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Will America's Seniors Vote Against Their Own Self-Interests...Again?

Max Richtman, NCPSSM President/CEOby Max Richtman, NCPSSM President/CEO

As a seniors’ advocate who’s worked on aging policy issues for decades, one of the most common questions I hear during campaign season is, “Why do America’s seniors vote against their own economic self-interests?” or more specifically, “Why have so many older (65+) Americans shifted to the Republican Party, even as it supports cutting the Social Security and Medicare benefits they depend on?” There is no single answer to this political quandary because there is far more at work in our fractured, divisive and polarized political system than simply age demographics. However, there’s no denying we could see American seniors vote against their own self-interests, once again in 2016, unless there’s a major awakening to what that vote means for them economically.

It’s important to start with some historical context. Democratic Presidents, Franklin D. Roosevelt and Lyndon B. Johnson, created Social Security and Medicare and -- for decades -- the party’s strong support among seniors and the middle-class reflected that reality. However, that was then. The erosion of senior support for Democratic candidates has been steady.  In 1993, Democrats had a 12 point advantage over Republicans among senior voters.  Today, that advantage is gone and is instead a deficit.

While the GOP claims this shift proves cutting earned benefits is no longer the “third rail” of American politics, the increasingly populist tone of this 2016 Presidential campaign combined with the nomination of a GOP Presidential candidate who’s promised no cuts certainly belies that assertion. In truth what’s happened in recent years is that conservatives have successfully co-opted the Social Security and Medicare political debate by promising Americans they’ll “preserve” and “strengthen” these vital programs on the campaign trail, while actually proposing benefit cuts, Social Security private accounts, or coupon care for seniors in Medicare only after they’re elected. This Orwellian doublespeak isn’t accidental but a well-crafted (and apparently effective) messaging strategy. Donald Trump has now taken that messaging a step further by promising he’ll leave Social Security and Medicare alone, even as he surrounds himself with staff and a Vice Presidential running mate with very different plans. Trump himself supported the privatization of Social Security for more than a decade, calling it a “Ponzi scheme,” but by 2013 he’d done the political calculus and warned conservatives they simply couldn’t win elections that way:

“ ‘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

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.” Donald Trump, Morning Joe, February 2016

The American people, of all ages and political parties understand we don’t have to destroy Social Security and Medicare to “save” them. The latest survey by the National Academy of Social Insurance shows large majorities of Americans, both Republicans and Democrats, agree on ways to strengthen Social Security, without cutting benefits. 74 percent of Republicans and 88 percent of Democrats agree that “it is critical to preserve Social Security even if it means increasing Social Security taxes paid by working Americans.”  Simply put, the American people are willing to pay more for Social Security.  They understand the growing impact these benefits have on individual lives and on our larger economy.  They know first-hand what America’s retirement crisis looks and feels like.

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.

Social Security is also a 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.  Unfortunately, Social Security’s economic contributions to communities, counties, and states continue to be misunderstood and often ignored in Washington’s fiscal debates. This election could change that.

The party that created Social Security and Medicare has an opportunity to regain lost ground by drawing a clear line in the sand in defense of the core American values of hard work, fairness and compassion embodied in our nation’s most successful programs – Social Security and Medicare. The Democrat’s 2016 platform is the strongest statement on strengthening Social Security seen in decades.  By pledging to fight efforts to “cut, privatize or weaken” Social Security, supporting expansion of the program, lifting the payroll tax and exploring a new COLA formula for seniors, the Democrats have tackled head-on the critical challenges facing millions of average Americans. Conversely, the Republican 2016 platform says benefit cuts must be considered, raising revenue rejected and privatization (the “power of the markets”) preferred. It’s no wonder Donald Trump has been running noticeably silent on Social Security and Medicare this summer, given the Republican Party’s clear rejection of his Social Security and Medicare campaign promises.

Senior turnout will play a huge role in November’s elections which means Democrats must continue to say what they mean, and mean what they say in a full-throated defense against attacks to America’s most effective health and retirement security programs.  Senior voters must also remain vigilant and demand more from candidates than empty promises and political double-speak, otherwise they may cast yet another vote against their own economic self-interests and end up with the biggest case of buyers’ remorse in American political history. 

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Republican Party Platform Promises Social Security Privatization

The newly released Republican Party platform provides the latest (in a growing amount of) evidence showing that no one in the party is willing to play along with Donald Trump’s empty campaign promises that he “won’t touch” Social Security and Medicare.  As the party’s nominee for President, Trump is the GOP’s leader; however, that didn’t stop Republicans from completely ignoring him in the party platform saying all options should be on the table.  That actually translates to meaning cuts only because the GOP still opposes the most popular option -- raising the payroll tax.  You'll also note the oh-so vague push for allowing Wall Street and the "power of the markets" to control your Social Security:  

“Of the many reforms being proposed, all options should be considered to preserve Social Security. As Republicans, we oppose tax increases and believe in the power of markets to create wealth and to help secure the future of our Social Security system.”

More than a decade after President Bush’s failed privatization campaign, it appears Republicans and their newly appointed party leader, Donald Trump, are caught in a time-warp where they remain determined to send Americans’ guaranteed Social Security’s benefits to Wall Street -- regardless of the financial recklessness which nearly destroyed our economy just years ago. The GOP still believes successful poverty-fighting programs like Social Security and Medicare are the true evil in our society and continue to equate these earned benefit programs to welfare.  It’s also important to remember that this missive didn’t happen in a vacuum. It came just days after Donald Trump chose one of Congress’ biggest privatizers, Mike Pence, as his running mate. 

“Mike Pence was one of Congress’ biggest proponents of privatization. He supports cutting Social Security benefits by raising the retirement age, reducing the COLA, means-testing and turning Medicare into “CouponCare.” As he told CNN, ‘I’m an all of the above guy.  I think we need to look at everything that’s on the menu,’ and the record shows he has done just that by supporting every form of Social Security, Medicare and Medicaid benefit cut proposed in the past decade.

The National Committee to Preserve Social Security and Medicare scored Mike Pence at 0% on issues important to seniors during the 2011-2012 Congress since he voted for multiple pieces of legislation that would cut benefits and programs that protect senior’s health and financial security.”...Max Richtman, NCPSSM President/CEO

Before his Pence announcement, Trump also met with House Speaker Paul Ryan and admitted he supports cutting Social Security but he just doesn’t think he can be elected by saying it:

“From a moral standpoint, I believe in it,” Trump told Ryan. “But you also have to get elected. And there’s no way a Republican is going to beat a Democrat when the Republican is saying, ‘We’re going to cut your Social Security’ and the Democrat is saying, ‘We’re going to keep it and give you more.’ ”

Of course, those comments also fit with the message his policy staff delivered to fiscal hawks at the annual Pete Peterson “how to cut middle-class benefits” soiree in May:

“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.

Trump himself has been noticeably silent on Social Security and Medicare this summer – leaving his staff, running mate and GOP Party members to deliver his message loud and clear:  cutting middle-class benefits, privatizing Social Security and turning Medicare into “Couponcare” remains the Republican Party’s goals if voters will give them the chance.

We’ve compiled a comprehensive timeline of Donald Trump’s evolving positions on Social Security and Medicare. You can see it and many other helpful resources for the 2016 Campaign on our NCPSSM SeniorVote2016 website. 


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Mike Pence’s Long History Attacking Social Security & Medicare

GOP Presidential candidate, Donald Trump, has chosen one of Congress’ most aggressive Social Security privatization supporters to serve as his Vice President. Indiana Governor and former Congressman, Mike Pence’s record on issues important to seniors, particularly cutting benefits to Social Security, Medicare and Medicaid couldn’t be worse:

“By choosing Governor Mike Pence as his running mate, presumptive Republican nominee Donald Trump has sent a very clear message to America’s seniors that their priorities will hold little weight in a Trump administration.  During his decade-plus tenure in the U.S. Congress, Mike Pence consistently voted in favor of legislative efforts to cut benefits in Social Security, Medicare and Medicaid. He has a long history of blaming earned benefit programs for America’s economic woes and supporting middle-class benefit cuts to protect tax cuts for the wealthy. Few members of Congress have an anti-seniors voting record as consistently strong as Mike Pence. 

Mike Pence was one of Congress’ biggest proponents of privatization. He supports cutting Social Security benefits by raising the retirement age, reducing the COLA, means-testing and turning Medicare into “CouponCare.” As he told CNN, ‘I’m an all of the above guy.  I think we need to look at everything that’s on the menu,’ and the record shows he has done just that by supporting every form of Social Security, Medicare and Medicaid benefit cut proposed in the past decade. 

The National Committee to Preserve Social Security and Medicare scored Mike Pence at 0% on issues important to seniors during the 2011-2012 Congress since he voted for multiple pieces of legislation that would cut benefits and programs that protect senior’s health and financial security.”...Max Richtman, NCPSSM President/CEO

As leader of the Republican Study Committee, the House’s far-right wing caucus, during the Bush administration, Pence doubled-down on President George Bush’s failed privatization efforts by calling for an even larger private accounts scheme to be implemented sooner, putting Americans at even greater fiscal risk than the President’s doomed plan. The Washington Times reported in 2005:

“The Bush plan allows workers to divert 4 percent of their wages into investment accounts, and to choose from a set of investment strategies. But the conservatives are leaning more toward a plan sponsored by Rep. Paul Ryan, Wisconsin Republican, which would allow diversion of 6 percent of wages.

‘Conservatives want to see personal retirement accounts that have immediate relevance to younger Americans, that they can see the value, and that will require that they be big and that they be implemented in the final bill without delay,’ said Rep. Mike Pence, Indiana Republican and chairman of the 100-member Republican Study Committee (RSC).”

Incredibly, even though Pence was among Congress’ most vocal fiscal hawks, he was willing to use deficit spending to pay for their Social Security privatization scheme but not to improve Social Security’s long-term funding or protect seniors’ benefits:  

“Mr. Pence said conservatives would be willing to accept borrowing money to pay for the transition costs, but “so long as we can achieve the fundamental reform of personal Social Security account for retirement.” He said the RSC will convey those principles to House Republican leaders early next week, and said they believe they have muscle to back up those principles.”

Beyond privatization, Pence’s comments make it clear there isn’t a Social Security, Medicare or Medicaid benefit cut he won’t embrace:

“I think everything has to be on the table...I think it’s absolutely imperative, whether it’s Social Security, Medicare or Medicaid.”

“With regard to entitlements we’re going to have to take some deep cuts in domestic spending.” CNN, 2010

“I was tea party before it was cool.”  Indianapolis Monthly, 2011

On health issues, Pence’s record is just as anti-senior as his Social Security stance. He aggressively opposed the Affordable Care Act (ACA) and fought for its repeal, which would worsen Medicare’s solvency and take away billions in added benefits and cost savings for seniors.  He voted against the creation of a prescription drug benefit (Part D) in Medicare, opposes allowing the re-importation of prescription drugs and allowing Medicare to negotiate for lower drug prices, he supported legislation that would deny non-emergency treatment for lack of a Medicare co-pay, and most importantly supports the GOP/Ryan budget which would destroy Medicare in favor of “Couponcare,” giving seniors a voucher to take shopping for insurance rather than protecting traditional Medicare’s guaranteed coverage.

In spite of his leadership in Congress against the ACA, as Governor he reluctantly acknowledged the healthcare needs of Indiana citizens and adopted Medicaid expansion, yet not without putting the GOP political spin on it.  As Politico reported, Pence incredibly claims the expansion was actually an elimination of Medicaid.

“In fact, a summary of the proposal describes it as a move to “eliminate traditional Medicaid” for non-disabled Hoosiers.

And by adding a requirement that Indiana residents must pay a premium, Pence promised to preserve citizens’ dignity:

“So the Indiana plan will charge small premiums—up to 2 percent of an individual's income—which will make only a tiny impact on the state's balance sheets, but will send a clear message to those layabouts; Pence talked about giving people the "dignity to pay for their own health insurance." (I'm sure that Pence declines to take a government handout in the form of the mortgage interest deduction, because that would undermine his dignity.)...American Prospect

While Donald Trump has promised on the campaign trail that he won’t cut Social Security and Medicare benefits, he continues to surround himself with advisors and now a running-mate with polar opposite intentions.  At the same time, his promise to “not touch” benefits has been noticeably absent in recent campaign appearances.  In fact, his most recent comments to an AARP survey take a very different tone:

“As our demography changes, a prudent administration would begin to examine what changes might be necessary for future generations.”...Donald Trump, AARP, June 27, 2016

That’s why NCPSSM President/CEO, Max Richtman, urges seniors and their families to beware of candidates who make promises on the campaign trail they have no intention of keeping once they get your vote:

"They say actions speak louder than words – and there’s no doubt about it -- Donald Trump’s choice of Mike Pence as his Vice-Presidential running mate speaks volumes to American seniors.”

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Why All Hospital Stays Aren’t Created Equal in Medicare

For years, patients and advocates have been warning of the increasing use of the patient classification status known as “observation stays.”  A growing number of patients covered by Medicare, have spent days in the hospital, only to be surprised with large out-of-pocket costs and an inability to access long-term care because they were totally unaware the hospital never actually admitted them as a patient. 

Beginning this summer, a new federal law will require hospitals to tell their Medicare patients if they have not been formally admitted and why. Kaiser Health News reports:

“The NOTICE Act requires that starting Aug. 6, Medicare patients receive a form written in ‘plain language’ after 24 hours of observation care but no later than 36 hours. Under the law, it must explain the reason they have not been admitted and how that decision will affect Medicare’s payment for services and patients’ share of the costs. The information must also be provided verbally, and a doctor or hospital staff member must be available to answer questions.”

A Wall Street Journal investigation showed observation stays at hospitals have increased 156% and explains why many hospitals have lowered their readmissions and thus the fines that come from too many Medicare patients returning to the hospital.  

“...at hospitals around the country, more patients are entering or re-entering hospitals under something called “observation status”—a category that keeps them out of the readmission tallies. Patients on observation status can remain in the hospital for days, and typically receive care that is indistinguishable from inpatient stays, experts say. But under Medicare billing rules, the stays are considered outpatient visits, and as such, don’t trigger penalties under the health law.

The Journal’s analysis of Medicare billing data shows that increases in observation stays can skew the readmission numbers, letting hospitals avoid penalties even if patients continue to have complications and return for repeat visits. Observation stays generally are cheaper for the government, but in some cases they can lead to big bills that are the patient’s responsibility.”

The American Hospital Association has asked that the new rules be delayed and one of the law’s co-sponsors also isn’t happy with the language used to explain observation stays to patients.

“It doesn’t require the hospital to explain exactly why the patient is getting observation care instead of being admitted, he {Rep. Lloyd Doggett (D-TX)} said, and doesn’t clearly explain the difference between Medicare’s Part A hospitalization and nursing home benefit and Part B, which covers outpatient services, including doctor’s visits, lab tests and hospital observation care.

The notice, he said, also does not sufficiently explain why observation patients are ineligible for Medicare’s nursing home coverage, which under law requires at least three consecutive days as an admitted patient.”

Medicare has been taking public comment and we’ll likely hear more implementation details this month. 

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Why Silence Isn’t Golden for Millions in Medicare

Nearly 30 million Americans suffer from hearing loss yet a small percentage have hearing aids.  Why? Many simply can’t afford the high cost...and Medicare does not cover hearing aids and related audiology services. 

Currently, Medicare Part B only covers hearing rehabilitation services for cases caused by an illness or accident. Progressive, age-related hearing loss is not covered, leaving many seniors to pay for their own hearing exams and hearing aids. Hearing aids are incredibly expensive, ranging from $600 to over $5,000 each. These high price tags discourage many seniors from seeking a very basic solution that could dramatically improve their lives.

Research shows even mild hearing loss can double the risk of dementia.  Untreated hearing loss also contributes to balance problems and falls, isolation, depression and a greater incidence of stress-related diseases like diabetes and heart disease.  Earlier this month, a Report from the National Academies of Sciences, Engineering, and Medicine found that hearing loss is a public health priority requiring national attention.

That’s why the National Committee is proud to join the Center for Medicare Advocacy, Rep. Rosa DeLauro (D-CT), Rep. Jim McDermott (D-WA) and hearing expert Frank R. Lin, M.D., in a briefing today on the need to expand Medicare to include hearing aids and treatment:

“Intervention would reduce the risks which come with hearing loss. This is hugely important in the case of dementia which, with the aging of the baby boomers, is a massive public health issue now.  Hearing loss may be one of the few modifiable risk factors that could reduce the risk of dementia; however, hearing health care is still broadly inaccessible and expensive.”...Dr. Frank Lin, M.D., Ph.D., Johns Hopkins School of Medicine and Bloomberg School of Public Health

“As always, there will be the critics who say “we can’t afford this” Well, yes we can. When the Affordable Care Act passed, 716 billion dollars in savings from Medicare were plowed right back into the program to provide expanded services such as preventive care and screenings at no cost to beneficiaries. And there are strategies such as restoring the pharmaceutical drug company rebates for medicines prescribed to dual-eligibles, people on both Medicare and Medicaid, which, according to CBO, could generate 121 billion dollars over ten years. If the Congressional will is there, we know it can be done.”...Max Richtman, NCPSSM President/CEO


Legislation introduced by Reps. Debbie Dingell (H.R. 1653), Jim McDermott (H.R. 5396) and Alan Grayson (H.R.3308) would close this gap in Medicare coverage. This legislation is vital to the health security of millions of Americans.

“Since its implementation in 1965, Medicare has enhanced health care for millions of Americans. But there are still major gaps in coverage. Given the growing numbers of older Americans who suffer from hearing loss, it’s time for that to change,” said Judith Stein, J.D., Executive Director of the Center for Medicare Advocacy.

"We don’t know exactly how much we spend on cases where we’re dealing with depression because they’re isolated...and hearing loss contributes to both. It’s absolutely critical that for an acceptable quality of life that people need to be able to hear the world around them.  In order for seniors to keep a good quality of live, just keeping them alive isn’t enough, we must have good hearing and dental care. This is not beyond our capacity to provide this for seniors.”...Rep. Jim McDermott (D-WA) 

“We’ve got millions of Americans over 45 effected by hearing loss. If untreated it has devastating impacts on our nation.  Medicare coverage should include audiology care, period. The promise of Medicare to keep Americans healthy is at stake.  Medicare should cover all the vital health needs of seniors. Why are we arbitrarily leaving some out?  There’s no reason for Medicare to remove the head from the body.”...Rep. Rosa DeLauro (D-CT)


Please call your Member of Congress or Sign our Congressional Petition today and tell them:

  We need hearing care coverage in Medicare.

(800) 998-0180

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