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From the category archives: Aging Issues

Will Seniors Reject Republicans in 2018?

Older voters have been gravitating to the Republican party for the better part of the past two decades. Forty-eight percent of seniors identify or lean Republican compared to 45% for Democrats --- and Donald Trump won 53% of the senior vote last Fall.  But are we about to witness a “grey” re-alignment?  According to an article in today’s The Hill newspaper, Democrats say maybe so.  Democratic strategists are hoping that Republicans are starting to repel seniors by striving to repeal Obamacare, gut Medicaid, privatize Medicare and cut Social Security.  It doesn’t help that President Trump’s proposed budget slashes federal block grants that help pay for Meals on Wheels and other programs that stabilize and support seniors.

In a Facebook Live broadcast with National Committee President Max Richtman today, Congresswoman Jan Schakowsky (D-IL) agreed that seniors may swing back to the Democratic party in the next election cycle.  “Republicans like to imply that seniors are greedy geezers,” Schakowsky said, “But their Obamacare replacement would have allowed seniors to be charged up to 500% more than younger Americans for private health insurance.”

There are myriad reasons for older voters’ preference for the GOP in recent years.  The majority of white voters identify as Republicans --- and some 85% of today’s seniors are white.  Many of today’s older voters came of age during the prosperous post-war America of the 1950s – and may feel alienated by cultural changes associated with the Democrats.  In fact, candidate Trump skillfully played on seniors’ nostalgia for a bygone (and in many ways, imaginary) America.

Another factor may be that seniors have felt supremely confident – some would say overly confident – about the sanctity of the two federal programs that benefit them the most, Social Security and Medicare.  The Democrats may have done such a good job protecting these programs that seniors simply take them for granted.   In fact, the last time that the majority of seniors voted Democratic was in the 2006 congressional elections, after President George W. Bush tried to privatize Social Security.  Democrats and seniors’ advocates like the National Committee stopped him.  On the other hand, President Trump won the senior vote not only by thrumming the strings of nostalgia, but by promising not to touch Social Security, Medicare, and Medicaid (promises he is already breaking). 

To win back seniors in 2018 and beyond, Democrats must remind them that Republicans are an existential threat to our cherished retirement and health security programs.  In other words, thanks to the GOP, the time for overconfidence in the inevitability of Social Security, Medicare and Medicaid is over.  President Trump is already shattering his sacred promises to older voters.  He fought for the GOP’s American Health Care Act which would have cut nearly $1 trillion from Medicaid (on which poorer seniors depend for long-term care) and reduced the solvency of Medicare by three years.  House Speaker Paul Ryan still dreams of turning Medicare into a voucher program.  Congressman Sam Johnson (R-TX) is pushing a bill to cut cost of living adjustments (COLAs) for Social Security and raise the retirement age to 69. And despite his campaign vows, the president has surrounded himself with budget hawks who are sharpening their knives for seniors’ earned benefits programs.  (Earlier this month, Budget Director Mick Mulvaney questioned whether disability benefits should even be a part of Social Security.)

Democrats must also bust the oft-repeated myths that Republicans use to justify benefit cuts --- that Social Security and Medicare are going “bankrupt” and need to be “modernized” (translation: privatized and cut).  If Congress does nothing, Medicare still will be able to pay 87% of benefits beyond its 2028 “insolvency” date and Social Security 79% of benefits beyond 2034.  To win the senior vote, Democrats must push the kind of modest and manageable solutions proposed by Senator Bernie Sanders, Congressman John Larson (D-CT), and others to keep these programs solvent for the long haul – with no benefit cuts.

Recent polling suggests that the party who sides with seniors on these crucial issues will reap political gains.  The National Committee’s own poll of likely voters showed overwhelming support for traditional Social Security and Medicare.  Even more encouraging, strong majorities opposed benefit cuts and higher eligibility ages --- and favored boosting benefits by scrapping the payroll tax cap so that the wealthy pay their fair share. As long as Democrats back up their rhetoric with action and vigorously oppose harmful changes to Social Security, Medicare, Medicaid, and Obamacare, they have a decent shot at winning back those coveted seniors at the ballot box.

Ryan's Revised Healthcare Bill Even Worse Than the Original

 


Let us not speak of pigs and lipstick, but simply say that the freshly tweaked GOP health care bill introduced last night still socks it to older Americans. In an attempt to throw bones to both moderate Republicans and Tea Partiers, Speaker Paul Ryan has come up with a revised bill that’s even worse than the original for seniors and “near seniors” (under 64 years of age).  The Center for Budget and Policy Priorities has just released a detailed analysis forecasting higher net premiums, co-pays, and out-of-pocket costs for older Americans under the revised bill.  Here is our own take on why there's nothing to like in the tweaked legislation: 

 

MEDICAID

 

Millions of seniors depend on Medicaid to cover the cost of long-term care, while low income Americans 50-64 rely on the program for basic health care.  The original GOP bill cut nearly $1 trillion from Medicaid and imposed per capita caps on federal payments to the states.  The revised legislation adds another insidious idea to the equation by introducing block grants, where states can decide to curtail or outright cut certain services.  Per capita caps and block grants mean one thing:  less funding for older patients who need medical services and long-term care - and in some cases, complete loss of coverage.  For seniors, It’s two bad ideas in one bill.

 

AGE RATING

 

The revised GOP bill does nothing to address a major problem with the original.  Under the revised legislation, Insurance companies would still be able charge older Americans up to five times as much as people in their 20s (a practice referred to as “age rating”), one reason why the Congressional Budget Office estimated that 24 million people would lose coverage under the Republican plan.

 

 

PREMIUM SUPPORT         

 

Obamacare provided generous subsidies to people who couldn’t afford private insurance premiums.  The GOP bill replaced those subsidies with paltry tax credits that discriminate against older patients.  Paul Ryan’s tweaked version kicks the problem over to the Senate by authorizing the upper chamber to increase tax credits for older Americans… if it wants to. There’s no guarantee the Senate will actually do this, or that fatter tax credits will make it into the final bill.  Once again, the revised GOP plan leaves older folks worse off.

 

TAX CUTS

 

While giving nothing to seniors, the revised bill still repeals $600 billion in tax cuts for the wealthy (and $24 billion for pharmaceutical companies) that Obamacare utilized to expand health coverage and strengthen Medicare.  The tweaked bill actually sweetens the deal for the wealthy – repealing the taxes in 2017 instead of 2018.

 

 

MEDICARE

 

The GOP plan still weakens Medicare through the repeal of a 0.9% tax on income over $200,000.  By rescinding the tax, the GOP plan reduces the solvency of Medicare by 3 years – and the revised bill does nothing to lengthen it.  Reducing Medicare’s solvency gives budget hawks an excuse to privatize and cut the program, which hurts seniors.

 

We don’t know whether the dressed-up GOP plan will pass the House.  It’s possible that the concessions to Tea Partiers and token gestures to moderates – plus active lobbying on President Trump’s part – will allow it to squeak by.  Either way, Speaker Ryan squandered an opportunity to reverse some of the damage to healthcare and long-term care for our older and most vulnerable citizens.

 

 

 

 

 

Did You Get the Most of Your Medicare This Year?

There’s no doubt about it...Medicare can be confusing.  However, there are many benefits out there that many seniors may not even realize exist.  Here’s a quick look at a few of the often overlooked Medicare benefits that you should be sure you are fully utilizing.

 

 

Annual wellness visit

If President-elect Trump follows up on his campaign promise to repeal the Affordable Care Act, this benefit will disappear, which is a real loss for millions of seniors who’ve used these visits preventatively to avoid potentially larger health issues in the future.  If you haven’t already, get your annual visit in soon.

Wellness visits are with your primary-care physician once a year, even when you're feeling fine. These visits give you and your doctor a chance to review your health and see where attention might be needed or improvements might be made. The focus is on your overall health and allows patients and doctors to red-flag any concerns that might seem small now but could lead to a more serious issue if ignored. Wellness visits are available to anyone covered by Part B or Medicare Advantage plans.  For now, anyway.

Depression screening

Once a year, every Medicare Part B recipient can receive free depression screening from his or her primary-care doctor.  This is an important benefit because one in six seniors suffers from depression yet estimates are only 10% of chronically depressed seniors receive the treatment they need for their disease.

Late life depression is an important public health problem. It is associated with increased risk of illness, increased risk of suicide, decreased physical, cognitive and social functioning, and greater self-neglect, all of which are in turn associated with an increased likelihood of death. 

Smoking cessation

According to the Centers for Disease Control, an estimated 40 million adults in the United States currently smoke cigarettes.  Smoking is the #1 cause of preventable disease and death in the United States.  In fact, more than 480,000 Americans die, or 1 of every 5 deaths, from tobacco use.  It’s never too late to stop smoking.  That’s why Medicare provides its beneficiaries help quitting. Anyone who uses tobacco and has Medicare Part B coverage can get up to eight smoking-cessation visits covered over a 12-month period. The only stipulation is that the visits are with a qualified doctor or other Medicare-recognized practitioner. These visits will not cost you a penny out of pocket, so if you're a smoker who wants to quit for good, make sure you take advantage of this Medicare benefit.

Paul Ryan Peddles Dangerous Fictions on "60 Minutes"

House Speaker Paul Ryan perpetuated dangerous falsehoods about Medicare on CBS “60 Minutes” Sunday night.  In an interview with correspondent Scott Pelley, Ryan hauled out the myth that “Medicare goes bankrupt in about 10 years.”  He continued, “The trust fund runs out of money.  So we have to make sure that we shore this program up.”  Really? 

To Ryan, “shoring up” Medicare means privatizing it, creating what we at the National Committee call “coupon care.”  Seniors would have to fend for themselves in the private insurance market with government-provided vouchers that wouldn’t fully cover their premiums or out-of-pocket costs.  Traditional Medicare would be left to wither and die.

Ryan’s plan is based on a fake crisis.  Contrary to the Speaker’s claims on “60 Minutes,” Medicare does not go bankrupt in 10 years.  It’s true that – without increasing payroll taxes – the Medicare Hospital Trust fund (which finances Medicare Part A) will become depleted in 2028.  However, as the Center for Budget and Policy Priorities (CBPP) points out, “incoming payroll taxes and other revenue will still cover 87% of Medicare hospital insurance costs.”  That’s a far cry from bankruptcy, Mr. Ryan.

Any shortfalls, CBPP notes, could be covered by “raising revenues, slowing the growth in costs, or most likely both,” without wrecking traditional Medicare - options that Ryan doesn’t seem inclined to consider.

The other fiction that Ryan perpetrates in his “60 Minutes” appearance is that his Medicare “reforms” wouldn’t “change the benefit” for anybody who is in or near retirement – only Gen X’ers (like Ryan himself) and subsequent generations. This is simply untrue.  Our own analysis at NCPSSM indicates that privatizing Medicare could adversely impact anyone 55 and older (including people currently enrolled in traditional Medicare) because of potentially higher premiums, benefit cuts, and higher out-of-pockets.  Neither seniors nor their children and grandchildren should believe Ryan’s false assurances.  There is simply too much at stake.

Medicare and End-of-Life Care

The Journal of the American Medical Association (JAMA) and the Kaiser Family Foundation examined Medicare’s costs for end-of-life care and created this interesting infographic.  Some of the results might surprise you:

  • Of 2.6 million total deaths in the United States in 2014, 2.1 million were among Medicare beneficiaries.
  • The share of total Medicare spending for people at the end of life decreased from 18.6% to 13.5% between 2000 and 2014.
  • Medicare spending for people at the end of life also decreased with age.
  • Surveys show that more than 7 in 10 people aged 65 years and older have not discussed end-of-life care with a physician and that 4 in 10 have not documented their end-of-life care wishes.

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