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From the category archives: Medicare

Celebrating Older Americans Month

Chances are if you, or anyone in your family, is 65 or older your life has been impacted by an Older Americans Act program.  From Meals on Wheels to senior centers, prevention of physical and financial abuse, computer training to legal assistance, OAA programs touch the lives of millions of seniors and their families.  This myriad of programs provides home and community-based services making it possible for older adults to remain independent, but they’ve continually faced flat or shrinking budgets at a time of growing needs.  Funding programs that allow seniors to age in place is cost-effective; however, the Older Americans Act languished for more than 5 years without Congressional reauthorization. 

Thankfully, this year is different.  Today we are celebrating Older Americans Month with a newly reauthorized OAA, signed by President Obama just a few weeks ago:

“The President believes in the Older Americans Act because it funds services that are central to older adults’ health and lasting independence, such as meals, job training, transportation, and health promotion.  And for those who do need consistent care, the law provides nursing home protections and enhances the Long-Term Care Ombudsman programs.”  Valerie Jarrett, Senior Advisor and Assistant to the President

The celebration continues as The Leadership Council of Aging Organizations (@LCAgingOrgs), chaired by the National Committee, will host a Twitter chat on May 24 @ 1-2 p.m. ET to celebrate Older Americans Month—and call for funding investments in Older Americans Act programs. You’re invited to join the chat using #WeAreOAA.

Join at www.twitter.com/#WeAreOAA or at http://twubs.com/WeAreOAA

Trump Campaign Admits They’re Open to “Entitlement Changes”

It was just a matter of time...

The Trump campaign was a participant in yesterday’s annual Pete Peterson fiscal summit which each year brings together the nation’s so-called “fiscal hawks” for a full day of doom-and-gloom prognosticating about how Social Security and Medicare will bankrupt America.  In case you’ve forgotten, multi-billionaire Wall Streeter and former Nixon Commerce Secretary Pete Peterson, has committed to spend a billion dollars in his war on America’s safety net programs.  This annual wing-ding for Washington’s “very important people” is just one of the many ways he spends that money. 

Now, you might think Donald Trump would be an unlikely guest at this event given his break from conservatives and often-stated position that he won’t cut Social Security and Medicare. In truth, Trump’s campaign was right at home with the Peterson crowd as his chief policy advisor, Sam Clovis, provided participants a fuller description of what Trump actually plans if elected President. It was music to the anti-Social Security crowd’s ears:

“After the administration has been in place, then we will start to take a look at all of the programs, including entitlement programs like Social Security and Medicare. We’ll start taking a hard look at those to start seeing what we can do in a bipartisan way.”

“...I think that whoever [is] the next president is going to have a horrible time in dealing with this, because those entitlements will race to the front of all the economic issues we have in this country.”

In other words, candidate Trump will continue to promise no cuts to Social Security and Medicare on the campaign trail.  However, President Trump clearly has a very different plan. 

As in all things Trump, he’s provided himself an out.  If voters read the fine print, Trump’s claims to leave Social Security and Medicare are completely dependent on the full adoption of his ever-morphing economic plan which promises budgetary magic turning a nearly $10 trillion deficit into a $7 trillion surplus (while also cutting taxes even further for corporations and the wealthy, increasing military spending, building a massive wall and deporting millions).  Even conservative columnists, who are thrilled to hear he is willing to cut Social Security and Medicare, left the event stunned:

“Clovis’s fiscal insouciance was breathtaking. ‘Our proposals, what we think will happen, will lead us in fact to about a $4.5 to $7 trillion surplus at the end of 10 years, if all of our initiatives are put in place,’ he said.

Pause for a moment to appreciate the audacity of this claim. The Congressional Budget Office estimates that deficits will total another $9.4 trillion during this period. So Trump is purporting to pay for his $10 trillion tax cut, plus eliminate that additional deficit, plus amass a surplus amounting to several trillion more? Outlandish is too kind a word for this.” ...Ruth Marcus, Washington Post columnist

“I understand less about Trump’s budget plan after listening to Clovis than I did before,” tweeted David Wessel of the Brookings Institution.

Maybe so...but Trump’s real plans for Social Security and Medicare are now much clearer.  

No One Really Knows What Trump Plans for Social Security...Possibly Including Trump Himself

Donald Trump’s flip-flopping on his tax plan this week has many politicos scratching their heads.  ABC reported it this way:

“As Donald Trump pivots to the general election battle, he's already walking back his tax plan, the most specific policy proposal he has released during the campaign. 'By the time it gets negotiated, it's going to be a different plan," Trump told George Stephanopoulos on ABC News' This Week.

In Trump’s tax plan, the wealthiest individuals would get a tax break, with the top tax rate dropping from 39.6 percent to 25 percent. But when pressed if he wants taxes on the wealthy to go up or down, he predicted that the top rate would be higher than the plan says. ‘On my plan they're going down. But by the time it's negotiated, they'll go up,’ Trump said.”

Well, of course any President’s budget plan, tax plan, Social Security plan, Medicare plan (...you get the idea) will be negotiated with a Congress which may hate the idea.  That’s why it’s called a “plan” and not “law.”  Doesn’t that really go without saying?  So what is “The Donald” actually proposing as the presumptive GOP nominee for President?

The Campaign for America’s Future noted Trump’s very similar approach on the minimum wage:

“What Trump actually did was say he would “like to see an increase” then took a position against using presidential power to mandate an increase – and, arguably, against having any federal minimum wage at all! – in deference to the states. It’s lovely that his wish is for those states to propose increases, but refusal to promote federal legislation makes him no different from every other Republican who opposes a federal minimum wage increase.”

So that leads us to the current Trump 2.0 campaign plan (please read our earlier post to compare Trump’s polar opposite views between campaigns) to not cut Social Security and Medicare.  Of course, that’s a “plan” too and there are many in the GOP House and Senate who don’t agree, so does that mean this plan is just as illusory as his now morphing tax plan and minimum wage plan?  More importantly, in direct relation to his convoluted tax musings, does Donald Trump oppose raising the payroll tax cap so that the wealthy contribute to Social Security based on their full income just as middle-class and poor Americans do? 

We certainly don’t know and wonder...does Donald Trump? 


New Report Shows Ethnic Discrepancies in Medicare Advantage

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). 

What do GOP “Affluenza,” Social Security and Average Americans have in Common?

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.


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