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From the category archives: Medicare

CBO Confirms: GOP Healthcare Bill is a Huge Setback for Older Americans

Twenty-three million people will lose health insurance in the next decade under the GOP's American Health Care Act (AHCA) according to the latest Congressional Budget Office (CBO) report.  The CBO analysis concludes that the House Republican plan benefits the young and healthy at the expense of older and sicker Americans. The report indicates that “near seniors” (aged 50-64) will be hit particularly hard by the GOP healthcare bill, as we discussed this morning on our Facebook Live broadcast from Capitol Hill.  

 

“The CBO report was no surprise to those of us who are looking out for the best interests of older Americans. The GOP leadership was so focused on passing repeal and replace legislation that they failed their due diligence by ignoring an ominous flaw; their bill will drive up seniors’ out-of-pocket costs by repealing subsidies that help defray the cost of premiums,” says Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare.  

 

According to the CBO, near seniors could see their net premiums rise by as much as 700-800 percent if the AHCA becomes law.  A 64 year-old with an income of $26,500 per year who paid $1,700 annually for an Obamacare policy would now pay a whopping $13,600 under the Republican plan.

 

The report also confirms that the House bill will only compound the problems faced by near seniors with pre-existing conditions. While an amendment by Rep. Fred Upton (R-MI) adds $8 billion over five years to fund high-risk pools for patients with pre-existing conditions, that will not be nearly enough to offset the extra costs to seniors. 

 

“People who are less healthy (including those with pre-existing or newly acquired medical conditions) would ultimately be unable to purchase comprehensive non-group health insurance at premiums comparable to those under current law, if they could purchase it at all,” the CBO says

 

Seniors who rely on Medicaid will suffer under the American Health Care Act.  The CBO report calculates that the AHCA slashes Medicaid spending by $834 billion. Medicaid currently helps pay for long term care for millions of seniors nationwide. The CBO estimates that some 14 million Medicaid recipients would lose coverage under the AHCA – or not be able to attain it in the first place – within the next 10 years.  In fact, more than half of the increase in uninsured Americans under the AHCA would come from this vulnerable population.

 

The GOP healthcare bill also weakens Medicare by repealing a tax on high wage earners, which would decrease the solvency of the Medicare Part A Trust Fund by three years.  The CBO had earlier estimated that the Part A Trust fund would forgo $177.3 billion over ten years if the ACA Medicare payroll tax is repealed, opening the door for those who want to privatize (or "voucherize") Medicare. 

 

The amended American Health Care Act is an assault on the health care of all seniors,” says Richtman.  “We can only hope that the Senate will take the CBO’s new figures into consideration – and reverse the provisions that are so demonstrably harmful to our nation’s seniors.” 


 

 

Trump Budget Shatters President's Promise on Social Security, Medicaid

The President’s promise not to touch Social Security was officially revealed to be a sham today.  Trump’s proposed 2018 budget slashes $64 billion from Social Security Disability Insurance (SSDI).  Some media outlets have let the President off the hook by saying the budget does not cut Social Security benefits.  This headline from Fox Business News is typical, even in the mainstream media:

Trump’s Budget Slashes Spending, Leaves Social Security & Medicare Untouched – Fox Business News, 5/22/17


A CNN Money correspondent just perpetuated the administration’s misleading spin, telling Wolf Blitzer this afternoon that Trump’s budget “doesn’t touch Social Security.”   

Other media outlets are hedging by saying the Trump budget doesn’t cut “core” Social Security benefits – whatever that means.  Social Security Disability Insurance is a crucial and inseparable part of Social Security. Period.  No amount of parsing can cleave the two.  When you cut a program, you hurt people – whether the cuts affect “core” benefits or not.

In this case, the millions of Americans with disabilities who rely on SSDI for basic income security are the ones who stand to be hurt.  Though SSDI helps younger Americans, too, most of its beneficiaries are 55 or over – meaning any cuts to the program will hit older Americans particularly hard.   The human consequences do not seem to disturb the President’s Budget Director Mick Mulvaney, as is obvious from this exchange with a reporter in the White House press room:


Reporter:  Will any of those individuals who receive SSDI receive less from this budget?

Mulvaney:  I hope so.

Mulvaney clarified that he thought the program has been enrolling too many people and called for cuts in the number of enrollees, even though that number has been shrinking.  Earlier this year, the Budget Director wondered aloud on television why SSDI is considered part of Social Security, despite the fact that it unequivocally is – and has been – since 1956.  SSDI is funded by workers’ Social Security payroll tax contributions – just like retirement benefits.   Qualifying disability beneficiaries must meet certain work history requirements, same as they do for retirement benefits.  When SSDI recipients reach retirement age, they transition seamlessly into the Social Security retirement program.  In no way is SSDI separable from Social Security.

The Center for Budget and Policy Priorities (CBPP) reports that the Trump budget contains $72 billion in cuts to federal disability programs — primarily Social Security Disability Insurance and Supplemental Security Income, which provides income assistance to poor seniors and people with disabilities.  The budget does not contain hard details of exactly how SSDI will be cut, but CBPP offers this insight:

$48 billion would come from a vague proposal to “test new approaches to increase labor force participation.”  But the Social Security Administration has undertaken many demonstration projects over the years to test new ways to encourage beneficiaries to return to work, and they have consistently shown limited results or proved not cost-effective. The budget also contains other proposals that would cut Social Security benefits for disabled workers and SSI benefits for households with more than one disabled family member.  – Center for Budget and Policy Priorities

Cutting benefits for Americans with disabilities fits right in with the cruel theme running through the President’s entire budget, which decimates programs for society’s most vulnerable citizens in order to give the rich and big corporations a massive tax cut.  In addition to SSDI, the Trump budget guts Medicaid, and cuts funding for other programs benefitting seniors including Meals on Wheels, home heating assistance, and community service employment.  

Candidate Donald Trump repeatedly vowed not to touch Social Security, Medicare, and Medicaid.  The drastic cuts to SSDI and Medicaid – along with the weakening of Medicare’s solvency in the Republicans’ healthcare legislation – makes the President zero for three on these promises.   Knowing that he cannot be trusted to protect seniors, advocates and everyday Americans must work to defeat the Trump budget in Congress – and make sure it never reaches his desk.

Paul Ryan's Medicare Privatization Scheme Edging Closer to Reality

Paul Ryan’s dystopian dream of privatizing Medicare may soon come true.  At least he seems to think so.  In an interview with right-wing Wisconsin radio host Vicki McKenna, the House Speaker said that Medicare “reform” is coming to the Capitol this Spring.  “I’m pretty sure the budget committee in the House will pass that on in the House Republican budget,” Ryan said.  In fact, House Budget Committee Chair Diane Black (R-TN) has already promised to include Medicare privatization in the budget resolution next month.  This is scary news for millions of current and future retirees.

To justify his Scrooge-like assault on Medicare, Ryan continues to perpetuate the myth that Medicare is an “entitlement.”  In fact, it is a remarkably efficient social insurance program.  Having paid into it their entire working lives, Americans are counting on having affordable health care coverage to protect them upon retirement.  Why does Paul Ryan want to take that away, effectively reneging on the nation's commitment to current and future retirees? 

In the past, President Obama stood as an impenetrable barrier between Ryan and his privatization scheme.  Though candidate Trump promised “not to touch” Medicare, the President has already broken that pledge by supporting the GOP healthcare plan, which shortens the solvency of the program.   Despite Trump’s campaign promises, his budget director refused to publicly discourage Congress from privatizing Medicare.  In fact, Speaker Ryan said in his radio interview that he and the Trump administration are having “an ongoing conversation” about it. Current and future retirees clearly cannot trust this White House to protect their Medicare benefits, which they have paid for during their entire working lives.

As we discussed on our "Behind the Headlines" Facebook Live broadcast Thursday, here is what Ryan’s insidious “reform” would do:  Instead of receiving guaranteed benefits, all Medicare participants would be given vouchers to help pay premiums for traditional Medicare or private health insurance.   In either case, the vouchers would not be able to keep up with rising health care costs, leaving seniors to cover the difference out of their own pockets.  That’s why we call the voucher program “coupon care.” 

Ryan's plan would likely drive healthier, younger and wealthier seniors toward private insurance. Poorer and sicker seniors would remain in traditional Medicare, driving up costs until the program collapsed under its own weight.  But that’s not all.  Ryan also wants to hike the Medicare eligibility age from 65 to 67.  This in itself is a massive benefit cut, as 65 and 66 year olds would have to buy private insurance on their own dime. Those who couldn’t afford it might go without health insurance entirely. In a recent National Committee poll, 65% of likely voters opposed raising the eligibility age.  Among younger voters, the opposition was even stronger.

As Ryan predicts, Medicare privatization will likely pass the House as part of the Republican budget resolution.  Its future in the Senate is less certain, but too close for comfort.  Senate Republican leaders need only 50 votes to wreck Medicare.  The National Committee is building a “firewall” of moderate GOP Senators who we believe can be convinced to protect Medicare.  With an unpredictable President in the White House, that is the best way – along with vocal grassroots activism – to defend current and future retirees against the destruction of a program that has worked effectively for more than 50 years, and enjoys enduring public support.

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Trump & GOP Should Do More than Pay Lip Service to Older Americans Month

May is Older Americans Month.  It began in 1963 as “Senior Citizens Month” by proclamation of President John F. Kennedy.  His proclamation half a century ago was not only an acknowledgment of seniors’ contributions to society, but an inspiring call to action:


“I urge all persons and public and private organizations to cooperate in its observance by increasing community awareness of the problems faced by older men and women, strengthening services and opportunities to meet their special needs… and making this special month the beginning of continuing interest and activity on their behalf.” – John F. Kennedy, April 18, 1963

 

At the time, approximately 33 percent of seniors in America lived in poverty. Today that figure is down closer to 10 percent, thanks in no small part to federal programs designed to buttress the financial and health security of older Americans, including Medicare and Medicaid – signed into law by President Lyndon B. Johnson in 1965.  LBJ also renamed Senior Citizens Month “Older Americans Month” that same year upon passage of the Older Americans Act.  This legislation created new forms of federal assistance for seniors – including Meals on Wheels and home heating assistance.  Every President since has issued proclamations honoring seniors during the month of May.  President Trump is no exception.  Today, the White House released a statement saying:


We… recommit ourselves to ensuring that older Americans are not neglected or abused, receive the best healthcare available, live in suitable homes, have adequate income and economic opportunities, and enjoy freedom and independence in their golden years.” – White House proclamation, 5/8/17


These sentiments sound quite noble.  But the Trump proclamation is an empty missive in light of the administration’s policies. National Committee President Max Richtman called out the President and his party in The Hill newspaper last week:


“May is Older Americans Month, but the Trump administration and Congressional Republicans are putting a serious damper on the celebration.” – Max Richtman, The Hill newspaper.


The Trump administration and its allies on Capitol Hill are engaged in a historic reversal of the promises of 54 years ago. In fact, not since President George W. Bush tried to privatize Social Security in 2005 have seniors’ programs been so much under siege.  In a little more than 3 months in office, here is what the President and/or Republicans in Congress have done to undermine the economic and health security of older Americans:

*Passed the American Health Care Act (AHCA), which weakens Medicare, cuts $1 trillion from Medicaid, and makes private health insurance unaffordable for most older Americans.

*Created a budget plan which eliminates federal funding for Older Americans Act programs including Meals on Wheels, community service jobs, and home heating assistance, among others.

*Pledged to turn Medicare into a voucher program during the mark-up of the FY 2018 budget later this month.

*Introduced a House bill to raise the Social Security retirement age to 70 and slow the growth of Cost-of-Living adjustments (COLAs), effectively cutting benefits 30%.

*Repeatedly pushed the concept of “entitlement reform” and questioned the validity of Social Security Disability insurance

Several of these break President Trump’s campaign promises “not to touch” Social Security, Medicare and Medicaid.  Some in the administration and Congress have attempted to fudge the issue by saying that none of their policies will affect current retirees.  But during this Older Americans Month, it’s wise to remember that all of us will be seniors some day.  Attempts to cleave today’s and tomorrow’s seniors is a cynical ploy that cannot be allowed to undermine time-honored programs that have helped older Americans for decades.  None of the actions of President Trump, his team, and his allies in Congress honor the spirit of Older Americans Month.  Much more fitting are the words of President Obama last night as he accepted an honor named after the President who created Older Americans Month, the John F. Kennedy Profiles in Courage award.

“… It actually doesn’t take a lot of courage to aid those who are already powerful, already comfortable, already influential — but it does require some courage to champion the vulnerable and the sick and the infirm.” - President Obama, 5/7/17

Seniors citizens are among society’s most vulnerable and infirm members. We must demand that our current elected leaders do much more than pay lip service to the ideals of Older Americans Month.


Ryan's Siren Song of Spring: Cut "Entitlements"

Along with Cherry Blossoms and the White House Easter Egg Roll, Spring has brought fresh talk of “entitlement reform” to the Nation’s Capital.  Of course, Social Security and Medicare are not “entitlements.”  They are earned benefits that Americans pay into during their working lives in exchange for retirement and health benefits during their senior years.  Nevertheless, House Speaker Paul Ryan and other budget hawks prefer to perpetuate the “entitlement” myth.  This week, Ryan said that fiscal responsibility means “reforming our entitlement programs.”  “Reforming” is code for undermining Social Security and privatizing Medicare, two politically unpopular ideas that nonetheless seem to drive Ryan’s agenda.  Never mind that Social Security and Medicare Part A are funded by workers’ payroll contributions and don’t contribute a penny to the deficit.  

Meanwhile, House Budget Committee Chairwoman Diane Black (R-TN) is looking to end traditional Medicare through the budget reconciliation process in May, according to Congressional Quarterly.

“The coming fiscal 2018 plan is likely to include proposals to transform Medicare… into a premium support program.  Under one House GOP model… people would be given a choice of traditional Medicare or insurer-run plans starting in 2024.” – Congressional Quarterly, 4/27/17

 “Premium support” is an innocuous sounding term that could have dire consequences for seniors.  What Diane Black means by “premium support” is converting Medicare into a voucher program.  Seniors would be offered the option of leaving traditional Medicare to buy insurance in the private market using vouchers.  These vouchers could never keep pace with rising premiums, meaning seniors would have to cover the difference or drop health insurance entirely.  Older and sicker seniors would likely remain in conventional Medicare, causing the program’s cost to skyrocket, benefits to be cut, and eventually the death of Medicare itself.

The canard that Ryan and his party use to justify cutting benefits, reducing COLAs, and raising retirement ages is that Social Security and Medicare are going “bankrupt.” While it’s true that the trust funds for Social Security and Medicare Part A won’t be able to pay full benefits after 2034 and 2028 respectively without corrective action, there are modest and manageable solutions that won’t hurt the seniors who depend on them.  Senator Bernie Sanders and Congressman John Larson (D-CT) have both offered common sense legislation to keep Social Security solvent for decades.  Both bills ask the wealthy to pay their fair share by scrapping the income cap on payroll taxes.  Larson’s legislation also increases the FICA tax by 1% over 25 years.  (Larson says that for a worker earning $50,000 a year, the payroll tax bump equals one Starbucks coffee drink every 9 weeks). Instead of cutting benefits for our most vulnerable citizens – or raising the retirement age – these bills actually increase benefits and COLAs. 

Medicare could be kept solvent well into this century by similarly modest and manageable means, if budget hawks like Ryan would stop insisting that privatization is the only fix. Congress could authorize Medicare to negotiate prescription drug prices (one of the biggest drivers of rising health care costs).  Innovative methods for saving Medicare costs under the Affordable Care Act, many of which have already reduced healthcare expenditures, could be expanded instead of repealed.  In fact, the Affordable Care Act itself extended the solvency of Medicare by four years.  Repealing the ACA – as Ryan and President Trump are still struggling to do – hurts the long-term solvency of the program.

Ryan and many conservative Republicans ignore these alternatives because, at heart, they do not believe in federal programs that provide Americans with retirement and health security – which puts them at odds with the majority of voters. The latest National Committee poll indicates wide public support for progressive solutions for Social Security and Medicare – and significant opposition to the GOP approach. Seventy-nine percent favor increasing Social Security benefits by scrapping the payroll tax income cap.  Sixty-five percent oppose raising the Medicare eligibility age.  Ninety-three percent want Medicare to be able to negotiate prescription drug prices with pharmaceutical companies.

The National Committee’s social media community seems to agree.  Comments on our Facebook posts over the past three months demonstrate deep skepticism about Republican talking points:

Bruce W. These programs are NOT "entitlements"--we have paid into them our entire working lives. If the income subject to SS fees was raised SS would be solvent for decades...
Suzanne S. Social Security has nothing to do with the deficit. It is a stand-alone program funded by workers. LEAVE IT ALONE.
Tom S.  Social Security and Medicare are lifelines to millions of seniors; anyone who votes in favor of cutting or reducing benefits should be ashamed of themselves!
Adam R.  Social Security has nothing to do with the general budget at all. FACT. It is not an entitlement, This is basically a Trust fund we have paid into all our working lives.

Americans intuitively understand that Social Security and Medicare are social insurance programs that they have already paid for through their hard-earned wages.  For 82 years and 52 years respectively, these programs have worked efficiently to keep seniors healthy and out of poverty.  Our Facebook commenter is perfectly correct to call them “lifelines to millions of seniors.”  Yes, their finances need to be shored up. But asking beneficiaries to bear the burden is not the right way. It’s too bad that some of our most powerful political leaders do not seem to understand… or care.

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