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From the category archives: Aging Issues

Medicare Turns 52: A Time for Cake, Candles, and Continued Vigilance

Medicare turns 52 years old this weekend.  It’s an occasion for both celebration and vigilance.  Surely the anniversary of a federal program that has provided quality healthcare for millions of seniors since 1965 is a happy moment.  But the fact that this highly successful, highly efficient program is under threat from the right after more than half a century of proven results tempers the celebration – and reminds us all that programs we all rely upon can be snatched away if we don’t protect them.

President Harry Truman first proposed a national healthcare system, but it took a Democratic supermajority in Congress and the relentless advocacy of President Lyndon Johnson to make Medicare a reality in 1965. (Fittingly, Harry Truman received the first-ever Medicare card.)  

If it were up to some Republicans, there would be no Medicare in the first place. In 1964. then-Senate candidate George H.W. Bush described Medicare as “socialized medicine.”  Republican Presidential Candidate Barry Goldwater likened Medicare to giving seniors “vacation resorts” for free.  Former Senator Bob Dole bragged that he was there in 1965 “fighting the fight, voting against Medicare.”  And then there was this whopper from future President Ronald Reagan in 1961: 

“If you don’t [stop Medicare], one of these days you and I are going to spend our sunset years telling our children and our children’s children what it once was like in America when men were free.” – Ronald Reagan (1961)  

Fast forward to the 1990’s, when House Speaker Newt Gingrich endorsed privatization, with the intended result that traditional Medicare would “wither on the vine.” Destroying traditional Medicare has been a long-held dream of the right for five decades now.  Unfortunately, with Republicans controlling all three branches of government, this is their best opportunity to make that nightmare a reality. 

As we commemorate Medicare’s anniversary, budget hawks in Congress are actively scheming to privatize the program through the budget process.  The House Budget Committee’s spending plan turns Medicare into a voucher system and cuts some $500 billion from the program. The budget resolution also raises the Medicare eligibility age from 65 to 67, a huge benefit cut itself. It’s another step toward a long-held goal of the right to destroy Medicare as an earned benefit. And it truly is an earned benefit. Americans pay into Medicare during their working lives, knowing they can depend on it for healthcare in their senior years. 

Medicare covers some 58 million American seniors and people with disabilities.  Almost every American will need Medicare in their older years. Many literally could not live without it, which is why efforts to turn it into a voucher system and raise the eligibility age are particularly cruel. Listening to the stories of members of our online community, we are reminded that Medicare has a very human face. 

Pam Ruigh (Newport, VT):  I love Medicare. It has made it possible for me to see again. I had cataracts on both eyes removed, Without these surgeries, I was slowly going blind. - Pam Ruigh, Newport, VT
In 2014, I had aortic valve replacement surgery. That's a $170,000 operation. All I had was Medicare. I could never have had the procedure without it. - Ron Moore, Utica, NY
Without Medicare and my supplemental insurance, I'd be dead or dying right now. I have multiple but manageable health issues. If this is taken away, I'm a dead woman walking. - Kate Reed
My late wife passed away from complications of Parkinson's Disease. After her last hospital stay, I received a copy of her bill, showing what we would have been responsible for had we not been under Medicare. It amounted to over $200,000.00. I only had to pay $700.00 out of pocket. - George Betram Lane (Jacksonville, FL) 

There are millions of stories just like these, and we know that Medicare beneficiaries around the country share our enthusiasm that Medicare has reached another anniversary. 

Yesterday, our president, Max Richtman, and a group of senior volunteers from our Capital Action Team participated in an anniversary celebration on Capitol Hill yesterday with several sister organizations and members of Congress.  

There was “Medicare birthday” cake for all, and impassioned remarks from the podium.  The main message was:  we need to protect and expand – not slash and burn – Medicare. 

Representative Lois Frankl (D-FL) reminded the crowd of seniors and advocates that we will fight to keep traditional Medicare intact and thriving. “This is Medicare’s 52nd anniversary,” she began. “And next year, there will be another.  And another.  And another.  I promise you that.”

Myths about Mental Illness and Social Security Disability Insurance Debunked

In order to justify its $64 billion in cuts to Social Security Disability Insurance (SSDI), the Trump administration and its allies have had to propagate several myths.  The most insidious one is that many SSDI recipients are not truly worthy of benefits.  They have suggested that mental illness is among the more dubious qualifications for SSDI.  Senator Rand Paul famously remarked that “over half the people on disability are either anxious or their back hurts.” Former Director of the National Economic Council Gene Sperling sums it up quite succinctly in The Atlantic:

 

The Administration is already deploying selective—and often deceptive—facts to stigmatize and caricature both the Social Security Disability Insurance program and its recipients. This sort of framing justifies using Social Security as a piggy bank to raid in order to help offset tax cuts for top-earning Americans. – Gene Sperling, 5/23/17

 

These convenient myths can be effective in undermining public support for SSDI, but they are dangerous for the millions of Americans with mental disorders who depend on federal disability benefits to prevent them from sinking into abject poverty.  Here are the facts: 

 

Nearly 25% of the nation’s 8 million SSDI recipients have a mental impairment as their primary diagnosis – or qualification – for benefits. They may suffer from a variety of disorders, including severe depression, anxiety, PTSD and intellectual impairment, which make it impossible for them to work or hold a job.  Many of those deemed eligible for SSDI benefits because of mental disorders also suffer from related physical disabilities.  The majority of these beneficiaries are over 50 years of age.  These are some of the vulnerable people the Trump administration is targeting with budget cuts – beneficiaries who struggle to make ends meet on an average $1172 per month from SSDI, just above the federal poverty line.  As Think Progress reports, for eight in ten beneficiaries, SSDI is their main or sole source of income. 

 

Why don’t these SSDI recipients simply work for a living, as OMB Director Mick Mulvaney and other administration apologists insinuate that they should?  Stacy Cloyd, Deputy Director of Government Affairs for the National Organization of Social Security Claimants Representatives (NOSSCR), explains why it’s so difficult for people with severe mental impairments to hold a job:  

 

“The symptoms of mental illness can make it difficult to concentrate on tasks, to routinely interact with customers and put on a friendly face, or handle changes in the workplace.  Like people with physical disabilities, those struggling with mental disorders may need to miss an excessive amount of work for doctor’s appointments, hospitalizations, or because of side effects from medications.”  - Stacy Cloyd, Deputy Dir. of Gov’t Affairs, NOSSCR

 

Stacy recalls two clients from a previous job assisting SSDI claimants whose stories starkly illustrate why it’s so difficult for the mentally impaired to sustain paying work.  One was a woman who suffered from PTSD due to domestic abuse.  After her husband tried to burn down their house, she experienced debilitating flashbacks and panic attacks that resembled seizures, and could barely leave home.  No longer to able to work, she had to discontinue her job in the fast food industry and applied for SSDI.  “She was awarded benefits at the time she needed them, which enabled her to keep a roof over head and food on the table while seeking treatment,” Cloyd explains.

 

The second client was a man in his 60s who had an intellectual impairment (formerly known as “mental retardation”) who for several years worked as a custodian through a special employment program and paid into Social Security.  He was later forced to give up the custodial work due to a variety of ailments.  Unable to find alternate employment because of his intellectual impairment, he applied for – and received – SSDI benefits.  It’s hard to imagine this older man being able to meet his basic living expenses without a job and without SSDI. 

 

While some fiscal conservatives and others perpetuate the myth that people on SSDI are simply lazy and scamming the system in order to avoid working, Cloyd insists that the opposite is true.

 

“If given a choice between dealing with the pain they suffer – mentally or physically – and collecting SSDI benefits… or being free of this pain and working for a living, I can tell you that they all would choose to work.” - Stacy Cloyd, Deputy Dir. of Gov’t Affairs, NOSSCR

 

Of course, having a severe mental or physical impairment is no guarantee of receiving SSDI benefits. The United States has one of the strictest federal disability standards in the world (only South Korea is more stringent).  Only one in four SSDI applicants is actually approved for benefits.  Wait times for approvals and appeals can be anywhere from months to years. In case anyone doubts the severity of beneficiaries’ conditions, one in six men on SSDI die within 5 years of approval for benefits; for women, the figure is one in seven.

 

Unfortunately, the cold facts do not deter the administration’s propagandists from insisting that many SSDI beneficiaries are somehow undeserving of help – even though they must have worked and paid into Social Security for five of the past ten years before applying.  The ARC advocacy organization estimates that 946,000 beneficiaries could be booted off SSDI if the Trump budget cuts are enacted:  that’s nearly one million mentally and physically impaired Americans deprived of minimal benefits to “keep a roof above their heads and food on the table” in order to give the wealthy and big corporations a massive tax cut. Capitol Hill watchers say the President’s budget is simply a “messaging document” with little chance of passage, in which case we say it is a cruel and frightening message to send some of our nation’s most vulnerable citizens.  

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For more on mental impairments and Social Security Disability Insurance, watch this week's "Behind The Headlines" on Facebook Live. 

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.

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