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From the category archives: privatization

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). 

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.


The Economic Crisis Candidates Continue to Ignore

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. 

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