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The Cruz/Fiorina Plan for Social Security and Medicare

Here’s a “Throwback Thursday” reminder of what a Cruz/Fiorina administration would mean for millions of Americans and their families who depend on Social Security and Medicare.

...at least what they’ll admit to today, anyway.  


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New Report Shows Ethnic Discrepancies in Medicare Advantage

For the first time, the Centers for Medicare and Medicaid Services has released data on the racial disparities reported by Medicare Advantage patients. 

Despite advances in healthcare access, increases in spending, and improvements in quality over the last decade, there is well-documented evidence that members of racial and ethnic minority groups continue to experience worse health outcomes, CMS said.

The data in disparity of care for eight patient experience measures shows that in seven areas, Asians and Pacific Islanders rated their experience in scores worse than that of whites, compared to five areas for Hispanics, three areas for blacks and only two areas for American Indians and Alaska natives...Healthcare Finance News

The CMS report surveyed customer service responses in a variety of categories. In categories of how easy it is to get needed care; getting needed prescription drugs; and getting information from their health plan about prescription drugs, whites gave the highest ratings, according to the survey.

In a question of getting appointments and care quickly; getting customer service from a health plan; and care coordination, American Indians/Alaska natives gave the highest scores. Blacks gave the highest score when asked how well doctors communicate with them. Asians and Pacific Islanders gave the highest score in a question of getting an annual flu vaccine.

"These data are a good first step in understanding disparities in Medicare Advantage," said Sean Cavanaugh, CMS deputy administrator and director of the Center for Medicare. "We look forward to working with plans in closing the differences in the quality of care that people with Medicare Advantage receive." 

Achieving Health Equity will also be the topic of a Congressional forum later this week, hosted by House Energy and Commerce Committee Democrats in partnership with the Congressional Black Caucus (CBC), Congressional Hispanic Caucus (CHC), and Congressional Asian Pacific American Caucus (CAPAC). 

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The Economic Crisis Candidates Continue to Ignore

The Economic Policy Institute’s “The State of American Retirement” combined with the National Institute on Retirement Security’s new report on women and retirement paint a very clear picture of a nation on the brink of an economic crisis that will devastate millions of average American families, if Washington continues to turn a blind eye.

The median family between the ages of 32 and 61 has only $5,000 saved in a retirement account, while the top 1 percent of families has a million dollars or more. For many groups—lower-income, black, Hispanic, non-college-educated, and unmarried—the typical working-age family has no savings at all in these accounts....The State of American Retirement.

“Our retirement system used to reduce inequality, but since the shift to 401(k)s it has only served to magnify it. These accounts are accidents of history that were never designed to replace pensions, and it should come as no surprise that they have not worked for the majority of people.” ...Monique Morrissey, EPI Economist

The numbers are stark:

  • Nearly half of all working-age families have zero retirement savings.
  • Almost nine in 10 families in the top income fifth have savings in retirement accounts, compared to fewer than one in 10 families in the bottom income fifth.
  • Only 41 percent of black families and 26 percent of Hispanic families have retirement account savings, compared with 65 percent of white non-Hispanic families.
  • Only married couples are more likely than not to have retirement account savings.

News that the income inequality hindering American workers now is also carrying over to their retirement is alarming for future generations who are taking an economic hit at every stage of life.  For women, the retirement picture is even worse. 

“A new analysis finds that women are 80% likely than men to be impoverished in retirement. The National Institute on Retirement Security (NIRS) finds that across all age groups, women have substantially less income in retirement than men. For women age 65 and older, the data indicate that their typical income is 25 percent lower than men. As men and women age, men’s income advantage widens to 44 percent by age 80 and older. Consequently, women were 80 percent more likely than men to be impoverished at age 65 and older, while women age 75 to 79 were three times more likely to fall below the poverty level as compared to their male counterparts.”... National Institute on Retirement Security

Just as we’ve seen from climate change deniers, many Republican politicians won’t even acknowledge the retirement crisis exists because improving the nation’s most successful federal retirement programs is anathema to their misguided belief that Wall Street should be handling your savings and for-profit insurance companies managing your health. Instead of supporting proposals to improve the backbone of America’s retirement system, Social Security and Medicare, conservatives continue their campaign to privatize and cut. 

There are legislative proposals which would improve Americans’ retirement picture but they are languishing in the GOP controlled Congress.  You can see many of these proposals on our Legislative tracker.  We also continue to advocate for meaning changes impacting retirement security for women.  Please take a moment and see those details on our Eleanor’s Hope initiative website. 

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Social Security & Medicare Finally a Topic of Debate

Ok, not a debate so much as a battle to see who can cut seniors’ benefits faster.  While Trump remains the only GOP Presidential candidate who promises he won’t cut Social Security, even that promise became squishy last night.  More on that, later. 

Here’s just a sampling of some of last night’s comments on what the remaining GOP candidates plan for generations of American families counting on Social Security, Medicare and Medicaid, followed by our comments:


Senator Marco Rubio

Social Security will go bankrupt and it will bankrupt the country with it.”

This is conservatives’ favorite lie.  Social Security isn’t going bankrupt.  According to SSA actuaries, the nearly $3 Trillion Trust Fund will be depleted in 2034 (as planned) to cover the baby boomer generation.  After that, there will still be enough income coming into the program to pay 79 percent of all benefits owed. If Congress does nothing seniors will face a 21% benefit cut.  A 21% benefit cut is not bankruptcy and certainly could not cause America’s bankruptcy.

“Medicare could very well become the option of using my Medicare benefit to buy a private plan that I like better”

The Republican dream of giving seniors a coupon to go out and buy private health insurance is a favorite of Speaker Paul Ryan and those in Congress who hope to destroy Medicare once and for all.  The program is too popular to kill outright, so they’ve chosen a privatization route for Medicare that is a political kissing-cousin to President Bush’s failed effort to privatize Social Security.  If they can’t kill these programs, conservatives want to (at least) turn America’s most successful retirement and health security programs over to industry so Wall Street, insurance companies and drug makers can profit. 


Senator Ted Cruz

“Social Security right now is careening towards insolvency... We need to see political courage to take this on and save and strengthen Social Security.”

In the classic case of “save” meaning “slash” and “strengthen” meaning privatize, Senator Cruz offers the well-worn conservative trope that cutting benefits to millions of American families while at the same time cutting taxes for the wealthy shows political courage and leadership.  See our comments above on the “careening towards insolvency” nonsense.

“We need to change the rate of growth of benefits so it matches inflation instead of exceeding inflation...we need to have for younger workers, that a portion of your tax payments are in personal accounts.” 

If hard to imagine how anyone can seriously argue that a zero cost of living increase for 3 out of the past 7 years, somehow exceeds inflation.  Seniors, veterans and people with disabilities have seen their costs increase in the same years their COLA was flat.  Social Security beneficiaries need a new COLA formula, one that actually measures seniors’ cost of living.  However, Ted Cruz wants the Chained CPI to cut benefits not to accurately measure inflation.


John Kasich

“I also had a plan in 1999 to save Social Security and take the $5 trillion projected surplus and not only have Social Security for our young people, but also to give them private accounts.”

John Kasich’s plan to “save” Social Security is standard GOP “we-must-slash-it-to-save-it” boilerplate with a little seniors just need to "get over it" thrown in.   Kasich would cut benefits to pay down the debt and privatize Social Security so seniors can watch their contributions ride the Wall Street roller coaster.  Then he’d cut billions more with lower COLA’s through the Chained CPI (again, what’s lower than zero?) and turning Social Security into a welfare program by means testing.


Donald Trump

Since we just wrote about Trump’s Social Security promises (there’s not really a plan) in detail we’ll focus only on last night’s twists.  For the first time ever, Trump’s promises to not cut Social Security benefits were offered with important qualifiers.  For a candidate who has no problem making big promises, last night’s about Social Security have taken on a downright passive tone – as if Trump, as President with potentially with a GOP House and Senate, wouldn’t have the power to leave Social Security benefits alone:

“I will do everything within my power not to touch Social Security”

“...it's my absolute intention to leave Social Security the way it is.”

This speech Trump gave to conservatives at the 2013 Conservative Political Action Conference provides one suggestion as to why he remains the only GOP candidate to promise he won’t cut Social Security & Medicare benefits (hint, it’s not because he loves the programs):   

"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

If you missed last night’s debate, you can read excerpts on what the candidates had to say specifically about Social Security, Medicare and Medicaid on our SeniorVote2016 website. 

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CMS Releases New Plan to Prevent Readmissions among Racially Diverse Medicare Beneficiaries


The Centers for Medicare & Medicaid Services (CMS) has long been working to reduce the number of hospital readmissions for Medicare patients. 

 

“Medicare—through Congressional direction and Administration initiatives—has started implementing incentives to reduce hospital readmissions. One example...is the Hospital Readmission Reduction Program (HRRP) which penalizes hospitals with relatively higher rates of Medicare readmissions.”  Kaiser Family Foundation, “Reducing Hospital U-Turns”

 

Research has shown that unplanned readmissions cost Medicare $17.4 billion in 2004 and that 20 percent of Medicare fee-for-service patients were readmitted within 30 days of discharge. According to CMS, racial and ethnic minority populations are more likely than their white counterparts to be readmitted within 30 days of discharge for chronic conditions, such as heart failure, heart attack, and pneumonia, among others. Why is that?  CMS says social, cultural, and language barriers contribute to these higher readmission rates.

 

CMS has released a new guide to preventing readmissions among communities of color in Medicare:

“This plan focuses on Medicare populations that experience disproportionately high burdens of disease, worse quality of care, and barriers to accessing care. For CMS, these populations include racial and ethnic minorities, sexual and gender minorities, persons with disabilities, as well as individuals living in rural areas. The CMS Equity Plan for Medicare was also developed with particular attention to disparities in chronic diseases such as diabetes, chronic kidney disease, and cardiovascular disease. Chronic conditions pose a significant human and financial burden, are prevalent in the Medicare population, and are likely to co-occur.”...CMS Equity Plan for Improving Quality in Medicare

Among the plan’s proposals are to:

·         Expand data Collection and Analysis

·         Evaluate Disparities and Integrate Solutions

·         Develop New Approaches to Reduce Disparities

·         Increase the Ability to Meet the Needs of Vulnerable Populations

·         Improve Communication and Language Access

·         Increase Physical Accessibility of Health Care Facilities

“CMS has an important opportunity and a critical role in preventing hospital readmissions while promoting health equity among diverse Medicare beneficiaries,” said Cara James, Director of CMS’s Office of Minority Health. “This Guide encourages action-oriented steps and solutions in achieving health equity, addresses reducing readmissions and focuses on our initiative of achieving better care, smarter spending, and healthier people throughout our health care system.”

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