We have just witnessed the seventh Democratic presidential debate of the 2020 election cycle without a single question about Social Security. The candidates tussled over foreign and domestic policy, but no one mentioned the program that 64 million Americans depend on for basic financial security – at a pivotal time when Social Security could be expanded and strengthened, or weakened and cut.
“I thought the moderators would, at long last, ask the candidates about Social Security,” said National Committee president and CEO Max Richtman, who attended last night’s debate at Drake University in Des Moines. “Needless to say, I was very disappointed.”
On Tuesday, the Des Moines Register (which cosponsored the debate with CNN) published an op-ed by Richtman and former Iowa Senator Tom Harkin, insisting that Social Security receive the attention it warrants:
As President Franklin Roosevelt made clear when he signed Social Security into law, the program is a ‘cornerstone in a structure… which is by no means complete.’ He understood that the program would need to be expanded over time. Presidential contenders in the party of Franklin Roosevelt must be asked about Social Security’s future on the debate stage. Seniors deserve to hear their answers. – Fmr. Senator Tom Harkin and National Committee President Max Richtman, Des Moines Register
For the past seven months, the National Committee has repeatedly called upon debate moderators to ask the candidates about their plans for Social Security, but once again those appeals have fallen on deaf ears.
Most of the Democratic presidential candidates have touted their own proposals for boosting and strengthening Social Security on the campaign trail, but debate-watchers may not be aware.
Much is at stake for current and future retirees, the disabled, and their families. Just one day before the debate, the National Institute on Retirement Security released a new report which found that 40% of older Americans rely entirely on Social Security for retirement income. (Only 7% receive income from Social Security, a pension, and a defined contribution account like a 401K.) The average monthly benefit of $1,500 is barely sufficient to keep many seniors out of poverty. That’s why the National Committee endorses legislation that would give seniors a boost in benefits while keeping Social Security financially healthy through the end of the century.
Meanwhile, prominent conservatives – from Trump budget director Mick Mulvaney to Senate GOP leader Mitch McConnell – have called for Americans’ earned benefits to be “reformed” (which really means cut and privatized). These “reformers” blame the swelling national debt on Social Security, even though the program is self-funded. In fact, ‘tax expenditures’ – especially the Trump/GOP tax cuts of 2017 – are the main driver of the federal debt. The Democratic presidential candidates should rebuke this ploy to cut benefits. The debates provide a platform with millions of viewers who need to know.
Although the candidates did not address Social Security last night, they did confront another issue that disproportionately impacts older Americans – soaring prescription drug prices.
“Senator Elizabeth Warren doubled down on a pledge to lower drug prices on her first day as president, using executive action to make it easier for generic drug makers to move in on brand-name drugs that were created using federally funded research.” – Stat News, 1/14/20
Candidates Joe Biden, Pete Buttigieg, Amy Klobuchar, and Bernie Sanders joined Warren in pledging to lower drug prices by various means, including price controls and allowing Medicare to negotiate drug costs with pharmaceutical companies. Senator Klobuchar also raised another crucial issue for seniors – the lack of affordable long-term care insurance:
“What should we do about long-term care, the elephant that doesn’t even fit in this room? We need to make it easier for people to get long-term care insurance. We need to make it easier for them to pay for their premiums.” – Sen. Amy Klobuchar, 1/14/20
“I was glad to see some of the candidates address prescription drug prices and long-term care,” said Richtman. “But the upcoming primary debates must include one of our most important social insurance programs, Social Security. We’ve been trying to put this on the radar for so long, and we’re going to keep trying.”
Advocates for seniors and the disabled – including the National Committee – are increasingly concerned about a proposed Trump administration rule regarding Continuing Disability Reviews (CDRs) for Social Security Disability Insurance (SSDI). These are periodic reviews conducted by the Social Security Administration to determine beneficiaries’ ongoing eligibility for SSDI benefits. The proposed rule would add a new level of CDR, which could result not only in unnecessary red tape and stress for beneficiaries, but also a loss of benefits for some of our most vulnerable citizens.
Disabled claimants’ cases currently are subject to periodic review depending on their assessed prognoses:
Medical Improvement Expected: Cases are reviewed every 6 months to 2 years
Medical Improvement Possible: Cases are reviewed at least every 3 years
Medical Improvement Not Expected: Cases are reviewed at least every 7 years.
The new rule imposes an additional layer of review: Medical Improvement Likely. Beneficiaries suffering from disabilities as diverse as leukemia and severe anxiety would be subject to these new reviews. Claimants who fall into this new category would be reviewed at least every 2 years – creating a new hurdle to continue receiving benefits. This is neither necessary or fair.
SSDI beneficiaries are among America’s most health insecure and financially challenged citizens. Beneficiaries undergoing CDRs have at least one severe disability. These claimants typically are older, poorer, less educated, and housing insecure. They are at least three times as likely to die within a year as other people the same age. The last thing they need is to be compelled to provide more CDR paperwork and medical records, which can also be a financial burden.
“Advocates for recipients say that the ‘medical improvement likely’ category appears to make no sense. In general, medical conditions deteriorate as people age, especially those who have limited resources. Compelling (these) recipients through a review every two years will make it even more difficult for them to comply with the review process, putting their benefit eligibility in jeopardy.” – Forbes, 12/17/19
As Rep. John Larson (D-CT) pointed out this week, the proposed rule particularly would impact the nation’s disabled veterans:
“Increasing the frequency of the reviews would force beneficiaries to go through a complex process that they may not be able to navigate, resulting in them losing their disability benefits even though nothing medically has changed. This would be devastating to impacted veterans, who rely on the Social Security disability benefits they have earned to put food on the table and a roof over their families’ heads.” – Rep. John Larson, 1/09/20
So far, there is no evidence that the administration proposal would improve the integrity of SSDI or help beneficiaries. In fact, the National Committee estimates that the new system would produce negligible cost savings because of the resources necessary to conduct additional Continuing Disability Reviews.
It’s reasonable to conclude, then, that the proposed rule is part of the Trump administration’s apparent indifference – or outright disdain – toward Americans on the bottom rungs of the socioeconomic ladder. The proposed rule is likely driven by the same ideological agenda behind the administration’s efforts to strip Americans of affordable, quality health coverage, to cut federal programs that feed the poor and elderly, and to impose new requirements that could force millions from Medicaid rolls. A compassionate cost/benefit analysis does not justify the imposition of fresh burdens on citizens with disabilities. Advocates and beneficiaries rightly oppose this rule and will continue to exert pressure against its enactment.
With every passing Democratic presidential debate, the odds that any of the moderators will ever ask a question about Social Security seem to be growing longer. Last night was the sixth debate of 2019, and the record remains unbroken: not a single question about Social Security for seven contenders for the nomination of the party of Franklin Roosevelt. However, two of the candidates – Bernie Sanders and Elizabeth Warren – did mention Social Security on their own, without being asked.
Early in the debate, Senator Sanders brought up Social Security as part of an attack on President Trump’s betraying his promise “not to touch” Americans’ earned benefits.
“I will personally be… making the case that we have a president who has sold out the working families of this country, who wants to cut Social Security, Medicare and Medicaid after he promised he would not do that…” – Bernie Sanders, Democratic presidential debate, 12/19/19
Both Sanders and Senator Warren have offered proposals to fortify Social Security’s finances and expand benefits – mainly by asking the wealthy to pay their fair share of FICA payroll contributions. During an exchange about candidate Andrew Yang’s universal basic income proposal (to give every American $1,000 per month), Warren defended the modest benefit bump in her Social Security plan:
“America is ready to expand Social Security payments and disability payments by $200 a month. You just give somebody $200 a month, they asked me this in a town hall. And a lady who wanted it said, you know what it will mean to me? It will mean I can get a prescription filled and I can still buy toilet paper the same week.” – Elizabeth Warren, Democratic presidential debate, 12/19/19
Social Security touches the lives of 69 million Americans, many of them seniors living on fixed incomes who rely on the average $1,400 monthly retirement benefit to stay out of poverty. Conservatives claim that Social Security is “going broke” and that it won’t be there for future generations. However, Social Security champions, including not only Warren and Sanders, but Rep. John Larson (D-CT) have lit up a pathway to long-term financial solvency AND expanded benefits, which voters deserve to know about.
We have pointed out many times in this space – and in other publications – that the mainstream media have failed to adequately cover these common sense, equitable solutions, relying on the false narrative that “neither party wants to take concrete action on Social Security.” To counter this narrative, the Democratic debates should include a robust discussion about seniors’ retirement benefits. A Democratic president created Social Security and it will be up to Democrats to protect the program – and allow it to grow with the needs of an ever-changing population.
While it’s laudable that Congress reached a 2020 spending deal in time to avert a government shutdown, the news wasn’t great for those who rely on the Social Security Administration (SSA), which basically means almost every American senior. Monday’s $1.4 trillion agreement – which does increase spending on other programs for older Americans – gives SSA only a small bump in its operating budget. The $99 million increase (less than 1%) over 2019 funding levels does not even keep pace with inflation, and perpetuates the decade-long divestment in crucial customer service functions for Social Security’s 69 million beneficiaries. The agency has been chronically underfunded at a time when 10,000 Americans turn 65 every day.
The divestment began at the start of this decade, coinciding with the Republican take-over of the House and the ascendancy of the Tea Party. Congress slashed SSA’s operating budget 11% (adjusted for inflation) between fiscal years 2010 and 2019. Left to fend for itself with a growing customer base and reduced resources, the SSA began closing field offices and furloughing employees. Customer service suffered and seniors – especially those of modest means – paid the price in the form of increased wait times to talk to an SSA representative and long delays in disability hearings during which thousands of claimants died before their appeals could be adjudicated.
As Mark Miller reported for Reuters last June:
“[Nearly one million] people were waiting for appeals hearings before administrative law judges on disability benefit applications in fiscal 2018. In the same year, the average wait time for callers to the Social Security toll-free number was 24 minutes, up from 13.6 minutes in fiscal 2016 – and 15% of callers received a busy signal. Social Security’s processing centers, which handle claims after beneficiaries are determined to be eligible, faced an enormous backlog of 2.9 million cases this year.” – Mark Miller, Reuters, 6/5/19
After years of cuts, Congress increased SSA’s operating budget by 2% for FY 2018. But the agency’s FY 2019 budget was cut by 2%, leaving SSA financially treading water. SSA’s former acting director, Nancy Berryhill, had requested a healthy $500 million increase for 2020. The Democratic-controlled House was poised to offer a $300 million (or roughly 3%) bump. Unfortunately, the Senate and President Trump sought a zero increase for SSA, producing a House-Senate compromise of only $99 million.
The main culprits are automatic caps that were imposed on discretionary federal spending beginning in 2011. Recent Congresses have adjusted those caps to allow more spending, but SSA’s budgets have continued to languish. This is especially egregious because SSA operations are funded by workers’ Social Security payroll contributions, and should not be lumped in with discretionary spending and subject to arbitrary caps and cuts. Seniors have earned their benefits and expect them to be administered with minimal time, trouble, and pain.
Earlier this year, a bipartisan three-person commission recommended exempting SSA’s operating budget from automatic spending caps. Meanwhile, Rep. John Larson’s Social Security 2100 Act would require that SSA’s administrative budget be fixed at 1.5% of total benefits paid. For 2020, that would translate to a $15 billion budget compared to the actual $11 billion just approved by Congress – or 36% more under Larson’s formula. That would go a long way toward restoring the level of customer service that beneficiaries truly need and expect.
Thursday was a historic day in the movement to lift the burden of crushing prescription drug prices. The U.S. House passed H.R. 3 – The Lower Drug Costs Now Act – which, among other things, empowers Medicare to negotiate prices directly with drug makers. H.R. 3 also delivers a sorely-needed, $2,000 annual cap on out-of-pocket drug costs for Medicare Part D beneficiaries. The bill then leverages the projected $456 billion in savings from lower drug prices to expand Medicare to include dental, vision, and hearing coverage – a long-sought goal of the National Committee and other seniors’ advocates. Lowering prescription prices is the objective of the National Committee’s Don’t Cut Pills, Cut Profits campaign.
“The U.S. House of Representatives resoundingly defied Big Pharma on Thursday by passing historic legislation to lower prescription drug prices for America’s seniors and their families. The Lower Drug Costs Now Act relieves two sources of financial pain inflicted on older Americans – soaring drug prices and unaffordable out-of-pocket expenses for the care of their eyes, ears, and teeth.” – Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare, 12/12/19
Under H.R. 3, the Department of Health and Human Services would be authorized to negotiate the prices of up to 50 prescription drugs every year, using the prices that other Western countries pay as a benchmark. Drug makers who refuse to negotiate within the bounds of the legislation would face significant financial penalties. The National Committee has fought for Medicare cost negotiation since the creation of the Part D drug benefit in 2003, believing that the government should harness the bargaining power of millions of Medicare beneficiaries to beat prices down.
The bill’s $2,000 out-of-pocket cap on Medicare Part D beneficiaries’ prescription drug costs represents a significant improvement over current law. Today, some one million Part D enrollees pay more than $3,200 in annual out-of-pocket costs. Roughly one quarter of American adults say they have had to leave prescriptions unfilled, ration pills, or forgo other necessities because of soaring out-of-pocket drug costs. At town halls held this fall, the National Committee has heard harrowing stories of seniors who couldn’t afford crucial medications for conditions including diabetes, heart disease, and cancer.
H.R. 3’s addition of dental, hearing, and vision coverage to traditional Medicare is excellent news for seniors who have had to foot the full cost of care for their eyes, ears, and teeth. Under the new legislation, Medicare would cover:
*50% of eligible dental care costs
*Hearing aids and care for severe hearing loss
*80% of eligible vision care costs (including eyeglasses and contact lenses)
While the passage of H.R. 3 demonstrates the Democrats’ commitment to lowering drug prices and expanding Medicare, its chances of being signed into law – in current form, at least – are slim. Republicans in the House and Senate have slammed the bill, calling it a “government takeover” of the prescription drug market, even though H.R. 3 would work within the existing market to bring prices into line with what other countries pay. And, as Democrats have pointed out, price negotiation is fundamental to a functional free market.
The Senate Finance Committee has approved a drug price reduction bill introduced by Senators Charles Grassley (R-IA) and Ron Wyden (D-OR), but majority leader Mitch McConnell has not indicated he will bring it to the Senate floor for a vote.
The Trump administration has signaled its support for the Grassley-Wyden bill, but President Trump has yet to make an outright endorsement – the kind which might compel the full Senate to vote on it. If Grassley-Wyden were to pass the Senate, a House-Senate conference would have to reconcile the differences between each chamber’s prescription drug pricing legislation.
Democrats will incorporate the passage of H.R. 3 into their 2020 campaign messaging, validating their promises to voters to cut skyrocketing drug costs and improve Americans’ health coverage. Meanwhile, seniors and their families can celebrate the House majority’s affirmation that they badly need relief from high drug prices – and look forward to a time when the provisions in H.R. 3 can finally become law.