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From the category archives: Aging Issues

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.

Combating Ageism in America

As a 2106 Influencer in Aging honoree, NCPSSM President/CEO, Max Richtman, answered the question: “What is the one thing you would like to change about aging in America?”  Max’s answer can be found in Forbes, Next Avenue and we’ve reposted it here:

Why We Must Combat Ageism In America

By Max Richtman, NCPSSM President/CEO

(Next Avenue invited all our 2016 Influencers in Aging to write essays about the one thing they would like to change about aging in America. This is the first of the essays.)

Bette Davis famously said, “Old age ain’t no place for sissies.” If you or someone you love has been there, you’ll likely agree.

Thankfully, Americans have Social Security and Medicare to help ease their transition into retirement and improve the likelihood they’ll age financially and medically secure. Social Security keeps 22 million Americans out of poverty, while Medicare provides universal health care for 55 million seniors and people with disabilities.

Pitting Young vs. Old

Social Security and Medicare are among our nation’s most successful federal programs, touching the lives of virtually every American family. In spite of this, these programs continue to be political targets by those who have tried to pit young vs. old, creating a generational battle over limited budget resources.

Portraying America’s parents and grandparents as “greedy geezers” who care only about their own benefits (which they’ve earned after a lifetime) at the expense of future generations is one of the most pernicious examples of the ageism that is all too common in our nation. We see it in the workplace, in public debate, between generations and in social policy.

Time for Government Leaders to Address Ageism

If I could change one thing about aging in the U.S., it would be how our government leaders address ageism through public law. They must ensure that all retirees and their families, present and future, have ample and easy access to health, income and job security, community supports and a robust aging network that offers choice, independence and dignity.

The retirement of America’s Baby Boom generation has provided us with a unique opportunity to create innovative and responsive aging policies that would serve our nation well for generations to come. Unfortunately, we have not done enough to modernize and revolutionize our aging policies.

It’s not like we didn’t know the boomers would retire someday. America built schools when this growing demographic was young, houses as it matured and large surpluses in the Social Security Trust Fund in anticipation of its retirement. However, now that 10,000 boomers turn 65 each day, the graying of America is too often presented as simply a drain on our national resources and — even worse — used as an opportunity to pit generations against each other.

 How Ageism Hurts America

Ageism, sadly, pervades our policy discourse, squandering this unique opportunity in our history to create policies, systems and programs that tap into the wealth of experience, knowledge and opportunities that our aging community provides.

The 14 percent of America that is now over 65 should be at the heart of public policies to improve our nation’s health care system and to increase employment opportunities, fair housing, and economic equity that can stretch across all generations.

Let’s remember these words of former Vice President Hubert Humphrey: “It was once said that the moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly and those who are in the shadows of life, the sick, the needy and the handicapped.”

We must fight back against ageism, which ignores the reality that America is strongest when the young, old and everyone in between are economically empowered, healthy and secure.

 

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