Ron Johnson’s Plan is Part of GOP Assault on Seniors’ Earned Benefits
Wikimedia Commons
Social Security and Medicare defenders often say that the public doesn’t understand the threat that Republicans pose to these programs. Indeed, many Republicans proclaim support for both while pushing proposals to undermine them. But lately it seems as if Republicans are going out of their way to lay bare their intentions – or, as some put it, “to say the quiet part out loud.”
Earlier this week, Senator Ron Johnson (R-WI) said during an interview that Social Security and Medicare should no longer be mandatory spending programs. Instead, he said, they should be considered “discretionary spending” and subject to routine budget negotiations every year. This, of course, violates the basic principles of social insurance, where workers pay into the system now in order to collect guaranteed benefits later. Leaving those benefits to the “discretion” of Congress every fiscal year would break the fundamental promise of Social Security and Medicare.
It’s little wonder, then, that Sen. Johnson’s proposal attracted a lot of media attention – and probably not the kind that he wanted. Here are just a few of the headlines:
Ron Johnson aims to put Social Security on the chopping block, White House says. (Truthout)
Lt. Governor Slams ‘Self-Serving, Multimillionaire’ Ron Johnson for Attack on Social Security, Medicare (Salon)
Chris Wallace calls Ron Johnson’s Social Security, Medicare idea ‘suicidal politics’ (The Hill)
Sen. Johnson suggests ending Medicare, Social Security as mandatory spending programs (Washington Post)
As these two landmark social insurance programs mark their anniversaries this summer (Medicare on July 30th and Social Security on August 14th), Republicans are piling up proposals that could weaken or outright end them. Sen. Johnson’s is merely the latest in a series of really bad ideas. (See Sen. Rick Scott’s proposal to sunset Social Security and Medicare after five years — or Sen. Mitt Romney’s TRUST Act, for starters.) This is not a surprise, as most Republicans opposed Social Security and Medicare when they were enacted in 1935 and 1965, respectively – and have been hoping to undo or privatize both programs for decades.
Sen. Johnson surely is no friend to Social Security and Medicare, having called the former “a Ponzi scheme” just last year. His Democratic opponent in the fall mid-terms, Wisconsin Lt. Governor Mandela Barnes, wasted no time calling Johnson out for his latest proposal:
“Barnes slammed Sen. Ron Johnson as a ‘self-serving, multimillionaire’ after the sitting Republican from Wisconsin called for making both Social Security and Medicare discretionary programs—a reform that would pave the way for the GOP to realize its half-century-long dream of dismantling two of the nation’s most essential and popular social programs.”
The White House, too, was quick to respond to Sen. Johnson, tweeting:
“Congressional Republicans like Senator Ron Johnson want to put Social Security and Medicare on the chopping block…That would devastate families.” – White House tweet, 8/2/22
None other than former FOX News anchor Chris Wallace excoriated Johnson during an interview on CNN:
“Social Security is not money that is just handed out to Americans. ‘Hey, here’s some free money.’ We pay into Social Security. We pay into Medicare. It’s, in effect, an insurance policy. Nobody would say, ‘You’re not entitled to the benefit for a life insurance when the person who has the policy dies.’ We have been paying into the system for years.”
Wallace called Johnson’s plan “suicidal politics.” That seems like a fair characterization given that Social Security and Medicare are incredibly popular. In poll after poll, overwhelming majorities say they want to see both programs protected and expanded, not cut and privatized.
“Both programs were first introduced in order to provide a crucial social safety net for seniors, disabled people and other vulnerable populations; Social Security… has allowed millions of people to retire and avoid poverty. Medicare has saved countless lives, and experts say that cutting it would be disastrous.” – Truthout, 8/3/22
By continuing to push proposals that undermine the very nature of Social Security and Medicare, Republicans are gambling that the public will be fooled or simply not care. Heading into this fall’s mid-term elections, all workers and retirees should make sure they know not just what their candidates say about these programs, but what they actually propose to do. Republicans – who hope to retake both houses of Congress in November – are making their destructive agenda increasingly apparent to anyone who is listening.
Much for Seniors to Cheer, Big Pharma to Jeer, in Senate Rx Deal
News of a deal between Senators Joe Manchin and Chuck Schumer for a broader reconciliation package including climate, inflation, and prescription drug reform measures is good for seniors. All three issues touch older Americans’ lives, though the health care provisions in the new deal are not radically different than the ‘skinnier’ version that the two Senators agreed upon earlier this month.
The measures that most directly help seniors in the current deal are:
*Empowering Medicare to negotiate the price of certain medications with Big Pharma
*A $2,000 cap on out-of-pocket costs for Medicare Part D beneficiaries
*Rebates to be paid by drug companies if they raise prices higher than the rate of inflation
While the latest reconciliation bill is far less ambitious than the original Build Back Better plan that took shape in 2021 (until Senator Manchin withdrew his support), these improvements for seniors are no small matter. In fact, advocates have been fighting for prescription drug price reform for years.
Most importantly, the bill would undo one of the most objectionable provisions of the legislation that created the Medicare Part D drug benefit back in 2003: the law actually forbade the government from negotiating prices with drug makers. Ever since then, the National Committee has been urging Congress to allow drug price negotiation. This legislation represents the first potential piercing of the barrier erected by the 2003 law.
While the number and type of drugs whose prices would be negotiated is limited in the new bill, the measure is “the camel’s nose under the tent” that seniors’ advocates have been looking for. And that is why Big Pharma has vigorously opposed any price negotiation with Medicare, no matter how limited.
“The industry is frightened by this (potential) cracking of the ceiling allowing at least some price negotiation when the law has forbidden it since 2003. That’s a long way to come in 20 years.” – Maria Freese, senior policy analyst at the National Committee to Preserve Social Security and Medicare, 7/29/22
The out-of-pocket cost cap for Medicare Part D beneficiaries would also be a significant step. Some seniors with serious health conditions (both chronic and acute) currently face exorbitant out-of-pocket prescription drug costs. Nearly 1 in 4 Americans say they have problems affording their medications.
“Today, there is no cap on spending for prescription drugs seniors buy from pharmacies. This proposal ensures that devastating diagnoses, like cancer, will never again mean paying tens of thousands out of pocket for just one drug.” – Senate Democrats, 7/28/22
Capping those out-of-pockets to $2,000 per year, as the proposed reconciliation bill does, would be another big win for older Americans – along with penalizing Big Pharma for hiking prices higher than the rate of inflation.
The Senate is expected to vote on the reconciliation bill during the week of July 31st,, providing that it passes muster with the Senate parliamentarian and that there are no objections from any Democratic Senators. The House may return to take up the bill in mid-August. Of course, success has seemed to be at hand in the past, only to have a deal collapse at the last minute. Time for action is running short.
“Democrats know that this bill is probably the only one they’ll be able to pass over Republicans’ objections, potentially for the rest of Biden’s presidency, if Republicans take back one or both chambers of Congress this fall.” – Washington Post, 7/29/22
There is some incidental symbolism to the timing of the new bill, as well. The Medicare program turns 57 years old on July 30th. As our president and CEO, Max Richtman writes in Common Dreams, with zero Republican support for the reconciliation bill, it falls to Democrats to improve Medicare, one of the party’s most significant legacies. “As we mark this 57th anniversary, let’s re-commit to protecting (and expanding) this tremendous pillar of the Great Society.”
Manchin Pulls the Football Away from Schumer – and Medicare
Wikimedia Commons
***The following is an update of our blog post from Wednesday, July 13, 2022***
Senator Joe Manchin has once again pulled the proverbial football away from Chuck Schumer just before the kick. After negotiating with the Senate Majority Leader over a pared-back version of the Build Back Better bill, Sen. Manchin has withdrawn his support – not for the entire plan, but for key components that would have strengthened Medicare. He declared on Thursday that he would not support any new tax provisions. One of these provisions would have closed a loophole, compelling the wealthy to pay a 3.8% investment tax. The revenue from this new iteration of the legislation would have been directed to the Medicare Part A trust fund, which is currently projected to run dry in 2028. This extra tax revenue would have kept the trust fund solvent for at least another decade from now. The main part of what’s left of Build Back Better (the part that Senator Manchin has not withdrawn his support for, at least not yet) is empowering Medicare to negotiate prescription drug prices with Big Pharma.
The negotiations between Senate Majority Leader Chuck Schumer and Senator Joe Manchin (D-WV) over a new budget reconciliation deal have been great fodder for political journalists, but they are also incredibly important to American seniors. Senators Schumer and Manchin are haggling over a pared-down version of the Build Back Better legislation, which the West Virginia Senator effectively killed earlier this year, designed to pass with only Democratic votes via the reconciliation process. The new package reportedly retains a crucial item for older Americans: prescription drug pricing reform.
According to press reports, the Schumer-Manchin deal finally would allow Medicare to negotiate prescription drug prices with Big Pharma – a marquee provision of the old Build Back Better plan. Drug price negotiation could save the Medicare program some $288 billion over ten years and exert downward pressure on prescription prices in general. This would be welcome news for seniors on fixed incomes who are skipping medications because of prohibitive costs.
“Under the Drug Price Negotiation Program (DPNP) that would be established in the Senate proposal, beginning in 2023, the secretary of health and human services would be required to negotiate lower prices for 10 of the most expensive drugs that lack market competition, with these prices going into effect in 2026. The number of drugs would increase to 20 by 2029.” – Center for American Progress, 7/12/22
The reconciliation bill reportedly also would cap Medicare Part D beneficiaries’ out-of-pocket drug costs at $2,000 per year. Currently, there is no limit on how much Medicare patients – whose median annual income is $26,000 – must pay out of pocket for prescriptions. The Schumer-Manchin deal would go further, requiring drugmakers to pay rebates for any price hikes exceeding the rate of inflation. “Just this year, some drug companies increased prices upward of 16 percent (more than double the rate of inflation), making already expensive drugs even more unaffordable,” observes the Center for American Progress.
None of this is certain. Senator Manchin signaled agreement with the Build Back Better plan throughout the past year, only to withdraw his support at the last minute. The current negotiations – which Senator Schumer is conducting virtually during his COVID isolation in Brooklyn – could fall apart at any time. Manchin told Politico, “(Senator Schumer) knows exactly where I’m at. Now whether (the Democrats) can get there or whatever, we’ll see.”
The deal reportedly taking shape is not nearly as ambitious or sweeping as Build Back Better, which would have expanded Medicare to cover basic hearing care. But seniors’ advocates, including NCPSSM, will gladly accept a partial victory that includes the long-sought goal of prescription drug price negotiation. As the Center for American Progress so aptly put it, “After decades of inaction, Congress cannot let this effort for reform simply come and go.”
Schumer-Manchin Negotiations May Yield Some Wins for Seniors
Wikimedia Commons
The negotiations between Senate Majority Leader Chuck Schumer and Senator Joe Manchin (D-WV) over a new budget reconciliation deal have been great fodder for political journalists, but they are also incredibly important to American seniors. Senators Schumer and Manchin are haggling over a pared-down version of the Build Back Better legislation, which the West Virginia Senator effectively killed earlier this year, designed to pass with only Democratic votes via the reconciliation process. The new package reportedly retains some crucial items for older Americans: prescription drug pricing reform and Medicare solvency.
According to press reports, the Schumer-Manchin deal finally would allow Medicare to negotiate prescription drug prices with Big Pharma – a marquee provision of the old Build Back Better plan. Drug price negotiation could save the Medicare program some $288 billion over ten years and exert downward pressure on prescription prices in general. This would be welcome news for seniors on fixed incomes who are skipping medications because of prohibitive costs.
“Under the Drug Price Negotiation Program (DPNP) that would be established in the Senate proposal, beginning in 2023, the secretary of health and human services would be required to negotiate lower prices for 10 of the most expensive drugs that lack market competition, with these prices going into effect in 2026. The number of drugs would increase to 20 by 2029.” – Center for American Progress, 7/12/22
The reconciliation bill reportedly also would cap Medicare Part D beneficiaries’ out-of-pocket drug costs at $2,000 per year. Currently, there is no limit on how much Medicare patients – whose median annual income is $26,000 – must pay out of pocket for prescriptions. The Schumer-Manchin deal would go further, requiring drugmakers to pay rebates for any price hikes exceeding the rate of inflation. “Just this year, some drug companies increased prices upward of 16 percent (more than double the rate of inflation), making already expensive drugs even more unaffordable,” observes the Center for American Progress.
There is more good news for Medicare in the reconciliation package. The Schumer-Manchin deal would bolster the solvency of the Part A Trust fund by closing a tax loophole so that wealthy business owners pay the 3.8% Net Investment Income Tax (NIIT). Revenue generated from the NIIT would be diverted to the Medicare Part A trust fund, which is currently projected to run dry in 2028. This provision would extend the life of the Part A trust fund for at least a decade from now, according to Rep. Lloyd Doggett, who introduced similar legislation in the House this week. NCPSSM President and CEO Max Richtman lauded Doggett’s legislation as a reasonable step to ensure Medicare’s financial health:
“The justifiably acute concern for the future solvency of the Medicare Trust Fund calls for common sense, immediate solutions that do not impose additional financial burdens on beneficiaries… (This legislation) meets both requirements by claiming misdirected tax revenue from the Treasury back to the Medicare Trust Fund.” – NCPSSM President and CEO Max Richtman, 7/11/22
None of this is certain. Senator Manchin signaled agreement with the Build Back Better plan throughout the past year, only to withdraw his support at the last minute. The current negotiations – which Senator Schumer is conducting virtually during his COVID isolation in Brooklyn – could fall apart at any time. Manchin told Politico, “(Senator Schumer) knows exactly where I’m at. Now whether (the Democrats) can get there or whatever, we’ll see.”
The deal reportedly taking shape is not nearly as ambitious or sweeping as Build Back Better, which would have expanded Medicare to cover basic hearing care. But seniors’ advocates, including NCPSSM, will gladly accept a partial victory that includes improved Medicare solvency without benefit cuts and the long-sought goal of prescription drug price negotiation. As the Center for American Progress so aptly put it, “After decades of inaction, Congress cannot let this effort for reform simply come and go.”
House Members Urge CMS to Expand Medicare Dental Coverage
More than 100 members of the U.S. House have sent a letter to the head of the Centers for Medicare and Medicaid Services (CMS) in an effort to expand Medicare dental coverage. (Traditional Medicare only covers “medically necessary” dental care in a narrowly defined way that excludes not only routine care, but many illness-related treatments.) The members implored CMS administrator Chiquita Brooks-LaSure to broaden the definition of “medically necessary” to cover many more types of dental care.
“To improve patient outcomes, promote greater health equity, and reduce Medicare spending, we urge CMS to use existing regulatory authority to improve coverage of medically necessary oral and dental care.” – House members’ letter to CMS, 6/29/22
Some 66% of Medicare beneficiaries have periodontal disease, but do not have dental coverage. Those who do have coverage can face high premiums, significant co-pays, and coverage limitations. In fact, many private dental plans only cover between $1,000-2,000 of dental care per patient per year.
The dearth of coverage and often unaffordable private insurance leaves many seniors without proper dental care. Neglecting dental care not only is bad for the teeth, but can negatively impact seniors’ overall health.
“Periodontal disease has been linked to other (medical) conditions, including diabetes, stroke, heart disease, kidney disease, and cancer. Nearly twenty percent of seniors have lost all their teeth and 68 percent have gum disease, resulting in seniors eating unhealthy foods that are easier to chew, but lead to elevated blood sugar and uncontrolled diabetes.” – House members’ letter to CMS
Expanding dental coverage also would significantly reduce Medicare’s costs. Simply by providing coverage for the treatment of periodontal disease for patients with heart disease, stroke, and diabetes, one study estimates that Medicare could save $63.5 billion over ten years.
In their letter, the House members urge CMS to expand Medicare dental and oral care coverage to include “all medically necessary situations,” including emergency room visits, hospitalizations for dental conditions in which oral bacteria is the underlying cause, Parkinson’s-related issues, multiple sclerosis, cancer treatment, organ transplant, and rheumatologic disease, among others.
Rep. Lloyd Doggett (D-TX), who had previously introduced a bill to expand dental coverage in traditional Medicare, signed the House letter to CMS
Even if CMS were to widen “medically necessary” coverage, that still would leave traditional Medicare patients without routine dental insurance – something the National Committee and other seniors’ groups have long advocated. Routine dental coverage in Medicare was included in early versions of the President’s Build Back Better plan but later removed. Expansions for hearing and vision coverage also were considered, to be paid for by savings from Medicare prescription drug price negotiation, but the entire bill stalled in the face of opposition from Senator Joe Manchin (D-WV).
The National Committee will continue to lobby on Capitol Hill for expansion, so that seniors’ teeth, eyes, and ears are more fully covered by traditional Medicare. Meanwhile, the House members’ advocacy for broadening Medicare regulations to include more types of dental care is a really good start.
For more information on dental care for seniors, visit our Aging, Health & Care web resource.
Ron Johnson’s Plan is Part of GOP Assault on Seniors’ Earned Benefits
Wikimedia Commons
Social Security and Medicare defenders often say that the public doesn’t understand the threat that Republicans pose to these programs. Indeed, many Republicans proclaim support for both while pushing proposals to undermine them. But lately it seems as if Republicans are going out of their way to lay bare their intentions – or, as some put it, “to say the quiet part out loud.”
Earlier this week, Senator Ron Johnson (R-WI) said during an interview that Social Security and Medicare should no longer be mandatory spending programs. Instead, he said, they should be considered “discretionary spending” and subject to routine budget negotiations every year. This, of course, violates the basic principles of social insurance, where workers pay into the system now in order to collect guaranteed benefits later. Leaving those benefits to the “discretion” of Congress every fiscal year would break the fundamental promise of Social Security and Medicare.
It’s little wonder, then, that Sen. Johnson’s proposal attracted a lot of media attention – and probably not the kind that he wanted. Here are just a few of the headlines:
Ron Johnson aims to put Social Security on the chopping block, White House says. (Truthout)
Lt. Governor Slams ‘Self-Serving, Multimillionaire’ Ron Johnson for Attack on Social Security, Medicare (Salon)
Chris Wallace calls Ron Johnson’s Social Security, Medicare idea ‘suicidal politics’ (The Hill)
Sen. Johnson suggests ending Medicare, Social Security as mandatory spending programs (Washington Post)
As these two landmark social insurance programs mark their anniversaries this summer (Medicare on July 30th and Social Security on August 14th), Republicans are piling up proposals that could weaken or outright end them. Sen. Johnson’s is merely the latest in a series of really bad ideas. (See Sen. Rick Scott’s proposal to sunset Social Security and Medicare after five years — or Sen. Mitt Romney’s TRUST Act, for starters.) This is not a surprise, as most Republicans opposed Social Security and Medicare when they were enacted in 1935 and 1965, respectively – and have been hoping to undo or privatize both programs for decades.
Sen. Johnson surely is no friend to Social Security and Medicare, having called the former “a Ponzi scheme” just last year. His Democratic opponent in the fall mid-terms, Wisconsin Lt. Governor Mandela Barnes, wasted no time calling Johnson out for his latest proposal:
“Barnes slammed Sen. Ron Johnson as a ‘self-serving, multimillionaire’ after the sitting Republican from Wisconsin called for making both Social Security and Medicare discretionary programs—a reform that would pave the way for the GOP to realize its half-century-long dream of dismantling two of the nation’s most essential and popular social programs.”
The White House, too, was quick to respond to Sen. Johnson, tweeting:
“Congressional Republicans like Senator Ron Johnson want to put Social Security and Medicare on the chopping block…That would devastate families.” – White House tweet, 8/2/22
None other than former FOX News anchor Chris Wallace excoriated Johnson during an interview on CNN:
“Social Security is not money that is just handed out to Americans. ‘Hey, here’s some free money.’ We pay into Social Security. We pay into Medicare. It’s, in effect, an insurance policy. Nobody would say, ‘You’re not entitled to the benefit for a life insurance when the person who has the policy dies.’ We have been paying into the system for years.”
Wallace called Johnson’s plan “suicidal politics.” That seems like a fair characterization given that Social Security and Medicare are incredibly popular. In poll after poll, overwhelming majorities say they want to see both programs protected and expanded, not cut and privatized.
“Both programs were first introduced in order to provide a crucial social safety net for seniors, disabled people and other vulnerable populations; Social Security… has allowed millions of people to retire and avoid poverty. Medicare has saved countless lives, and experts say that cutting it would be disastrous.” – Truthout, 8/3/22
By continuing to push proposals that undermine the very nature of Social Security and Medicare, Republicans are gambling that the public will be fooled or simply not care. Heading into this fall’s mid-term elections, all workers and retirees should make sure they know not just what their candidates say about these programs, but what they actually propose to do. Republicans – who hope to retake both houses of Congress in November – are making their destructive agenda increasingly apparent to anyone who is listening.
Much for Seniors to Cheer, Big Pharma to Jeer, in Senate Rx Deal
News of a deal between Senators Joe Manchin and Chuck Schumer for a broader reconciliation package including climate, inflation, and prescription drug reform measures is good for seniors. All three issues touch older Americans’ lives, though the health care provisions in the new deal are not radically different than the ‘skinnier’ version that the two Senators agreed upon earlier this month.
The measures that most directly help seniors in the current deal are:
*Empowering Medicare to negotiate the price of certain medications with Big Pharma
*A $2,000 cap on out-of-pocket costs for Medicare Part D beneficiaries
*Rebates to be paid by drug companies if they raise prices higher than the rate of inflation
While the latest reconciliation bill is far less ambitious than the original Build Back Better plan that took shape in 2021 (until Senator Manchin withdrew his support), these improvements for seniors are no small matter. In fact, advocates have been fighting for prescription drug price reform for years.
Most importantly, the bill would undo one of the most objectionable provisions of the legislation that created the Medicare Part D drug benefit back in 2003: the law actually forbade the government from negotiating prices with drug makers. Ever since then, the National Committee has been urging Congress to allow drug price negotiation. This legislation represents the first potential piercing of the barrier erected by the 2003 law.
While the number and type of drugs whose prices would be negotiated is limited in the new bill, the measure is “the camel’s nose under the tent” that seniors’ advocates have been looking for. And that is why Big Pharma has vigorously opposed any price negotiation with Medicare, no matter how limited.
“The industry is frightened by this (potential) cracking of the ceiling allowing at least some price negotiation when the law has forbidden it since 2003. That’s a long way to come in 20 years.” – Maria Freese, senior policy analyst at the National Committee to Preserve Social Security and Medicare, 7/29/22
The out-of-pocket cost cap for Medicare Part D beneficiaries would also be a significant step. Some seniors with serious health conditions (both chronic and acute) currently face exorbitant out-of-pocket prescription drug costs. Nearly 1 in 4 Americans say they have problems affording their medications.
“Today, there is no cap on spending for prescription drugs seniors buy from pharmacies. This proposal ensures that devastating diagnoses, like cancer, will never again mean paying tens of thousands out of pocket for just one drug.” – Senate Democrats, 7/28/22
Capping those out-of-pockets to $2,000 per year, as the proposed reconciliation bill does, would be another big win for older Americans – along with penalizing Big Pharma for hiking prices higher than the rate of inflation.
The Senate is expected to vote on the reconciliation bill during the week of July 31st,, providing that it passes muster with the Senate parliamentarian and that there are no objections from any Democratic Senators. The House may return to take up the bill in mid-August. Of course, success has seemed to be at hand in the past, only to have a deal collapse at the last minute. Time for action is running short.
“Democrats know that this bill is probably the only one they’ll be able to pass over Republicans’ objections, potentially for the rest of Biden’s presidency, if Republicans take back one or both chambers of Congress this fall.” – Washington Post, 7/29/22
There is some incidental symbolism to the timing of the new bill, as well. The Medicare program turns 57 years old on July 30th. As our president and CEO, Max Richtman writes in Common Dreams, with zero Republican support for the reconciliation bill, it falls to Democrats to improve Medicare, one of the party’s most significant legacies. “As we mark this 57th anniversary, let’s re-commit to protecting (and expanding) this tremendous pillar of the Great Society.”
Manchin Pulls the Football Away from Schumer – and Medicare
Wikimedia Commons
***The following is an update of our blog post from Wednesday, July 13, 2022***
Senator Joe Manchin has once again pulled the proverbial football away from Chuck Schumer just before the kick. After negotiating with the Senate Majority Leader over a pared-back version of the Build Back Better bill, Sen. Manchin has withdrawn his support – not for the entire plan, but for key components that would have strengthened Medicare. He declared on Thursday that he would not support any new tax provisions. One of these provisions would have closed a loophole, compelling the wealthy to pay a 3.8% investment tax. The revenue from this new iteration of the legislation would have been directed to the Medicare Part A trust fund, which is currently projected to run dry in 2028. This extra tax revenue would have kept the trust fund solvent for at least another decade from now. The main part of what’s left of Build Back Better (the part that Senator Manchin has not withdrawn his support for, at least not yet) is empowering Medicare to negotiate prescription drug prices with Big Pharma.
The negotiations between Senate Majority Leader Chuck Schumer and Senator Joe Manchin (D-WV) over a new budget reconciliation deal have been great fodder for political journalists, but they are also incredibly important to American seniors. Senators Schumer and Manchin are haggling over a pared-down version of the Build Back Better legislation, which the West Virginia Senator effectively killed earlier this year, designed to pass with only Democratic votes via the reconciliation process. The new package reportedly retains a crucial item for older Americans: prescription drug pricing reform.
According to press reports, the Schumer-Manchin deal finally would allow Medicare to negotiate prescription drug prices with Big Pharma – a marquee provision of the old Build Back Better plan. Drug price negotiation could save the Medicare program some $288 billion over ten years and exert downward pressure on prescription prices in general. This would be welcome news for seniors on fixed incomes who are skipping medications because of prohibitive costs.
“Under the Drug Price Negotiation Program (DPNP) that would be established in the Senate proposal, beginning in 2023, the secretary of health and human services would be required to negotiate lower prices for 10 of the most expensive drugs that lack market competition, with these prices going into effect in 2026. The number of drugs would increase to 20 by 2029.” – Center for American Progress, 7/12/22
The reconciliation bill reportedly also would cap Medicare Part D beneficiaries’ out-of-pocket drug costs at $2,000 per year. Currently, there is no limit on how much Medicare patients – whose median annual income is $26,000 – must pay out of pocket for prescriptions. The Schumer-Manchin deal would go further, requiring drugmakers to pay rebates for any price hikes exceeding the rate of inflation. “Just this year, some drug companies increased prices upward of 16 percent (more than double the rate of inflation), making already expensive drugs even more unaffordable,” observes the Center for American Progress.
None of this is certain. Senator Manchin signaled agreement with the Build Back Better plan throughout the past year, only to withdraw his support at the last minute. The current negotiations – which Senator Schumer is conducting virtually during his COVID isolation in Brooklyn – could fall apart at any time. Manchin told Politico, “(Senator Schumer) knows exactly where I’m at. Now whether (the Democrats) can get there or whatever, we’ll see.”
The deal reportedly taking shape is not nearly as ambitious or sweeping as Build Back Better, which would have expanded Medicare to cover basic hearing care. But seniors’ advocates, including NCPSSM, will gladly accept a partial victory that includes the long-sought goal of prescription drug price negotiation. As the Center for American Progress so aptly put it, “After decades of inaction, Congress cannot let this effort for reform simply come and go.”
Schumer-Manchin Negotiations May Yield Some Wins for Seniors
Wikimedia Commons
The negotiations between Senate Majority Leader Chuck Schumer and Senator Joe Manchin (D-WV) over a new budget reconciliation deal have been great fodder for political journalists, but they are also incredibly important to American seniors. Senators Schumer and Manchin are haggling over a pared-down version of the Build Back Better legislation, which the West Virginia Senator effectively killed earlier this year, designed to pass with only Democratic votes via the reconciliation process. The new package reportedly retains some crucial items for older Americans: prescription drug pricing reform and Medicare solvency.
According to press reports, the Schumer-Manchin deal finally would allow Medicare to negotiate prescription drug prices with Big Pharma – a marquee provision of the old Build Back Better plan. Drug price negotiation could save the Medicare program some $288 billion over ten years and exert downward pressure on prescription prices in general. This would be welcome news for seniors on fixed incomes who are skipping medications because of prohibitive costs.
“Under the Drug Price Negotiation Program (DPNP) that would be established in the Senate proposal, beginning in 2023, the secretary of health and human services would be required to negotiate lower prices for 10 of the most expensive drugs that lack market competition, with these prices going into effect in 2026. The number of drugs would increase to 20 by 2029.” – Center for American Progress, 7/12/22
The reconciliation bill reportedly also would cap Medicare Part D beneficiaries’ out-of-pocket drug costs at $2,000 per year. Currently, there is no limit on how much Medicare patients – whose median annual income is $26,000 – must pay out of pocket for prescriptions. The Schumer-Manchin deal would go further, requiring drugmakers to pay rebates for any price hikes exceeding the rate of inflation. “Just this year, some drug companies increased prices upward of 16 percent (more than double the rate of inflation), making already expensive drugs even more unaffordable,” observes the Center for American Progress.
There is more good news for Medicare in the reconciliation package. The Schumer-Manchin deal would bolster the solvency of the Part A Trust fund by closing a tax loophole so that wealthy business owners pay the 3.8% Net Investment Income Tax (NIIT). Revenue generated from the NIIT would be diverted to the Medicare Part A trust fund, which is currently projected to run dry in 2028. This provision would extend the life of the Part A trust fund for at least a decade from now, according to Rep. Lloyd Doggett, who introduced similar legislation in the House this week. NCPSSM President and CEO Max Richtman lauded Doggett’s legislation as a reasonable step to ensure Medicare’s financial health:
“The justifiably acute concern for the future solvency of the Medicare Trust Fund calls for common sense, immediate solutions that do not impose additional financial burdens on beneficiaries… (This legislation) meets both requirements by claiming misdirected tax revenue from the Treasury back to the Medicare Trust Fund.” – NCPSSM President and CEO Max Richtman, 7/11/22
None of this is certain. Senator Manchin signaled agreement with the Build Back Better plan throughout the past year, only to withdraw his support at the last minute. The current negotiations – which Senator Schumer is conducting virtually during his COVID isolation in Brooklyn – could fall apart at any time. Manchin told Politico, “(Senator Schumer) knows exactly where I’m at. Now whether (the Democrats) can get there or whatever, we’ll see.”
The deal reportedly taking shape is not nearly as ambitious or sweeping as Build Back Better, which would have expanded Medicare to cover basic hearing care. But seniors’ advocates, including NCPSSM, will gladly accept a partial victory that includes improved Medicare solvency without benefit cuts and the long-sought goal of prescription drug price negotiation. As the Center for American Progress so aptly put it, “After decades of inaction, Congress cannot let this effort for reform simply come and go.”
House Members Urge CMS to Expand Medicare Dental Coverage
More than 100 members of the U.S. House have sent a letter to the head of the Centers for Medicare and Medicaid Services (CMS) in an effort to expand Medicare dental coverage. (Traditional Medicare only covers “medically necessary” dental care in a narrowly defined way that excludes not only routine care, but many illness-related treatments.) The members implored CMS administrator Chiquita Brooks-LaSure to broaden the definition of “medically necessary” to cover many more types of dental care.
“To improve patient outcomes, promote greater health equity, and reduce Medicare spending, we urge CMS to use existing regulatory authority to improve coverage of medically necessary oral and dental care.” – House members’ letter to CMS, 6/29/22
Some 66% of Medicare beneficiaries have periodontal disease, but do not have dental coverage. Those who do have coverage can face high premiums, significant co-pays, and coverage limitations. In fact, many private dental plans only cover between $1,000-2,000 of dental care per patient per year.
The dearth of coverage and often unaffordable private insurance leaves many seniors without proper dental care. Neglecting dental care not only is bad for the teeth, but can negatively impact seniors’ overall health.
“Periodontal disease has been linked to other (medical) conditions, including diabetes, stroke, heart disease, kidney disease, and cancer. Nearly twenty percent of seniors have lost all their teeth and 68 percent have gum disease, resulting in seniors eating unhealthy foods that are easier to chew, but lead to elevated blood sugar and uncontrolled diabetes.” – House members’ letter to CMS
Expanding dental coverage also would significantly reduce Medicare’s costs. Simply by providing coverage for the treatment of periodontal disease for patients with heart disease, stroke, and diabetes, one study estimates that Medicare could save $63.5 billion over ten years.
In their letter, the House members urge CMS to expand Medicare dental and oral care coverage to include “all medically necessary situations,” including emergency room visits, hospitalizations for dental conditions in which oral bacteria is the underlying cause, Parkinson’s-related issues, multiple sclerosis, cancer treatment, organ transplant, and rheumatologic disease, among others.
Rep. Lloyd Doggett (D-TX), who had previously introduced a bill to expand dental coverage in traditional Medicare, signed the House letter to CMS
Even if CMS were to widen “medically necessary” coverage, that still would leave traditional Medicare patients without routine dental insurance – something the National Committee and other seniors’ groups have long advocated. Routine dental coverage in Medicare was included in early versions of the President’s Build Back Better plan but later removed. Expansions for hearing and vision coverage also were considered, to be paid for by savings from Medicare prescription drug price negotiation, but the entire bill stalled in the face of opposition from Senator Joe Manchin (D-WV).
The National Committee will continue to lobby on Capitol Hill for expansion, so that seniors’ teeth, eyes, and ears are more fully covered by traditional Medicare. Meanwhile, the House members’ advocacy for broadening Medicare regulations to include more types of dental care is a really good start.
For more information on dental care for seniors, visit our Aging, Health & Care web resource.