disincentive 

runs directly counter to our shared goal of expanding employment opportunities for 

people with disabilities. 

For these reasons, the undersigned national organizations strongly oppose the "Social 

Security Disability Insurance and Unemployment Benefits Double Dip Elimination Act of 

2015" and the "Reducing Overlapping Payments Act of 2015." We urge Congress to 

reject these bills and any similar legislation. 

Sincerely, 

9to5 

ACCSES* 

AFL-CIO 

Alliance for Retired Americans 

Alliance for Strong Families and Communities 

American Council of the Blind* 

American Federation of Government Employees (AFGE) 

American Federation of State, County and Municipal Employees (AFSME) 

American Foundation for the Blind (AFB)* 

Americans for Democratic Action (ADA) 

Association of Assistive Technology Act Programs* 

Association of University Centers on Disabilities* 

Autism National Committee* 

Autistic Self Advocacy Network (ASAN)* 

B'nai B'rith International 

Brain Injury Association of America* 

Campaign for America's Future 

Center for Community Change Action 

Center for Effective Government 

Coalition on Human Needs 

2 
75 

Community Legal Services* 

Disability Rights Education and Defense Fund* 

Easter Seals* 

Equal Rights Advocates 

Every Child Matters Education Fund 

Food Research & Action Center (FRAC) 

Goodwill Industries International* 

Health & Disability Advocates* 

Justice in Aging* 

Latinos for a Secure Retirement 

Lupus Foundation of America* 

Lutheran Services in America Disability Network* 

MomsRising 

NAACP 

National Advocacy Center of the Sisters of the Good Shepherd 

National Alliance on Mental Illness* 

National Association of Councils on Developmental Disabilities* 

National Association of Disability Representatives* 

National Association of State Directors of Special Education* 

National Association of State Head Injury Administrators* 

National Committee to Preserve Social Security and Medicare* 

National Council of Jewish Women 

National Council on Aging* 

National Council on Independent Living* 

National Disability Rights Network (NDRN)* 

National Down Syndrome Congress* 

National Employment Law Project 

National Employment Lawyers Association 

National Industries for the Blind* 

National Multiple Sclerosis Society* 

National Organization for Women 

National Organization of Social Security Claimants' Representatives* 

National Priorities Project 

National Respite Coalition* 

National Women's Law Center 

NETWORK, A National Catholic Social Justice Lobby 

OWL-The Voice of Women 40+ 

Paralyzed Veterans of America* 

Provincial Council of the Clerics of St. Viator (Viatorians) 

Racial and Ethnic Health Disparities Coalition 

Social Security Works 

SourceAmerica* 

Special Needs Alliance* 

Strengthen Social Security Coalition 

The Arc of the United States* 

The Jewish Federations of North America* 

The John O'Leary Organization 

The Judge David L Bazelon Center for Mental Health Law* 

3 
76 

Union for Reform Judaism 

United Cerebral Palsy* 

United Spinal Association* 

United Steelworkers (USW) 

USAction 

Vietnam Veterans of America (WA)* 

World Institute on Disability* 

CC: 

Original cosponsors. S. 499 

The Honorable Daniel Coats 

The Honorable James M. lnhofe 

The Honorable James Lankford 

The Honorable Tim Scott 

Original cosponsors. H.R. 918 

The Honorable Todd C. Young 

The Honorable Mike Kelly 

The Honorable Patrick J. Tiberi 

The Honorable Diane Black 

The Honorable David G. Reichert 

The Honorable Charles W. Boustany, Jr. 

The Honorable Adrian Smith 

The Honorable James B. Renacci 

The Honorable Tom Reed 

The Honorable Aaron Schock 

Members, U.S. Senate 

Members, U.S. House of Representatives 

* Members of the Consortium for Citizens with Disabilities (CCD). 

The CCD is a coalition of national organizations working together to advocate for federal 

public policy that ensures the self-determination, independence, empowerment, 

integration, and inclusion of the approximately 57 million children and adults with 

disabilities in all aspects of society. 

4 
77 

GAO Responses to Questions for the Record from the 

4/27/16 HSGAC Duplication Hearing 

Questions from Kelly Ayotte 

(1) In prior testimony you commented favorably on the legislation that my colleague Joe 

Manchin and I introduced-the Duplication Elimination Act-saying you were 

supportive of it and thought that it was necessary. Looking at the most recent 

duplication report and all of the unaddressed actions, it seems like we still need ways 

to compel executive and congressional action on GAO's good work. We must craft 

better ways for Congress to do its job and at the same time make sure that executive 

branch is taking action as well. Absent statutory forcing mechanisms, how often do 

agencies reach out to GAO to ask how to achieve necessary reforms or in most cases 

is outside pressure-such as from Congress---necessary to spur action? 

GAO has several means for encouraging agencies to take action on recommendations in 

our reports. 1 We start by obtaining comments on our draft reports, including our draft 

recommendations, to understand agencies' views about them and plans to implement them. 

We then maintain frequent dialogue and constructive working relationships with agencies to 

help ensure our recommendations are implemented effectively and in a timely manner. For 

example, at least once a year we reach out to agencies to determine the extent to which 

they have implemented our recommendations and if benefits can be attributed to our work. 

We also engage with agencies on an ongoing basis about opportunities to improve program 

performance during the course of our audit work. We report on the status of our 

recommendations on a public database at www.gao.gov. Experience has shown that it 

takes time for some recommendations to be implemented, and executive branch agencies 

have implemented an average of about 80 percent of our recommendations within a 4-year 

period. 

In addition, our high-risk and fragmentation, overlap, and duplication work highlights critical 

unimplemented recommendations that we believe warrant special attention by agencies and 

Congress. We maintain attention on these issues through our biennial reports to Congress 

on high-risk issues and our annual reports on duplication and cost savings. As part of our 

high-risk initiative, we meet with the Office of Management and Budget's (OMB) Deputy 

Director for Management and with top agency officials to discuss progress in addressing 

individual high-risk areas. We report on the status of duplication and cost savings actions in 

the fall and spring each year in GAO's Action Tracker, a publicly accessible website that 

allows Congress, executive branch agencies, and the public to track the progress the 

government is making in addressing the issues we have identified. 

In 2015, we undertook an additional effort to call attention to unimplemented 

recommendations and highlighted those that we believe warrant priority attention by the 

Secretary or agency heads at key departments and agencies. We sent letters to the heads 

of these departments and agencies identifying the high priority recommendations and urging 

1 GAO, Government Efficiency and Effectiveness: Implementing GAO Recommendations Can Achieve Financial 

Benefits and Strengthen Government Performance GA0-16-272T (Washington, D.C., Dec. 10, 2015). 
78 

the agency head to continue to provide attention to these issues. We plan to update our first 

round of priority recommendations this summer. 

Finally, Congress plays a key role in providing oversight and maintaining focus on our 

recommendations to ensure they are implemented and produce desired results. In addition 

to reporting on the status of recommendations to Congress, we engage with Congress on 

strategies for further addressing our recommendations. For example, these strategies 

include: 

Congress using our work to assist in drafting legislation. For example, several of our 

reports and recommendations on cybersecurity issues informed the Cybersecurity 

Act of 2015. 2 

GAO recommending agencies assess the need for legislation and report their 

findings to Congress. For example, we concluded that IRS possibly could better 

prevent identity theft by accelerating W-2 reporting deadlines for employers, and 

recommended that the Internal Revenue Service (IRS) report on the costs and 

benefits of accelerating Form W-2 deadlines. The IRS did so, which informed 

congressional deliberations on a proposed amendment to the tax code, which was 

subsequently enacted. 3 

Additionally, Congress can use its budget, appropriations, and oversight processes to 

incentivize executive branch agencies to act on our recommendations. For example, Congress 

can hold hearings, withhold funds, or take other actions to provide incentives for the agencies to 

act. This strategy can be useful when agencies disagree or have a limited response to our 

recommendations. For example, Congress instructed the Department of Interior to reform its 

system for administering Bureau of Indian Education schools and to present a reorganization 

proposal in its next budget request. Specifically, Congress urged Interior to promptly address 

our recommendations to improve how it manages and oversees schools, including 

implementing a strategic plan for the Bureau of Indian Education and strengthening 

accountability measures for school spending. 

(2) On roughly what portion of GAO duplication report recommendations is GAO actively 

working with the executive branch to produce successful outcomes? 

GAO monitors all of our recommendations at least annually. As noted above, in 2015, we 

undertook an effort to call attention to unimplemented recommendations that we believe 

warrant priority attention, and sent letters to the heads of key departments and agencies 

identifying these high priority recommendations and urging the agency head to continue to 

provide attention to these issues. Copies of these letters were provided to Congress. In 

addition to updating these letters this summer, we are developing a web-based application 

that will feature our priority recommendations and help the Congress and executive branch 

agencies during the transition to a new Congress and a new Administration. They can also 

2Pub. L. No. 114-113, div. N. 129 Stat. 2935 (2015). 

3

Pub. L. No. 114-113, div. Q. § 201,129 Stat. 2242 (Dec. 18, 2015). 

2 
79 

be helpful during confirmation hearings for executive branch nominees. We also included, 

as Appendix I to our testimony, open action items for the Congress.• 

With regard to our annual Duplication and Cost Savings reports, we assess agencies' 

progress and update open recommendations twice per year. Our annual reports have 

produced numerous successful outcomes, including improved efficiency and effectiveness 

across the federal government and approximately $125 billion in expected financial benefits 

from 2010-2025. 

As of March 2, 2016, there were 333 open duplication and cost savings actions directed to 

executive branch agencies, which represents 61 percent of all recommendations we made 

to executive branch agencies from 2011-2016. To enhance progress on outstanding 

duplication and cost savings recommendations, we regularly engage with OMS and recently 

identified a list of key issues where OMS's attention could be instrumental in furthering 

progress on recommendations that involve multiple agencies or government-wide issues. As 

noted earlier, we also monitor the progress executive branch agencies have made in 

addressing the actions identified in our annual reports. To maintain attention on these 

issues, in 2013, we launched GAO's Action Tracker, which we update each year in the fall 

and spring. 

4GAO, Government Efficiency and Effectiveness: Opportunities to Reduce Fragmentation, Overlap, and Duplication 

and Achieve Other Financial Benefits GA0-16-580T (Washington, D.C., Apr. 27, 2016). 

3 
80 

Questions from Tammy Baldwin 

(1) As Ranking Member of the Federal Spending Oversight and Emergency Management 

Subcommittee, I am concerned about the new areas of waste identified in the federal 

government. However, I am encouraged by the progress the federal government has 

made in addressing the previous 544 GAO recommendations and am hopeful that we 

can find ways in Congress to act upon the new recommendations in order to save 

resources, cut costs, and collection additional revenue. The GAO report notes that 

DHS's human resource administrative environment is fragmented and duplicative 

with, "little uniformity in its data management practices." 

(a) Can you please elaborate on this finding and explain what this lack of uniformity 

means to DHS's human resource systems? 

As we reported in February 2016, DHS's human resources administrative environment 

includes fragmented systems, duplicative and paper-based processes, and little uniformity in 

its data management practices5

. According to DHS, these limitations in its human resources 

environment compromise the department's ability to effectively and efficiently carry out its 

mission. Among other things, according to DHS, reporting and analyzing enterprise human 

capital data are time-consuming, labor-intensive, and challenging because the department's 

data management largely consists of disconnected, standalone systems with multiple data 

sources for the same content. For example, we reported in 2014 that DHS could not provide 

complete information on how much it had spent on administratively uncontrollable overtime 

to its personnel from fiscal years 2008 through 2014. 6 

To address these issues, in 2003, DHS initiated the Human Resources Information 

Technology (HRIT) investment to consolidate, integrate, and modernize the human 

resources information technology infrastructure of the department and its eight components. 

As part of the HRIT effort, DHS determined that it had 422 human resources systems and 

applications. 

We found in a February 2016 report that DHS had made very limited progress in 

implementing HRIT. Of 15 improvement opportunities included in the investment, such as 

end-to-end hiring and personnel action processing, DHS had fully implemented only 1, as of 

November 2015. HRIT's limited progress was in part due to a lack of involvement of the 

HRIT executive steering committee-the investment's core oversight and advisory body. 

Moreover, HRIT's strategy may not have reflected DHS's current priorities, in part because 

the department had not updated the HRIT strategic planning document since 2011 Until 

DHS takes key actions to re-evaluate and manage this neglected investment (as described 

in our responses to your questions below), the department's ability to effectively and 

efficiently carry out its mission will continue to be significantly hampered by its fragmented 

human resources system environment. 

5GAO, Homeland Security: Oversight of Neglected Human Resources Information Technology Investment Is Needed. 

GA0-16-253 (Washington, D.C., Feb. 11, 2016). 

6GAO, Department of Homeland Security: Continued Action Needed to Strengthen Management of Administratively 

Uncontrollable Overtime, GA0-15-95 (Washington, D.C.: Dec. 17, 2014). 

4 
81 

(b) Can you explain some of GAO's recommendations to help address this problem? 

Can you also explain your sense of whether DHS has expressed a commitment to 

addressing this issue? 

We made 14 recommendations to DHS to, among other things, address HRIT's poor 

progress and ineffective management. For example, to ensure that the HRIT investment 

receives necessary oversight and attention, we recommended that the executive 

steering committee be consistently involved in overseeing and advising HRIT. We also 

recommended that DHS re-evaluate HRIT's goals and priorities, and update its strategy 

accordingly. 

DHS concurred with our recommendations, outlined timeframes for implementing each 

of the recommendations, and identified initial actions that it had taken to evaluate HRIT 

and improve oversight of the investment. 

(2) In your testimony, you highlight the potential for duplicative federal spending on 

health insurance for individuals who transition between Medicaid and health 

insurance programs through the Affordable Care Act. As you know, many of the 

individuals who transition between Medicaid and subsidized heath exchange 

coverage are low-income individuals who experience income volatility. It is critical 

that we do not put more pressure on tis vulnerable population or allow them to slip 

through the cracks. However, in a fiscal climate like this one, where medial expense 

are rising, I would also hope that we are not unnecessarily doubling expense and 

taxing already limited resources. 

(a) In your opinion, how can we ensure that individuals are able to maintain their 

health coverage, while also ensuring that the government isn't duplicating 

coverage for individuals? 

In our October 2015 report, we found that to the extent states and the federal 

government are able to effectively share eligibility and enrollment data across Medicaid 

and the exchange as well as build IT system controls to prevent duplicate coverage, they 

are better positioned to minimize coverage gaps and duplicate coverage for individuals 

transitioning between the two coverage types due to changes in income or other 

factors. 7 The states with state-based exchanges that were included in our 2015 report 

all had integrated eligibility and enrollment systems for Medicaid and their exchange to 

help prevent coverage gaps and duplicate coverage. Among other things, their systems 

made eligibility determinations in real time and included system rules that did not allow 

an individual to be determined eligible for Medicaid and exchange subsidies 

simultaneously. 

However, for individuals in states with a federally facilitated exchange (FFE), we found 

that the Centers for Medicare & Medicaid Services (CMS) had taken several steps to 

minimize coverage gaps and duplicate coverage for individuals, yet we found that these 

steps were not sufficient and made several recommendations to the agency. For 

example, we found that individuals transitioning from Medicaid to exchange coverage 

7 See GAO, Medicaid and Insurance Exchanges: Additional Federal Controls Needed to Minimize Potential for Gaps 

and Duplication in Coverage, GA0-16-73. (Washington, D.C.: Oct. 9, 2015). 

5 
82 

may be more likely to experience coverage gaps to the extent that their accounts are not 

transferred from the state Medicaid agency to the exchange in a timely fashion. 

However, we found that CMS did not track the timeliness of such transfer and 

recommended that the agency begin doing so. In responding to our recommendation, 

CMS reported that they monitor the frequency of account transfers on a weekly basis 

and collecting information from states on account transfers to identify challenges. As part 

of this effort, we encouraged CMS to collect information on the amount of time it takes 

the state to transfer an individual's account to CMS after determining that the individual 

is no longer eligible for Medicaid, as such information is necessary to ensure the 

timeliness of transfers. 

(b) Are you aware of any effort HHS has made to better monitor and assess 

individuals' health coverage to reduce duplicate coverage? 

CMS has taken some important initial steps to monitor and assess individuals' health 

coverage; however, additional steps are needed to avoid lengthy periods of duplicate 

coverage. In our October 2015 report, we recommended that CMS establish a schedule 

for regular checks for duplicate coverage and develop a plan to routinely monitor the 

effectiveness of these checks and other planned procedures to prevent and detect 

duplicate coverage. In March 2016, CMS reported that it executed its first check in July 

of 2015. As of March 2016, CMS had not yet conducted a second check, but was 

planning for its execution, in part by making changes to the FFE IT system and by 

working with states to improve functionality of their IT systems so that the data matching 

involved in checks for duplicate coverage will be more successful. CMS also stated that 

it was in the process of (1) developing a schedule for future checks and intends to 

conduct them multiple times per year and (2) working to implement additional internal 

controls to prevent duplicate coverage, including developing functionality within the FFE 

to remove exchange subsidies from individuals who are identified as having duplicate 

coverage through the checks and do not take action on their own within a specified 

period of time. CMS officials said that such functionality would be in place by late 2016 

at the earliest. 

However, as of March 2016 it had been at least six months since CMS conducted its last 

check for duplicate coverage and in our 2015 report, we found that such frequency could 

result in individuals having duplicate coverage for 7 months longer than what might be 

expected as part of the normal transition from subsidized exchange coverage to 

Medicaid. We believe it is important for CMS to implement its next check and establish a 

schedule to conduct future checks as soon as possible. Finally, our 2015 report notes 

the importance of CMS developing target levels of duplicate coverage the agency deems 

acceptable-and it is not clear that the agency plans to do so. Without such targets, it 

will be difficult for CMS to provide reasonable assurance that its procedures are 

sufficient or whether additional steps are needed. 

6 
83 

Questions from Thomas R Carper 

Last month, I introduced a bipartisan, bicameral bill that builds on longstanding 

management efforts to increase the efficiency and effectiveness of the federal 

government by enhancing its ability to address many of the issues highlighted in GAO's 

report on Duplication, Fragmentation and Overlap in federal programs. This bill S. 2834, 

the Getting Results through Enhanced Accountability and Transparency Act, would 

update the decades old statutes that govern how agencies manage and review their 

operations to help them identify opportunities for efficiency and economy in all of their 

functions and activities. The bill would also ensure that agencies address issues of 

duplication in their strategic planning, including in their annual performance plans they 

send us along with their budget submissions to Congress. Further, the bill includes 

provisions requiring agency Performance Improvement Officers and the interagency 

council they serve on to address issues of coordination and duplication, to consult more 

widely in their work with non-federal stakeholder, and make their operations more 

transparent to Congress. 

(a} To what extent do you believe that legislation such asS. 2834 could enhance the 

ability of agencies to address the issues raised in your report? 

The Getting Results through Enhanced Accountability and Transparency (GREAT) Act 

would amend existing statutory requirements and could help focus agencies on addressing 

issues identified in our duplication and cost savings reports. The GREAT Act would do this, 

in part, by amending various provisions of the Government Performance and Results Act 

Modernization Act of 2010 (GPRAMA). For example, the GREAT Act would amend the 

existing requirement for the Office of Management and Budget (OMB), in consultation with 

Congress, to develop Federal Government Priority Goals (also known as Cross-Agency 

Priority (CAP) goals) by directing OMB to consider actions we recommend in our annual 

report on duplication and cost savings and our high risk update when developing those 

goals. In addition, the GREAT Act would require agencies to identify actual or potential 

duplication in their performance plans, and agency leadership to focus on risks that span 

across multiple programs and organizations. The GREAT Act also would provide additional 

transparency by requiring agencies to post certain information to their public websites. 8 

(b) Which existing resources and institutions in the federal government are in the best 

position to address issues of unnecessary duplication, fragmentation, and overlap? 

GAO's annual Duplication reports to Congress are required to identify federal programs, 

agencies, offices, and initiatives-either within departments or government-wide-that have 

duplicative goals or activities9 Since 2011, GAO has annually reported such information 

and will continue to support the Congress in addressing issues of unnecessary 

fragmentation, overlap and duplication through this effort. 

8 The Act would also require GAO to include in its Duplication reports information on the cost of unnecessary 

duplication and the cost savings and revenue generation possible through addressing recommendations in our 

annual duplication and cost savings reports. 

9Pub. L. No. 111-139, § 21, 124 Stat 29 (2010), 31 U.S.C. § 712 Note. 

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OMB, like GAO, has a cross-government vantage point, and an opportunity to review all 

agency missions and programs through the budget preparation process. This role is 

particularly important when fragmentation, overlap or duplication exists across multiple 

agencies and cannot be resolved by a single agency. We routinely discuss our 

Duplication work with OMB officials, and have provided them lists of priority open actions 

where increased OMB attention could be instrumental in helping reduce fragmentation, 

overlap, and duplication. For example, OMB could take a number of steps to better 

ensure that the Federal Data Center Consolidation Initiative is meeting its established 

objectives, such as asking that agencies prioritize and take the steps necessary to 

improve their plans for consolidating, including providing a full master consolidation 

schedule and reporting their expected cost savings Consolidating federal data centers 

could achieve cost savings and avoidances of $5.4 billion in fiscal year 2016 or later if 

further action is taken, according to GAO's analysis of data from 24 agencies involved in 

the initiative. 

OMS's role also encompasses oversight of how agencies devise, implement, manage, 

and evaluate the statutory programs and policies for which they are responsible. This 

responsibility is central to OMS's efforts to assist in agency strategic planning, goalsetting, performance measurement, information management, evaluation, and policy 

research, and includes working with Congress agencies to develop Federal Government 

Priority Goals (also known as Cross-Agency Priority (CAP)) goals. 

Congress also plays an important role in resolving fragmentation, overlap and 

duplication and maintaining focus on our recommendations to ensure they are 

implemented and produce desired results. In addition to reporting on the status of 

recommendations to Congress, we engage with Congress on strategies for further 

addressing our recommendations. These strategies include: 

Congress using our work to assist in drafting legislation. For example, several of our 

reports and recommendations on cybersecurity issues informed the Cybersecurity 

Act of 2015. 10 

GAO recommending agencies assess the need for legislation and report their 

findings to Congress. For example, we concluded that IRS possibly could better 

prevent identity theft by accelerating W-2 reporting deadlines for employers, and we 

recommended that the Internal Revenue Service (IRS) report on the costs and 

benefits of accelerating Form W-2 deadlines. The IRS did so, which informed 

congressional deliberations on a proposed amendment to the tax code, which was 

subsequently enacted. 11 

Additionally, Congress can use its budget, appropriations, and oversight processes to 

incentivize executive branch agencies to act on our recommendations. For example, 

Congress can hold hearings, withhold funds, or take other actions to provide incentives 

for the agencies to act. This strategy can be useful when agencies disagree or have a 

limited response to our recommendations. Congress instructed the Department of 

Interior to reform its system for administering Bureau of Indian Education schools and to 

10Pub. L. No. 114-113, div. N. 129 Stat. 2935 (2015). 

11 Pub. L. No. 114-113, div. Q. § 201, 129 Stat. 2242 (2015). 

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present a reorganization proposal in its next budget request. Specifically, Congress 

urged Interior to promptly address our recommendations to improve how it manages and 

oversees schools, including implementing a strategic plan for the Bureau of Indian 

Education and strengthening accountability measures for school spending. 

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Questions from Heidi Heitkamp 

(1) In January ofthis year, the GAO report (GA0-16-222) found that the FCC and USDA 

do not coordinate to develop joint outreach and training for their programs that 

promote high-speed Internet access in tribal lands, which could result in a an 

inefficient use of federal resources and missed opportunities for resource leveraging 

between the two agencies. One of the primary challenges that tribes identified, 

according to the GAO's study, is the lack of connectivity to core Internet networks, 

called middle-mile infrastructure. How can the FCC and USDA work together to 

address this primary challenge to connect rural tribal communities? 

While we recommended, as discussed below, that FCC and USDA increase their 

coordination and collaboration, we did not make recommendations specifically related to 

middle-mile infrastructure, However, FCC and USDA could work together to address the 

concern over middle-mile infrastructure costs to connect tribes to core networks by ensuring 

their subsidy and grant programs are efficiently distributed. Updating the Broadband Map to 

more accurately reflect where connectivity issues exist would help both FCC determine 

where to best invest their subsidies and USDA their grants and loans. 

(2) One of the recommendations that GAO made to the FCC was to better define "tribal" 

on funding applications to improve data accuracy for tribal connectivity. Do you 

think that including the option to distinguish tribal applications would better increase 

the visibility and fundability of these applications from agency standpoint? 

As you note, our recommendation was intended to improve data accuracy for tribal 

connectivity and applies specifically to FCC's Universal Service Fund Schools and Library 

Program, also known as E-rate. E-rate provides discounts to eligible schools and libraries on 

telecommunications services, internet access, and internal connections. While defining tribal 

would make such applicants visible to FCC, E-rate is not specifically targeted to tribal 

schools and libraries, although some are eligible for assistance 

(3) The GAO report stated that FCC and USDA have invited one another to outreach 

events, but do not synchronize activities, polices, or procedures for providing 

technical assistance. I understand that the FCC has invited USAD to its 2016 

consultations, but what can further be done to increase synchronization? 

(a) How should we measure synchronization efforts? 

To further synchronize training and outreach, FCC and USDA could implement our 

recommendation to increase their coordination and collaboration. 12 However, FCC and 

USDA could accomplish this without signing a formal MOU by conducting joint meetings 

and training events. Possible ways to measure synchronization include, by the number 

of joint meetings, tribes reached and trained, and the training dollars saved as a result. 

12GAO, Telecommunications: Additional Coordination and Performance Measurement Needed for High-Speed 

lntemet Access Programs on Tribal Lands, GA0-16-222. (Washington, D.C.: Jan. 29, 2016). 

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Questions from Claire McCaskill 

The Department of Defense's (DOD) disposal of its excess inventory was one of the new 

items in GAO's report on duplication and overlap in the federal government. In the 

report, GAO notes that there are 12 programs that DOD runs to give nonfederal entities 

priority in accessing DOD excess inventory over non-law enforcement federal agencies. 

The report noted, for example, that DOD is giving away construction equipment that cost 

taxpayers $25 million while the Department of Interior is turning around and buying 

construction equipment at the same time that may be identical to what DOD is giving 

away. 

My concern is that DOD itself is doing this. After a hearing lied with Dr. Coburn in 2014 

looking at the 1033 program, I asked DOD for 2 lists: 1 of the items it declared as excess 

that were in Condition Code A- what DOD considers to be "almost new" condition - and 

a 2"d list of any of those items that it had purchased new in the last 5 years. I got back a 

list of over 3,000 distinct items that were declared as excess one year and then DOD 

turned around repurchased the same thing, and I do not believe that that list is complete 

either. 

(1) Has GAO looked at the controls that DOD has in place to ensure that procurement 

officers are reviewing DOD's excess inventory list before making purchases to 

ensure that DOD is not declaring as excess certain items and buying those same 

exact items at the same time or the following year? 

In our January 2016 review of DOD's process for disposing of excess personal property, 

we reviewed many aspects of the disposal process, but did not review DOD's 

procurement processes in relation to excess property disposal because it was outside 

the scope of our review. 13 While we did not review this issue, it is covered in Part 8 of the 

Federal Acquisition Regulation (FAR). According to FAR 8.102, when practical, agencies 

must use excess property from other agencies before initiating a contract action. FAR 

8.103 then addresses how agencies learn about available excess property. 

Among the potential recipients of DOD excess personal property are 12 DOD special 

programs, which include the foreign security assistance program and the program that 

provides excess DOD personal property to state, local, federal, and tribal law 

enforcement agencies. At the time of our audit work, DOD's disposal process for excess 

personal property allowed these special programs to obtain excess personal property in 

the earliest stage of the disposal process.•• Thus, special programs could potentially 

13GAO, Excess Personal Property: DOD Should Further Reassess the Priorities of Its Disposal Process, GA0-16-44, 

(Washington, D.C.: Jan. 29, 2016). Our report on DOD's excess personal property disposal process (1) describes the 

process for disposing of DOD's excess personal property in the U.S.; (2) assesses how DOD's priorities in its 

disposal process affect the distribution of excess property; and (3) assesses the extent to which DOD has 

encountered challenges in its capacity to manage excess personal property to be processed. Prior to this review, in 

June 2014, we reported on the Defense Logistics Agency's (DLA) inventory reduction goals and the risk that DLA 

was disposing of inventory that it would be more economical to keep and would then need to buy the same items 

again in the future. GAO, Defense Inventory: Actions Needed to Improve the Defense Logistics Agency's Inventory 

Management, GA0-14-495 (Washington, D.C .. June 19, 2014). 

14During the course of our audit, we relied on DOD's August 1997 Defense Materiel Disposition Manual, which 

implemented the requirements of the Federal Property Management Regulation and other laws as appropriate, as 

they apply to the disposition of DOD's excess, surplus, and foreign excess personal property. On October 22, 2015, 

DOD released an updated four-volume Materiel Disposition Manual, which, in general, clarifies aspects of DOD's 

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obtain excess property turned in by a DOD component before other DOD components 

had the opportunity to screen and request that property. 15 

In October 2015, DOD revised its process to explicitly give priority to DOD components 

for obtaining excess property during the first 14 days of the disposal process. 16 While 

this change should better ensure that DOD components have the first opportunity to 

obtain excess DOD personal property, it does not change the priority consideration given 

to special programs, which are still able to obtain excess property before federal civilian 

agencies have had a chance to assess such property for their needs. 

As a result, we recommended that DOD further reassess its disposal process to 

determine whether additional changes are needed in the priorities of recipients within the 

process, including potential changes to the categories and quantities of property that 

special programs may obtain, and revise its guidance reflecting those priorities, 

accordingly, to avoid the risk that federal agencies will procure personal property that 

they could have obtained at little or no cost through the disposal program. Although DOD 

concurred with our recommendation and stated that it would continue to assess all 

aspects of the disposal process as part of its standard operating procedures, it did not 

identify specific steps it would take to implement our recommendation. We maintain that 

DOD should separately assess the priorities in its disposal process, to include 

preferences provided to the special programs. 

Bridge contracts are supposed to be short-term, temporary extensions of contracts to 

allow agencies time to fully rebid the existing contact in accordance with federal 

regulations. I understand why an agency might need to extend these bridge contracts 

for a short period of time if it is at the tail end of a negotiation and just needs a bit more 

time to complete the deal. But, GAO found that some of these bridge contracts are 

lasting for 2 and 3 years. 

(2) When does a bridge contract become a no-bid sole-source contract? 

The FAR does not define bridge contracts, so we are answering this question using the 

definition we developed for our report. We defined a bridge contract as an extension to 

an existing contract beyond the period of performance (including base and option years), 

or a new, short-term contract awarded on a sole-source basis to an incumbent 

contractor to avoid a lapse in service caused by a delay in awarding a follow-on contract 

disposition process while maintaining the essential structure of the program. Because the 1997 manual was in effect 

during the audit period, our report relied on the 1997 guidance. Our findings and recommendation remained valid, 

however, when considered within the context of the updated guidance, since the fundamental framework of the 

disposition process remains unchanged. See Department of Defense, DOD 4160.21-M, Defense Materiel Disposition 

Manual (August 1997) and DOOM 4160.21, Defense Materiel Disposition, vats. 1-4 (Oct 22, 2015). 

15This practice also allowed the special programs to obtain excess property before it would become available to some 

federal civilian agencies that may have similar needs. 

16While special programs may place orders during that time, they would not receive property until the end of the 

reutilization stage of the process, thus ensuring that DOD components will receive the property they request before 

special programs. Special programs continue to receive priority for obtaining DOD excess personal property ahead of 

federal civilian agencies. DOD Manual 4160.21, Defense Materiel Disposition: Reutilization, Transfer, and Sale of 

Property, vaL 3, encl. 5, § 3(b)(3) (Oct 22, 2015). 

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Using this definition, a bridge contract becomes a sole-source contract when the 

contract preceding the bridge-which may have been awarded competitively or on a 

sole-source basis-expires and the agency extends the existing contract or awards a 

new sole source contract to the incumbent contractor using other than full and open 

competition procedures .. For example, contract options that were not assessed at the 

time of award are considered sole-source as are new sole-source stand-alone contracts 

when awarded to the incumbent contractor to bridge a gap in service. 

(3) Should there be a limit on the length of time for a bridge contract? 

At this time, because bridge contracts have not been defined federal government-wide 

and agencies we reviewed have not developed strategies to track their use, there is not 

enough information available to say whether there should be a limit on the length of time 

a bridge contract should be awarded for. However, we do know from our prior work that 

bridge contracts are typically envisioned to be used for short periods of time, and that 

when noncompetitive contracts such as these are used frequently or for prolonged 

periods of time, the government is at risk of paying more than it should for goods and 

services. A uniform, government-wide definition and strategies for tracking and 

managing the use of bridge contracts would help ensure all agencies have better 

insights into their use of these contracts and provide agencies with the information 

necessary to manage their use, and in October 2015 we made recommendations to 

address this issue. Similarly, a definition and tracking and managing the use of these 

contracts could inform a decision as to whether it would be prudent to impose a limit on 

the length of time for bridge contracts. 

(4) What are some factors that result in a 2- or 3-year bridge contract? 

For bridge contracts we reviewed that exceeded 2 years in length, several reasons were 

cited as contributing to the length of the bridge contract, including late acquisition 

planning, bid protests, and acquisition workforce challenges, among others. 

(5) In your opinion how much of this is a staffing issue, how much of this is a training 

issue, and how much of this is just poor contract management? 

While it is difficult to determine the precise influence of these factors, in most of the 

cases we reviewed, acquisition planning issues were cited as an initial reason for delays 

in the award of follow-on contracts that led to the use of a bridge contract Other 

reasons, such as, acquisition workforce challenges, bid protests and budget 

uncertainties may have exacerbated that initial delay, and led to the continued need for a 

bridge contract 

(6) Where is the Office of Federal Procurement Policy in coming up with a standard 

definition of bridge contracts, the length of time they should be, and when they 

are appropriate? 

The Office of Federal Procurement Policy (OFPP) is in the process of addressing our 

recommendations. Specifically, in October 2015, we recommended the following: 

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To gain visibility and enable efficient management on the use of bridge contracts in 

federal agencies, we recommend that the Administrator of OFPP take the following two 

actions: 

(1) Take appropriate steps to develop a standardized definition for bridge contracts and 

incorporate it as appropriate into relevant FAR sections, and 

(2) As an interim measure, until the FAR is amended, provide guidance to agencies on 

•a definition of bridge contracts, with consideration of contract extensions as well as 

stand-alone bridge contracts; and 

•suggestions for agencies to track and manage their use of these contracts, such as 

identifying a contract as a bridge in a Justification and Approval when it meets the 

definition, and listing the history of previous extensions and stand-alone bridge 

contracts back to the predecessor contract in the Justification and Approval. 

In response to a request for an update on the status of our recommendations, in May 

2016 OFPP staff stated that OFPP will be convening the Federal Acquisition Council to 

discuss regulatory action after it completes the development of agency guidance. The 

guidance, which includes a definition of bridge contracts, has been drafted for review by 

the agency Chief Acquisition Officers and Senior Procurement Executives. 

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Æ 

Questions from Jon Tester 

Mr. Dodaro, the Government Accountability Office (GAO) holds a tremendous 

responsibility for providing agency information to Congress. The work you and your 

staff do informs what programs we authorize, how money is spent, and where spending 

is wasteful or fraudulent. As a strong proponent of government transparency, this 

requires agencies to comply with information requests from GAO. 

1. Currently, GAO does not enjoy full access to the information held at the National 

Database of New Hires (NDNH) at the Department of Health and Human Services 

(HHS). How would full access to NDNH help GAO in its oversight mission? 

NDNH is a database of quarterly wages, unemployment insurance, and W-4 filings collected 

by the states and federal agencies and reported to HHS. Therefore, it is a valuable source 

of employment data that can be used to support GAO's improper payments and fraud work, 

as well as other work involving programs where eligibility is means tested. The government 

continues to face challenges in determining the full extent of improper payments, including 

those for means-tested programs. Reliable access to the NDNH data will facilitate GAO's 

future efforts to identify indicators of the extent of improper payments across major 

government programs. 

2. What programmatic duplication or waste would GAO be better able to uncover if 

permitted full access to NDNH in statute? 

GAO could use the NDNH to uncover potential indicators of fraud, duplication, and waste in 

programs that provide income-based benefits, including the following: Medicaid; 

Supplemental Nutrition Assistance Program (SNAP); Temporary Assistance for Needy 

Families (TANF); Special Supplemental Nutrition Program for Women, Infants and Children 

(WIC); Federal Employee Compensation Act (FECA), various disability programs from SSA, 

the Office of Personnel Management, and Department of Veterans Affairs; School Meals 

programs, the Department of Housing and Urban Development's Section-8 Voucher 

program, the Internal Revenue Service's Earned Income Tax Credit (EITC), and Federal Pell 

Grants. 

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