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Balanced Budget Amendment Would Devastate Social Security, Medicare

The Balanced Budget Amendment (BBA) under consideration in the U.S. House is a colossally dangerous idea.  The BBA would mandate that government expenditures not exceed revenues in any given year.  Among other disastrous effects, it would result in devastating cuts to Social Security and Medicare.  The House Republican leadership intends to schedule a vote on the amendment to the U.S. Constitution sometime this Spring – perhaps as early as mid-April.  All current and future retirees should oppose it.

In order to balance the budget every year, Congress would be forced to make draconian cuts to Medicare Part B, Medicaid and other programs that seniors depend upon. Medicare and Medicaid cannot sustain cuts (other than common sense cost-saving measures) without hurting beneficiaries.  Period.  At a time when seniors’ out of pocket health care costs are rising, the BBA puts the health and financial security of Medicare’s 58.5 million beneficiaries and Medicaid’s 72.3 million at risk.

Equally serious is the BBA’s potential impact on Social Security.  Under the BBA, if federal expenditures exceed revenues, the government would be forbidden from paying benefits from the Social Security trust fund reserves – even though the trust fund is self-financed by workers’ payroll contributions and unrelated to general revenues. Ditto for reserves in the Medicare Part A trust fund.   Benefits would then have to be slashed in order to keep the federal budget in balance, something seniors on fixed incomes could ill afford.

Under the BBA, it would also be difficult to reverse tax cuts (including Trump and the Republicans’ $1.5 giveaway to the wealthy and big corporations) to close any revenue gaps.  This could cripple the government’s ability to respond to crises like recessions, natural disasters, and war. Without the ability to leverage taxes and deficit spending, the government cannot stimulate the economy when necessary. The BBA would also increase the chances of the United States defaulting on its debts, which would have dangerous consequences for everyone.

The last time Republicans tried to push through a Balanced Budget Amendment was in 2011. It failed by less than 40 votes in the House.  Had it passed, the overall economic consequences of the BBA would hurt all Americans – retired or not.  According to the Center for Budget and Policy Priorities (CBPP):

“If such an amendment had been ratified… the effect on the economy would have been catastrophic.  It would have caused the unemployment rate to double from 9 percent to 18 percent by throwing an additional 15 million people out of work.” – CBPP quoting a report from Macroeconomic Advisors, 3/16/18

Proponents of the BBA – mainly conservative House Republicans but also some Blue Dog Democrats – are hauling out tattered, old arguments to bolster their case.  States balance their budgets, they say.  Why can’t the federal government?  Families balance their budgets? Why not Congress?  While it’s true that some states have balanced budget amendments, many of those apply only to operating budgets, not capital expenditures for long-term projects.  Regardless, states do not have the sweeping responsibilities of the federal government, including national defense, federal disaster response, and Social Security or Medicare. As for families, many do strive to balance their household budgets, but still carry mortgages on their homes, auto loans, and sometimes, lines of credit.  In other words, like the federal government, states and families are leveraged to meet their vital needs.

The National Committee supports responsible government budgeting; however, we oppose a balanced budget amendment to the U.S. Constitution because the measure would significantly harm the economy, result in a government default, and force severe cuts in Social Security, Medicare, Medicaid, and other vital federal programs. - National Committee" Viewpoint," 3/29/18

In sum, the BBA is a bumper sticker masquerading as sound public policy.  We expect that the BBA will fail this time around as it has in the past, since passage would require 2/3 majorities in the House and Senate – and ratification by at least 38 states.  But even bringing the amendment up for a vote in the House is playing with fire.  It's important that Americans – especially retirees or anyone hoping to retire sometime in the future – recognize the incredibly high stakes of this irresponsible scheme. 

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Lamb's Victory a Win for Social Security, Medicare, and Working Americans Everywhere

 

Not only is Democrat Conor Lamb’s victory in Pennsylvania’s special Congressional election a rebuke to President Trump, it is an affirmation that voters want Social Security and Medicare to be vigorously protected.  Last month, the National Committee endorsed Lamb, a U.S. Marine and former federal prosecutor who champions Americans’ retirement and health security.

 “Our nation needs his leadership, vision and determination to fight for working families and older Americans.  Conor Lamb understands and supports the critical roles that Social Security and Medicare play in the lives of our nation’s older citizens and their families.  We look forward to working with Conor Lamb to protect – if not expand – Americans’ earned benefits.”” - National Committee president and CEO Max Richtman.

On Wednesday, President Trump and House Speaker Paul Ryan twisted themselves into knots trying to spin Lamb’s victory as a win for conservatism. Though Lamb took a few conservative positions (as well he might in a historically Republican district), his support for programs benefitting working families was rock solid.

 *He promised to boost Social Security benefits and expand Medicare to cover hearing, vision, and dental care – and to protect both programs from GOP attempts to cut and privatize them.

 *He opposed the Trump/GOP tax scam, calling it a “giveaway” to the wealthy, advocating instead for a tax cut truly aimed at “working and middle class people” without adding to the debt.

 *He railed against GOP attempts to repeal and undermine Obamacare, promising to work to “help people with pre-existing conditions, improve the quality of care, and reduce premiums, out-of-pocket costs, and prescription drug prices.”

On issue after issue, Lamb is unabashedly on the side of working Americans.  This election was a test of voters commitment to these issues – and the results were clear. The fact that Lamb earned more votes – albeit by a razor-thin margin – in a deep red district where the Democrats didn’t even field a candidate in the previous two elections proves that voters want to protect working people’s interests. 

Health care, in particular, was voters’ top-ranking concern in Pennsylvania’s special election, according to an exit poll released yesterday. As The Hill newspaper reports, “For 52 percent of voters, health care [was the] top issue when deciding who to vote for, while 19 percent said it wasn’t at all important to them.” 

 The poll also found that 53 percent disapprove of Republican efforts to repeal Obamacare, while 39 percent approve. This is leading some Democrats to think health care could be a winning issue for them in the 2018 midterms, when they hope to retake seats in Congress. – The Hill newspaper, 3/15/18

For more than a year, President Trump and Congressional Republicans have engaged in a war against the programs that working Americans rely on for basic income and health security – while passing trillions of dollars in tax breaks for the wealthy and big corporations.  Working people’s well-being hinges on electing more defenders of Social Security, Medicare, Medicaid, and Obamacare to Congress this Fall.  With the 2018 Congressional elections drawing closer, Conor Lamb’s victory is a positive harbinger for those who fight for the working class, and a warning to those who don’t.

Watch our live analysis of Conor Lamb's win on "Behind the Headlines" via Facebook Live. 

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Bipartisan Budget Bill a Pretty Good Deal for Seniors

The bipartisan budget bill passed by Congress early this morning is, on balance, good news for seniors and the federal programs that provide them with financial and health security. 

“Seniors will feel these changes in their pocketbooks and even in the way they feel physically. We have been fighting for these measures for quite some time and are happy to see Congress take action on a bipartisan basis.” - Max Richtman, National Committee president 

On the positive side, the budget bill:

*Closes Medicare Part D “donut hole” in 2019.  The prescription drug coverage gap embedded in the original law, which the Affordable Care Act has been gradually closing, will be altogether eliminated one year early. This will save seniors thousands of dollars in out-of-pocket prescription drug costs.

*Repeals Medicare therapy caps.  The bill scraps arbitrary caps on physical, speech, language and occupational therapies that have cost seniors money – or delayed care at crucial times.  Beneficiaries will now find it easier – and more affordable – to get the therapies they need without undue interruption. 

*Lifts non-defense domestic spending caps, allowing Congress to appropriate more adequate funding for the Social Security Administration’s operating budget. The SSA has suffered from draconian budget cuts since 2011 which have impinged on customer service, even as 10,000 Baby Boomers retire every day.  This badly-needed (but yet unspecified) higher level of funding should allow SSA to improve customer service for the program’s 67 million beneficiaries.

On the negative side, the bill increases Medicare premiums for some individuals by further expanding Medicare means-testing. 

“Congress continues to expand Medicare means-testing, and they will not stop until middle-class seniors are burdened with higher Medicare premiums.” - Max Richtman.

Here is a more detailed summary of the budget bill’s implications for seniors. 

For more on this story, view our Behind the Headlines broadcast live from Capitol Hill here


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Medicare Therapy Caps: It's Time for a Permanent Repeal

Many of us have loved ones who’ve heard those dreaded words “Medicare won’t approve any more physical therapy (or occupational therapy or speech therapy) for you this year” – or have been told the same thing ourselves.  Whether recovering from a stroke, heart attack, serious fall or myriad other conditions, few things are more frustrating for convalescing seniors than being informed they have hit a coverage limit in the midst of medically necessary therapy.

Congress imposed caps on outpatient therapies for Medicare Part B beneficiaries in 1997 as part of the Balanced Budget Act.  Since then, the National Committee and other Medicare advocates have been shouting from the rooftops that therapy caps are bad policy.

Realizing the hardship these caps would cause patients, subsequent Congresses enacted - and continually renewed – an exceptions process for exceeding the caps.  Under this process, beneficiaries could get coverage for therapy beyond the caps until they hit a higher threshold (currently $3700 per year), after which Medicare would manually review every claim before deciding whether to pay.  

However, the current Congress failed to extend the exceptions process, meaning that as of January 1st, all Medicare beneficiaries are subject to a hard, annual cap of $1,980 on physical therapy – and the same for occupational therapy.

In a letter to Congress, the Legislative Council of Aging Organizations (of which the National Committee is a member) says the therapy caps are random – and harmful.

“These arbitrary caps are aimed at federal cost-savings rather than providing clinically appropriate service and disproportionately impact the most vulnerable Medicare beneficiaries who require ongoing therapy services.” – LCAO letter to Congress

Christina Metzler, Chief Public Affairs Officer at the American Occupational Therapy Association (AOTA), says Congress has left the Medicare community in the lurch by failing to at least renew the exceptions process:

“Consumers and practitioners are in a very difficult spot right now.  While few people will hit the cap right away, if you have a severe injury or are just getting out of the hospital, your outpatient visits are going to start piling up.” – Christina Metzler, AOTA, 1/5/18

The Centers for Medicare and Medicaid Services (CMS) has issued zero guidance for providers or patients on how to handle the situation, opening the door for potential confusion and denial of proper care.

Ironically, there already is a bipartisan solution to this problem.  Last fall, Republicans and Democrats on key Senate and House committees agreed on a policy to make the exceptions process permanent – and less onerous for patients and providers.

As Metzler describes it, the bipartisan policy would result in:

*Elimination of therapy caps

*A nimbler process for obtaining coverage beyond cost thresholds

*Greater clarity for beneficiaries and providers

“The benefit of this approach is that there are no caps.  Instead, we’d have a new and different methodology for documenting and reviewing therapy claims. Patients would be assured of a permanent policy, and we wouldn’t be in a situation of confusion where beneficiaries and providers are in the dark.”  - Christina Metzler, AOTA, 1/5/18

The National Committee, AOTA, and other advocacy groups are calling on Congress to attach the bipartisan measure to pending legislation without delay.  Some Hill-watchers believe that reauthorization of the Children’s Health Insurance Program (CHIP) funding is the most likely vehicle.  (Congress would have to act on CHIP by January 19th before some states run out of money for children’s health insurance.)

“Anything less than a permanent fix that finally allows patients to receive medically necessary therapies without interruption or financial worry would be a disservice to everyone who relies on Medicare.” - National Committee president and CEO Max Richtman, 1/8/18

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Hollow Victory for Trump & GOP is a Loss for Seniors, Working Americans

National Committee President and CEO Max Richtman issued the following statement after passage of the Trump/GOP tax plan.

“Congressional Republicans have just pulled off the biggest heist in American history – transferring trillions of dollars of wealth to the rich and profitable corporations at the expense of working and middle class Americans.  By ramming this ill-considered legislation through Congress in a reckless manner, GOP members of Congress put partisanship over people and donors over constituents.  Last-minute revisions designed to woo holdout Senators – including a change benefitting real estate moguls like President Trump – tilted the bill even further toward wealthy elites.  

It is wrong to ask the poor, the working class, and elderly to pay for tax breaks for the rich and powerful, which is exactly what the Trump/GOP tax bill will do.  The tax cuts will explode the federal debt by at least $1.5 trillion, laying the groundwork for an all-out effort to cut Social Security, Medicare, and Medicaid.  House Speaker Paul Ryan and Florida Senator Marco Rubio have already promised as much in recent public statements.  Blowing up the debt for tax cuts, then claiming that there’s no choice but to cut benefits for seniors is the height of hypocrisy. As proof of Republicans’ intent, the 2018 GOP budget resolution slashes nearly $500 billion from Medicare and more than $1 trillion from Medicaid. 

The bill’s repeal of the Obamacare individual mandate will result in 13 million Americans losing coverage, and an average $1,500 hike in health insurance premiums for older adults aged 50-64.  Adopting the miserly “Chained CPI” inflation index for calculating tax brackets and deductions could easily creep into the formula for determining Social Security cost-of-living adjustments (COLAs), which would cost retirees thousands of dollars in the long run.  Unfortunately, the pleas of advocates and everyday Americans demanding that Congress abandon this cynical legislation has fallen on deaf ears. But it’s a hollow victory for the GOP. While the perpetrators of the tax scam may be popping the champagne today, next November they surely will see that voters have declared the party’s over.” 

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