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Ryan's Siren Song of Spring: Cut "Entitlements"

Along with Cherry Blossoms and the White House Easter Egg Roll, Spring has brought fresh talk of “entitlement reform” to the Nation’s Capital.  Of course, Social Security and Medicare are not “entitlements.”  They are earned benefits that Americans pay into during their working lives in exchange for retirement and health benefits during their senior years.  Nevertheless, House Speaker Paul Ryan and other budget hawks prefer to perpetuate the “entitlement” myth.  This week, Ryan said that fiscal responsibility means “reforming our entitlement programs.”  “Reforming” is code for undermining Social Security and privatizing Medicare, two politically unpopular ideas that nonetheless seem to drive Ryan’s agenda.  Never mind that Social Security and Medicare Part A are funded by workers’ payroll contributions and don’t contribute a penny to the deficit.  

Meanwhile, House Budget Committee Chairwoman Diane Black (R-TN) is looking to end traditional Medicare through the budget reconciliation process in May, according to Congressional Quarterly.

“The coming fiscal 2018 plan is likely to include proposals to transform Medicare… into a premium support program.  Under one House GOP model… people would be given a choice of traditional Medicare or insurer-run plans starting in 2024.” – Congressional Quarterly, 4/27/17

 “Premium support” is an innocuous sounding term that could have dire consequences for seniors.  What Diane Black means by “premium support” is converting Medicare into a voucher program.  Seniors would be offered the option of leaving traditional Medicare to buy insurance in the private market using vouchers.  These vouchers could never keep pace with rising premiums, meaning seniors would have to cover the difference or drop health insurance entirely.  Older and sicker seniors would likely remain in conventional Medicare, causing the program’s cost to skyrocket, benefits to be cut, and eventually the death of Medicare itself.

The canard that Ryan and his party use to justify cutting benefits, reducing COLAs, and raising retirement ages is that Social Security and Medicare are going “bankrupt.” While it’s true that the trust funds for Social Security and Medicare Part A won’t be able to pay full benefits after 2034 and 2028 respectively without corrective action, there are modest and manageable solutions that won’t hurt the seniors who depend on them.  Senator Bernie Sanders and Congressman John Larson (D-CT) have both offered common sense legislation to keep Social Security solvent for decades.  Both bills ask the wealthy to pay their fair share by scrapping the income cap on payroll taxes.  Larson’s legislation also increases the FICA tax by 1% over 25 years.  (Larson says that for a worker earning $50,000 a year, the payroll tax bump equals one Starbucks coffee drink every 9 weeks). Instead of cutting benefits for our most vulnerable citizens – or raising the retirement age – these bills actually increase benefits and COLAs. 

Medicare could be kept solvent well into this century by similarly modest and manageable means, if budget hawks like Ryan would stop insisting that privatization is the only fix. Congress could authorize Medicare to negotiate prescription drug prices (one of the biggest drivers of rising health care costs).  Innovative methods for saving Medicare costs under the Affordable Care Act, many of which have already reduced healthcare expenditures, could be expanded instead of repealed.  In fact, the Affordable Care Act itself extended the solvency of Medicare by four years.  Repealing the ACA – as Ryan and President Trump are still struggling to do – hurts the long-term solvency of the program.

Ryan and many conservative Republicans ignore these alternatives because, at heart, they do not believe in federal programs that provide Americans with retirement and health security – which puts them at odds with the majority of voters. The latest National Committee poll indicates wide public support for progressive solutions for Social Security and Medicare – and significant opposition to the GOP approach. Seventy-nine percent favor increasing Social Security benefits by scrapping the payroll tax income cap.  Sixty-five percent oppose raising the Medicare eligibility age.  Ninety-three percent want Medicare to be able to negotiate prescription drug prices with pharmaceutical companies.

The National Committee’s social media community seems to agree.  Comments on our Facebook posts over the past three months demonstrate deep skepticism about Republican talking points:

Bruce W. These programs are NOT "entitlements"--we have paid into them our entire working lives. If the income subject to SS fees was raised SS would be solvent for decades...
Suzanne S. Social Security has nothing to do with the deficit. It is a stand-alone program funded by workers. LEAVE IT ALONE.
Tom S.  Social Security and Medicare are lifelines to millions of seniors; anyone who votes in favor of cutting or reducing benefits should be ashamed of themselves!
Adam R.  Social Security has nothing to do with the general budget at all. FACT. It is not an entitlement, This is basically a Trust fund we have paid into all our working lives.

Americans intuitively understand that Social Security and Medicare are social insurance programs that they have already paid for through their hard-earned wages.  For 82 years and 52 years respectively, these programs have worked efficiently to keep seniors healthy and out of poverty.  Our Facebook commenter is perfectly correct to call them “lifelines to millions of seniors.”  Yes, their finances need to be shored up. But asking beneficiaries to bear the burden is not the right way. It’s too bad that some of our most powerful political leaders do not seem to understand… or care.

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Ryan's Revised Healthcare Bill Even Worse Than the Original

 


Let us not speak of pigs and lipstick, but simply say that the freshly tweaked GOP health care bill introduced last night still socks it to older Americans. In an attempt to throw bones to both moderate Republicans and Tea Partiers, Speaker Paul Ryan has come up with a revised bill that’s even worse than the original for seniors and “near seniors” (under 64 years of age).  The Center for Budget and Policy Priorities has just released a detailed analysis forecasting higher net premiums, co-pays, and out-of-pocket costs for older Americans under the revised bill.  Here is our own take on why there's nothing to like in the tweaked legislation: 

 

MEDICAID

 

Millions of seniors depend on Medicaid to cover the cost of long-term care, while low income Americans 50-64 rely on the program for basic health care.  The original GOP bill cut nearly $1 trillion from Medicaid and imposed per capita caps on federal payments to the states.  The revised legislation adds another insidious idea to the equation by introducing block grants, where states can decide to curtail or outright cut certain services.  Per capita caps and block grants mean one thing:  less funding for older patients who need medical services and long-term care - and in some cases, complete loss of coverage.  For seniors, It’s two bad ideas in one bill.

 

AGE RATING

 

The revised GOP bill does nothing to address a major problem with the original.  Under the revised legislation, Insurance companies would still be able charge older Americans up to five times as much as people in their 20s (a practice referred to as “age rating”), one reason why the Congressional Budget Office estimated that 24 million people would lose coverage under the Republican plan.

 

 

PREMIUM SUPPORT         

 

Obamacare provided generous subsidies to people who couldn’t afford private insurance premiums.  The GOP bill replaced those subsidies with paltry tax credits that discriminate against older patients.  Paul Ryan’s tweaked version kicks the problem over to the Senate by authorizing the upper chamber to increase tax credits for older Americans… if it wants to. There’s no guarantee the Senate will actually do this, or that fatter tax credits will make it into the final bill.  Once again, the revised GOP plan leaves older folks worse off.

 

TAX CUTS

 

While giving nothing to seniors, the revised bill still repeals $600 billion in tax cuts for the wealthy (and $24 billion for pharmaceutical companies) that Obamacare utilized to expand health coverage and strengthen Medicare.  The tweaked bill actually sweetens the deal for the wealthy – repealing the taxes in 2017 instead of 2018.

 

 

MEDICARE

 

The GOP plan still weakens Medicare through the repeal of a 0.9% tax on income over $200,000.  By rescinding the tax, the GOP plan reduces the solvency of Medicare by 3 years – and the revised bill does nothing to lengthen it.  Reducing Medicare’s solvency gives budget hawks an excuse to privatize and cut the program, which hurts seniors.

 

We don’t know whether the dressed-up GOP plan will pass the House.  It’s possible that the concessions to Tea Partiers and token gestures to moderates – plus active lobbying on President Trump’s part – will allow it to squeak by.  Either way, Speaker Ryan squandered an opportunity to reverse some of the damage to healthcare and long-term care for our older and most vulnerable citizens.

 

 

 

 

 

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Paul Ryan and House GOP on Fast-Track to Repeal ACA, Putting Millions of Insured at Risk

Speaker Paul Ryan and the House GOP are on a tear to repeal the Affordable Care Act (ACA), without being any closer to agreement on a replacement plan. The House will likely introduce a budget reconciliation bill to effectively repeal the ACA in the next two weeks… with no immediate replacement.  Ryan and his troops hope to have a replacement plan by April, but Max Richtman, the President of the National Committee to Preserve Social Security and Medicare is skeptical: 

 

"Given the potential political risk of displacing 20 million Americans who now have health coverage through the ACA, the legislative battle will probably take longer than they think."

Republicans meeting in Philadelphia this week to strategize about replacements for the Affordable Care Act were unable to come to a consensus. The disarray in the GOP caucus made for an alarming headline in this morning’s Los Angeles Times:  Republicans divided over whether millions of Americans should lose government-subsidized health coverage.

In the meantime, if Congress repeals the ACA soon but blows past April struggling to replace it, says Richtman, that could destabilize the health insurance market and endanger ACA policyholders’ coverage.

 
"If key parts of the ACA are repealed now, and insurance companies think the situation is too unpredictable, you have an immediate de facto loss of coverage for more than 20 million Americans."

The nearly 60 million seniors and disabled on Medicare are also at risk of losing benefits that the ACA mandated, including annual wellness visits and preventative screenings with no out of pocket costs, and will have to pay an average $1,000 per year more for prescription drugs unless those parts of Obamacare are retained.  Of course, at this point no one knows which of the ACA’s benefits will stay or be shredded, including House Republicans.

 
In a related development, the Washington Post reports the White House is pulling ads for ACA enrollments in advance of the 2017 enrollment deadline.

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Enjoy the Holidays. Ring in the New Year. Fight for Social Security and Medicare.

While we at the National Committee extend warm holiday wishes to all our readers, the joy of the season is overshadowed by the knowledge that the coming year is full of unprecedented peril for our cherished income security programs – and our health care.  

Throughout the year, we warned about the dangerous positions Trump and the GOP had taken on Social Security, Medicare, Medicaid, and the Affordable Care Act.  As early as March, we exposed Trump’s past statements in favor of raising the retirement age to 70 and privatization.  At the same time, we warned about renewed GOP plans to slash Medicare benefits.  In June, we predicted that Speaker Ryan and Donald Trump would eventually join forces to privatize Medicare.  After Donald Trump locked up the nomination, we flagged the dangers to Social Security in the Republican platform.  When Trump picked his running mate, we shined a harsh light on Mike Pence’s long history attacking Social Security and Medicare.  After the election, the National Committee began pushing back against the GOP’s race to dismantle our income security programs, beginning with a benefit-slashing bill by House Social Security Subcommittee Chair Sam Johnson, and Trump’s naming a notorious privatizer for Health and Human Services Secretary. 

Make no mistake about it, the GOP-led 115th Congress will waste no time implementing their plans to destroy Medicare and Social Security as we know it – and repeal the Affordable Care Act.  President-elect Trump has offered no assurance that he will stand by his campaign promise not to touch Social Security and Medicare, and as we reported, his past statements on both programs are not comforting.  Pending legislation on Capitol Hill could cut Social Security benefits by 1/3, raise the retirement age, and decrease COLAs.  If Paul Ryan gets his way, Medicare will be turned into “Coupon Care” and seniors will be given vouchers to fend for themselves in the private insurance market.  Thirty million Americans could lose health insurance (including a disproportionate number in areas that Trump won in November) if the Affordable Care Act is repealed (not to mention the lost improvements to Medicare included in the ACA).  Americans who depend on any of these programs could sink into poverty.

Working Americans, the disabled, seniors, and their families should know what’s at stake – and they must participate in the movement to stop Republicans from snatching away their earned benefits and health care.  The National Committee will vigorously lobby members of Congress, gather millions of petition signatures, and encourage working Americans to contact their elected representatives about these critical issues.  We will partner with our allies to promote an agenda that protects – and boosts – our earned benefits instead of slashing them.  So, by all means enjoy the holidays and ring in a peaceful New Year.  Then… let’s shift gears into battle mode and stop the war on the working class together.

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No, the Budget Deal Did NOT Cut Your Social Security Benefits

America’s seniors, people with disabilities and their families who depend on Social Security have legitimate reason to be scared whenever Congress starts cutting backdoor deals because they know from experience that Social Security, Medicare and Medicaid have been used as piggy banks or political hostages by GOP leaders always looking for ways to cut benefits.   

The good news is, contrary to claims by largely financial writers, Social Security benefits were not cut in this week’s Congressional Budget deal.   

We take on one of the seriously flawed stories in NCPSSM’s “Equal Time”:  

 “Proposed budget bill would have devastating effects on millions’ Social Security benefits”, Laurence Kotlikoff, PBS Columnist 

“...the new budget ​drastically cuts Social Security benefits for many of those now collecting, drastically cuts benefits for many of those who were about to collect, exacerbates Social Security work disincentive and induces households to do exactly the wrong thing, namely take their benefits too early at the cost of permanently lower benefits.”

In a column loaded with scary and inflammatory rhetoric describing Congress’ budget deal as  “devastating,” “radical,” and “truly draconian,” Laurence Kotlikoff does his readers and especially Social Security beneficiaries a huge disservice by presenting changes that impact a tiny percentage of Americans as something much larger.  At issue is a little-used benefit strategy called File and Suspend.  The Budget deal modifies this practice and fixes the unintended consequences (the Social Security Actuary calls it a loophole) in a 2000 Social Security law that allows retirees to file for Social Security and then suspend receipt of their benefits to maximize their Social Security payout. Under the Budget deal, the tiny percentage of beneficiaries (estimated to be about 100,000 people) who’ve used this strategy will be allowed to continue to do so.  Their benefits will not be cut.  However, Congress is changing this claiming practice for the future.  Spouses, divorced spouses, the disabled and children will still quality for their regular earned Social Security benefits much as they have in the past. As the co-author of a how-to book advising people on ways to use “aggressive claiming strategies,” there’s no surprise Kotlikoff finds this provision frustrating; however, these changes are far from “reneging” on Social Security’s promise as claimed in his piece. 

The National Committee does not support the Congressional majority’s continuing use of Social Security as a bargaining chip in budget negotiations.  However, it’s vital that Americans receive the full story about Congressional action on Social Security, including who is truly affected and in what ways.  The Congressional budget deal does not cut benefits and will not harm millions of people, contrary to what was reported by PBS.  

The Economic Policy Institute also provides this description of the file and suspend change:

“Eliminating “aggressive Social Security-claiming strategies, which allow upper-income beneficiaries to manipulate the timing of collection of Social Security benefits in order to maximize delayed retirement credits” was something the president included in his fiscal-year 2015 budget, not something the administration reluctantly agreed to. And most advocates, including the Social Security Works coalition, to which EPI belongs, think it’s a loophole that needs to be closed, since the purpose of the delayed retirement credit is to equalize lifetime benefits, not to give savvier beneficiaries who can afford to delay take-up a little something extra. The dissidents counter that a benefit cut by any other name is still a benefit cut, and say it’s a strategy that can help divorced women, who can be particularly vulnerable in retirement.

 The dissidents make a strong case with feminist appeal. But it’s still double dipping even if a few people who take advantage actually need a larger benefit. In the end, it all seems a distraction from the benefits of the agreement, which include averting large benefit cuts to disabled beneficiaries.”

The budget agreement will benefit literally millions of Americans in Medicare and Social Security yet conservatives are up in arms claiming that Speaker Boehner gave away too much (as if preventing massive disability benefits cuts, Medicare hikes and government default are bad things). 

Specifically, this Budget Deal:

  • Prevents a 19% cut in Social Security Disability Insurance benefits that would have occurred in late 2016
  • Ensures 7 years of certainty that the Social Security Disability insurance program will pay full benefits
  • Mitigates a 52% Medicare Part B premium increase for 30% of Medicare beneficiaries
  • Alleviates an increase in the Part B deductible for all beneficiaries, lowering it from a projected $223 to $167
  • Provides sequester relief to programs like the Older Americans Act, Low Income Home Energy Assistance Program and Social Security field offices.

This Budget Deal is good news for seniors but it’s far from perfect.  Unfortunately, the bill also:

  • Provides NO financial relief to seniors who will receive no cost of living adjustment in 2016.
  • Extends the Medicare provider reimbursement sequester and uses the savings to pay for unrelated programs.

Lastly, let’s make it clear that the biggest problem with the Budget Deal is that Congressional leadership continues to use middle-class benefits as hostages to try and force concessions on legislation that has nothing to do with Social Security, Medicare or Medicaid. 

With a new House Speaker, Rep. Paul Ryan, now in charge (and his views on slashing Social Security and turning Medicare into CouponCare are well known) we’ll likely face this battle again as soon as next month in the Transportation bill debate as conservatives hope to use benefit cuts to pay for highways.  

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