From the category archives: Medicare
For the first time, the Centers for Medicare and Medicaid Services has released data on the racial disparities reported by Medicare Advantage patients.
Despite advances in healthcare access, increases in spending, and improvements in quality over the last decade, there is well-documented evidence that members of racial and ethnic minority groups continue to experience worse health outcomes, CMS said.
The data in disparity of care for eight patient experience measures shows that in seven areas, Asians and Pacific Islanders rated their experience in scores worse than that of whites, compared to five areas for Hispanics, three areas for blacks and only two areas for American Indians and Alaska natives...Healthcare Finance News
The CMS report surveyed customer service responses in a variety of categories. In categories of how easy it is to get needed care; getting needed prescription drugs; and getting information from their health plan about prescription drugs, whites gave the highest ratings, according to the survey.
In a question of getting appointments and care quickly; getting customer service from a health plan; and care coordination, American Indians/Alaska natives gave the highest scores. Blacks gave the highest score when asked how well doctors communicate with them. Asians and Pacific Islanders gave the highest score in a question of getting an annual flu vaccine.
"These data are a good first step in understanding disparities in Medicare Advantage," said Sean Cavanaugh, CMS deputy administrator and director of the Center for Medicare. "We look forward to working with plans in closing the differences in the quality of care that people with Medicare Advantage receive."
Achieving Health Equity will also be the topic of a Congressional forum later this week, hosted by House Energy and Commerce Committee Democrats in partnership with the Congressional Black Caucus (CBC), Congressional Hispanic Caucus (CHC), and Congressional Asian Pacific American Caucus (CAPAC).
Believe it or not...it’s Donald Trump.
While the Republican Party in Washington continues its search for a solution to “the Donald problem,” a number of analysts have offered insight into how Donald Trump has continued to convince voters that he’s qualified to be President. In the immortal words of James Carville, President Bill Clinton’s iconic campaign advisor: “It’s (still) the economy, stupid.”
“...the Republicans were so busy fighting Obamacare, pushing to cut taxes and the size of government, and fighting culture wars that they didn’t see that their party had changed and along with it their base’s needs. Much of what Republicans were talking about didn’t resonate with working-class people who didn’t have the luxury to weigh abstract issues when they had to worry about how to feed, clothe, and house their kids, and how to make it to the next paycheck.”...Charlie Cook, National Journal Political Analyst
The New York Times also describes how the GOP elite lost its voters to Donald Trump:
“...the story is also one of a party elite that abandoned its most faithful voters, blue-collar white Americans, who faced economic pain and uncertainty over the past decade as the party’s donors, lawmakers and lobbyists prospered. From mobile home parks in Florida and factory towns in Michigan, to Virginia’s coal country, where as many as one in five adults live on Social Security disability payments, disenchanted Republican voters lost faith in the agenda of their party’s leaders.
In dozens of interviews, Republican lawmakers, donors, activists and others described — some with resignation, some with anger — a party that paved the way for a Trump-like figure to steal its base, as it lost touch with less affluent voters and misunderstood their growing anguish.
While wages declined and workers grew anxious about retirement, Republicans offered an economic program still centered on tax cuts for the affluent and the curtailing of popular entitlements like Medicare and Social Security.”
We all remember the incongruence of Tea Party protestors bashing the federal government while also holding signs in support of America’s most successful federal programs, Social Security and Medicare. However, that conflicting message isn’t hard to understand once you acknowledge the fact that while wealthy GOP donors remain the nation’s most vociferous supporters of privatizing and cutting these programs (they have the most to gain financially) average Americans of all political persuasions do not support destroying our nation’s retirement and healthcare safety net.
“In Washington, Republicans read Tea Party anger over Mr. Obama’s health care law as a principled rejection of social welfare programs, despite evidence that those voters broadly supported spending they believed they deserved, like Social Security and Medicare. Amid intense anger at Wall Street, Republicans urged voters to blame the recession on excessively generous federal home-lending policies, while moving to roll back regulation of one of their biggest sources of campaign money, the financial industry.”
“During a recent interview with CNBC, Mr. Ryan was asked if Republicans needed to respond to less-affluent voters who believed that Republicans were tending only to the interests of those at the top. Mr. Ryan, who during the same interview called again for the overhaul of entitlements and the reduction of debt, rejected that idea. “People don’t think like that,” he said. “People want to know the deck is fair. Bernie Sanders talks about that stuff. That’s not who we are.”...The New York Times.
Paul Ryan is right, that’s not who the modern Republican Party is – and that’s where Donald Trump comes in. Unlike the GOP leadership in Washington, he recognized the massive disconnect between conservative elites and voters. He even warned conservatives at the 2013 Conservative Political Action Conference:
"As Republicans, if you think you are going to change very substantially for the worse Medicare, Medicaid and Social Security in any substantial way, and at the same time you think you are going to win elections, it just really is not going to happen," Mr. Trump said, adding that polls show that tea partyers are among those who don't want their entitlements changed." ...Donald Trump, 2013 CPAC speech, Washington Times
However, let’s not confuse political astuteness with policy conviction. Donald Trump version 2.0 is very different than the Donald Trump who’s called Social Security a “Ponzi scheme,” advocated for raising the retirement age to 70 and privatizing Social Security. Even this newly-minted candidate Trump has yet to offer a plan for Social Security other than the classic conservative canard of getting rid of waste, fraud and abuse, which is very small:
- Since 1989, SSA’s annual administrative costs have been about 1%
- Fraud in SSI is less than 1% with underpayments more likely than overpayments.
- There are Social Security numbers linked to people that should have been closed; however, it has not led to significant overpayments
It’s no wonder the Republican Party is in a panic. Republican strategist Steve Schmidt on MSNBC’s Morning Joe called the Republican Party, “disconnected and decapitated” as they, to this day, continue to ignore the economic reality (and the effect of their trickle-down economic policies) on average Americans.
“The Republican establishment in Washington has a case of affluenza. You have six of the 10 wealthiest counties in the country surround D.C. You have a real-estate market that took a narrow downturn but rebounded very quickly. You have a city that’s insulated from economic distress; it’s recession-proof to some degree. So this Republican establishment, the consulting class in Washington, these are not living-wage jobs. And at the end of the day, I think they totally miss the psychic impact, the economic impact of the Great Recession, of the economic collapse.
It was such a seismic event in the modern history of the country that even eight years later it's the defining issue of the 2016 campaign as it was the defining issue of the 2008 fall campaign. And they just don't get it. They don't understand the impact for blue-collar wage workers in this country over a 20 year basis and you're seeing this now all play out in this general election.”
Not surprisingly, all of the GOP’s preferred candidates for President (those already gone and still remaining) support cutting Social Security, Medicare and Medicaid. Proving, once again, they still don’t get it.
The Economic Policy Institute’s “The State of American Retirement” combined with the National Institute on Retirement Security’s new report on women and retirement paint a very clear picture of a nation on the brink of an economic crisis that will devastate millions of average American families, if Washington continues to turn a blind eye.
The median family between the ages of 32 and 61 has only $5,000 saved in a retirement account, while the top 1 percent of families has a million dollars or more. For many groups—lower-income, black, Hispanic, non-college-educated, and unmarried—the typical working-age family has no savings at all in these accounts....The State of American Retirement.
“Our retirement system used to reduce inequality, but since the shift to 401(k)s it has only served to magnify it. These accounts are accidents of history that were never designed to replace pensions, and it should come as no surprise that they have not worked for the majority of people.” ...Monique Morrissey, EPI Economist
The numbers are stark:
- Nearly half of all working-age families have zero retirement savings.
- Almost nine in 10 families in the top income fifth have savings in retirement accounts, compared to fewer than one in 10 families in the bottom income fifth.
- Only 41 percent of black families and 26 percent of Hispanic families have retirement account savings, compared with 65 percent of white non-Hispanic families.
- Only married couples are more likely than not to have retirement account savings.
News that the income inequality hindering American workers now is also carrying over to their retirement is alarming for future generations who are taking an economic hit at every stage of life. For women, the retirement picture is even worse.
“A new analysis finds that women are 80% likely than men to be impoverished in retirement. The National Institute on Retirement Security (NIRS) finds that across all age groups, women have substantially less income in retirement than men. For women age 65 and older, the data indicate that their typical income is 25 percent lower than men. As men and women age, men’s income advantage widens to 44 percent by age 80 and older. Consequently, women were 80 percent more likely than men to be impoverished at age 65 and older, while women age 75 to 79 were three times more likely to fall below the poverty level as compared to their male counterparts.”... National Institute on Retirement Security
Just as we’ve seen from climate change deniers, many Republican politicians won’t even acknowledge the retirement crisis exists because improving the nation’s most successful federal retirement programs is anathema to their misguided belief that Wall Street should be handling your savings and for-profit insurance companies managing your health. Instead of supporting proposals to improve the backbone of America’s retirement system, Social Security and Medicare, conservatives continue their campaign to privatize and cut.
There are legislative proposals which would improve Americans’ retirement picture but they are languishing in the GOP controlled Congress. You can see many of these proposals on our Legislative tracker. We also continue to advocate for meaning changes impacting retirement security for women. Please take a moment and see those details on our Eleanor’s Hope initiative website.
The House Ways & Means Subcommittee on Health held a hearing entitled "Preserving and Strengthening Medicare." Unfortunately, as the ranking member Rep. Jim McDermott (D-WA) made clear, this hearing actually had virtually nothing to do with preserving and strengthening Medicare:
“This is the first Health Subcommittee hearing of the year, and it could have been an opportunity to have a fresh, constructive conversation about Medicare. Unfortunately, this won’t be the case. It looks like we should expect more of the same from my Republican colleagues this morning – bad ideas repeated incessantly in the hope that the American people eventually fall for them.
The core proposal that my Republican colleagues have offered – to end Medicare as we know it – will have devastating effects on seniors. It will shift costs onto beneficiaries, create more losers than winners, and lead to a death spiral in traditional Medicare.
We all know this.”
NCPSSM President/CEO, Max Richtman, submitted testimony to the Committee and reacted to the day’s proceedings:
“Unfortunately, today’s Congressional hearing on ‘Preserving and Strengthening Medicare’ offered no new ideas and was instead an Orwellian political exercise in which politicians say preserve when they actually mean privatize, and strengthen when they mean slash.
Republicans in the House envision a future in which millions of seniors will lose their guaranteed Medicare benefits in favor of a privatized CouponCare system in which they receive a government coupon to try and buy private insurance. Millions of seniors in Medicaid will lose their benefits due to block-granting to states without providing the resources to pay for it. The repeal of the Affordable Care Act will leave tens of millions without insurance and strip benefits from seniors in Medicare.
The Republican leadership has offered no plans to improve benefits in Medicare or make reforms to reign in the skyrocketing price of drugs and healthcare costs system wide. Instead, the GOP vision for seniors in Medicare is they must just do more with less. Stagnant wages are grinding away at the middle class’s ability to save for retirement. Many employers have significantly scaled back or eliminated the traditional retirement benefits offered to their employees. As a result, current and future retirees simply cannot afford proposals to cut benefits, raise the eligibility age or privatize the program.”...Max Richtman, NCPSSM President/CEO
While the House Ways and Means Health Subcommittee promoted destroying traditional Medicare in favor of a fully privatized system during today’s Congressional hearing, their GOP colleagues are moving a budget through Congress that would make that plan reality.
The House budget would cut Social Security and Medicare by $463 billion over 10 years, while cutting Medicaid and other health programs by $1.028 trillion, not including the Affordable Care Act. The GOP budget protects the wealthiest Americans and big corporations from any tax increases while imposing massive spending cuts on average Americans and their families.
Max Richtman’s full testimony as submitted to the House Ways and Means Health Subcommittee is here.
Ok, not a debate so much as a battle to see who can cut seniors’ benefits faster. While Trump remains the only GOP Presidential candidate who promises he won’t cut Social Security, even that promise became squishy last night. More on that, later.
Here’s just a sampling of some of last night’s comments on what the remaining GOP candidates plan for generations of American families counting on Social Security, Medicare and Medicaid, followed by our comments:
Senator Marco Rubio
“Social Security will go bankrupt and it will bankrupt the country with it.”
This is conservatives’ favorite lie. Social Security isn’t going bankrupt. According to SSA actuaries, the nearly $3 Trillion Trust Fund will be depleted in 2034 (as planned) to cover the baby boomer generation. After that, there will still be enough income coming into the program to pay 79 percent of all benefits owed. If Congress does nothing seniors will face a 21% benefit cut. A 21% benefit cut is not bankruptcy and certainly could not cause America’s bankruptcy.
“Medicare could very well become the option of using my Medicare benefit to buy a private plan that I like better”
The Republican dream of giving seniors a coupon to go out and buy private health insurance is a favorite of Speaker Paul Ryan and those in Congress who hope to destroy Medicare once and for all. The program is too popular to kill outright, so they’ve chosen a privatization route for Medicare that is a political kissing-cousin to President Bush’s failed effort to privatize Social Security. If they can’t kill these programs, conservatives want to (at least) turn America’s most successful retirement and health security programs over to industry so Wall Street, insurance companies and drug makers can profit.
Senator Ted Cruz
“Social Security right now is careening towards insolvency... We need to see political courage to take this on and save and strengthen Social Security.”
In the classic case of “save” meaning “slash” and “strengthen” meaning privatize, Senator Cruz offers the well-worn conservative trope that cutting benefits to millions of American families while at the same time cutting taxes for the wealthy shows political courage and leadership. See our comments above on the “careening towards insolvency” nonsense.
“We need to change the rate of growth of benefits so it matches inflation instead of exceeding inflation...we need to have for younger workers, that a portion of your tax payments are in personal accounts.”
If hard to imagine how anyone can seriously argue that a zero cost of living increase for 3 out of the past 7 years, somehow exceeds inflation. Seniors, veterans and people with disabilities have seen their costs increase in the same years their COLA was flat. Social Security beneficiaries need a new COLA formula, one that actually measures seniors’ cost of living. However, Ted Cruz wants the Chained CPI to cut benefits not to accurately measure inflation.
“I also had a plan in 1999 to save Social Security and take the $5 trillion projected surplus and not only have Social Security for our young people, but also to give them private accounts.”
John Kasich’s plan to “save” Social Security is standard GOP “we-must-slash-it-to-save-it” boilerplate with a little seniors just need to "get over it" thrown in. Kasich would cut benefits to pay down the debt and privatize Social Security so seniors can watch their contributions ride the Wall Street roller coaster. Then he’d cut billions more with lower COLA’s through the Chained CPI (again, what’s lower than zero?) and turning Social Security into a welfare program by means testing.
Since we just wrote about Trump’s Social Security promises (there’s not really a plan) in detail we’ll focus only on last night’s twists. For the first time ever, Trump’s promises to not cut Social Security benefits were offered with important qualifiers. For a candidate who has no problem making big promises, last night’s about Social Security have taken on a downright passive tone – as if Trump, as President with potentially with a GOP House and Senate, wouldn’t have the power to leave Social Security benefits alone:
“I will do everything within my power not to touch Social Security”
“...it's my absolute intention to leave Social Security the way it is.”
This speech Trump gave to conservatives at the 2013 Conservative Political Action Conference provides one suggestion as to why he remains the only GOP candidate to promise he won’t cut Social Security & Medicare benefits (hint, it’s not because he loves the programs):
"As Republicans, if you think you are going to change very substantially for the worse Medicare, Medicaid and Social Security in any substantial way, and at the same time you think you are going to win elections, it just really is not going to happen," Mr. Trump said, adding that polls show that tea partyers are among those who don't want their entitlements changed." Donald Trump, 2013 CPAC speech, Washington Times
If you missed last night’s debate, you can read excerpts on what the candidates had to say specifically about Social Security, Medicare and Medicaid on our SeniorVote2016 website.
Have a Social Security or Medicare question?