Dems Should Unite Around Medicare Expansion, RX Drug Price Negotiation
***This is an update of a previous Entitled to Know blog post.***
For years, we have been advocating for the expansion of seniors’ Medicare benefits. Traditional Medicare doesn’t cover basic dental, hearing, or vision care – which are the gateways to good health. Many seniors on fixed incomes simply can’t afford this kind of care on their own, so they skip visits to the eye doctor, the audiologist, or the dentist. We and other seniors’ advocates cheered President Biden’s Build Back Better plan, which called for adding dental, vision, and hearing coverage to Medicare. That plan is having a difficult birth in Congress, as moderate and Progressive Democrats wrangle over the plan’s size and scope, in anticipation of passing it via the budget reconciliation process.
Democratic leadership has set its sights on a possible vote on the package by the end of October, but some Hill-watchers believe that may be an overly optimistic target – as the party’s factions seem no closer to agreement than they were a few weeks ago. Meanwhile, seniors and their advocates anxiously await the outcome – hoping that long sought-after Medicare expansions will finally be enacted – and knowing that there is a limited window of opportunity to get it done, given that Democrats may lose control of one or both houses of Congress in 2022.
Policy analysts say that the most endangered of the potential new benefits is dental care, because it likely would be the most costly of the putative Medicare expansions – and would take the longest to get up and running. Dental coverage also faces dogged opposition from the American Dental Association (ADA), which is lobbying hard against it. Some Democrats have proposed dental vouchers as a compromise measure that could be activated much more quickly than a full-out dental benefit. But seniors’ advocates are wary of vouchers, because dentists could simply increase their prices significantly above the value of the vouchers, negating any serious net out-of-pocket savings for patients. Vouchers are also regarded as a big step toward privatization of Medicare, which advocates and the majority of the public rightly oppose. The ADA (and some Democrats) have even proposed the wrong-headed idea of means-testing any new benefits – so that only the poorest of beneficiaries would be eligible.
These roadblocks to Medicare expansion could have grave real-life consequences. Forgoing dental, vision, and hearing care increases seniors’ risk of serious injury and other health issues, which endangers beneficiaries and costs Medicare even more in the long run.
One thing is clear: the public wants Medicare expanded. According to a new Morning Consult poll, 84% of voters support adding dental, vision and hearing coverage to traditional Medicare. That number includes 79% percent of Republicans. Clearly, there is immense bipartisan support among everyday Americans for giving seniors these crucial coverages.
Morning Consult poll
Originally, Democrats wanted to pay for expanding Medicare with savings achieved through prescription drug pricing reform. The House-passed Elijah Cummings Lower Drug Costs Now Act (H.R.3) would save Medicare some $450 billion over ten years, mainly by allowing the program to negotiate prices directly with Big Pharma. But Democratic centrists in both chambers have balked at Medicare price negotiation, leaving the fate of the measure uncertain. Analysts say that a compromise negotiation measure may emerge, but that it could have less impact on actual drug prices.
On this issue, the public has made its preferences crystal clear. Poll indicates that a majority of voters across party lines support Medicare drug price negotiations. Republicans in Congress have called this commonsense proposal “Socialism,” even though the V.A. has been negotiating prices with drug-makers for years – and realizing significant savings in the process. According to one analysis, Medicare could save some 40% in drug costs if it were allowed to negotiate as the V.A. does. Of course, Big Pharma has launched an expensive lobbying effort and ad blitz against Medicare negotiation.
If drug pricing legislation is weakened in the budget reconciliation process, there will be less savings to the Medicare program. According to Adcock, that may limit the scope of dental, hearing, and vision coverage that can be added to Medicare. In fact, one or more of those coverages may not make it into the final legislation if there aren’t sufficient Medicare savings to pay for them.
“It’s possible we will see Medicare expansion enacted by the end of the year. It depends on how the Democrats are able to finesse this process. I wouldn’t bet the farm on it, but there’s a decent chance we’ll get something.” – Dan Adcock, NCPSSM Director of Government Relations and Policy
Seniors and their advocates will be understandably frustrated and disappointed if this historic opportunity to expand Medicare and tame Big Pharma price increases slips away because of intra-party conflicts. Voters delivered the White House and the House and Senate to Democrats in 2020, but left the party with slim majorities leaving little room for defections. As one analyst puts it, “Trying to do transformational change with a razor thin majority was going to be a daunting task in the first place. It’s going to remain an uphill slog.” We hope that Congress will keep slogging until seniors receive the coverage expansions they need to stay healthy — and some sorely-needed relief from soaring drug prices.
5.9% COLA is Good, But Seniors Need a Permanent Boost
The federal government announced today that Social Security beneficiaries will receive a 5.9% cost-of-living adjustment (COLA) in 2022. That’s about $92 extra per month for the average beneficiary. According to USA Today, “the sharp increase is tied to a COVID-19-fueled spike in inflation after years of paltry consumer price increases.” The 5.9% COLA is the largest in nearly forty years.
“This is welcome news for seniors, who need a boost to confront ever-rising living costs. However, the fact that this is the highest COLA since 1982 does not speak well for Social Security’s ability to keep pace with those expenses. The average COLA for the past ten years was only 1.65%. In three of the past 12 years the COLA was zero. Were it not for COVID-related inflation, the COLA for 2022 likely would have been more in line with the modest increases of decades past.” – Max Richtman, President & CEO, National Committee to Preserve Social Security and Medicare
Meanwhile, the cost of essentials such as housing, food, and health care have skyrocketed. So, while an average $92 per month increase in Social Security benefits is helpful, it may only make a dent in many seniors’ ability to pay their monthly bills. Not to mention that an increase in Medicare premiums – to be announced in November – will take a bite out of most beneficiaries’ COLAs.
More than half of seniors receive over 50 percent of their income from Social Security, and it provides at least 90 percent of income for more than one-in-five seniors. They deserve a COLA formula that reflects their spending patterns. The current formula, the Consumer Price Index for Urban Wage Earners (CPI-W), simply does not. That’s why we support legislation to adopt the Consumer Price Index for the Elderly (CPI-E), which is designed to calculate the true impact of inflation on seniors.
But the problem runs deeper. Seniors haven’t received an increase in their baseline monthly benefits in fifty years. The average annual benefit is only a few thousand dollars above the federal poverty line. It is time to boost benefits for everyone on Social Security. Rep. John Larson (D-CT) has for years been leading an effort, which we support, to expand Social Security, including an across-the-board benefit increase — and a specific boost for lower income workers.
“Congress has failed seniors and that needs to change. Next week we will be introducing the bill, Social Security 2100: A Sacred Trust, to strengthen Social Security and expand benefits. The time is now to enhance Social Security.” – Rep. John Larson, 10/13/21
America’s seniors have paid into the system their entire working lives. They shouldn’t have to walk a financial tightrope every month, in constant fear of falling into poverty. This Congress, representing the wealthiest country in the world, must do better for its older – and most vulnerable – citizens.
What’s Happening with Budget Reconciliation Legislation Affecting Seniors?
As Democrats attempt to unite around a final budget reconciliation package – otherwise known as President Biden’s Build Back Better Plan – seniors advocates are keeping a close eye on key provisions affecting older Americans. The Democrats’ plan included adding dental, vision, and hearing coverage to Medicare — and allowing the Medicare program to negotiate prescription drug prices with Big Pharma. We spoke to Dan Adcock, director of government relations and policy here at the National Committee, about what is likely to happen to those key provisions for American seniors.
Q: Is it still realistic that the Democrats’ final reconciliation bill will include dental, vision, and hearing coverage for Medicare beneficiaries?
A: It’s hard to know at this point. Benefits improvements may be scaled back, especially if prescription drug reforms are weakened. Democrats had planned to use savings from prescription drug reform to pay for some of these expansions, but now those reforms may not be as robust and produce fewer savings. There are other ways to pay for Medicare expansion, such as higher taxes on the wealthy and big corporations included in the budget reconciliation bill approved by the House Ways and Means Committee. But how this revenue will be used in the final spending bill is still uncertain.
Q: If Medicare expansion is pared back, which of the new coverages would likely survive?
A: For months, the odds-on favorite was dental benefits. But the problem is that a dental benefit will take longer to implement. It could take anywhere from 3-5 years to design and put into effect. From a policy standpoint, that’s a laudable objective, but from a political standpoint, it creates a problem. Vision and hearing coverage would be easier to assemble and get off the ground – maybe just a year or two.
Q: Are there any workarounds for getting a dental benefit up and running sooner?
A: Some centrist Democrats have proposed giving beneficiaries dental vouchers in lieu of a formal benefit. The problem with that is that dentists could raise prices for their services so that the net out-of-pocket expense for seniors would still be high, even with the vouchers. The voucher plan might also deprive CMS of money and administrative bandwidth to develop a fuller dental benefit in the future. For these reasons, we don’t support vouchers. However, in the meantime, Medicare could expand existing coverage for dental care considered “medically necessary,” so that more dental procedures would be covered moving forward.
Q: Seniors’ advocates have pressed very hard for Medicare to be allowed to negotiate prescription drug prices, but the fate of that provision in the reconciliation bill is unclear?
A: I would say that Medicare price negotiation is not dead, but is on ‘life support.’ The final reconciliation package is unlikely to have full-on negotiation. But we and other seniors’ advocates are still pushing for it. And we are encouraging our members and supporters to contact their members of Congress to demand Medicare price negotiation. Unfortunately, Big Pharma has been pulling out all the stops to stop Medicare negotiation, and the industry wields outsized power on Capitol Hill. Centrist Democrats, especially in the Senate, may not vote for a final package if it contains price negotiation.
Q: Without Medicare price negotiation, what kind of drug cost reform can we still expect?
A: We expect to at least see something resembling the Grassley-Widen bill (first introduced in the previous Congress), which would cap drug price increases at the rate of inflation and peg some prices to what other countries pay for drugs. These reforms would not be as effective as Medicare negotiation, but they would definitely lower what seniors pay for prescription drugs. Given that many seniors can’t currently afford their medications, these other reforms would be a step in the right direction and provide some much-needed relief.
Q: When do you think the reconciliation package will actually be finalized and brought to the floor for a vote?
A: I think it’s unlikely to be this week. The hold-up is that Democrats need a bill that can pass both the House and Senate. Leadership is trying to ascertain what centrists will support in the end. The problem is that some centrists have said what they’re against in the reconciliation package, but not what they’re for. Until that is made apparent, it will be hard to bring a final bill to the floor.
NCPSSM President to Manchin & Sinema: Protect Seniors’ Voting Rights!
Wikimedia Commons
The National Committee to Preserve Social Security and Medicare is appealing to Senators Joe Manchin and Krysten Sinema to support changes to the filibuster in order to protect older Americans’ voting rights. In letters to each senator co-signed by some 40 advocates and political influencers, NCPSSM President and CEO Max Richtman writes that adjusting the Senate filibuster is the only way to safeguard ballot access for seniors if enough Republican Senators won’t support new federal voting rights legislation. Such legislation is necessary, says Richtman, because of restrictive, new state laws that infringe on seniors’ right to vote by mail.
The National Committee, with millions of members and supporters nationwide (including some 38,000 in Arizona and 12,000 in West Virginia), supported both senators’ campaigns in 2018.
“We urge you to support a narrow change to the filibuster rule to allow the Senate to approve new voting rights legislation by a simple majority vote. This crucial legislation will help to protect our democracy and the right to vote for all Americans, including older Arizonans and West Virginians who cast ballots by mail.” – Max Richtman, President and CEO, National Committee to Preserve Social Security and Medicare.
At least 14 states have passed new laws that restrict access to the vote. The West Virginia State Senate has approved a bill which would move up the deadline for requesting an absentee ballot from six days before Election Day to 11 days. Meanwhile, Arizona lawmakers enacted legislation to prohibit sending absentee ballots or ballot applications to voters unless requested.
“The sole purpose of restrictive, new state laws is to suppress votes that the majority party in these legislatures don’t like. We urge Senator Sinema and Senator Manchin to protect American voters from being disenfranchised — including millions of seniors who otherwise can’t safely make it to the polls. If it becomes clear that adjusting the filibuster is the only option to guarantee voting rights, we hope the Senator will reconsider her position.” – Max Richtman, 9/21/21
Currently, seniors who are immobile, sick, or don’t want to risk being infected by the delta COVID variant can request mail ballots — along with those who cannot drive or lack access to mass transit. Voting by mail allows these older citizens to exercise their constitutional rights in a safe, convenient way. In 2020, the majority of voters over age 65 cast their ballots by mail.
Those who want to restrict that right falsely claim that voting by mail is rife with fraud. Nothing could be farther from the truth. Studies have shown mail-in voting to be consistently free of fraud. An M.I.T. study found that only 0.00006% of 250 million mail-in votes nationwide were fraudulent. Additionally, scholars at Stanford University analyzing more than twenty years’ worth of data in California, Utah and Washington found vote-by-mail did not advantage one political party over another.
Nevertheless, Republicans in the Arizona legislature and West Virginia state senate bought into the “Big Lie” that the 2020 presidential election results were illegitimate. Arizona’s law is a solution in search of a problem since county election officials recently reported fewer than 200 cases of potential voter fraud out of more than 3 million ballots cast statewide in the 2020 election.
The National Committee implores both senators to stand up for seniors by supporting a narrow change to the filibuster rule to allow the Senate to approve the For the People Act on a simple majority vote. That is the only truly democratic choice.
Read our letters to Senator Sinema and Senator Manchin.
Holdout House Dems Should Side with the People, Not Big Pharma
Nearly 90% of the American public wants Medicare to be able to negotiate drug prices with Big Pharma – including a majority of Republicans. Unfortunately, the will of the people is being thwarted not only by Republicans on Capitol Hill — who refuse to support Medicare price negotiation — but holdout ‘moderate’ Democrats.
This week three Blue Dog Democrats, Reps. Kurt Schrader (D-OR), Kathleen Rice (D-NY), and Scott Peters (D-CA), voted against Medicare drug price negotiation in the House Energy & Commerce Committee, preventing the measure from being sent to the House floor. Over at the House Ways and Means Committee, Rep. Stephanie Murphy (D-FL) was the sole Democrat casting her vote against Medicare negotiation, though there were enough other votes to pass it out of that committee. (Rep. Murphy voted against every provision in the Democrats’ $3.5 trillion plan, saying she needed more time to study it.)
These ‘No’ votes have not yet doomed Medicare drug cost negotiation – which we have long argued is the best way to reduce prescription prices for seniors – but they do signal that there may not be enough Democratic support for the measure to pass in the full U.S. House, where the party has only the slimmest of majorities.
Even if Medicare price negotiation survives a House vote (as part of President Biden’s $3.5 trillion Build Back Better plan), it is unlikely to garner sufficient support in the Senate. Republicans, of course, will not vote for it, and Senate Democrats are already working on a more modest drug price reform package that does not allow Medicare to negotiate prices.
“The purpose of the drug pricing policy is to pay for a host of new health care policies. The way it works is that it allows the government to restrict the maximum price that drug companies can charge for insulin and a set of expensive drugs that don’t face competition, and generate savings by forcing pharmaceutical companies to take the hit — the measure could save the government $500 billion over a decade.” – MSNBC, 9/16/21
This is another one of those moments in history when reformers put forward commonsense proposals (with the support of the majority of the American people) — and wealthy, powerful interests block their efforts. Big Pharma has intensified its lobbying efforts to defeat drug pricing reform – and especially the ability of Medicare to negotiate prices. In fact, Big Pharma successfully lobbied to exclude Medicare price negotiation when the Medicare Modernization Act was written and enacted in 2003.
Seniors and their advocates felt that this year – with a Democratic President and both houses of Congress in the party’s control – was a golden opportunity to realize the long-held goal of Medicare drug price negotiation. But Big Pharma’s choke hold on federal policy decisions is formidable.
Some question the role that campaign contributions could be playing in this scenario. Of the three House Energy & Commerce committee Democrats who voted to nix Medicare price negotiation, two receive significant contributions from Big Pharma. Reps. Schrader and Peters have collected nearly $1.5 million over the course of their careers. In fact, Congressman Peters is the House’s “top recipient of pharmaceutical industry donations in the 2022 election cycle,” according to MSNBC. (Rep. Rice has received a relatively modest $8,500 from the industry since 2020, says MSNBC.)
“Leaders of nearly two dozen drug manufacturers said that though they share Americans’ concerns over healthcare costs, ‘these dangerous policy experiments are not the answer.’ Dangerous policy experiments? Nearly every other developed country worldwide allows its government insurance system to negotiate drug prices. And guess what? This reasonable use of market power allows people in other countries to pay roughly half what Americans pay for prescription meds.” – Los Angeles Times, 9/16/21
Of course, everyday Americans living paycheck to paycheck deserve to be heard, too. And while seniors’ advocates like us continue to fight for meaningful reform, it can be an uphill battle against Big Pharma’s billions. Not for lack of trying by the President. Earlier this week, President Biden reiterated his support for Medicare price negotiation, which is part of his Build Back Better plan.
We and our members and supporters still will embrace other meaningful reforms to emerge from the 117th Congress. Linking drug price increases to inflation and capping Medicare beneficiaries’ out of pocket drug costs are solid steps toward taming prescription prices. They would help seniors on fixed incomes — and likely lower drug costs for the public at large. But the American people want the full package, including Medicare price negotiation. They know that out of control drug prices are hurting Americans of all ages. When people ration medications or don’t fill prescriptions because of cost, it can literally kill them. Members of Congress should not turn their backs on the people they are supposed to represent. They should muster the courage to stand with the public — and not Big Pharma.
Dems Should Unite Around Medicare Expansion, RX Drug Price Negotiation
***This is an update of a previous Entitled to Know blog post.***
For years, we have been advocating for the expansion of seniors’ Medicare benefits. Traditional Medicare doesn’t cover basic dental, hearing, or vision care – which are the gateways to good health. Many seniors on fixed incomes simply can’t afford this kind of care on their own, so they skip visits to the eye doctor, the audiologist, or the dentist. We and other seniors’ advocates cheered President Biden’s Build Back Better plan, which called for adding dental, vision, and hearing coverage to Medicare. That plan is having a difficult birth in Congress, as moderate and Progressive Democrats wrangle over the plan’s size and scope, in anticipation of passing it via the budget reconciliation process.
Democratic leadership has set its sights on a possible vote on the package by the end of October, but some Hill-watchers believe that may be an overly optimistic target – as the party’s factions seem no closer to agreement than they were a few weeks ago. Meanwhile, seniors and their advocates anxiously await the outcome – hoping that long sought-after Medicare expansions will finally be enacted – and knowing that there is a limited window of opportunity to get it done, given that Democrats may lose control of one or both houses of Congress in 2022.
Policy analysts say that the most endangered of the potential new benefits is dental care, because it likely would be the most costly of the putative Medicare expansions – and would take the longest to get up and running. Dental coverage also faces dogged opposition from the American Dental Association (ADA), which is lobbying hard against it. Some Democrats have proposed dental vouchers as a compromise measure that could be activated much more quickly than a full-out dental benefit. But seniors’ advocates are wary of vouchers, because dentists could simply increase their prices significantly above the value of the vouchers, negating any serious net out-of-pocket savings for patients. Vouchers are also regarded as a big step toward privatization of Medicare, which advocates and the majority of the public rightly oppose. The ADA (and some Democrats) have even proposed the wrong-headed idea of means-testing any new benefits – so that only the poorest of beneficiaries would be eligible.
These roadblocks to Medicare expansion could have grave real-life consequences. Forgoing dental, vision, and hearing care increases seniors’ risk of serious injury and other health issues, which endangers beneficiaries and costs Medicare even more in the long run.
One thing is clear: the public wants Medicare expanded. According to a new Morning Consult poll, 84% of voters support adding dental, vision and hearing coverage to traditional Medicare. That number includes 79% percent of Republicans. Clearly, there is immense bipartisan support among everyday Americans for giving seniors these crucial coverages.
Morning Consult poll
Originally, Democrats wanted to pay for expanding Medicare with savings achieved through prescription drug pricing reform. The House-passed Elijah Cummings Lower Drug Costs Now Act (H.R.3) would save Medicare some $450 billion over ten years, mainly by allowing the program to negotiate prices directly with Big Pharma. But Democratic centrists in both chambers have balked at Medicare price negotiation, leaving the fate of the measure uncertain. Analysts say that a compromise negotiation measure may emerge, but that it could have less impact on actual drug prices.
On this issue, the public has made its preferences crystal clear. Poll indicates that a majority of voters across party lines support Medicare drug price negotiations. Republicans in Congress have called this commonsense proposal “Socialism,” even though the V.A. has been negotiating prices with drug-makers for years – and realizing significant savings in the process. According to one analysis, Medicare could save some 40% in drug costs if it were allowed to negotiate as the V.A. does. Of course, Big Pharma has launched an expensive lobbying effort and ad blitz against Medicare negotiation.
If drug pricing legislation is weakened in the budget reconciliation process, there will be less savings to the Medicare program. According to Adcock, that may limit the scope of dental, hearing, and vision coverage that can be added to Medicare. In fact, one or more of those coverages may not make it into the final legislation if there aren’t sufficient Medicare savings to pay for them.
“It’s possible we will see Medicare expansion enacted by the end of the year. It depends on how the Democrats are able to finesse this process. I wouldn’t bet the farm on it, but there’s a decent chance we’ll get something.” – Dan Adcock, NCPSSM Director of Government Relations and Policy
Seniors and their advocates will be understandably frustrated and disappointed if this historic opportunity to expand Medicare and tame Big Pharma price increases slips away because of intra-party conflicts. Voters delivered the White House and the House and Senate to Democrats in 2020, but left the party with slim majorities leaving little room for defections. As one analyst puts it, “Trying to do transformational change with a razor thin majority was going to be a daunting task in the first place. It’s going to remain an uphill slog.” We hope that Congress will keep slogging until seniors receive the coverage expansions they need to stay healthy — and some sorely-needed relief from soaring drug prices.
5.9% COLA is Good, But Seniors Need a Permanent Boost
The federal government announced today that Social Security beneficiaries will receive a 5.9% cost-of-living adjustment (COLA) in 2022. That’s about $92 extra per month for the average beneficiary. According to USA Today, “the sharp increase is tied to a COVID-19-fueled spike in inflation after years of paltry consumer price increases.” The 5.9% COLA is the largest in nearly forty years.
“This is welcome news for seniors, who need a boost to confront ever-rising living costs. However, the fact that this is the highest COLA since 1982 does not speak well for Social Security’s ability to keep pace with those expenses. The average COLA for the past ten years was only 1.65%. In three of the past 12 years the COLA was zero. Were it not for COVID-related inflation, the COLA for 2022 likely would have been more in line with the modest increases of decades past.” – Max Richtman, President & CEO, National Committee to Preserve Social Security and Medicare
Meanwhile, the cost of essentials such as housing, food, and health care have skyrocketed. So, while an average $92 per month increase in Social Security benefits is helpful, it may only make a dent in many seniors’ ability to pay their monthly bills. Not to mention that an increase in Medicare premiums – to be announced in November – will take a bite out of most beneficiaries’ COLAs.
More than half of seniors receive over 50 percent of their income from Social Security, and it provides at least 90 percent of income for more than one-in-five seniors. They deserve a COLA formula that reflects their spending patterns. The current formula, the Consumer Price Index for Urban Wage Earners (CPI-W), simply does not. That’s why we support legislation to adopt the Consumer Price Index for the Elderly (CPI-E), which is designed to calculate the true impact of inflation on seniors.
But the problem runs deeper. Seniors haven’t received an increase in their baseline monthly benefits in fifty years. The average annual benefit is only a few thousand dollars above the federal poverty line. It is time to boost benefits for everyone on Social Security. Rep. John Larson (D-CT) has for years been leading an effort, which we support, to expand Social Security, including an across-the-board benefit increase — and a specific boost for lower income workers.
“Congress has failed seniors and that needs to change. Next week we will be introducing the bill, Social Security 2100: A Sacred Trust, to strengthen Social Security and expand benefits. The time is now to enhance Social Security.” – Rep. John Larson, 10/13/21
America’s seniors have paid into the system their entire working lives. They shouldn’t have to walk a financial tightrope every month, in constant fear of falling into poverty. This Congress, representing the wealthiest country in the world, must do better for its older – and most vulnerable – citizens.
What’s Happening with Budget Reconciliation Legislation Affecting Seniors?
As Democrats attempt to unite around a final budget reconciliation package – otherwise known as President Biden’s Build Back Better Plan – seniors advocates are keeping a close eye on key provisions affecting older Americans. The Democrats’ plan included adding dental, vision, and hearing coverage to Medicare — and allowing the Medicare program to negotiate prescription drug prices with Big Pharma. We spoke to Dan Adcock, director of government relations and policy here at the National Committee, about what is likely to happen to those key provisions for American seniors.
Q: Is it still realistic that the Democrats’ final reconciliation bill will include dental, vision, and hearing coverage for Medicare beneficiaries?
A: It’s hard to know at this point. Benefits improvements may be scaled back, especially if prescription drug reforms are weakened. Democrats had planned to use savings from prescription drug reform to pay for some of these expansions, but now those reforms may not be as robust and produce fewer savings. There are other ways to pay for Medicare expansion, such as higher taxes on the wealthy and big corporations included in the budget reconciliation bill approved by the House Ways and Means Committee. But how this revenue will be used in the final spending bill is still uncertain.
Q: If Medicare expansion is pared back, which of the new coverages would likely survive?
A: For months, the odds-on favorite was dental benefits. But the problem is that a dental benefit will take longer to implement. It could take anywhere from 3-5 years to design and put into effect. From a policy standpoint, that’s a laudable objective, but from a political standpoint, it creates a problem. Vision and hearing coverage would be easier to assemble and get off the ground – maybe just a year or two.
Q: Are there any workarounds for getting a dental benefit up and running sooner?
A: Some centrist Democrats have proposed giving beneficiaries dental vouchers in lieu of a formal benefit. The problem with that is that dentists could raise prices for their services so that the net out-of-pocket expense for seniors would still be high, even with the vouchers. The voucher plan might also deprive CMS of money and administrative bandwidth to develop a fuller dental benefit in the future. For these reasons, we don’t support vouchers. However, in the meantime, Medicare could expand existing coverage for dental care considered “medically necessary,” so that more dental procedures would be covered moving forward.
Q: Seniors’ advocates have pressed very hard for Medicare to be allowed to negotiate prescription drug prices, but the fate of that provision in the reconciliation bill is unclear?
A: I would say that Medicare price negotiation is not dead, but is on ‘life support.’ The final reconciliation package is unlikely to have full-on negotiation. But we and other seniors’ advocates are still pushing for it. And we are encouraging our members and supporters to contact their members of Congress to demand Medicare price negotiation. Unfortunately, Big Pharma has been pulling out all the stops to stop Medicare negotiation, and the industry wields outsized power on Capitol Hill. Centrist Democrats, especially in the Senate, may not vote for a final package if it contains price negotiation.
Q: Without Medicare price negotiation, what kind of drug cost reform can we still expect?
A: We expect to at least see something resembling the Grassley-Widen bill (first introduced in the previous Congress), which would cap drug price increases at the rate of inflation and peg some prices to what other countries pay for drugs. These reforms would not be as effective as Medicare negotiation, but they would definitely lower what seniors pay for prescription drugs. Given that many seniors can’t currently afford their medications, these other reforms would be a step in the right direction and provide some much-needed relief.
Q: When do you think the reconciliation package will actually be finalized and brought to the floor for a vote?
A: I think it’s unlikely to be this week. The hold-up is that Democrats need a bill that can pass both the House and Senate. Leadership is trying to ascertain what centrists will support in the end. The problem is that some centrists have said what they’re against in the reconciliation package, but not what they’re for. Until that is made apparent, it will be hard to bring a final bill to the floor.
NCPSSM President to Manchin & Sinema: Protect Seniors’ Voting Rights!
Wikimedia Commons
The National Committee to Preserve Social Security and Medicare is appealing to Senators Joe Manchin and Krysten Sinema to support changes to the filibuster in order to protect older Americans’ voting rights. In letters to each senator co-signed by some 40 advocates and political influencers, NCPSSM President and CEO Max Richtman writes that adjusting the Senate filibuster is the only way to safeguard ballot access for seniors if enough Republican Senators won’t support new federal voting rights legislation. Such legislation is necessary, says Richtman, because of restrictive, new state laws that infringe on seniors’ right to vote by mail.
The National Committee, with millions of members and supporters nationwide (including some 38,000 in Arizona and 12,000 in West Virginia), supported both senators’ campaigns in 2018.
“We urge you to support a narrow change to the filibuster rule to allow the Senate to approve new voting rights legislation by a simple majority vote. This crucial legislation will help to protect our democracy and the right to vote for all Americans, including older Arizonans and West Virginians who cast ballots by mail.” – Max Richtman, President and CEO, National Committee to Preserve Social Security and Medicare.
At least 14 states have passed new laws that restrict access to the vote. The West Virginia State Senate has approved a bill which would move up the deadline for requesting an absentee ballot from six days before Election Day to 11 days. Meanwhile, Arizona lawmakers enacted legislation to prohibit sending absentee ballots or ballot applications to voters unless requested.
“The sole purpose of restrictive, new state laws is to suppress votes that the majority party in these legislatures don’t like. We urge Senator Sinema and Senator Manchin to protect American voters from being disenfranchised — including millions of seniors who otherwise can’t safely make it to the polls. If it becomes clear that adjusting the filibuster is the only option to guarantee voting rights, we hope the Senator will reconsider her position.” – Max Richtman, 9/21/21
Currently, seniors who are immobile, sick, or don’t want to risk being infected by the delta COVID variant can request mail ballots — along with those who cannot drive or lack access to mass transit. Voting by mail allows these older citizens to exercise their constitutional rights in a safe, convenient way. In 2020, the majority of voters over age 65 cast their ballots by mail.
Those who want to restrict that right falsely claim that voting by mail is rife with fraud. Nothing could be farther from the truth. Studies have shown mail-in voting to be consistently free of fraud. An M.I.T. study found that only 0.00006% of 250 million mail-in votes nationwide were fraudulent. Additionally, scholars at Stanford University analyzing more than twenty years’ worth of data in California, Utah and Washington found vote-by-mail did not advantage one political party over another.
Nevertheless, Republicans in the Arizona legislature and West Virginia state senate bought into the “Big Lie” that the 2020 presidential election results were illegitimate. Arizona’s law is a solution in search of a problem since county election officials recently reported fewer than 200 cases of potential voter fraud out of more than 3 million ballots cast statewide in the 2020 election.
The National Committee implores both senators to stand up for seniors by supporting a narrow change to the filibuster rule to allow the Senate to approve the For the People Act on a simple majority vote. That is the only truly democratic choice.
Read our letters to Senator Sinema and Senator Manchin.
Holdout House Dems Should Side with the People, Not Big Pharma
Nearly 90% of the American public wants Medicare to be able to negotiate drug prices with Big Pharma – including a majority of Republicans. Unfortunately, the will of the people is being thwarted not only by Republicans on Capitol Hill — who refuse to support Medicare price negotiation — but holdout ‘moderate’ Democrats.
This week three Blue Dog Democrats, Reps. Kurt Schrader (D-OR), Kathleen Rice (D-NY), and Scott Peters (D-CA), voted against Medicare drug price negotiation in the House Energy & Commerce Committee, preventing the measure from being sent to the House floor. Over at the House Ways and Means Committee, Rep. Stephanie Murphy (D-FL) was the sole Democrat casting her vote against Medicare negotiation, though there were enough other votes to pass it out of that committee. (Rep. Murphy voted against every provision in the Democrats’ $3.5 trillion plan, saying she needed more time to study it.)
These ‘No’ votes have not yet doomed Medicare drug cost negotiation – which we have long argued is the best way to reduce prescription prices for seniors – but they do signal that there may not be enough Democratic support for the measure to pass in the full U.S. House, where the party has only the slimmest of majorities.
Even if Medicare price negotiation survives a House vote (as part of President Biden’s $3.5 trillion Build Back Better plan), it is unlikely to garner sufficient support in the Senate. Republicans, of course, will not vote for it, and Senate Democrats are already working on a more modest drug price reform package that does not allow Medicare to negotiate prices.
“The purpose of the drug pricing policy is to pay for a host of new health care policies. The way it works is that it allows the government to restrict the maximum price that drug companies can charge for insulin and a set of expensive drugs that don’t face competition, and generate savings by forcing pharmaceutical companies to take the hit — the measure could save the government $500 billion over a decade.” – MSNBC, 9/16/21
This is another one of those moments in history when reformers put forward commonsense proposals (with the support of the majority of the American people) — and wealthy, powerful interests block their efforts. Big Pharma has intensified its lobbying efforts to defeat drug pricing reform – and especially the ability of Medicare to negotiate prices. In fact, Big Pharma successfully lobbied to exclude Medicare price negotiation when the Medicare Modernization Act was written and enacted in 2003.
Seniors and their advocates felt that this year – with a Democratic President and both houses of Congress in the party’s control – was a golden opportunity to realize the long-held goal of Medicare drug price negotiation. But Big Pharma’s choke hold on federal policy decisions is formidable.
Some question the role that campaign contributions could be playing in this scenario. Of the three House Energy & Commerce committee Democrats who voted to nix Medicare price negotiation, two receive significant contributions from Big Pharma. Reps. Schrader and Peters have collected nearly $1.5 million over the course of their careers. In fact, Congressman Peters is the House’s “top recipient of pharmaceutical industry donations in the 2022 election cycle,” according to MSNBC. (Rep. Rice has received a relatively modest $8,500 from the industry since 2020, says MSNBC.)
“Leaders of nearly two dozen drug manufacturers said that though they share Americans’ concerns over healthcare costs, ‘these dangerous policy experiments are not the answer.’ Dangerous policy experiments? Nearly every other developed country worldwide allows its government insurance system to negotiate drug prices. And guess what? This reasonable use of market power allows people in other countries to pay roughly half what Americans pay for prescription meds.” – Los Angeles Times, 9/16/21
Of course, everyday Americans living paycheck to paycheck deserve to be heard, too. And while seniors’ advocates like us continue to fight for meaningful reform, it can be an uphill battle against Big Pharma’s billions. Not for lack of trying by the President. Earlier this week, President Biden reiterated his support for Medicare price negotiation, which is part of his Build Back Better plan.
We and our members and supporters still will embrace other meaningful reforms to emerge from the 117th Congress. Linking drug price increases to inflation and capping Medicare beneficiaries’ out of pocket drug costs are solid steps toward taming prescription prices. They would help seniors on fixed incomes — and likely lower drug costs for the public at large. But the American people want the full package, including Medicare price negotiation. They know that out of control drug prices are hurting Americans of all ages. When people ration medications or don’t fill prescriptions because of cost, it can literally kill them. Members of Congress should not turn their backs on the people they are supposed to represent. They should muster the courage to stand with the public — and not Big Pharma.