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From the category archives: Budget

GOP Tax Cuts Could Cost Seniors in the Long Run

The GOP had scarcely emerged from the defeat of their latest Obamacare repeal legislation when they pivoted lightning-quick from healthcare to taxes.  The tax reform plan the party unveiled last week may ultimately endanger the well-being of older Americans more than the vanquished healthcare bill.  Here’s why:  The nonprofit Tax Policy Center estimates that the GOP tax plan will reduce federal revenues by a net $2.4 trillion in the next 10 years.  As the deficit grows, Congress will look to cut spending.  Republicans have already called for deep cuts to Social Security and Medicare, and would no doubt come after those programs looking for massive savings. Seniors’ earned benefits could be used as piggy banks to pay for reckless tax cuts that largely benefit the wealthy.

Americans for Tax Fairness put it his way:

"[The tax plan’s] eye-popping cost will lead to deep cuts in Social Security, Medicaid, Medicare, and public education that will leave working families in the cold."- Americans for Tax Fairness

… while House Democratic leader Nancy Pelosi predicted:

“Make no mistake: after Republicans’ tax plan blows a multi-trillion dollar hole in the deficit, they will sharpen their knives for Social Security, Medicare, Medicaid.” – House Minority Leader Nancy Pelosi 

Budget hawks (including President Trump’s budget director Mick Mulvaney and House Speaker Paul Ryan) have long dreamed of cutting Social Security and Medicare.  Once their tax plan balloons the deficit, they will have the perfect excuse for gutting those programs – even though Social Security and Medicare Part A are completely self-funded by workers’ payroll contributions; they contribute not a penny to the deficit.

In fact, the budget cutters’ knives are already sharpened. The 2018 House Budget resolution calls for nearly $500 billion in cuts to Medicaid over the next decade.  That would be devastating for the 1.4 million seniors who rely on Medicaid for long-term care, and millions of others who are dually eligible for Medicaid and Medicare.  The House budget resolution also includes nearly $500 billion in cuts to Medicare over the next ten years.  Under the House budget plan, Medicare would be privatized and the eligibility age raised from 65 to 67 (an effective benefit cut). If these changes are enacted, seniors will be left to fend for themselves in the private insurance market with vouchers that may not keep up with rising costs. 

Despite President Trump’s protestations that the GOP tax plan won’t benefit the rich, that’s precisely who would reap the biggest gains.  (Trump himself could save an estimated $1 billion in taxes!)  According to the Tax Policy Center’s analysis:

"Taxpayers in the top 1 percent would receive about 50 percent of the total tax benefit from the tax overhaul, with their after-tax income forecast to increase an average of 8.5 percent." – Tax Policy Center 

On the other hand, some in the middle class would see their taxes go up.  One in seven households earning between $48,000 and $86,000 per year would pay more in taxes next year; the proportion would double during the next decade.  For households earning $150,000-217,000 a year, one third would immediately pay more in taxes. 

Republicans claim that the tax cuts will pay for themselves through intense economic growth.  They have tried this before (Most recently, with the Bush tax cuts in the early 2000s), and it didn’t work out.  Instead, deficits swelled, reinforcing budget hawks’ instincts to cut programs for the most vulnerable members of our society, including and especially seniors.  One of the (repentant) architects of the failed trickle-down economics of the 1980s, Bruce Bartlett, put it best in a recent column for USA Today: 

"Tax cuts and tax rate reductions will not pay for themselves; they never have. Republicans don’t even believe they will, they are just excuses to slash spending for the poor when revenues collapse and deficits rise." – Bruce Bartlett, former Congressional economist

 

 

Rep. Brat at His Worst: Spreading Myths about Social Security and Medicare

In a contentious interview with CNN’s Kate Bolduan this week, Rep. Dave Brat (R-VA) perpetuated some dangerous myths about Social Security and Medicare.  Brat, a Tea Partier and fiscal bomb thrower, has been campaigning to cut seniors’ earned benefits since first running for Congress in 2014.

The CNN interview heated up when Bolduan pressed Brat about the recently-passed deal to suspend the debt ceiling and keep the government open, which he opposed.  It’s worth quoting Brat’s answer at length here, because it is only borderline comprehensible and riddled with inaccuracies:

“I was just at my convocations back home with the kids. The kindergarteners are in the class of 2030, they just told me. They will graduate college in 2034. So if you do know the context, the context is that is the year Medicare and Social Security are insolvent. I don’t think people do know the context.  Otherwise there’d be more urgency and they wouldn’t put up with the nonsense we’re doing up here on the fiscal front. Right? If the press would weigh in on what the damage -- it’s a guaranteed fiscal crisis in 2034. Guaranteed.  In law, I’m on the budget committee, we can’t touch it.  Right--You got to pass in law.  So that’s – that’s the context and so with that; if you ask the average voter how you should vote on a clean debt ceiling increase with no fiscal discipline whatsoever, it’s the whole country 90%.”

Where to begin dissecting this statement?  The relevance of kindergarteners graduating college in 2034 notwithstanding, Social Security and Medicare will not be insolvent that year.  If Congress takes no corrective action whatsoever, the Medicare Part A Trust Fund and the Social Security Trust Funds will be depleted in 2029 and 2034, respectively.  But that does not mean the programs will be insolvent.  Revenue from workers’ payroll taxes still will be flowing in, allowing Medicare to pay 88% of full benefits and Social Security 77% --- with no further action from Washington.  In fact, the 2017 Social Security Trustees Report says there is now $2.847 trillion in the Social Security Trust Fund, which is $35.2 billion more than last year --- and that it will continue to grow with payroll contributions and interest on the Trust Fund's assets.)  

Does this mean we sit by and do nothing?  Of course not.  But Rep. Brat’s prescriptions are as draconian as his statements are inaccurate.  The Congressman has championed cutting Social Security and Medicare and raising eligibility ages as the only solution.  When running for office in 2014, he told a Tea Party crowd:

“It’s not just little marginal changes, right?  In order to avoid those insolvency issues with Medicare and Social Security, you’re going to have to do some major cuts."

According to PolitiFact, Brat went on to say that people will ‘have to work longer before receiving benefits’ – meaning raising the retirement age.  This favorite proposal of fiscal hardliners is actually a benefit cut.  And it is based on the misconception that just because average life expectancy is rising, everyone can work well past 65 – even though working class Americans (especially those doing physical labor on the job) may not be physically able to continue working into their late 60s like their wealthier counterparts.

Hardliners don’t like to talk about this, but there are other ways to keep our earned benefits fiscally sound without punishing the people who depend on them. The National Committee supports legislation by Senator Bernie Sanders (I-VT), Rep. John Larson (D-CT), and others in Congress to keep Social Security solvent without cutting benefits or raising the retirement age – mainly by lifting the payroll tax income cap so that the wealthy pay their fair share.  In fact, the Sanders and Larson bills actually boost benefits and cost-of-living increases while ensuring the fiscal health of Social Security well past those kindergartners’ 2034 graduation date. That way, those kids can count on their benefits when they retire around 2077.

But some members of Congress – and Rep. Brat in particular - ignore or dismiss these modest and manageable solutions, proposing instead that seniors shoulder the burden through benefit cuts and a higher retirement age.

Now we come to the second myth that Brat likes to propagate:  that Social Security and Medicare are major drivers of the federal budget deficit.  At that same 2014 Tea Party campaign event, Brat justified Social Security and Medicare cuts by saying:

“We’re going to have to take some bad medicine… to just balance the budget. If you don’t solve it, then in 11 years nearly all federal revenue will go only to [Social Security and Medicare].”

The fact is that Social Security has no net effect on the federal budget and contributes not one penny to the deficit. It is self-financed through workers’ payroll taxes.  Ditto for Medicare Part A.  Suggesting that these programs must be cut to balance the budget is disingenuous at best, but that doesn’t stop fiscal hardliners and the mainstream media from spreading the myth.  

Notice how Brat conflates the debt crisis with Social Security and Medicare at the end of his CNN rant.  Unfortunately, this claim is made far too often, but is hardly ever challenged by on-air journalists, this time being no exception (though, in truth, Bolduan was struggling just to control the interview).

Why do the on-air rantings of Congressman Brat matter? His arch-conservative philosophy wouldn’t be so dangerous if he were truly on the margins of political debate. But for the first time in more than a decade, fiscal hawks have the power to impose their hardline views on America’s most vulnerable citizens. Brat is a member of the House Budget Committee, which has already voted to privatize Medicare and raise the eligibility age.  That’s a powerful perch for spreading myths about Social Security and Medicare in order to justify cuts that are just plain cruel. 

House GOP Recklessly Pursues Privatization of Medicare in Budget Process

Congress is targeting the health and financial well-being of America’s seniors by making yet another attempt to privatize Medicare.   Yesterday the House Budget Committee passed the GOP’s FY 2018 budget resolution, which includes Speaker Paul Ryan’s “Medicare premium support” scheme – an innocuous name for turning time-tested senior health care coverage into “Coupon-Care.”  

The House budget blueprint slashes nearly $500 billion from Medicare over ten years and raises the eligibility age from 65 to 67 – along with gutting Medicaid and other social safety net programs for needy seniors.  

The Associated Press had a pithy summary of the painful cuts that the GOP proposes in its new budget:

“The plan, in theory at least, promises to balance the budget through unprecedented and unworkable cuts across the budget. It calls for turning this year's projected $700 billion or so deficit into a tiny $9 billion surplus by 2027. It would do so by slashing $5.4 trillion over the coming decade, including almost $500 billion from Medicare, $1.5 trillion from Medicaid and the Obama health law, along with enormous cuts to benefits such as federal employee pensions, food stamps, and tax credits for the working poor.” – Associated Press, 7/18/17

 National Committee President Max Richtman says that converting Medicare into a voucher program is an existential threat to the program itself. 

 “Over time, giving seniors vouchers to purchase health insurance would dramatically increase their out of pocket costs since the fixed amount of the voucher is unlikely to keep up with the rising costs of health care. And, as healthier seniors choose less costly private plans, the sicker and poorer seniors would remain in traditional Medicare, leading to untenable costs, diminished coverage, and an eventual demise of traditional Medicare, plain and simple.” – Max Richtman, NCPSSM President

Of course, raising the Medicare eligibility age from 65 to 67 as the House spending plan also proposes, is in itself a drastic benefit cut.

Undermining Medicare has been a long-held dream of fiscal conservatives. Their “premium support” proposal is a thinly veiled scheme to allow traditional Medicare to “wither on the vine,” as former House Speaker Newt Gingrich once put it.

Privatization is being sold as “improving customer choice,” but based on the way current Medicare Advantage plans work, private insurance will continue to offer fewer choices of doctors than traditional Medicare does.  If traditional Medicare is allowed to shrink and collapse, choice will disappear, too.

“Weakening Medicare is a politically perilous path for Republicans.  Recent polling indicates that large majorities of Americans across party lines prefer that Medicare be kept the way it is, not to mention that President Trump repeatedly promised to protect the program during the 2016 campaign.” – Max Richtman, NCPSSM President

Meanwhile, the National Committee strongly condemns other priorities of the House Republican budget resolution, as well.  The GOP budget resolution will mean: 

*Hundreds of billions in painful cuts to Medicaid, which seniors depend on for long-term care services and supports.

*Reaffirmation of a House rule that puts 11 million Social Security Disability Insurance (SSDI) beneficiaries at risk of a 7% benefit cut in 2028.

*Reductions to SSI (Supplemental Security Insurance), which provides cash assistance to low-income seniors and people with disabilities.

 *Caps on non-defense spending that will likely lead to devastating cuts to Older Americans Act programs and the Social Security Administration (SSA) operating budget.

 *Slashing of programs that benefit our nation’s veterans and deep cuts to spending on medical research (including cancer, diabetes, heart disease, and other conditions afflicting the elderly).

The savings from these devastating cuts will likely go to tax breaks for the wealthy.  Last year’s House Republican tax plan gave 99.6% of its benefits to the top one-percent of earners, with virtually nothing for middle and low income Americans.

 

 

Of Course People Will Die if Senate Health Bill Becomes Law

Two days in a row now we have seen CNN anchor Kate Bolduan react with incredulity when a Democratic member of Congress points out the obvious:  that people will die if the Senate healthcare bill becomes law.  “We’ll have to ask a Republican about that!” Bolduan breathlessly replied to one Democrat. What she – along with advocates of the bill – fails to understand or prefers to ignore is that you cannot snatch healthcare away from 22 million people without incurring casualties.  Of course people will die as a result. 

Speaking against the GOP healthcare bill last week, Senator Elizabeth Warren (D-MA) called its cuts to healthcare for older and lower-income Americans “blood money.”  She went on to say:

“Let’s be very clear.  Senate Republicans are paying for tax cuts for the wealthy with American lives.  People will die.” – Sen. Elizabeth Warren, 6/22/17

Republicans propose to pay for those tax cuts by gutting the Medicaid program – 40% of which pays for services to the elderly like nursing home care.  Some one million seniors nationwide could lose the ability to pay for the long term care they need to survive.  States facing $770 billion in federal Medicaid cuts will have no choice but to offer skimpier coverage or kick seniors off the Medicaid rolls altogether.

By law, state Medicaid programs have to cover nursing homes. If those states receive less funding from the federal government, it could increase the pressure on the operations of nursing homes, in turn possibly limiting who can qualify for care. – Yahoo Finance, 6/26/17 

We are talking about people with Alzheimer’s, cancer, diabetes, neurological disorders, and other chronic diseases.  Few seniors (or their families) can afford to pay the average cost of nursing home care (running some $80,000 a year) without government assistance. Many of these seniors were formerly in the middle class, but had to impoverish themselves to qualify for Medicaid.  If they are forced to go without skilled long term care (whether in a nursing home, in the community, or at home), the real question is not whether some of them will die, but how will they survive? 

The bill’s age rating provisions could also prove deadly for older Americans.  The Senate legislation – like the House’s – allows insurers to charge near seniors (aged 50-64) up to five times as much as younger adults, which will price many out of the market.  The rate of uninsured Americans who earn up to 200% of the federal poverty line will double if this bill becomes law.  Chronic health conditions tend to develop and intensify during this period of life.   If millions of near seniors can’t afford health insurance, they will go without the care they need – which could lead to premature death.  You don’t have to be a brain surgeon to figure that one out.

Taking away the guarantee of essential benefits coverage – which the Senate bill also threatens to do – means Americans (especially the poor and elderly) will no longer benefit from timely treatment of festering health problems.  One of those is heart disease. According to Kaiser Health News, the leading killer of men and women in the U.S. has been decreasing since Obamacare went into effect. 

“The Journal of the American Heart Association found that the rate of sudden cardiac arrest outside of a hospital dropped by 17% among people aged 45-64 after the Affordable Care Act expanded insurance coverage.” – Kaiser Health News, 6/28/17

It stands to reason that repealing the Affordable Care Act could lead to an increase in heart attacks, which could also mean an increase in fatalities. 

This is why the pleas for bipartisanship from Republicans and some of the media ring especially hollow.  We have heard pundits describe the disagreements between Republicans and Democrats on healthcare as “semantics”:  is the Senate bill a true “repeal” of Obamacare or not?  Why, oh why, can’t both sides just get along? Of course, that misses the point.  Not only does the bill roll back important protections for all Americans, it is a Trojan Horse for gutting Medicaid and giving the wealthy a $700 billion tax cut.  Congressional Democrats refuse to enable the GOP to make these drastic changes.  Seniors and their advocates must keep that issue at the forefront – and work to defeat the Senate bill while there is still time. This is not semantics. It is literally life and death. 

Mitch McConnell's "Secret" Healthcare Plan... and the SeniorHeroes who could stop him

When the House passed its American Health Care Act (AHCA) last month, conventional wisdom said it was doomed in the Senate.  Moderate Republican Senators would never go along with the more harmful provisions of the House bill – or so the narrative went.  It appears those predictions were off base.  If the latest reporting from Capitol Hill is accurate, Majority Leader Mitch McConnell has put the Republican healthcare plan on a fast-track for passage in late June or early July.  A 13-member working group has been meeting in secret to craft the Senate version of the AHCA – without committee hearings.  Zero open debate.  Zero public input.  Or as the Washington Post described the process:  “sabotage, speed and secrecy.”  In order to keep pushback to a minimum, McConnell may not release the details of the bill until about 48 hours before the Senate votes on it.  That is insufficient time for Senators – and the public at large – to evaluate legislation that could dramatically affect the lives of tens of millions of Americans.

 Another false prediction from a few weeks ago said that the Senate would scrap the House bill and start from scratch. But this week Senator John Cornyn (R-TX) revealed that the Senate bill retains about 80% of what the House passed.  Since the House bill was so unequivocally bad for older Americans, hearing that the Senate version is at least 80% as bad is cold comfort. The Senate leadership will try to appease GOP moderates with the same kind of token gestures that saved the AHCA from defeat in the House.  It is vitally important that those moderates not cave like their House colleagues did.  Too much is at stake for our nation’s seniors and Americans as a whole.

 The National Committee has identified 11 moderate GOP Senators who may be persuaded to vote against the Republican health care plan – if they are willing to put their constituents’ well-being above party and political expediency.  They are:

 Sens. Lisa Murkowski and Dan Sullivan (R-AK)

Sens. John McCain and Jeff Flake (R-AZ)

Sen. Cory Gardner (R-CO)

Sen. Charles Grassley (R-IA)

Sen. Susan Collins (R-ME) 

Sen. Dean Heller (R-NV)

Sen. Rob Portman (R-OH)

Sen. Lamar Alexander (R-TN)

Sen. Shelley Moore Capito (R-WV)

 In fact, we call on these Senators to become what we call “SeniorHeroes” – real-life superheroes standing up for older Americans while the rest of their party pursues a dubious scheme.  From what we know of the Senate bill, there isn’t much in the evolving Senate bill for moderates to applaud.  Sen. Lisa Murkowski expressed those doubts publicly on Thursday.  Here are some of the key areas where the Senate version will likely fail older Americans:

 MEDICAID EXPANSION.  Senate Republicans are considering “compromises” that would phase out funding more slowly – but do not appear to be considering any approach that would maintain Medicaid expansion over the long run.  (Many of the more moderate Senators represent states which chose to expand Medicaid – and have a lot to lose.)

 PER CAPITA CAPS.  The Senate reportedly will retain the House-passed bill’s Medicaid per capita caps, which would strain state budgets and possibly force rollbacks in benefits or outright termination of coverage for millions of seniors who depend on Medicaid to pay for long-term care.  Although it’s unclear whether the Senate will keep the House bill’s $834 billion in Medicaid cuts, Medicaid still likely will be slashed by hundreds of billions of dollars. 

PRE-EXISTING CONDITIONS AND ESSENTIAL HEALTH BENEFITS.  The Senate may reject provisions in the House bill that would have allowed insurers to charge higher premiums for individuals with pre-existing conditions, but will likely allow states to waive essential benefits coverage.  This would dearly cost older Americans seeking essential benefits, such as hospitalization, ambulance services, and rehabilitation services. 

TAX CREDITS.  The House bill would drive up seniors’ out-of-pocket costs by replacing Obamacare’s income-based subsidies with tax credits based solely on age.  Older Americans could pay up to 800 percent more in net premiums under this plan.  The Senate has toyed with making these tax credits more “robust,” but the more it increases these credits, the deeper it must cut Medicaid to match the savings in the House bill. 

We do not know whether the Senate will allow insurers to charge older enrollees five times more than younger ones, as the House legislation does.  Also uncertain is whether the Senate will repeal the Medicare payroll tax on high income wage earners (as the House did), which would reduce the solvency of Medicare by three years.

It’s a safe bet that, like the House version, the Senate GOP healthcare plan will cost older Americans more, make essential health benefits harder to obtain, and cause millions who desperately need healthcare to lose coverage.  GOP moderates will be under intense political pressure to toe the line and support the party’s plan, even though the Republican bill has scant public support in even the reddest of states.  In asking GOP moderates to don their capes and become SeniorHeroes, we hope they remember who they were elected to serve.  It certainly wasn’t Mitch McConnell. 

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For more about the GOP's secret Senate healthcare plan, watch this week's "Behind the Headlines" on Facebook Live from Capitol Hill. 

 

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