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From the category archives: entitlement reform

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 Privatization Tops the GOP Agenda

Well, that didn’t take long.  Just days after the election and already the GOP has confirmed, what we’ve been warning for months.  Destroying traditional Medicare in favor of a privatized CouponCare system is at the top of the Republican agenda.  In fact, they want it to happen as soon as next year.

“Below is a transcript of what Ryan said on Fox's Special Report, along with a flat out false statement suggesting that Obamacare has weakened Medicare's finances.

BRET BAIER: Your solution has always been to put things together including entitlement reform. That is Paul Ryan's plan. That's not Donald Trump's plan.

PAUL RYAN: Well, you have to remember, when Obamacare became Obamacare, Obamacare rewrote Medicare, rewrote Medicaid. If you are going to repeal and replace Obamacare, you have to address those issues as well. What a lot of folks don't realize is this 21-person board called the ipap is about to kick in with price controls on Medicare. What people don't realize is because of Obamacare, Medicare is going broke, Medicare is going to have price controls because of Obamacare, Medicaid is in fiscal straits. You have to deal with those issues if you are going to repeal and replace Obamacare. Medicare has serious problems [because of] Obamacare. Those are part of our plan.” ...Talking Points Memo

Let’s be crystal clear about this – without Obamacare, Medicare’s Part A trust fund would have faced insolvency now.  Instead, because of the cost savings in the Affordable Care Act, including; trimming the billions in government subsidies going to the insurance industry in Medicare Advantage and productivity adjustments to how Medicare pays providers the program gained more than a decade of solvency.

“The net result was that the “insolvency” date was extended by 12 years. Before the law was passed, the trustees said in 2009, the fund was going to be depleted in 2017. “The short-range financial outlook for the HI [hospital insurance] trust fund is substantially more favorable than projected in last year’s annual report, primarily as a result of the Affordable Care Act,” the Medicare trustees said in their 2010 report, saying the fund would last until 2029.”...Washington Post

Fact checkers appropriately gave Speaker Ryan Four Pinnochios for this obvious lie:

“Medicare certainly faces financial stress as the baby-boom generation begins to retire in full force, but it’s important to get the facts straight. It’s bad enough that Ryan, like many politicians, uses imprecise rhetoric such as “broke”; that’s a Two-Pinocchio violation. But the House speaker really went off the rails when he said on national television that Obamacare is making the program go broke. That’s the exact opposite of what happened.”

 

 

As we’ve said here before, repeal of the ACA will have an immediate impact on seniors. While Republicans continue their cynical promise that “reforms” won’t touch current seniors (because they believe America’s “greedy geezers” only care about their own benefits and don’t care about what happens to their children and grandchildren) the truth is, repealing Obamacare hits millions of American seniors immediately and robs the Part A trust fund of more than a decade of solvency:  

“Medicare’s financing challenges would be much greater without the health reform law (the Affordable Care Act, or ACA), which substantially improved the program’s financial outlook.  Repealing the ACA, a course of action promoted by some who simultaneously claim that the program is approaching “bankruptcy,” would worsen Medicare’s financial situation.”... Center on Budget and Policy Priorities.

“The Affordable Care Act strengthens Medicare's financing by increasing efforts to reduce waste, fraud and abuse; slowing the rate of increase in payments to providers; improving quality of care and phasing out overpayments to private Medicare Advantage plans, plans that are continuing to increase their enrollments each year.  The impact of these provisions has already resulted in extending the solvency of the Medicare Part A Trust Fund by more than a decade and lowering Part B out-of-pocket costs for beneficiaries.

In addition to Medicare beneficiaries, the Affordable Care Act is very important to millions of adults ages 50-64 who are uninsured because they do not have access to affordable private insurance.  Many of these individuals are now able to purchase private insurance even if they have pre-existing medical conditions, and costs are more affordable due to the law's limits on age rating and the subsidies available for lower-income beneficiaries.

The number of uninsured “young seniors,” aged 50-64, would increase, leaving them in poorer health by the time they are eligible for Medicare – thereby increasing Medicare’s costs.”...NCPSSM, 2015 ACA Repeal Letter to Congress

And all of this only addresses the clearly false assertion made by Speaker Ryan that Medicare is going “bankrupt” and that Obamacare is the reason.  What is equally important for seniors to understand is what Ryan’s CouponCare plan actually means for them. We’ll address that more completely in a future post but as a reminder:  the Ryan plan will end traditional Medicare, privatizing it, while raising seniors’ costs.  Under CouponCare seniors pay more for less coverage.

The GOP’s voucher plan works this way:

•           Rather than you going to your doctor and Medicare pays the bill, under CouponCare the federal government will give you a voucher each year that you will then use to go out and buy private insurance out in the open market or to pay for Medicare.

•           However, those coupons’ values are based on the cost of Medicare in a particular community or the second lowest private health insurance plan, whichever is cheaper.  So if, you choose to stay in traditional Medicare, and it costs more than virtually the cheapest plan out there, you’ll pay more.  Let’s be really clear, vouchers are designed to shift costs to seniors.  That’s how the government saves money. 

The Kaiser Family Foundation estimates 59% of seniors would have to pay higher premiums in order to receive the same Medicare plans they now have, with the average premium increase coming in at $107 per month, they didn’t even look at co-pays and out-of-pocket costs. 

The Congressional Budget Office looked at this in 2011 and said it would double beneficiaries’ costs.

After George Bush won re-election in 2004 and the Republicans controlled Congress, privatizing Social Security was the first order of business.  Here were go again -- but this time your Medicare is the target. The American people don’t support privatizing Medicare; however, it has long been the goal of conservatives who believe seniors should be forced back into a private insurance marketplace which history has proven, over and over again, they simply can’t afford. 

The Trump Conundrum: He Can’t Keep His Promise to Seniors While Also Repealing Obamacare

Donald Trump made a lot of promises to the American people during the Presidential campaign.  For seniors, who supported him overwhelmingly, none was more important that his promise “not to touch” middle-class benefits in Social Security and Medicare.  There’s no doubt his political calculus during this campaign accurately tapped in to a core middle-class value: 

"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."...Donald Trump, 2013 CPAC speech, Washington Times

The problem for President-elect Trump is that the American people fully expect his administration to now keep that campaign promise. Unfortunately, preserving Medicare and Social Security benefits could be among the first of his promises to go. Trump and Republican leaders in Congress have vowed the repeal of the Affordable Care Act will be one of their first acts. For seniors, that means billions in lost Medicare benefits, the return of the Part D prescription drug donut hole and years of solvency taken from Medicare. Millions of seniors will immediately feel the effects of these Medicare cuts which will weaken the program itself.

“The Affordable Care Act strengthens Medicare's financing by increasing efforts to reduce waste, fraud and abuse; slowing the rate of increase in payments to providers; improving quality of care and phasing out overpayments to private Medicare Advantage plans, plans that are continuing to increase their enrollments each year.  The impact of these provisions has already resulted in extending the solvency of the Medicare Part A Trust Fund by more than a decade and lowering Part B out-of-pocket costs for beneficiaries.

In addition to Medicare beneficiaries, the Affordable Care Act is very important to millions of adults ages 50-64 who are uninsured because they do not have access to affordable private insurance.  Many of these individuals are now able to purchase private insurance even if they have pre-existing medical conditions, and costs are more affordable due to the law's limits on age rating and the subsidies available for lower-income beneficiaries. 

The number of uninsured “young seniors,” aged 50-64, would increase, leaving them in poorer health by the time they are eligible for Medicare – thereby increasing Medicare’s costs.”...NCPSSM, 2015 ACA Repeal Letter to Congress

In addition to the immediate Medicare cuts that come with the repeal of Obamacare, the Republican Congress has made it clear another top priority is to turn Medicare into CouponCare.  In fact, the Medicare Payment Advisory Commission (MedPac), has already announced it will include analysis of the GOP’s Medicare privatization plan in its annual report next year. The Republican plans for Medicare, passed in GOP budgets over many years was most recently described in the “A Better Way” campaign led by House Speaker Paul Ryan.  It has already been embraced by Vice President-elect Mike Pence:

“What’s so inspiring to me is how much consistency there is between Donald Trump and the agenda House Republicans have put forward with a ‘Better Way.'”...Vice President-elect Mike Pence.

Again, President-elect Trump won’t be able to have it both ways on this issue.  If he wants to preserve seniors’ benefits in Medicare, as promised during the campaign, then adopting a voucher plan designed to shift costs to seniors fundamentally violates that pledge. Privatizing Medicare with a voucher plan, will leave seniors and people with disabilities – some of our most vulnerable Americans – hostage to the whims of private insurance companies and making it even harder for seniors to choose their own doctors. Beneficiaries will pay more money for less coverage because vouchers will not keep up with the increasing cost of health insurance. That is how the program saves money – at seniors’ expense. In fact, the Congressional Budget Office predicted the CouponCare proposal in the GOP’s 2011 budget would cost seniors $20,000 more each year. Over time, this proposal will create a death-spiral ending traditional Medicare. This scheme is, by definition, the antithesis of “not touching” seniors’ benefits.

This conundrum for the Trump administration doesn’t end there. On Social Security, unfortunately, the warning signs for seniors are just as alarming.  Trump advisors and the Republican platform have made it clear that “entitlements” will very likely be on the agenda of a Trump presidency.

“After the administration has been in place, then we will start to take a look at all of the programs, including entitlement programs like Social Security and Medicare. We’ll start taking a hard look at those to start seeing what we can do in a bipartisan way.”

“...I think that whoever [is] the next president is going to have a horrible time in dealing with this, because those entitlements will race to the front of all the economic issues we have in this country.”  Sam Clovis, Trump campaign Chief Policy Advisor, May 2016

"I think you're going to see him do it across the board on entitlements."

"He's not making the case because it's a political suicide to make this case. If you go up and start saying I'm going to attack Social Security, I'm going to attack Medicaid...there goes those votes. So no smart politician is going to step into this milieu."

"At the end of the day, somebody's gotta say you've got to move the retirement age up two years."...Tom Barrack, Trump Economic Advisor, August 2016

The American people have spoken.  They said they wanted change – they got it.  And yet...they’ve also made it clear they don’t support cutting middle-class benefits for millions of American families who depend on Social Security and Medicare. Time will tell whether President Trump will keep the promises candidate Trump has made and what this “change” election will actually mean to workers who’ve earned their Social Security and Medicare benefits and expect them to be protected, as promised. 

Telling the Truth about Social Security's Funding isn't "Nasty" it's Just Reality

OK...we're just 18 days until election day and the final debate has come and gone.  Thank goodness.  

While Social Security and Medicare finally got their 90 seconds of fame last night, as expected, the question was framed exactly how Washington's well-funded fiscal hawks had hoped -- America can't afford "entitlements," (wrong), the programs are the biggest drivers of our debt (nope), are going bankrupt (actually no, they're not) and then the real heart of the question:  How are you going to cut benefits? 

Unfortunately, this approach guaranteed there would be no real conversation about the benefits millions of seniors depend on.  Here is NCPSSM's President/CEO, Max Richtman's reaction: 

“Rather than focusing on the candidate’s plans for improving Social Security and Medicare’s long-term solvency, strengthening benefits and tackling the retirement crisis looming for millions of workers and retirees, last night’s viewers were stuck with the same old crisis calls that ‘entitlements’ are bankrupting America.  No doubt, Washington’s billion dollar anti-Social Security lobby was happy to have some life pumped back into their middle-class killing campaign to cut benefits; however, America’s voters deserved far more from this debate.

Make no mistake about it, the choices between Clinton and Trump couldn’t be starker.  Donald Trump’s Social Security shape-shifting leaves voters with no idea of how he plans to improve solvency and benefit adequacy.  Doing nothing isn’t an option.  Contrary to his insult last night, hearing Hillary Clinton tell the truth about how to strengthen Social Security's funding isn't ‘nasty,’ it's just reality.  As long as America's wealthiest are allowed to avoid paying their share of payroll taxes, Social Security suffers. Period.  While Clinton supports expanding benefits, Trump’s only policy promise last night was to repeal Obamacare. That cuts years from Medicare’s solvency and billions in preventive care, prescription drugs and cost-reducing benefits to seniors.

Most Americans know that our nation faces a retirement crisis. Our economy depends on strong Social Security and Medicare programs and improving benefits is vital to keeping millions from poverty. Too bad voters weren’t allowed to hear any of that debated last night.”...Max Richtman, NCPSSM President/CEO

 

How to Talk About Social Security (& Medicare) Without Really Talking About It

News that Social Security and Medicare might finally be topics discussed in the last Presidential debate on Wednesday night should be welcome news for those of us who’ve worked hard all year to try and get Presidential candidates to talk specifics about their plans for the nation’s most important government programs.  It should be...but unfortunately, it’s not.

Why?  Because, debate moderator Chris Wallace says “entitlements” will be discussed as part of a debt discussion.  This framing follows the talking points crafted by the billion dollar Wall Street/corporate funded anti-Social Security and Medicare lobby that’s worked for decades to cut benefits.  Framing benefits cuts as a way to “save” Social Security and Medicare while reducing the debt has long been the poll-tested language used to sell the American people on middle-class benefit cuts to pay for tax cuts for the wealthy:

“The push for benefit cuts to Social Security, Medicare and Medicaid in the name of deficit reduction has always been the goal of the billion dollar corporate and Wall Street backed crisis campaign driving Washington's deficit hysteria. “Never let a good crisis go to waste” was a strategic political move capitalizing on deficits as a way to force middle-class benefit cuts on Americans already shell-shocked in the Great Recession.  Once deficits reduced (without the drastic cuts to benefits that corporate lobbyists assured us must happen), the anti-“entitlement” lobby lost its inside-the-Beltway political momentum.”...Entitled to Know

Lumping Social Security and Medicare together and calling them “entitlements” is also telling. These are earned benefits, not entitlements, which American workers have contributed to throughout their working lives. Conservatives have long used the word “entitlements” to make those earned benefits seem like welfare. This political strategy also ignores the fact that Social Security and Medicare are unique programs, providing different services to a diverse group of Americans.  These programs face very distinctive challenges. There is no one-size-fits-all solution for America’s most important healthcare program (Medicare) and retirement security program (Social Security).  However, this is exactly the way next week’s debate has framed the conversation. 

As we’ve said before,

“There is an important Social Security and Medicare conversation to be had.  We must find long-term solvency solutions that also address our nation’s retirement and health security crisis.  Obamacare went a long way toward improving the health care picture but more work remains to be done.  Retirement USA reports the gap between what Americans need to retire and what they actually have is $7.7 trillion. In fact, about half of households age 55 and older have no retirement savings and a third of current workers aged 55 to 64 are likely to be poor or near-poor in retirement. Unfortunately, the median retirement account balance is a puny $3,000 for all working-age households and $12,000 for near-retirement households. Vanguard reports that 401K balances, for those who do have them, fell a median of 11% last year.  Social Security remains the only stable retirement income for many Americans.”

While conservative fiscal hawks, including many Fox news commentators, see Social Security as solely a source of “investment-draining and economy-staling uncertainty,” the truth is, Social Security is a hugely stabilizing force for the economy.  A new report from the National Committee to Preserve Social Security and Medicare Foundation shows that, in 2014 alone, Social Security delivered a $1.6 trillion fiscal boost nationwide as benefits were spent and cycled through the economy.  Is there any chance that Social Security’s vital contribution to our economy will come up in next week’s debate?  Nah.

There is a way to have the conversation that needs to be had on the future of Social Security and Medicare and it starts with one simple question:

 “What are your specific plans to ensure Social Security and Medicare’s long-term solvency and improve benefits?”

The final Presidential debate is at 9 p.m. (Eastern Time) on Wednesday, Oct. 19, at the University of Nevada, Las Vegas. Each of the subjects will get a 15-minute time segment.

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