From the category archives: entitlement reform
The fight to defend and strengthen Social Security, Medicare and Medicaid has seemed relentless in recent years as the programs have been under almost constant assault by the billion dollar anti-"entitlement" lobby and their supporters in Congress. For staff here at the National Committee to Preserve Social Security & Medicare it's been a challenging yet rewarding year as we have won many important battles in Washington to stop the shredding of America's social safety. But it's not over yet.
Here is our 2014-15 Annual Report for look back at a very important year in the fight to strengthen Social Security, Medicare and Medicaid.
Orginally published in Huffington Post.
by Max Richtman, NCPSSM President/CEO
About this time ten years ago it was becoming clear that President George Bush’s plan to forever change Social Security by turning the program over to Wall Street was on the ropes. Even though his Social Security privatization road tour still had two more months of scheduled stops, the more the President talked about his plan, the less people liked it. Gallup reported disapproval of privatizing Social Security rose by 16 points from 48 to 64 percent between the President’s State of the Union address and June. It was an incredibly risky and unpopular idea that rapidly flat-lined thanks to the overwhelming rejection by the public. Yet here we are a decade later and conservatives campaigning for Congress and the White House are resuscitating the Bush strategy by offering up approaches to Social Security which are stark reminders that the GOP playbook really hasn’t changed that much.
What Else Has NOT Changed
Americans of all ages, political parties and income levels, continue to oppose cutting Social Security benefits through privatization or other means. They understand the retirement crisis is real. A recent Gallup poll reports more non-retirees believe Social Security will be a major source of income in their retirement now than at any point in the last 15 years. The National Academy of Social Insurance’s survey, "Americans Make Hard Choices on Social Security" shows that Americans' support for Social Security is unparalleled and they are willing to pay more in taxes to stabilize the system's finances and improve benefits. Seven out of 10 participants prefer a package that would eliminate Social Security's long-term financing gap without cutting benefits.
Even though Americans clearly understand the value of Social Security and are willing to pay more to strengthen it, Republicans in Congress and GOP candidates for President continue to push for Social Security cuts and/or privatization plans. Governor Chris Christie may have hoped savaging the program would give him the attention and conservative credentials needed to revive his flagging poll numbers before announcing his Presidential campaign against a roster of other candidates who already offered their own plans to cut Social Security benefits. The GOP Presidential primary has become a race to see who can deny more benefits for seniors, people with disabilities, survivors and their families faster. While cutting benefits in Social Security, Medicare and Medicaid isn’t really new among conservatives, what has changed in the decade since the Democrats led the charge against Social Security privatization is how some Democrats are now talking about these vital programs in the language of the conservatives.
Why Opposing Privatization Isn’t Enough
During the last decade I’ve observed a growing willingness by some Democrats to buy into the conservative mythology that targeting average Americans for benefit cuts makes them more “honest” and “courageous” than other politicians. This Republican talking point is built on the false premise that supporting successful federal programs which keep millions of Americans economically and medically secure is “pandering to seniors” while supporting billionaire tax breaks and corporate giveaways costing the federal treasury billions of dollars is “fiscal responsibility.”
Ten years ago Democrats were united in their opposition to Social Security privatization. That’s still largely true today; however, given the lessons of the past decade, opposing privatization simply isn’t enough to convince constituents that their benefits are fully protected. The broader questions voters should ask incumbents and candidates alike include: Do they support benefit cuts in any other form such as the Chained CPI, raising the retirement age, and means testing? Do they support the failed Bowles-Simpson plan which would have done all of these things? Do they support the reallocation of trust fund monies to avoid a 20 percent cut to Social Security disability benefits? The answers to these questions can reveal the truth about a candidate’s vision for the future of Social Security and the generations of Americans who have earned their benefits. “I oppose privatization” was enough ten years ago but it doesn’t tell us whether an incumbent has been a Social Security defender or benefit cuts collaborator in the many battles since then.
While it’s safe for Democrats to declare their opposition to privatization, the bolder step they need to make in this politically charged benefit-cuts environment is to demand that any Social Security conversation must address benefit adequacy as well as long-term solvency. It’s clear that the majority in Congress has little interest in protecting this program even though our nation faces a retirement crisis leaving the average working household with virtually no retirement savings. The truth is Congress should Boost Social Security benefits not cut them. That’s a position that demonstrates true political leadership. Not because it’s unrealistic or opportunistic, as the billion dollar anti-Social Security lobby would like you to believe, but because it pushes back against a decade long quest to cut Social Security benefits as the next best thing to privatization. “Death by a thousand cuts” is a political goal the American people simply can not afford nor should they have to. We have Democratic and Independent leaders in Congress who understand this and they support legislation to improve Social Security benefits. The National Committee has endorsed numerous pieces of legislation that would enhance Social Security, boost benefits, lift the payroll tax cap and adopt the more accurate consumer price index for the elderly (CPI-E). Proposals like the Social Security 2100 Act not only improve benefits but also extend Social Security’s long-term solvency.
I believe the old truism that those who cannot remember the past are condemned to repeat it. When Democrats were unified in representing the American people’s views on Social Security they were on the correct side of the issue from both a policy and political perspective. Defeating the privatization of Social Security saved millions of Americans from an even worse economic fate than they already suffered through during the great recession. Current and future Democratic lawmakers now have an opportunity to do the right thing again by joining the growing Boost Social Security movement and supporting legislation which would improve benefits while also strengthening the program’s long-term outlook.
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."
Hyperbole -- fact twisting and sheer omission -- false truths presented by “courageous truth-tellers.” None of this is really new to American politics. However, today New Jersey Governor Chris Christie deployed all of these time-worn propaganda techniques to unveil his plan to cut $1 trillion in benefits (that’s $1,000,000,000,000) from generations of Americans who will depend on Social Security, Medicare and Medicaid.
He says it’s all about “fairness.” However, he proposes not a single dime of new revenue and has no problem with average Americans paying payroll taxes on all of their income while the wealthy do not.
Apparently, slashing pensions in New Jersey to preserve his no tax pledge simply isn’t enough. Now he hopes to do the same nationwide. In spite of his promise to offer the GOP Presidential primary race something new, today’s comments were merely a recitation and doubling-down on the same GOP claims that our nation can’t afford to honor its commitment to America’s workers and future retirees.
NCPSSM President/CEO, Max Richtman, sums it up this way:
“The Governor’s plan to means-test Social Security, cutting off some Americans and transitioning the program from an earned benefit to welfare has long been the goal of those who oppose social insurance programs. It seems the Governor acknowledges that his flagging Presidential campaign needed a jolt because today’s speech was far more about burnishing Governor Christie’s conservative credentials than offering new proposals that could help America’s workers and retirees. He certainly isn’t showing bold leadership by claiming we must cut middle-class benefits, while protecting tax expenditures benefiting huge corporations and the wealthy. That’s been the GOP position for a very long time. Today Governor Christie joins a long line of conservative politicians who hope to convince voters they are “courageous truth-tellers” when in truth their goal is to dismantle the very programs which have kept millions from poverty.
The majority of Americans – of all ages, no matter their political party -- opposes cutting already modest benefits and is willing to pay more to boost the program. They understand Social Security and Medicare are not welfare programs nor should they be. Getting any GOP Presidential candidate to acknowledge that fact takes true political courage. But unfortunately that’s not the ‘red meat’ the GOP’s conservative base expects to hear nor the truth candidates like Governor Christie are willing to tell.”...Max Richtman, NCPSSM President/CEO
While he claims “no one” will talk about cutting benefits like he will, the fact is, the past decade has seen numerous attacks on the programs from Presidents, Presidential commissions, Congressional “Gangs of 6” and too many legislative proposals to even list here. Senate Governor Christie is merely the latest in a growing list of GOP Presidential candidates who all promote the same “strengthen = slash” approach. They tout their protection of poorer seniors while proposing benefit cuts, cost sharing and means testing that will impact millions of poor and middle-class beneficiaries. Each candidate also follows the conservative-crafted playbook which promises current retirees (who consistently vote) will be protected from cuts, instead targeting their children and grandchildren (who aren’t thinking about retirement yet) for even smaller benefits.
Many GOP Candidates – Same Social Security & Medicare Approach
- Senator Ted Cruz supports privatizing Social Security, turning Medicare into “Coupon Care”, raising the retirement age and Medicare eligibility age, and cutting Cost of Living Allowances (COLAs). Each of these proposals would cut benefits well below the current $1,200 average monthly benefit.
- Senator Rand Paul has called Social Security a Ponzi scheme and supports allowing people to opt out of the program. He also supports raising the retirement age and Medicare eligibility age, Social Security privatization, and raising seniors’ Medicare premiums and copayments.
- Senator Marco Rubio supports privatizing Social Security, raising the retirement age and cutting Cost of Living Allowances (COLAs). He considers current benefits “generous” and supports the GOP/Ryan budget which turns Medicare into “Coupon Care”.
None of these candidates have expressed support for lifting the payroll tax cap so that wealthy Americans pay the same rate as everyone else or proposals addressing income adequacy for millions of beneficiaries of all ages.
Now, that would be a true act of political courage.
"Reps. Tom Cole (R-OK) and John Delaney (D-MD) plan to introduce a bill this Congress that would create a Social Security commission to propose changes to the program, Cole's office confirmed to TPM on Monday." - Talking Points Memo.
“The commission would probably gradually raise retirement age, it would probably look at chained CPI, would probably look at means-testing and probably look at some sort of revenue, or reduce benefits for upper-income people,” Cole said. “Then you have to vote.” - The Hill.
“We are troubled that H.R. 1578 takes several steps to circumvent a deliberative public process, limiting the participation of Social Security stakeholders and advocates. For example, the Committees of jurisdiction over the Social Security program — the Senate Committee on Finance and the House Committee on Ways and Means — would have limited input in the development of the Commission’s recommendations. Under “fast track” procedural rules in your bill, the legislation embodying the Commission’s recommendations would be considered by Congress on an expedited, “take-it-or-leave-it” basis. No amendments to the Commission’s bill could be offered and it could be passed in both the House and Senate by a simple majority vote. Normally, Section 310(g) of the Budget Act and the Senate’s “Byrd rule” require 60 votes in the Senate to approve legislation which changes Social Security." - Max Richtman.
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