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It Could Be Worse – Our Reaction to Budget Deal

In these days where nothing in Congress can get done without making threats to slash benefits, holding programs like Social Security and Medicare hostage or creating a crisis that could easily be fixed – today’s news that budget negotiators have reached a deal to avoid a full government default is welcome news. 

But of course, the devil is in the details. 

“At the risk of damning by faint praise, the newly negotiated budget deal certainly could have been a lot worse. The good news is Democrats in Congress and the White House were able to stop a 52% premium increase from hitting millions of seniors in Medicare next year.  They also negotiated a re-allocation (originally blocked by the GOP) for the Social Security disability program that prevents a massive benefit cut in 2016 for Americans with disabilities.  In this current Congressional atmosphere of hostage-taking and never-ending threats to benefits, these victories are significant.

Unfortunately, seniors will still receive no cost of living adjustment in 2016 and the sequester cuts to Medicare providers will continue to pay for non-Medicare programs. It’s clear the GOP-led Congress still sees Social Security, Medicare and Medicaid as piggy banks to fund other legislative priorities and this hostage-taking, threats to benefits and crisis creation will continue. We hope Congress can get the votes to approve this budget deal so that seniors, people with disabilities and their families may finally see a temporary cease-fire in this ongoing assault on their benefits.”...Max Richtman, NCPSSM President/CEO

Specifically, this budget agreement, if passed, would:

·         Prevent a 19% cut in Social Security Disability Insurance benefits that would have occurred in late 2016

·         Ensure 7 years of certainty that the Social Security Disability insurance program will pay full benefits

·         Mitigate a 52% Medicare Part B premium increase for 30% of Medicare beneficiaries

·         Alleviate an increase in the Part B deductible for all beneficiaries, lowering it from a projected $223 to $167

·         Provide sequester relief to programs like the Older Americans Act, Low Income Home Energy Assistance Program and Social Security field         offices without cutting Social Security, Medicare and Medicaid benefits.

Unfortunately, the bill would also:

·         Provide NO relief to seniors who will receive no cost of living adjustment in 2016.

·         Extend the Medicare provider reimbursement sequester and uses the savings to pay for unrelated programs.

·  .While this two-year budget agreement could provide a cease-fire in the attacks on Social Security, Medicare and Medicaid it is likely to be fleeting as funding for the nation’s transportation system runs out again in December. What does highway funding have to do with Social Security & Medicare?  The answer should be nothing.  However, as we reported in July, the GOP Congress has tried to pay for the transportation bill with cuts in Social Security and are likely to try again next month.

“...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.”  Entitled to Know, July 2015

The House is expected to vote on the 2 year budget agreement tomorrow. 

GOP Sticks to Demands for Social Security & Medicare Cuts

As the days and weeks pass, with the GOP Congress still unable to find anyone willing to be Speaker of a chaotic House, the party remains committed to one thing.  They won’t agree to extend the debt limit or any of the other critical budget deadline looming without getting cuts to Social Security and Medicare.  Politico reports:

“...that means entitlement reform, which is where the big money is,” said Sen. Johnny Isakson (R-Ga.). “We got our feet wet on the [Medicare doc fix]. We ought to get a little more wet. We’re up ankle deep. Maybe we ought to go waist deep.”

As a reminder, the Medicare “doc fix” passed earlier this year cut benefits for millions of beneficiaries.  Apparently, GOP leaders see that as just the beginning...

No Social Security COLA Increase + Massive Medicare Hike for Millions

Today’s announcement that there will be no Social Security cost-of-living adjustment (COLA) increase next year, for only the third time in 40 years, means that millions of seniors who rely on their Social Security to get by will once again find their expenses outpacing their Social Security benefit.  For 30% of Medicare beneficiaries, Part B premiums are now projected to increase next year by 52%—up to $159.30 per month from $104.90. This increase will be also accompanied by an increase in the Part B deductible—up to $223 from $147. 

“The average American senior simply can’t afford a triple-digit increase for their Medicare coverage. We have urged Congress to pass legislation to address this urgent problem looming for millions of seniors, the disabled and their families. For millions of seniors, this large Medicare hike is devastating and a result of a well-intended “hold harmless” provision that left out too many Medicare beneficiaries.

All of this was triggered by a zero COLA increase in Social Security for 2016, confirming yet again, that the current Social Security COLA formula isn’t accurately measuring seniors’ expenses.  Seniors across this nation understand how important having an accurate measure of the increase in their real costs is to their day-to-day survival.  While there has been a lot of talk in Washington about the need to find a more accurate COLA formula; unfortunately, that attention has largely focused on ways to cut the COLA even further.  Leaving many Americans to wonder what’s less than zero?  If accurate inflation protection for seniors is truly our goal, Congress needs to adopt a fully developed CPI for the elderly (CPI-E). Until then, we urge Congress to act quickly to mitigate the devastating Medicare hikes headed for millions of Americans who can’t afford them.” ...Max Richtman, NCPSSM President/CEO

The National Committee is working with a large cross-section of the nation’s leading organizations representing seniors, people with disabilities, retirees, public service employees and health plans urging Congress to consider options that would prevent this Medicare hike from being implemented in 2016.  The coalition has told the Senate:

“We are deeply concerned by the projected Part B premium and deductible increases, most notably for current and newly eligible beneficiaries living on low- and fixed incomes. In 2014, half of the Medicare population lived on annual incomes of $24,150 or less. Newly enrolled Medicare beneficiaries, those not collecting Social Security benefits—many of whom are retired public servants—and State Medicaid programs should not be expected to carry the burden of paying for increased costs in Part B through higher premiums and cost sharing.

As you consider options, we also encourage you to consider prior, bipartisan legislation, the Medicare Premium Fairness Act of 2009. This bill effectively extended the hold harmless to all Medicare beneficiaries and passed the U.S. House of Representatives with an overwhelming bipartisan majority.”

You can read the coalition letter to the Senate and also from the Leadership Council Of Aging Organizations.


They Never Learn. The GOP Threatens Cut Social Security & Medicare or Else

Senate Majority Leader Mitch McConnell has started budget and debt ceiling talks with the GOP’s favorite attack...cut Social Security or Medicare or else ______ (fill in the blank to fit the debate of the day).  This time it’s... “or else we’ll shutdown the government.”

“Mitch McConnell privately wants the White House to pay this price to enact a major budget deal: Significant changes to Social Security and Medicare in exchange for raising the debt ceiling and funding the government.”  CNN

“Chained CPI is off the table as an offset to pay for higher spending caps. One person with knowledge of the talks said Senate Majority Leader Mitch McConnell opened the negotiation with a proposal to offset higher discretionary spending with chained CPI and Medicare means testing, though McConnell's office would not confirm that he made the request.” CQ News

“In a direct rebuke to his Republican counterpart, Senate Minority Leader Harry Reid (D-Nev.) said Tuesday that raising the debt limit is non-negotiable. Speaking hours before the first Democratic presidential debate, which is being held in his home state, Reid encouraged President Barack Obama not to enter into talks with congressional Republicans, who have plotted to use the debt limit as a means of extracting spending cuts.”  Huffington Post

You’ll also note there is no talk of reversing trillions of dollars in tax breaks and loopholes for large corporations shipping jobs overseas.  No talk of the billions more in tax breaks given to the ultra-wealthy.   Instead, Republican leaders want to cut the whopping $1,291 average monthly Social Security retirement benefit.  A benefit Americans have paid for throughout their working lives. 

The debt limit expires November 5th so there’s not much time to make it clear...once again...that the American people are paying attention and you won’t stand by and watch as Social Security is used as a political bargaining chip.  Make that call!

Two New Reports on Private Medicare Advantage Plans Reveal Real Problems for Seniors

 According to a new Government Accountability Office (GAO) report private insurers who offer Medicare Advantage plans need tougher oversight. 

“Federal investigators have found Medicare officials rarely enforce rules for private insurance plans intended to make sure beneficiaries will be able to see a doctor when they need care.

The U.S. Centers for Medicare and Medicaid Services, which oversees Medicare Advantage, requires the plans to have doctors in sufficient numbers and specialties who are near enough — in distance and travel time — so seniors can reach them. 

But the GAO found CMS checked the provider networks of less than 1 percent of the plans since 2013 — serving just 2 percent of Medicare Advantage members — and only when the plans expanded to a new county.” ... Kaiser Health News & Conn. Health I-Team 

In 2013, United Healthcare, which is the nation’s biggest health insurance company and a provider of private Medicare Advantage in Connecticut, dropped hundreds of health care providers and 1,200 doctors.  Medicare Advantage beneficiaries are restricted to a network of providers. If their provider leaves, they cannot change plans during the year. What happened in Connecticut is the perfect example of how MA plans have been allowed to skirt the rules, dropping providers thereby limiting coverage for seniors with little warning and leaving them with few options. 

“The GAO report shows Medicare ‘was not verifying network adequacy. That’s their job and they abdicated that responsibility,’ said U.S. Rep. Rosa DeLauro, D-New Haven, who requested the investigation along with other members of the Connecticut congressional delegation.”

Also this week, a new Brown University study shows that once medical care becomes costly for seniors in Medicare Advantage and no longer meets their needs beneficiaries are leaving the private MA plans.

"Our results raise questions about whether current Medicare Advantage regulations and payment formulas are designed to meet the needs of Medicare Advantage members who use post-acute and long-term care," wrote Momotazur Rahman, assistant professor (research) of health services, policy and practice in the Brown University School of Public Health, and colleagues in the October issue of the journal Health Affairs. "The unidirectional flow of these high-risk and often high-spending patients from Medicare Advantage to traditional Medicare appears to transfer responsibility to traditional Medicare just as patients enter a period of intensive health care needs." 

Private Medicare Advantage plans continue to see growth as they promise gym-memberships, limited optometric coverage or zero premium plans.  However, as predicted by many healthcare experts and indicated in the Brown study, seniors find that once they actually need help with more costly care, MA plans aren’t providing the coverage they need. 

Ultimately, this means that younger and healthier seniors are being lured into private insurers’ plans only to have to switch to traditional Medicare once they need coverage for more serious health issues (and isn’t that why we have health insurance in the first place – to cover when we get sick, not when we’re healthy?).  Meanwhile, private insurance companies continue to reap the benefits of annual federal subsidies to provide this limited coverage for healthier seniors – which are tax dollars that could have been used in traditional Medicare to serve all beneficiaries. 



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