More than 100 older Americans and activists from across the nation have converged on Washington this week to urge Congress and the White House to protect not cut Social Security and Medicare benefits.  Today these senior activists took their personal stories directly to their Members of Congress during a full day of training sessions and Capitol Hill lobbying.

Tomorrow the group will attend the White House Senior Community Leaders Summit on Tuesday, June 26th. We here at the National Committee to Preserve Social Security and Medicare sponsored this summit to provide a unique opportunity for participants to share directly with the Administration their personal experiences with and outlook on the Affordable Care Act, Social Security, Medicare, and Medicaid. The summit will include policy briefings, panel discussions, and a question and answer session on proposals that would impact these vital federal programs which touch the lives of virtually every American family. The message from America’s seniors today has been clear... Washington should not cut Social Security and Medicare benefits to pay for fiscal failures these programs did not create. 

 

 

While the nation waits for the Supreme Court’s decision on the Affordable Care Act, we think it’s important that the real-world implications of this decision for millions of American seniors not get lost in the shuffle. Here is an analysis of the impact on seniors’ Medicare and Medicaid benefits if the ACA is completely overturned: If the individual mandate is declared unconstitutional and is not severed from the rest of the law the whole ACA would be struck down. All of the provisions which positively impact senior’s health would be stripped away. The Part D Donut Hole will return.  Prescription drug costs will rise because discounts provided by ACA will be revoked. Beginning in 2011, brand-name drug manufacturers provided a 50% discount on brand-name and biologic drugs for Part D enrollees in the donut hole.  By 2013, Medicare would have begun to provide an additional discount on brand-name and biologic drugs for enrollees in the donut hole. By 2020, Part D enrollees would have been responsible for only 25% of donut hole drug costs.  All of these savings will be gone if the ACA is repealed New Preventive Services provided with the ACA will disappear.

• Prior to the ACA, Medicare beneficiaries were required to pay a deductible and 20% co-pay for many preventive health services.
• The ACA eliminated cost-sharing for many preventive services and introduced an annual wellness visit for beneficiaries.
• The ACA also eliminated cost-sharing for screening services, like mammograms, Pap smears, bone mass measurements, depression screening, diabetes screening, HIV screening and obesity screenings.

Savings for Chemotherapy and Dialysis patients in Medicare Advantage plans lost

• In the past, Medicare Advantage plans have had flexibility to impose cost-sharing structures that differ from traditional Medicare.  Prior to the ACA, plans increased co-insurance for some services, like chemotherapy and dialysis.  Beneficiaries who were enrolled in MA plans that needed those services were left worse off than if they had the same conditions and were in traditional Medicare.  Many beneficiaries enrolled in these plans did not understand the differences in cost sharing.
• The ACA attempts to remedy this by preventing Medicare Advantage plans from imposing higher cost-sharing for chemotherapy and dialysis than is permitted under Medicare Parts A and B.
• The Centers for Medicare and Medicaid Services (CMS) issued final regulations on these improvements in 2011, and many became effective January 1 of this year.

Improvements in care for individuals with chronic conditions gone

• The ACA has several provisions targeted to improving the quality of care for patients with chronic illness and reducing the costs to Medicare and Medicaid for serving those beneficiaries.

Improvements to help seniors transition from the hospital back home repealed

• The ACA established the Community-Based Care Transition Program which targets individuals who are in traditional fee-for-service Medicare and are hospitalized and at risk for readmission.  The program provides grants to hospitals to work with community-based organizations to provide transitional care interventions.
• 30 community-based organizations across the country have already partnered with local hospital systems and are committed to reducing readmissions by 20% and hospital acquired conditions by 40%.

Improvements in seniors’ access to primary care physicians lost

• Through the Independence at Home demonstration, that ACA will pay physicians and nurse practitioners to provide home-based primary care to targeted chronically ill individuals for a three-year period.
• CMS recently launched this primary care initiative with 16 practices across the country.

Medicare’s Trust Fund will face insolvency 8 years (or even more) sooner than expected

• The Affordable Care Act includes many measures to control costs as well as models for reform that will increase the solvency of the Medicare.  If the ACA is repealed those cost saving measures will be lost and Medicare’s solvency threatened.

The National Committee has partnered with the highly respected National Senior Citizens Law Center to provide detailed analysis of the various Affordable Care Act rulings that could come from the Supreme Court. Our full analysis will be available immediately following the Court’s ruling, expected soon.

The Supreme Court is wrapping up three days of hearings on the Affordable Care Act today.  Seniors with the National Committee’s “Rally Corps” joined other activists on the steps of the Court urging Justices to uphold the health care reform law. “The truth is the more seniors get the facts about healthcare reform the more they support it.  But unfortunately all the partisan bickering surrounding the law’s passage and continuing even now, two years later, has left too many Medicare beneficiaries unaware or misinformed about all the new benefits now available to them thanks to the ACA. Our Rally Corps members understand they’ll end up paying more for their prescription drugs, preventative screenings and higher out-of-pocket costs if the ACA is dismantled so they’re glad to take their case in support of health care reform to the steps of the Supreme Court today. ” Max Richtman, NCPSSM President/CEO The Patients Aware campaign, created by the National Committee Foundation, the National Physicians Alliance, and the Herndon Alliance , has built a national network of doctors, nurses, and caregivers to provide information directly to beneficiaries about the Affordable Care Act.  Doctors, nurses and other care providers are among the most trusted sources of health care information for seniors and their families and they are leading town hall meetings in communities nationwide to sort the fact from fiction about health care reform’s impact on Medicare beneficiaries.  You can get more info about Patients Aware here.

If America’s seniors really want to get at the heart of the ongoing political debate about our nation’s economic mess and the solutions offered to change course, yesterday provided a good snapshot of what’s at stake House Budget Chairman Paul Ryan has introduced the GOP/Ryan budget and as expected it envisions balancing the budget by turning Medicare into a privatized program giving seniors a voucher (designed not to keep pace with their health costs over time) to buy private insurance.  The new twist offered this year is a promise to also keep traditional Medicare as an option.  Unfortunately, what that really means is private insurers will siphon-off younger-healthier seniors while older and sicker patients remain in traditional Medicare which will increase the programs costs, potentially limit doctor participation, and create a death spiral to the Medicare’s demise.  Ultimately, the ideological goal of getting the government out of the business of providing healthcare for seniors will be achieved.  The American Prospect offers this description:

“Most Republicans really do believe that Medicare is a vile, socialistic cancer on the American system, and things would be much better if it were privatized. The fact that Medicare works so much better than private insurance (it has far lower administrative costs, and its overall costs have been rising at a slower rate than those of private insurance), and that it's so popular, is just all the more reason why it's so hateful to them. Medicare validates the idea that government can do something better than the private sector, standing as a living rebuke to arguments they make in so many areas.”

And maybe this also explains while Congressman Ryan continues to conflate America’s retirees with the poor and welfare with Medicare.   By lumping these programs together he attempts to paint a picture of Americans simply milking the system, which conveniently ignores the fact that workers contribute to Medicare.  He did it again in yesterday’s budget news conference (25 minutes into this video):

“but we don’t want to turn this safety net into a hammock that lulls able-bodied people into lives of dependency and complacency, that drains them of their will and the intent to make the most of their lives.”

Now, Congressman Ryan knows that Medicare isn’t welfare.  He knows that American workers help fund Medicare throughout their working lives.  Still…the hammock analogy remains one of his favorite talking points.  Now, consider the fact that on the flipside there were very few details offered yesterday describing the huge tax cuts proposed in this GOP/Ryan budget.  This plan would provide even more tax cuts to the wealthy, an average of $150,000 for the richest among us, while also protecting tax breaks and giveaways to corporations reaping huge profits.  The National Journal reports:

The fiscal 2013 House Republican budget proposal contains a tax-code overhaul lowering corporate and individual tax rates, eliminating the Alternative Minimum Tax, and repealing taxes associated with the health care reform law. This would result in $4.6 trillion in lost revenue over a 10-year period, according to the nonpartisan Tax Policy Center. That’s on top of the estimated $5.4 trillion lost by extending the Bush-era tax cuts. House Budget Chairman Paul Ryan, R-Wis., on Tuesday called his plan revenue-neutral, saying eliminated loopholes and tax shelters would pay for the cuts. Pressed at a news conference for specifics, he declined to say which tax breaks he’d like to forgo. Ryan said he would leave that decision to the House Ways and Means Committee.

Simply put, this GOP budget proposes tax cuts for corporations and billionaires and benefit cuts for everyone else. Speaking of billionaires… One of Mitt Romney’s top economic advisors , Greg Mankiw,  proved that what’s funny for the 1% isn’t quite so humorous for the rest of us.  Mankiw posted this “joke” on his blog under the headline: “A Fiscal Solution”.

Romney’s  staff says “obviously it’s not serious”.  We say obviously it’s not funny either -- especially when you know that Governor Romney supports the Ryan/GOP budget which is a fiscal plan that threatens the health and security of millions of American seniors.  That’s certainly no joke.

Talking Points Memo has a good post on the New England Journal of Medicine’s new report on slowing the cost growth in Medicare spending. NEJM asks, “Slower Growth in Medicare Spending — Is This the New Normal?”

“On the whole, we do not believe that the recent slowdown in Medicare spending growth is a fluke,” wrote the researchers Chapin White and Paul Ginsburg. Thanks to the cost-control reforms over the last decade, they added, “the CBO projects that over the next decade Medicare spending per enrollee will grow substantially more slowly than the overall economy.” They argued that the ACA in particular lays the framework for longer term cost-control by transitioning the provider reimbursement system from paying for quantity to paying for quality, something even Republicans quietly believe is a good idea.”

TPM also writes:

“If the cost-growth slowdown continues into the foreseeable future, it could have dramatic implications on the future of health care policy. The conservative movement has disliked Medicare ever since its inception in the early 1960s, when Ronald Reagan argued it would spell the end of freedom in America. Half a century after enactment, Republicans have found a potent pretext to dismantle the senior safety-net program: impending fiscal doom. Indeed, official projections in recent years have found that Medicare spending is on course to swallow the entire federal budget in half a century. And that has been the central justification for the GOP’s plan, written by Rep. Paul Ryan, to phase out traditional Medicare and replace it with a subsidized private insurance system. But if the NEJM projections hold, the threat of fiscal catastrophe would lose steam. And that means Republicans would have to resort to ideological arguments against Medicare if they want to end its basic structure — a hard sell given the program’s immense popularity. Prior efforts to dramatically scale back Medicare benefits have fallen flat, and without being able to portray privatization or “premium support” as critical to avoiding fiscal apocalypse, as Ryan does on a regular basis, there’s no reason to expect a different outcome.”

What this piece doesn’t mention is the fact that not only has healthcare reform slowed cost growth, it also uses some of those savings to provide new benefits for seniors -- a fact never discussed by conservatives who want the Affordable Care Act repealed before seniors even realize these new benefits exist. The Patients Aware campaign has launched a nationwide campaign to cut through all this political rhetoric on Medicare.  You can check it out  at

www. patientsaware.org