All House Dems Should Cosponsor Social Security 2100 Bill
If you are represented by a Democrat in the U.S. House, chances are that your member of Congress has already cosponsored a piece of landmark legislation to boost and strengthen Social Security: Rep. John Larson’s Social Security 2100: A Sacred Trust. In fact, the bill currently has 202 Democratic cosponsors (and zero Republicans). But some Democrats have not signed on as cosponsors, even though improving Social Security benefits and extending the solvency of the trust fund are priorities that Democrats should agree on. The more Democratic co-sponsorships the bill garners, the stronger the case that House leadership should bring it to the floor for a vote.
Rep. Larson, chair of the House Ways and Means Social Security subcommittee, introduced a new version of the bill in October, 2021. Among other things, Social Security 2100 would provide an across-the-board benefit increase for all beneficiaries. It would also boost benefits for particularly vulnerable groups – including widows, widowers, and the ‘oldest of the old’ seniors. The bill also includes a new COLA formula that better reflects seniors’ spending priorities.
“The pandemic has only underscored what we already knew and has exacerbated systemic inequities — current benefits are not enough! 5 million seniors are living in poverty due to longstanding workplace discrimination affecting mostly people of color and women. For too long, Congress has forsaken its duty to enhance benefits. With 10,000 Baby Boomers a day becoming eligible, and with Millennials needing Social Security more than any generation, the time for Congress to act is now.” – Rep. John Larson, 10/26/21
Social Security 2100 covers the costs of expanding benefits by adjusting the payroll wage cap so that higher earners contribute their fair share. This would only impact those earning more than $400,000 per year in wages – or less than 2% of working Americans.
In addition to the 202 House cosponsors, Social Security 2100 has been endorsed by over 100 advocacy groups, including the National Committee to Preserve Social Security and Medicare. Among the members who have not yet stepped forward as cosponsors, the National Committee hopes that Reps. Cynthia Axne (D-IA), Rep. Susie Lee (D-NV), and Rep. Tom O’Halleran (D-AZ) will do so now. Each of these House members are Social Security champions who earned 100% ratings on the National Committee’s most recent legislative scorecard.
Some of these Democrats may be worried that if they cosponsor the bill, Republicans will run attack ads accusing them of raising taxes. But President Biden won the White House promising not to increase taxes on anyone earning less than $400,000 a year, and the Sacred Trust bill conforms with that pledge. Many high earners who would be affected by the bill have told pollsters they don’t mind paying their fair share. And the group Patriotic Millionaires has long advocated adjusting the payroll wage cap.
The measures in Rep. Larson’s bill have overwhelming public support. A poll by Lake Research Partners showed that across party lines, 79% supported paying for an increase in benefits by having wealthy Americans pay the same rate into Social Security as everyone else. A recent survey of our members and supporters indicated 96 percent support for raising the cap. Survey respondents were unequivocal in their comments:
“Eliminate the wage cap! It’s common sense.”
“Make them pay their fair share!”
“The wealthy should pay Social Security taxes on everything they earn – just like we do.”
“There should not be a cap at all!”
Rep. Larson’s bill is awaiting mark-up by the full House Ways and Means committee, which is expected to happen in June. Lawmakers are also waiting for the Congressional Budget Office (CBO) to score the legislation, which is required for Social Security 2100 to be brought to the House floor for a vote.
Rep. Larson’s bill is truly historic. Social Security benefits have not been increased in more than fifty years. Retirees, people with disabilities, and their families need a benefit boost and a better COLA formula to meet ever-rising costs. They need the certainty that Social Security’s trust fund will remain solvent past the projected depletion date of 2034. The Republican response to Social Security’s challenges is to raise the retirement age (or enact other benefit cuts) and privatize the program — or as the chairman of the party’s Senatorial campaign committee proposed, to sunset all federal programs (including Social Security and Medicare) after five years.
Social Security 2100: A Sacred Trust presents an opportunity for Democrats to continue building on the foundation that President Franklin D. Roosevelt built when the program was created in 1935. Eighty-six years later, the program is at a crossroads. For the sake of all Americans who rely on Social Security, Rep. Larson’s bill is something that all House Democrats can – and should – get behind.
SSA Woefully Underfunded, Struggling to Provide Customer Service, Witnesses Tell Congress
Witness after witness at Tuesday’s Congressional hearing on Social Security Administration (SSA) customer service testified that the agency is in dire need of additional resources in order to properly serve the public. The hearing was held by the House Ways and Means Social Security subcommittee, chaired by Rep. John Larson (D-CT), with testimony from a variety of witnesses from SSA and advocacy groups. While witnesses praised SSA employees for doing their best to provide the public with customer service during the pandemic, they painted a picture of an underfunded and overworked agency in desperate need of Congressional action.
“The Agency and its employees have done an extraordinary job of making the most effective use of the dollars they have been appropriated. But backlogs that pre-existed the pandemic have grown exponentially, staff levels have dropped precipitously, and the Agency will need the strong support of Congress if it is to continue fulfilling its mission to your constituents,” urged Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare, in a written statement to the subcommittee.
Rebecca Vallas of the Century Foundation advocacy group told lawmakers at the hearing, “A decade-plus history of congress underfunding SSA’s already incredibly lean operating budget, worsened by the pandemic, has spurred several urgent crises in the agency’s customer service…The casualties are your constituents.”
Among the most pressing problems that have plagued SSA customer service are long hold times, disconnects, and busy signals on the agency’s toll-free phone line and excessive delays in Social Security Disability Insurance (SSDI) hearings. (Over 100,000 claimants have died waiting for their cases to be adjudicated.). In April, SSA was able to re-open most of its field offices after being shuttered for almost two years during the COVID pandemic.
SSA Deputy Commissioner for Operations, Grace Kim, credited managers, employees, labor unions, and advocates for the agency’s “ability to transition from remote work to walk-in service.” The field office re-openings went more smoothly than many advocates expected, but the agency must now contend with a huge backlog of work with inadequate resources.
“We are doing what we can with current staff and funding. The demand for service is high; we are losing staff; and morale is low,” testified Peggy Murphy, Director of the Social Security field office in Great Falls, Montana. “SSA is at a critical juncture as we face the future.”
Chairman Larson blamed SSA’s problems on budget cuts that Congress began imposing in 2010, pointing out that the agency’s operating funds have shrunk by 14% since then (adjusted for inflation), at the same time as demand for its services has skyrocketed as waves of Baby Boomers retire (at the rate of 10,000 every day).
Those budget cuts have forced SSA to lay off workers or allow vacant positions to remain unfilled, said Chairman Larson. “SSA has the lowest number of workers in 25 years despite almost double the number of beneficiaries.”
The Chairman pointed out that most of SSA’s operating budget is funded by payroll contributions from American workers “with each and every paycheck,” and that it is unjust for Congress to suppress funding for the agency that administers workers’ earned benefits.
Several witnesses voiced support for Chairman Larson’s Social Security 2100: A Sacred Trust legislation that would safeguard SSA customer service, including:
*A provision to prevent field office closures unless certain requirements are met.
*A provision to clarify that Congress did indeed intend for annual Social Security Statements to be mailed to workers age 25 and older so that they can plan for their financial security
The National Committee to Preserve Social Security and Medicare has enthusiastically endorsed Chairman Larson’s bill, which also boosts Social Security benefits across the board and extends the solvency of the program’s trust fund. Chairman Larson says that the bill will be marked-up in committee later in May or early June. The legislation has over 200 cosponsors in the House.
While the Social Security 2100 bill would improve SSA customer service, witnesses said that Congress must provide more robust funding for the struggling agency. “Our FY2022 appropriation is insufficient to provide the level of service your constituents expect and deserve,” said SSA’s Grace Kim.
The National Committee to Preserve Social Security and Medicare urges lawmakers to boost SSA funding to $15.55 billion for FY 2023, which is the amount submitted by the Agency itself to the Office of Management and Budget (OMB).
“Adequate funding for SSA is vitally important to your constituents and to our millions of members and supporters across the country who either are receiving Social Security or expect to do so in the future,” wrote Max Richtman in his statement to the subcommittee, “both to ensure that they receive the benefits they have earned and to maintain the public’s strong support for this essential program.”
The Part D Prescription Drug Bait and Switch
Medicare Part D prescription drug beneficiaries can be in for a rude surprise after they sign up for coverage. In an article this week in Kaiser Health News, Susan Jaffe writes that the price of a drug may jump within a month of a patient enrolling in a Part D drug plan. She cites the case of Linda Griffith, a California woman who used Medicare’s plan finder to select coverage last December, only to find that the price of one of her medications had jumped from $70 to $275 by January.
“As early as three weeks after Medicare’s drug plan enrollment period ends on Dec. 7, insurance plans can change what they charge members for drugs — and they can do it repeatedly.” – Kaiser Health News, 5/3/22
In fact, an AARP analysis found that the prices for the 75 most frequently prescribed drugs for Medicare beneficiaries climbed by as much as 8% between the end of December 2021 and the end of January 2022.
If this sounds like a bait-and-switch, the Centers for Medicare and Medicaid Services says that is just the way our current drug pricing system works. According to Medicare’s website, “Your plan may raise the copayment or coinsurance you pay for a particular drug when the manufacturer raises their price, or when a plan starts to offer a generic form of a drug,”
“I want my money back, and I want to be charged the amount I agreed to pay for the drug… I think this needs to be fixed because other people are going to be cheated.” – Linda Griffith, Medicare Part D beneficiary (Kaiser Health News)
Fixing the problem would require a change in the law. The 2003 Medicare Modernization Act, passed during the George W. Bush administration, established Part D drug coverage (to be provided by private insurance companies like Humana, Aetna, and Cigna), but forbade Medicare from negotiating prices with Big Pharma. NCPSSM President and CEO Max Richtman recently told CNBC that the ban on price negotiation “was put in in the middle of the night. We were not in the room when that deal was made.”
For many years, the National Committee to Preserve Social Security and Medicare and other seniors’ advocates have fought for new legislation empowering Medicare to negotiate prices. That goal finally seemed within reach when Congress took up President Biden’s Build Back Better plan, which contained a Medicare price negotiation provision.
The House-passed version of the bill would have allowed negotiations for a limited number of drugs. It wasn’t everything that advocates had hoped, but it would have been a good start. In the end, the Build Back Better plan failed to garner enough support in the Senate, due largely to the opposition of Senator Joe Manchin (D-WV).
Though Medicare price negotiation would be the single most effective way to lower seniors’ drug costs, other solutions have been percolating on Capitol Hill. These include an out-of-pocket cap on Part D drug costs and limiting drug price increases to the rate of inflation. All of these proposals have garnered the support of wide majorities in public opinion surveys. A 2021 Kaiser Health News poll found 83% of the public — including majorities of Democrats and Republicans —favored the federal government negotiating lower drug prices for both Medicare and private insurance.
Unfortunately, Big Pharma has used its multi-billion dollar lobbying and advertising arsenal to kill meaningful drug price reform so far. Some lawmakers apparently feel more beholden to drug makers than to their constituents, many of whom are skipping life-saving medications they can’t afford. Until Congress musters the political will to take another run at reform, the industry will continue to raise prices at will – leaving everyday Americans like Linda Griffith scrambling to cover the costs.
Medicare Advantage Slammed in New HHS Inspector General’s Report
We have been sounding alarm bells for many years about Medicare Advantage (MA), the privately-run health plans for seniors that are growing in popularity as an alternative to traditional Medicare. This week, an eye-opening report by the Inspector General’s office at the Department of Health and Human Services (HHS) confirmed some key criticisms by the National Committee and other seniors’ advocates – namely, that MA plans are denying legitimate claims and refusing to authorize reasonable medical procedures.
“Tens of millions of denials are issued each year for both authorization and reimbursements, and audits of the private insurers show evidence of ‘widespread and persistent problems related to inappropriate denials of services and payment,’ the investigators found.” – New York Times, 4/28/22
The Inspector General’s office estimated that 13% of claims that Medicare Advantage insurers denied should have been covered. MA plans also improperly denied up to 85,000 prior authorizations. The New York Times reports, “In some cases, plans ignored prior authorizations or other documentation necessary to support the payment. The most frequent denials found by the investigators included those for imaging services like M.R.I.s and CT scans.”
“Advantage plans also denied requests to send patients recovering from a hospital stay to a skilled nursing center or rehabilitation center when the doctors determined that those places were more appropriate than sending a patient home.” – New York Times, 4/28/22
Medicare Advantage insurers are paid a fixed price per beneficiary by the federal government. The rationale is that private plans can theoretically provide more cost-effective, coordinated care to save the Medicare program money. The profits that MA plans have realized from this arrangement surely have rolled in, but the savings to Medicare haven’t materialized. As our president and CEO, Max Richtman, recently wrote in Common Dreams:
Between 2009 and 2021, the government paid Medicare Advantage plans $140 billion more than it would have if the same patients had stayed in traditional Medicare. In fact, the cost to taxpayers of switching seniors to MA plans ‘has exploded since 2018 and is likely to rise even higher.’” – NCPSSM President & CEO Max Richtman, Common Dreams, 3/25/22
Instead of being held accountable for overbilling the government and denying care to beneficiaries, MA plans have been rewarded with an 8.5% increase in rates for 2023 by the Centers for Medicare and Medicaid Services.
MA plans also continue to grow in popularity. More than 26 million seniors – or 42% of all Medicare beneficiaries – were enrolled in an MA plan last year. And the Congressional Budget Office (CBO) projects that more than half of all beneficiaries will be in MA plans by 2030. This isn’t because MA plans are patently superior for patients; it is because of the lure of putative cost-savings (in the form of lower premiums or free extras like gym memberships) and a torrent of television ads featuring famous pitchmen like Joe Namath and Jimmy Walker.
The Medicare Advantage tv ads do not mention any of the downsides of these plans – including restricted networks of providers, inaccurate network listings, and the wrongly denied claims and pre-authorizations that the Inspector General’s office has just flagged. In fact, the ads make it seem as if Medicare Advantage is the whole Medicare program, with many enrollees not even aware that publicly-run, traditional Medicare is another – and often better – option.
As our President and CEO argues in his Common Dreams column, there is a movement to privatize traditional Medicare that is gaining momentum, which NCPSSM considers harmful for older Americans. The shifting of market share to MA plans is part of it. But so are recent efforts to increase the role of private, for-profit companies in traditional Medicare.
The National Committee and other seniors’ advocates are particularly wary of a pilot program by CMS recently re-branded as ACO/REACH and previously known as Direct Contracting, which allows private entities more opportunities to manage traditional Medicare beneficiaries’ care. Meanwhile, progressive Democrats on Capitol Hill, most prominently Rep. Pramila Jayapal (D-WA), have taken a hard line against the new program:
“(There is) a clear-cut argument for why we must immediately end Medicare privatization programs like ACO Reach. There’s no excuse for allowing the same Medicare Advantage organizations to now administer ‘care’ for traditional Medicare beneficiaries.” – Rep. Pramila Jayapal tweet, 4/28/22
While CMS presses forward with the ACO/REACH program, Medicare officials say they are looking at the Inspector General’s report about Medicare Advantage practices. “Plans found to have repeated violations will be subject to increasing penalties,” reports the New York Times. “The agency ‘is committed to ensuring that people with Medicare Advantage have timely access to medically necessary care.’”
At the same time, some in Congress are attempting to rein-in MA plans and protect patients. A piece of bipartisan legislation called the Improving Seniors’ Timely Access to Care Act has been introduced in both the House and Senate. According to one of the House sponsors, Rep. Suzan DelBene (D-WA), the legislation “would improve care for seniors by streamlining and standardizing the way Medicare Advantage plans use prior authorization and increasing oversight and transparency.”
It is only appropriate that these private plans, which are consuming a growing chunk of Medicare market share every year, be subject to strict oversight and thorough scrutiny. As MA insurers rake in hefty profits, it is crucial that proper patient care isn’t sacrificed in the process.
It’s Time to Bring Back the House Select Committee on Aging
Some two decades ago, seniors had a Congressional committee dedicated solely to safeguarding their interests. Then the Republicans, led by Speaker Newt Gingrich, took control of the House for the first time in 40 years and shut down the House Select Committee on Aging. Today, there is a movement to revive that committee – and there truly is no moment since the early 90s when it has been so sorely needed.
In a letter to members of Congress, the Legislative Council of Aging Organizations (LCAO), of which we are a member, explained why the time is now to reinstate the House committee:
“The last two years have proven particularly difficult for older adults in our country and globally as the coronavirus had a disparate impact on the lives of older individuals, particularly those residing in assisted living facilities and nursing homes. As Americans are aging, we also face a variety of intergenerational concerns that merit attention, such as growing demands on family caregivers and a burgeoning retirement security crisis.” LCAO letter to members of Congress, 3/4/22
Last August, Rep. David Cicilline (D-RI) introduced a resolution (H. Res. 583) to re-instate the House Select Committee on Aging, which the National Committee to Preserve Social Security and Medicare fully supports. It is more than appropriate that this committee be reinstated, with seniors representing a growing portion of the overall population. By 2030, nearly 75 million people in the U.S. – or 20% of the country – will be age 65 and older.
Several federal programs that seniors rely upon are at an inflection point, increasing the need for a House committee to advocate for older Americans. Social Security’s finances must be shored up so that the trust fund doesn’t become depleted in the 2030’s, while retirees’ benefits need to be boosted to meet 21st century living expenses. The Medicare Part A trust fund faces a shortfall in just a few years. At the same time, benefits covered through Part B should be expanded to include dental, vision, and hearing care, and attempts to privatize the program must be resisted. Medicaid requires additional funding for Home and Community-based Services (HCBS) as a lower-cost and often preferred alternative to nursing homes.
Programs that help seniors under the Older Americans Act (OAA) – including Meals on Wheels grants and home heating assistance – must continue to be adequately funded. When Donald Trump was President, his proposed budgets zeroed-out these programs so crucial to lower-income seniors. A House Committee on Aging would provide greater protection for – and promotion of – seniors’ ongoing needs.
The most prominent chairman of the House Aging Committee was the legendary Rep. Claude Pepper (D-FL) – a true champion for seniors. Under Congressman Pepper’s leadership, the committee was able to affect genuine change for the better.
“Pepper pushed the ban on mandatory retirement… protected nursing homes, expanded home healthcare and bolstered Social Security, with solvency through 2034. That put him on the cover of Time Magazine… as America’s ‘Spokesman For the Elderly.’” – Miami Herald, 3/21/22
In an op-ed in the Miami Herald, former House Aging Committee Chief of Staff Robert Weiner and Ben Lasky, senior policy analyst at Weiner Associates, argue that a re-instated committee could play a significant role in the well-being of today’s seniors. “With Pepper’s legacy as the guide, pandemic deaths, nursing homes, home care, Social Security, and Medicare would be improved by the sunlight of oversight.”
Rep. Claude Pepper (D-FL) was a seniors’ champion and longtime chair of the House Select Committee on Aging
In order for the House Aging Committee to be re-instated, the full House would have to vote on Rep. Cicilline’s resolution. It could pass by a simple majority and the committee would be revived. But House Speaker Nancy Pelosi has not yet committed to bringing Cicilline’s resolution to the floor. To increase the chances that it comes up for a vote, we urge voters to contact their representatives and tell them to cosponsor/support H. Res. 583.
Without a House Select Committee on Aging, there is no body on the House side to focus holistically on older Americans’ priorities. True, there are other committees with jurisdiction over seniors’ programs – but no single committee dedicated to keeping an eye on the big picture for seniors. Fortunately, the Senate Special Committee on Aging has continued to operate in the absence of a House counterpart. Today, the Senate committee is working on everything from scams against seniors to increasing HCBS services, to calling out questionable billing practices by Medicare Advantage insurers. Seniors have been better off these past decades with a Senate Aging Committee at work – and would greatly benefit from a reinstated and robust House Aging Committee, whose sole mission would be to look out for older Americans’ needs.
All House Dems Should Cosponsor Social Security 2100 Bill
If you are represented by a Democrat in the U.S. House, chances are that your member of Congress has already cosponsored a piece of landmark legislation to boost and strengthen Social Security: Rep. John Larson’s Social Security 2100: A Sacred Trust. In fact, the bill currently has 202 Democratic cosponsors (and zero Republicans). But some Democrats have not signed on as cosponsors, even though improving Social Security benefits and extending the solvency of the trust fund are priorities that Democrats should agree on. The more Democratic co-sponsorships the bill garners, the stronger the case that House leadership should bring it to the floor for a vote.
Rep. Larson, chair of the House Ways and Means Social Security subcommittee, introduced a new version of the bill in October, 2021. Among other things, Social Security 2100 would provide an across-the-board benefit increase for all beneficiaries. It would also boost benefits for particularly vulnerable groups – including widows, widowers, and the ‘oldest of the old’ seniors. The bill also includes a new COLA formula that better reflects seniors’ spending priorities.
“The pandemic has only underscored what we already knew and has exacerbated systemic inequities — current benefits are not enough! 5 million seniors are living in poverty due to longstanding workplace discrimination affecting mostly people of color and women. For too long, Congress has forsaken its duty to enhance benefits. With 10,000 Baby Boomers a day becoming eligible, and with Millennials needing Social Security more than any generation, the time for Congress to act is now.” – Rep. John Larson, 10/26/21
Social Security 2100 covers the costs of expanding benefits by adjusting the payroll wage cap so that higher earners contribute their fair share. This would only impact those earning more than $400,000 per year in wages – or less than 2% of working Americans.
In addition to the 202 House cosponsors, Social Security 2100 has been endorsed by over 100 advocacy groups, including the National Committee to Preserve Social Security and Medicare. Among the members who have not yet stepped forward as cosponsors, the National Committee hopes that Reps. Cynthia Axne (D-IA), Rep. Susie Lee (D-NV), and Rep. Tom O’Halleran (D-AZ) will do so now. Each of these House members are Social Security champions who earned 100% ratings on the National Committee’s most recent legislative scorecard.
Some of these Democrats may be worried that if they cosponsor the bill, Republicans will run attack ads accusing them of raising taxes. But President Biden won the White House promising not to increase taxes on anyone earning less than $400,000 a year, and the Sacred Trust bill conforms with that pledge. Many high earners who would be affected by the bill have told pollsters they don’t mind paying their fair share. And the group Patriotic Millionaires has long advocated adjusting the payroll wage cap.
The measures in Rep. Larson’s bill have overwhelming public support. A poll by Lake Research Partners showed that across party lines, 79% supported paying for an increase in benefits by having wealthy Americans pay the same rate into Social Security as everyone else. A recent survey of our members and supporters indicated 96 percent support for raising the cap. Survey respondents were unequivocal in their comments:
“Eliminate the wage cap! It’s common sense.”
“Make them pay their fair share!”
“The wealthy should pay Social Security taxes on everything they earn – just like we do.”
“There should not be a cap at all!”
Rep. Larson’s bill is awaiting mark-up by the full House Ways and Means committee, which is expected to happen in June. Lawmakers are also waiting for the Congressional Budget Office (CBO) to score the legislation, which is required for Social Security 2100 to be brought to the House floor for a vote.
Rep. Larson’s bill is truly historic. Social Security benefits have not been increased in more than fifty years. Retirees, people with disabilities, and their families need a benefit boost and a better COLA formula to meet ever-rising costs. They need the certainty that Social Security’s trust fund will remain solvent past the projected depletion date of 2034. The Republican response to Social Security’s challenges is to raise the retirement age (or enact other benefit cuts) and privatize the program — or as the chairman of the party’s Senatorial campaign committee proposed, to sunset all federal programs (including Social Security and Medicare) after five years.
Social Security 2100: A Sacred Trust presents an opportunity for Democrats to continue building on the foundation that President Franklin D. Roosevelt built when the program was created in 1935. Eighty-six years later, the program is at a crossroads. For the sake of all Americans who rely on Social Security, Rep. Larson’s bill is something that all House Democrats can – and should – get behind.
SSA Woefully Underfunded, Struggling to Provide Customer Service, Witnesses Tell Congress
Witness after witness at Tuesday’s Congressional hearing on Social Security Administration (SSA) customer service testified that the agency is in dire need of additional resources in order to properly serve the public. The hearing was held by the House Ways and Means Social Security subcommittee, chaired by Rep. John Larson (D-CT), with testimony from a variety of witnesses from SSA and advocacy groups. While witnesses praised SSA employees for doing their best to provide the public with customer service during the pandemic, they painted a picture of an underfunded and overworked agency in desperate need of Congressional action.
“The Agency and its employees have done an extraordinary job of making the most effective use of the dollars they have been appropriated. But backlogs that pre-existed the pandemic have grown exponentially, staff levels have dropped precipitously, and the Agency will need the strong support of Congress if it is to continue fulfilling its mission to your constituents,” urged Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare, in a written statement to the subcommittee.
Rebecca Vallas of the Century Foundation advocacy group told lawmakers at the hearing, “A decade-plus history of congress underfunding SSA’s already incredibly lean operating budget, worsened by the pandemic, has spurred several urgent crises in the agency’s customer service…The casualties are your constituents.”
Among the most pressing problems that have plagued SSA customer service are long hold times, disconnects, and busy signals on the agency’s toll-free phone line and excessive delays in Social Security Disability Insurance (SSDI) hearings. (Over 100,000 claimants have died waiting for their cases to be adjudicated.). In April, SSA was able to re-open most of its field offices after being shuttered for almost two years during the COVID pandemic.
SSA Deputy Commissioner for Operations, Grace Kim, credited managers, employees, labor unions, and advocates for the agency’s “ability to transition from remote work to walk-in service.” The field office re-openings went more smoothly than many advocates expected, but the agency must now contend with a huge backlog of work with inadequate resources.
“We are doing what we can with current staff and funding. The demand for service is high; we are losing staff; and morale is low,” testified Peggy Murphy, Director of the Social Security field office in Great Falls, Montana. “SSA is at a critical juncture as we face the future.”
Chairman Larson blamed SSA’s problems on budget cuts that Congress began imposing in 2010, pointing out that the agency’s operating funds have shrunk by 14% since then (adjusted for inflation), at the same time as demand for its services has skyrocketed as waves of Baby Boomers retire (at the rate of 10,000 every day).
Those budget cuts have forced SSA to lay off workers or allow vacant positions to remain unfilled, said Chairman Larson. “SSA has the lowest number of workers in 25 years despite almost double the number of beneficiaries.”
The Chairman pointed out that most of SSA’s operating budget is funded by payroll contributions from American workers “with each and every paycheck,” and that it is unjust for Congress to suppress funding for the agency that administers workers’ earned benefits.
Several witnesses voiced support for Chairman Larson’s Social Security 2100: A Sacred Trust legislation that would safeguard SSA customer service, including:
*A provision to prevent field office closures unless certain requirements are met.
*A provision to clarify that Congress did indeed intend for annual Social Security Statements to be mailed to workers age 25 and older so that they can plan for their financial security
The National Committee to Preserve Social Security and Medicare has enthusiastically endorsed Chairman Larson’s bill, which also boosts Social Security benefits across the board and extends the solvency of the program’s trust fund. Chairman Larson says that the bill will be marked-up in committee later in May or early June. The legislation has over 200 cosponsors in the House.
While the Social Security 2100 bill would improve SSA customer service, witnesses said that Congress must provide more robust funding for the struggling agency. “Our FY2022 appropriation is insufficient to provide the level of service your constituents expect and deserve,” said SSA’s Grace Kim.
The National Committee to Preserve Social Security and Medicare urges lawmakers to boost SSA funding to $15.55 billion for FY 2023, which is the amount submitted by the Agency itself to the Office of Management and Budget (OMB).
“Adequate funding for SSA is vitally important to your constituents and to our millions of members and supporters across the country who either are receiving Social Security or expect to do so in the future,” wrote Max Richtman in his statement to the subcommittee, “both to ensure that they receive the benefits they have earned and to maintain the public’s strong support for this essential program.”
The Part D Prescription Drug Bait and Switch
Medicare Part D prescription drug beneficiaries can be in for a rude surprise after they sign up for coverage. In an article this week in Kaiser Health News, Susan Jaffe writes that the price of a drug may jump within a month of a patient enrolling in a Part D drug plan. She cites the case of Linda Griffith, a California woman who used Medicare’s plan finder to select coverage last December, only to find that the price of one of her medications had jumped from $70 to $275 by January.
“As early as three weeks after Medicare’s drug plan enrollment period ends on Dec. 7, insurance plans can change what they charge members for drugs — and they can do it repeatedly.” – Kaiser Health News, 5/3/22
In fact, an AARP analysis found that the prices for the 75 most frequently prescribed drugs for Medicare beneficiaries climbed by as much as 8% between the end of December 2021 and the end of January 2022.
If this sounds like a bait-and-switch, the Centers for Medicare and Medicaid Services says that is just the way our current drug pricing system works. According to Medicare’s website, “Your plan may raise the copayment or coinsurance you pay for a particular drug when the manufacturer raises their price, or when a plan starts to offer a generic form of a drug,”
“I want my money back, and I want to be charged the amount I agreed to pay for the drug… I think this needs to be fixed because other people are going to be cheated.” – Linda Griffith, Medicare Part D beneficiary (Kaiser Health News)
Fixing the problem would require a change in the law. The 2003 Medicare Modernization Act, passed during the George W. Bush administration, established Part D drug coverage (to be provided by private insurance companies like Humana, Aetna, and Cigna), but forbade Medicare from negotiating prices with Big Pharma. NCPSSM President and CEO Max Richtman recently told CNBC that the ban on price negotiation “was put in in the middle of the night. We were not in the room when that deal was made.”
For many years, the National Committee to Preserve Social Security and Medicare and other seniors’ advocates have fought for new legislation empowering Medicare to negotiate prices. That goal finally seemed within reach when Congress took up President Biden’s Build Back Better plan, which contained a Medicare price negotiation provision.
The House-passed version of the bill would have allowed negotiations for a limited number of drugs. It wasn’t everything that advocates had hoped, but it would have been a good start. In the end, the Build Back Better plan failed to garner enough support in the Senate, due largely to the opposition of Senator Joe Manchin (D-WV).
Though Medicare price negotiation would be the single most effective way to lower seniors’ drug costs, other solutions have been percolating on Capitol Hill. These include an out-of-pocket cap on Part D drug costs and limiting drug price increases to the rate of inflation. All of these proposals have garnered the support of wide majorities in public opinion surveys. A 2021 Kaiser Health News poll found 83% of the public — including majorities of Democrats and Republicans —favored the federal government negotiating lower drug prices for both Medicare and private insurance.
Unfortunately, Big Pharma has used its multi-billion dollar lobbying and advertising arsenal to kill meaningful drug price reform so far. Some lawmakers apparently feel more beholden to drug makers than to their constituents, many of whom are skipping life-saving medications they can’t afford. Until Congress musters the political will to take another run at reform, the industry will continue to raise prices at will – leaving everyday Americans like Linda Griffith scrambling to cover the costs.
Medicare Advantage Slammed in New HHS Inspector General’s Report
We have been sounding alarm bells for many years about Medicare Advantage (MA), the privately-run health plans for seniors that are growing in popularity as an alternative to traditional Medicare. This week, an eye-opening report by the Inspector General’s office at the Department of Health and Human Services (HHS) confirmed some key criticisms by the National Committee and other seniors’ advocates – namely, that MA plans are denying legitimate claims and refusing to authorize reasonable medical procedures.
“Tens of millions of denials are issued each year for both authorization and reimbursements, and audits of the private insurers show evidence of ‘widespread and persistent problems related to inappropriate denials of services and payment,’ the investigators found.” – New York Times, 4/28/22
The Inspector General’s office estimated that 13% of claims that Medicare Advantage insurers denied should have been covered. MA plans also improperly denied up to 85,000 prior authorizations. The New York Times reports, “In some cases, plans ignored prior authorizations or other documentation necessary to support the payment. The most frequent denials found by the investigators included those for imaging services like M.R.I.s and CT scans.”
“Advantage plans also denied requests to send patients recovering from a hospital stay to a skilled nursing center or rehabilitation center when the doctors determined that those places were more appropriate than sending a patient home.” – New York Times, 4/28/22
Medicare Advantage insurers are paid a fixed price per beneficiary by the federal government. The rationale is that private plans can theoretically provide more cost-effective, coordinated care to save the Medicare program money. The profits that MA plans have realized from this arrangement surely have rolled in, but the savings to Medicare haven’t materialized. As our president and CEO, Max Richtman, recently wrote in Common Dreams:
Between 2009 and 2021, the government paid Medicare Advantage plans $140 billion more than it would have if the same patients had stayed in traditional Medicare. In fact, the cost to taxpayers of switching seniors to MA plans ‘has exploded since 2018 and is likely to rise even higher.’” – NCPSSM President & CEO Max Richtman, Common Dreams, 3/25/22
Instead of being held accountable for overbilling the government and denying care to beneficiaries, MA plans have been rewarded with an 8.5% increase in rates for 2023 by the Centers for Medicare and Medicaid Services.
MA plans also continue to grow in popularity. More than 26 million seniors – or 42% of all Medicare beneficiaries – were enrolled in an MA plan last year. And the Congressional Budget Office (CBO) projects that more than half of all beneficiaries will be in MA plans by 2030. This isn’t because MA plans are patently superior for patients; it is because of the lure of putative cost-savings (in the form of lower premiums or free extras like gym memberships) and a torrent of television ads featuring famous pitchmen like Joe Namath and Jimmy Walker.
The Medicare Advantage tv ads do not mention any of the downsides of these plans – including restricted networks of providers, inaccurate network listings, and the wrongly denied claims and pre-authorizations that the Inspector General’s office has just flagged. In fact, the ads make it seem as if Medicare Advantage is the whole Medicare program, with many enrollees not even aware that publicly-run, traditional Medicare is another – and often better – option.
As our President and CEO argues in his Common Dreams column, there is a movement to privatize traditional Medicare that is gaining momentum, which NCPSSM considers harmful for older Americans. The shifting of market share to MA plans is part of it. But so are recent efforts to increase the role of private, for-profit companies in traditional Medicare.
The National Committee and other seniors’ advocates are particularly wary of a pilot program by CMS recently re-branded as ACO/REACH and previously known as Direct Contracting, which allows private entities more opportunities to manage traditional Medicare beneficiaries’ care. Meanwhile, progressive Democrats on Capitol Hill, most prominently Rep. Pramila Jayapal (D-WA), have taken a hard line against the new program:
“(There is) a clear-cut argument for why we must immediately end Medicare privatization programs like ACO Reach. There’s no excuse for allowing the same Medicare Advantage organizations to now administer ‘care’ for traditional Medicare beneficiaries.” – Rep. Pramila Jayapal tweet, 4/28/22
While CMS presses forward with the ACO/REACH program, Medicare officials say they are looking at the Inspector General’s report about Medicare Advantage practices. “Plans found to have repeated violations will be subject to increasing penalties,” reports the New York Times. “The agency ‘is committed to ensuring that people with Medicare Advantage have timely access to medically necessary care.’”
At the same time, some in Congress are attempting to rein-in MA plans and protect patients. A piece of bipartisan legislation called the Improving Seniors’ Timely Access to Care Act has been introduced in both the House and Senate. According to one of the House sponsors, Rep. Suzan DelBene (D-WA), the legislation “would improve care for seniors by streamlining and standardizing the way Medicare Advantage plans use prior authorization and increasing oversight and transparency.”
It is only appropriate that these private plans, which are consuming a growing chunk of Medicare market share every year, be subject to strict oversight and thorough scrutiny. As MA insurers rake in hefty profits, it is crucial that proper patient care isn’t sacrificed in the process.
It’s Time to Bring Back the House Select Committee on Aging
Some two decades ago, seniors had a Congressional committee dedicated solely to safeguarding their interests. Then the Republicans, led by Speaker Newt Gingrich, took control of the House for the first time in 40 years and shut down the House Select Committee on Aging. Today, there is a movement to revive that committee – and there truly is no moment since the early 90s when it has been so sorely needed.
In a letter to members of Congress, the Legislative Council of Aging Organizations (LCAO), of which we are a member, explained why the time is now to reinstate the House committee:
“The last two years have proven particularly difficult for older adults in our country and globally as the coronavirus had a disparate impact on the lives of older individuals, particularly those residing in assisted living facilities and nursing homes. As Americans are aging, we also face a variety of intergenerational concerns that merit attention, such as growing demands on family caregivers and a burgeoning retirement security crisis.” LCAO letter to members of Congress, 3/4/22
Last August, Rep. David Cicilline (D-RI) introduced a resolution (H. Res. 583) to re-instate the House Select Committee on Aging, which the National Committee to Preserve Social Security and Medicare fully supports. It is more than appropriate that this committee be reinstated, with seniors representing a growing portion of the overall population. By 2030, nearly 75 million people in the U.S. – or 20% of the country – will be age 65 and older.
Several federal programs that seniors rely upon are at an inflection point, increasing the need for a House committee to advocate for older Americans. Social Security’s finances must be shored up so that the trust fund doesn’t become depleted in the 2030’s, while retirees’ benefits need to be boosted to meet 21st century living expenses. The Medicare Part A trust fund faces a shortfall in just a few years. At the same time, benefits covered through Part B should be expanded to include dental, vision, and hearing care, and attempts to privatize the program must be resisted. Medicaid requires additional funding for Home and Community-based Services (HCBS) as a lower-cost and often preferred alternative to nursing homes.
Programs that help seniors under the Older Americans Act (OAA) – including Meals on Wheels grants and home heating assistance – must continue to be adequately funded. When Donald Trump was President, his proposed budgets zeroed-out these programs so crucial to lower-income seniors. A House Committee on Aging would provide greater protection for – and promotion of – seniors’ ongoing needs.
The most prominent chairman of the House Aging Committee was the legendary Rep. Claude Pepper (D-FL) – a true champion for seniors. Under Congressman Pepper’s leadership, the committee was able to affect genuine change for the better.
“Pepper pushed the ban on mandatory retirement… protected nursing homes, expanded home healthcare and bolstered Social Security, with solvency through 2034. That put him on the cover of Time Magazine… as America’s ‘Spokesman For the Elderly.’” – Miami Herald, 3/21/22
In an op-ed in the Miami Herald, former House Aging Committee Chief of Staff Robert Weiner and Ben Lasky, senior policy analyst at Weiner Associates, argue that a re-instated committee could play a significant role in the well-being of today’s seniors. “With Pepper’s legacy as the guide, pandemic deaths, nursing homes, home care, Social Security, and Medicare would be improved by the sunlight of oversight.”
Rep. Claude Pepper (D-FL) was a seniors’ champion and longtime chair of the House Select Committee on Aging
In order for the House Aging Committee to be re-instated, the full House would have to vote on Rep. Cicilline’s resolution. It could pass by a simple majority and the committee would be revived. But House Speaker Nancy Pelosi has not yet committed to bringing Cicilline’s resolution to the floor. To increase the chances that it comes up for a vote, we urge voters to contact their representatives and tell them to cosponsor/support H. Res. 583.
Without a House Select Committee on Aging, there is no body on the House side to focus holistically on older Americans’ priorities. True, there are other committees with jurisdiction over seniors’ programs – but no single committee dedicated to keeping an eye on the big picture for seniors. Fortunately, the Senate Special Committee on Aging has continued to operate in the absence of a House counterpart. Today, the Senate committee is working on everything from scams against seniors to increasing HCBS services, to calling out questionable billing practices by Medicare Advantage insurers. Seniors have been better off these past decades with a Senate Aging Committee at work – and would greatly benefit from a reinstated and robust House Aging Committee, whose sole mission would be to look out for older Americans’ needs.