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From the category archives: privatization

Clinton vs Trump – What That Means for Social Security & Medicare

As Hillary Clinton declared victory after winning four of the six primaries last night, the Democratic ticket for President solidified.  While Donald Trump has been in that position for a while now, his campaign has now entered rough political waters...again. 

And so it will likely go until November...

Unfortunately, what’s lost as the media and political punditry focus on the horserace, who’s stuck their foot in it today and the inevitable mud-slinging that Trump has already promised to begin on Monday, are the important policy differences between candidates.  There are plenty of them, especially on economic issues impacting average Americans.

Bernie Sanders’ campaign ensured that issues of income inequality, economic security and fairness, social justice and boosting Social Security remained top of the political agenda.  He vowed to continue that effort:

“Our campaign from day one has understood some very basic points and that is first, we will not allow right-wing Republicans to control our government. And that is especially true with Donald Trump as the Republican candidate. The American people, in my view, will never support a candidate whose major theme is bigotry, who insults Mexicans, who insults Muslims and women, and African-Americans. 

But we understand that our mission is more than just defeating Trump; it is transforming our country. The vast — the vast majority of the American people know that it is not acceptable that the top one-tenth of 1 percent owns almost as much as wealth as the bottom 90 percent. We are going to change that. And when millions of Americans are working longer hours for lower wages, we will not allow 57 percent of all new income to go to the top 1 percent...

We will not allow Donald Trump to become President of the United States."

When it comes to Social Security and Medicare, the differences between Hillary Clinton and Donald Trump are stark. Clinton supports expanding benefits, while Trump promises he won’t cut Social Security. That position has given the GOP party establishment heartburn but Trump has repeatedly acknowledged the GOP can’t win by promising benefit cuts and so he’s not:

"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

You know the Republicans also have to get elected, you do know that. And if you watch Bernie, and if you watch Hillary, they don't only want to not cut, they want to increase Social Security.” Donald Trump, Morning Joe, February 2016

And yet his policy staff says the Trump administration is open to “entitlement changes.”

“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.”  Sam Clovis, Trump campaign Chief Policy Advisor, May 2016

You can read more about the Trump campaign positions here, here and here.

Hillary Clinton has a long history of fighting the privatization of Social Security and Medicare, something Donald Trump supported in his first Presidential campaign. These days, that position alone is not enough but Clinton has also articulated a real plan to boost benefits, provide caregiving credits, lift the payroll tax cap and improve spousal benefits. She also opposes Trump’s plan to repeal the Affordable Care Act which means seniors in Medicare would lose billions in drug savings, well-care visits, lower premiums and improved care. 

There will be many more months to draw clear comparisons between these candidates’ positions on Social Security, Medicare and Medicaid as the Presidential campaign moves to the conventions and their platform debates

The National Committee’s SeniorVote 2016 will keep you updated and candidates’ accountable on their plans for programs which touch the lives of virtually every American family.You can sign up for email alerts to be sure the latest news comes straight to your mailbox. 

Ryan Says Trump Will Promote House Agenda -- You Know What That Means for Medicare!

No one was really surprised when House Speaker Paul Ryan lined up behind the rest of the GOP party leadership to endorse Donald Trump.  It’s also not too surprising that Ryan is confident Trump will support the Ryan/House agenda, regardless of his pesky campaign promises to leave seniors’ programs alone:

“We’ve discussed how the House can be a driver of policy ideas. We’ve talked about how important these reforms are to saving our country. Through these conversations, I feel confident he would help us turn the ideas in this agenda into laws to help improve people’s lives. That’s why I’ll be voting for him this fall.”...Rep. Paul Ryan

Modern Healthcare says:

“Last month, I raised the question of whether Trump would follow the politically risky healthcare policy path Ryan has blazed on Medicare, Medicaid and other big issues.

The House speaker apparently has concluded that he would.

Ryan
 has spearheaded a series of partisan House budget outlines that would significantly restructure Medicare and Medicaid and sharply reduce federal spending on those two programs. The Wisconsin Republican wants to convert Medicare into a defined-contribution, voucher-style program and change Medicaid into a capped state block grant program. Some experts say the plan would impose significantly higher costs on seniors.”

Let’s not forget that it’s already been reported by sources in on the Ryan/Trump Capitol Hill meeting that cutting Social Security and Medicare was something Trump could “morally support”.  He just doesn’t think he can win if he says it.

“From a moral standpoint, I believe in it,” Trump told Ryan. “But you also have to get elected. And there’s no way a Republican is going to beat a Democrat when the Republican is saying, ‘We’re going to cut your Social Security’ and the Democrat is saying, ‘We’re going to keep it and give you more.’ ”

Which also fits with the message his campaign staff delivered to fiscal hawks at last month’s annual Pete Peterson “how to cut middle-class benefits” soiree:

“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.”...Sam Clovis, Trump campaign chief policy advisor.

So, while Trump’s actual plans for Social Security, Medicare and Medicaid remain ever-elusive Paul Ryan’s plans for these programs – which he apparently believes President Trump will deliver on – are very clear

“The House GOP’s budget would privatize Medicare with a voucher plan, leaving seniors and the disabled – some of our most vulnerable Americans – hostage to the whims of private insurance companies.  Over time, this will end traditional Medicare and make it harder for seniors to choose their own doctor.  Vouchers will not keep up with the increasing cost of health insurance… that is why seniors will pay more.  Incredibly, the GOP budget also tries to have it both ways by counting the savings in Medicare since the passage of health care reform and then repealing the law that delivered those same savings. Seniors need to pay careful attention to this next fact: if the GOP isn’t stopped from repealing healthcare reform, Medicare beneficiaries would immediately lose billions in prescription drug savings, wellness visits and preventative services with no out-of-pocket costs, and years of solvency will be lost to the Medicare program.” ...Max Richtman, NCPSSM President/CEO.

The Cruz/Fiorina Plan for Social Security and Medicare

Here’s a “Throwback Thursday” reminder of what a Cruz/Fiorina administration would mean for millions of Americans and their families who depend on Social Security and Medicare.

...at least what they’ll admit to today, anyway.  


New Medicaid Rules Designed to Put Care Over Profit

CMS has announced tightened Medicaid rules for private insurance plans that administer most Medicaid benefits for the poor. The Obama administration says the rules will limit profits, ease enrollment, require minimum levels of participating doctors and eventually provide quality ratings.  However, those ratings would still be years away as the industry continues to fight against such measures. 

Kaiser Health News provides details on the biggest changes for Medicaid managed care in a decade.  The new rules will:

  • Require states to set rules ensuring Medicaid plans have enough physicians in the right places. The standards will include “time and distance” maximums to ensure doctors aren’t too far away from members.
  • Limit insurer profits by requiring rate setting that assumes 85 percent of revenue will be spent on medical care. Unlike a similar rule for other plans, such as insurance sold through Obamacare marketplaces, the requirement would not compel Medicaid insurers to rebate the difference if they don’t hit 85 percent. Future rates would be adjusted instead.
  • Make plans regularly update directories of doctors and hospitals. A 2014 investigation by the Department of Health and Human Services’ inspector general found that half the doctors listed in official insurer directories weren’t taking new Medicaid patients.
  • Push plans to better detect and prevent fraud by providers, including mandatory reporting of suspected abuse to the states.
  • Tighten rules for Medicaid plans and states to collect patient data and submit it to HHS.
  • Make it easier for states to offer managed-care plans incentives to improve clinical outcomes, reduce costs and share patient information among hospitals and doctors.

Nearly two-thirds of Medicaid’s 72 million member are enrolled in private managed-care plans.  Consumer advocates have pushed HHS to set stricter rules for managed-care plans, which they said too often favored profits over patients. The industry and some state Medicaid directors resisted, saying plans needed flexibility to serve different members in different states.

The rules will be phased-in over the next three years, starting next summer. 


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). 

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