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From the category archives: Disability

If They Can't Cut Benefits--Cutting Social Security Administrative Funding is the GOP Fall Back Strategy

 

It’s often been said budgets are the best indicator of a nation’s priorities because talk is cheap but where Congress actually spends taxpayers’ money is what really matters.  If you believe that premise, then American seniors have a lot to worry about.  On the Medicare side of the ledger, we’ve already reported about efforts by GOP Senate appropriators to kill the vitally important State Health Insurance Assistance Program (SHIP) program: 

“The SHIP network provides critical information upon which people with Medicare rely to make informed decisions about their coverage options and enrollment decisions,” says Judith A. Stein, Executive Director, Center for Medicare Advocacy, Inc. “The SHIPs are critical to providing assistance with these increasingly complicated choices. People with Medicare and their families from all over the country depend on SHIPs as the key source of unbiased guidance.

‘Senate appropriators have turned their backs on a growing number of people who will need SHIP services to navigate the complexities of Medicare coverage by proposing to eliminate program funding. This kind of penny-wise, pound-foolish lawmaking will threaten the economic security of millions of Medicare beneficiaries and their families.”…Max Richtman, NCPSSM President/CEO”

The news is just as bad on the Social Security side as the Senate Appropriations Committee cut the agency’s administrative budget request by nearly 5.5% at a time when 10,000 Americans a day turn 65.  As Los Angeles Times columnist, Michael Hiltzik, reports this cut is especially telling:

“In fiscal terms, there’s no earthly reason for Congress to be stingy with Social Security’s administrative budget. The money comes out of workers’ payroll taxes and the system’s other revenue, not from the general treasury. And it’s spent with painstaking care: The Social Security Administration is one of the government’s most efficient agencies, with a core administrative budget of 0.7% of benefits, devoted to upholding a decades-old reputation for superb customer service.” 

Politically, this effort is a continuation of a decades-long campaign to diminish successful government programs which, since the vast majority of the American public of both parties supports them, can’t be killed outright.  Whether it’s right-winger Grover Norquist’s goal "to get it {government} down to the size where we can drown it in the bathtub" or former Speaker Newt Gingrich’s plan to “starve the beast” by slashing taxes on the wealthy and underfunding government programs conservatives don’t like, Republican efforts to weaken programs like Social Security and Medicare continue in full force.   

In the case of the Social Security Administration, the Senate Special Committee on Aging reports that years of Congressional under funding is clearly taking its toll.

“At a time when Baby Boomers are retiring and filing disability and retirement claims at record numbers, SSA has shed 11,000 workers agency-wide over three years. Hiring freezes resulted in disproportionate staffing across the nation’s 1,245 field offices, with some offices losing a quarter of their staff. These past five years have also served witness to the largest five-year decline in the number of field offices in the agency’s 79-year history as 64 field offices have been shuttered, in addition to the closure of 533 temporary mobile offices known as contact stations. SSA has also reduced or eliminated a variety of in-person services as it attempts to keep up with rising workloads and shift seniors and others online to conduct their business.”…Reduction in Face-to-Face Services at The Social Security Administration

The Center on Budget and Policy Priorities detailed the real-life effects this has on millions of American seniors:

“Before the budget cuts, more than 90 percent of applicants could schedule an appointment within three weeks; by 2015, fewer than half could.”

“Starting in 2011, budget cuts forced SSA to freeze hiring, and the teleservice centers lost many agents through attrition.  In just three years, SSA lost more than 15 percent of its 800 number staff. Wait times and busy rates spiked.  In 2014, wait times peaked at over 22 minutes and busy rates at 13 percent.”

Again, let’s not forget that American workers have contributed a lifetime to support Social Security.  This isn’t even general revenue at issue.  While the numbers are important, they only offer a glimpse into what these cuts actually mean to average Americans, many who find themselves at the Social Security office during some of the hardest times of the lives:

“For me, this was just one bill. But there’s much more at stake for many people who need the benefits offered by the Social Security Administration, who are not in a position to put this kind of time or legwork in. Many who visit are poor, old, widowed, homeless, or disabled, and if they aren’t one of those things themselves, they are likely caring for someone who is. They are at the end of their rope, perhaps experiencing the worst scenario of their lives: They need a wheelchair. They’ve gone blind. Their spouse died. Or, like me, they have a baby in the NICU.”…Laura Kwerkel, The Atlantic

The battle to fully fund the Social Security administration and the Medicare SHIP program continues.  Chances are good your Member of Congress will tell you protecting these programs is a “top priority” but their actual vote on these particular programs could likely tell you a very different story.

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. 


Trump 2.0 on Social Security

“Does the name Ponzi all of a sudden come to mind?” – Donald Trump, 2000 

As voters in 12 Super Tuesday states head to the polls today we thought it would be a good time to look at arguably the biggest policy flip seen by any Presidential candidate, let alone a front-runner, on the issue of Social Security.  Simply put, the differences between Presidential candidate Donald Trump in 2000 and candidate Donald Trump in 2016 are h-u-u-u-g-e. 

Here are just a couple of the Social Security proposals the Donald supported last time he ran for President:

Raise the Retirement age to 70

“A firm limit at age seventy makes sense for people now under forty,” Trump writes. “We’re living longer. We’re working longer. New medicines are extending healthy human life. Besides, how many times will you really want to take that trailer to the Grand Canyon?” Donald Trump, The America We Deserve.

As we’ve discussed here many times, the problem with the “everyone is living longer” argument for raising the retirement is that it’s simply not true.

“Men at the top of the economic ladder saw an eight-year increase in life expectancy, while men at the bottom saw virtually no change.”... National Academy of Science

Privatize Social Security

“Privatization would be good for all of us. Directing Social Security funds into personal accounts invested in real assets would swell national savings, pumping hundreds of billions of dollars into jobs and the economy. These investments would boost national investment, productivity, wages, and future economic growth.” Donald Trump, The America We Deserve.

The American people, of all political parties and ages, don’t want their guaranteed Social Security benefits put on the Wall Street roller coaster.  They know that what’s good for Wall Street has proven disastrous for Main Street.

So, here were are with a second Presidential campaign and the promises are quite different.  First we have this MSNBC appearance in February:

SCARBOROUGH:  What about raising the retirement age? People are living older than they ever have  --

TRUMP:  Let me just say. Waste, fraud and abuse is massive in Social Security and Medicaid.

SCARBOROUGH:  Why wouldn't you raise the retirement age if Americans are getting older and living longer and longer.

TRUMP:  I'm not doing it. I don't want to do it. I don't want to do it. Two reasons. Number one I don't want to do it and number two, the Democrats aren't going to do it. You know the Republicans also have to get elected, you do know that. And if you watch Bernie, and if you watch Hillary, they don't only want to not cut, they want to increase Social Security.

SCARBOROUGH:  All right.

TRUMP:  Now. I'm not doing it for that reason. I'm just saying this. We don't have to do it. We're going to make our economy strong, we're going to make our economy rich, and we're not going to have to  --

While no one has been able to pin Trump down to his actual plan for Social Security, his message in the South Carolina debate shifted to the perennial GOP promise to cut waste, fraud and abuse and grow the economy:

TRUMP: First of all, the -- when you say I'm the only candidate, if you listen to the Democrats, they want to do many things to Social Security and I want to do them on its own merit. You listen to them, what they want to do to Social Security, none of these folks are getting elected, OK, whether they can do it or not. I'm going to save Social Security. I'm going to bring jobs back from China. I'm going to bring jobs back from Mexico and from Japan, where they're all -- every country throughout the world -- now Vietnam, that's the new one.

TRUMP: You have tremendous waste, fraud and abuse. That we're taking care of. That we're taking care of. It's tremendous.

However, even those who’ve built careers urging Social Security cuts or privatization know this “waste, fraud and abuse” claim doesn’t hold water:

“Now, it is true, according to Social Security’s inspector general, that there are as many as 6.5 million Social Security numbers linked to people over the age of 112. Virtually none of those people are receiving benefits. Their accounts simply were never officially closed following their deaths.” ...Michael Tanner, CATO Institute

Here are the real numbers for the Trump’s mythically huge “waste, fraud and abuse” claims:

  • 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 

A speech Trump gave to conservatives at the 2013 Conservative Political Action Conference provides one suggestion as to why the massive change of position:  

"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

As the polls close tonight on Super Tuesday, we’ll likely see the GOP field narrow.  This certainly wouldn’t be the first time a candidate promised a politically popular proposal on the campaign trail and then acted very differently in office.  However, America’s seniors and their families must expect more from these candidates than big promises, no details and being wrong on the facts.  


Social Security & Medicare: The GOP Congress’ New “Pay-For” for Everything Under the Sun

In just over a week federal funding runs out for the nation’s highways, bridges and roads.  The House has passed a temporary fix but the Senate, led by Mitch McConnell, wants to take an entirely different approach.

What does this have to do with Social Security or Medicare?  The answer should be “nothing” but thanks to legislation now being debated in the Senate, the real answer is “everything.”  Once again, GOP leaders want to use Social Security and/or Medicare benefits to pay for something entirely unrelated to the income and health security of millions of Americans. 

NCPSSM President/CEO, Max Richtman, has written to the Senate urging Members to reject efforts to use Social Security benefits to pay for the Transportation bill: 

“...there are at least two Social Security policy changes that are currently being considered as “offsets” for legislation that would extend highway transportation funding. One of these is a measure barring payment of Social Security benefits for seniors with outstanding warrants for their arrest. Almost none of the seniors who would be affected by this provision are actual fugitives from justice and most of the warrants in question are many years old and involve minor infractions. Moreover, the Social Security Administration attempted to administer a similar provision for a number of years, with catastrophic effect for many vulnerable elderly seniors, employing procedures that did not withstand judicial scrutiny. Reenacting this requirement should be something the Congress does only after careful analysis and with ample opportunity for public discussion.

The second provision relates to the concurrent receipt of both Social Security Disability Insurance (SSDI) benefits and unemployment compensation. Given the importance that all policy makers ascribe to encouraging disabled Americans to return to the workforce, I am perplexed by the desire on the part of some in the Congress to strip working SSDI beneficiaries of their eligibility to receive unemployment compensation when, through no fault of their own, they lose a job. Concurrent eligibility, which derives directly from a disabled person’s efforts to return to work, is a work incentive. That incentive should be altered only after the committees of jurisdiction have carefully considered all of the ramifications associated with such a change and, again, after ample opportunity for public comment.”

This is the third time in less than a year that Congress has attempted to use Social Security and/or Medicare as an ATM to pay for a completely unrelated priority.  Last year Congress voted to extend the Medicare sequester cuts into 2024 to cover a reversal of cost-of-living cuts to veterans' pension benefits. This summer Medicare was cut again to help pay for the Trade bill.  Now it appears, rather than consider tax reform for huge corporate tax dodgers sending billions of profits oversee to avoid paying taxes, GOP leaders in the Senate prefer cutting benefits to seniors, people with disabilities and their families who depend on Social Security. 

The Senate is expected to vote on the highway funding bill and these proposed Social Security benefit cuts this week.  While we all want good highways, Congress should not pay for them by cutting Social Security benefits for seniors, people with disabilities and their families.  Social Security is our money – not the government’s. We’ve worked hard to earn our benefits.

Call our Legislative Hotline ASAP and we’ll connect you to your Senators. Tell them to oppose cutting Social Security to pay for the Transportation bill. 

CALL CONGRESS

1-800-998-0180



GOP Budget Plan: Even More Cuts for Seniors in Medicare

In keeping with every GOP budget passed over many years, benefit cuts for average Americans and tax cuts for the wealthy rule the day.  The Senate this week will pass the Budget Conference Report (it only needs a majority, which the GOP now has) including massive benefit cuts for seniors in Medicare.  

National Committee policy staff has laid out what this Budget bill means for seniors in our letter to the Senate:  

The conference agreement would be devastating to today's seniors and future retirees, people with disabilities and children due to the proposed changes it makes to Medicare, Medicaid and the Affordable Care Act.  While it proposes huge cuts to our social insurance safety net, the conference report would give massive tax cuts to the very wealthy. The conference agreement assumes the privatization of Medicare and achieves savings by shifting costs to Medicare beneficiaries.  Beginning in 2024, when people become eligible for Medicare they would not enroll in the current traditional Medicare program which provides guaranteed benefits.  Rather they would receive a voucher, also referred to as a premium support payment, to be used to purchase private health insurance or traditional Medicare through a Medicare Exchange.  The amount of the voucher would be determined each year when private health insurance plans and traditional Medicare participate in a competitive bidding process.  Seniors choosing a plan costing more than the average amount determined through competitive bidding would be required to pay the difference between the voucher and the plan's premium.  In some geographic areas, traditional Medicare could be more expensive.  This would make it harder for seniors, particularly lower-income beneficiaries, to choose their own doctors if their only affordable options are private plans that have limited provider networks.  Wealthier Medicare beneficiaries would be required to pay a greater share of their premiums than lower-income seniors.

The plan to end traditional Medicare requires private plans participating in the Medicare Exchange to offer insurance to all Medicare beneficiaries.  However, it is likely that plans could tailor their benefits to attract the youngest and healthiest seniors and still be at least actuarially equivalent to the benefit package provided by fee-for-service Medicare.  This would leave traditional Medicare with older and sicker beneficiaries.  Their higher health costs would lead to higher premiums that people would be unable or unwilling to pay, resulting in a death spiral for traditional Medicare.  This would adversely impact people age 55 and older, including people currently enrolled in traditional Medicare, despite the conference agreement’s assertion that nothing will change for them.

The conference report threatens to shift costs to Medicare beneficiaries.  S. Con. Res. 11 contains $431 billion over ten years in unnamed Medicare cuts.  Over half of Medicare beneficiaries had incomes below $23,500 per year in 2013, and they are already paying 23 percent of their average Social Security check for Parts B and D cost-sharing in addition to paying for health services not covered by Medicare.  When coupled with requirements to shift costs to beneficiaries in the Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114-10), the unspecified Medicare benefit cuts included in the conference agreement would be burdensome to millions of seniors and people with disabilities.

In addition, the conference agreement calls for repealing provisions in the Affordable Care Act (ACA), which would make health insurance inaccessible for seniors age 64 and younger.  Without the guarantees in the ACA, such as requiring insurance companies to cover people with pre-existing medical conditions and to limit age rating, younger seniors may not be able to purchase or afford private health insurance.

Repealing the ACA would also take away improvements already in place for Medicare beneficiaries – closing the Medicare Part D coverage gap, known as the "donut hole"; providing preventive screenings and services without out-of-pocket costs; and providing annual wellness exams.  The Centers for Medicare and Medicaid Services recently reported that since the passage of the ACA, over 9.4 million Medicare beneficiaries in the Medicare Part D donut hole have saved $15 billion on their prescription drugs, an average of $1,595 per person.  An estimated 39 million people with Medicare took advantage of at least one preventive service with no cost sharing in 2014.

The agreement includes reductions to Medicaid funding that would affect low-income seniors.  Medicaid provides funding for health care to help the most vulnerable Americans, including low-income seniors, people with disabilities, children and some families.  The conference report would end the current joint federal/state financing partnership and replace it with fixed dollar amount block grants, giving states less money than they would receive under current law.  In exchange, states would have additional flexibility to design and manage their Medicaid programs.  The proposed block grants would cut federal Medicaid spending by $500 billion over the next 10 years.  Giving states greater flexibility in managing and designing their programs in no way compensates for the significant reductions that beneficiaries, including nursing home residents and their families, could face by turning Medicaid into block grants.

The conference report also would repeal the Medicaid expansion in the ACA. Beginning in 2014, states have had the option to receive federal funding to expand Medicaid coverage to uninsured adults with incomes up to 138 percent of the federal poverty level ($16,242 for an individual in 2015).  Over half of the states have expanded their Medicaid programs, and some others will likely participate in the future.  The conference agreement would hurt states and low-income individuals by repealing Medicaid expansion, taking away $900 billion from the program over 10 years.  Altogether, S. Con. Res. 11 cuts the Medicaid program by more than $1.4 trillion over 10 years, compared to current law.

Moreover, the conference agreement puts 11 million severely disabled Social Security Disability Insurance (SSDI) beneficiaries at risk of a 20 percent benefit cut next year by reaffirming a House rule requiring legislation to address the financing of the SSDI program be accompanied by revenue increases or much more likely benefit cuts.  That’s why the National Committee urges the Senate to reject the House’s SSDI recommendations in the conference report and instead make a modest reallocation of Social Security payroll taxes from the retirement trust fund to the Disability Insurance Trust Fund as has been done 11 times in the past on a bipartisan basis.

The National Committee urges you to oppose the Conference Report on the FY 2016 Budget Resolution, which would be harmful to seniors, people with disabilities and children."

 

 

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