The National Committee has been beating the drum about seniors’ rising health care costs for several years.  Now, a new study from Health Affairs confirms that seriously ill seniors face especially daunting financial hardships.  According to the study, 53% of seriously ill Medicare patients are experiencing grave difficulty paying their medical bills, with unaffordable prescription drug costs posing the biggest challenge.

“The perception that Medicare works well for most beneficiaries obscures the financial exposure that is concentrated among the seriously ill.  High-need Medicare beneficiaries may be especially vulnerable, since patients in the top 5% of spending account for more than half of out-of-pocket spending.” – Health Affairs, November, 2019 

The study indicates that these financial burdens are taking a serious toll on seniors and their families. One quarter of respondents said that costs were a “major burden,” and 60% reported that family members and friends had helped out with health care costs “a lot.”  When asked which medical costs posed the largest burden, 30% responded “prescription drugs,” second only to “any medical expense.”

Source: Health Affairs

Older Americans have been particularly hard hit at the pharmacy counter in recent years. Prices for the 20 most-prescribed drugs for seniors increased approximately ten times the rate of inflation between 2013-2018.  One million Medicare beneficiaries paid nearly $3,200 in out-of-pocket drug costs in 2016.  Increased cost sharing for prescription drugs has forced seniors to forgo needed medications, cut pills, and skip doses – or choose between medicine and groceries.

The National Committee is in the midst of a campaign to reduce seniors’ prescription drug costs, entitled “Don’t Cut Pills, Cut Profits.”  The campaign includes town halls in select American cities.  The first one took place in Milwaukee in October; the second happens Friday in Portland, Oregon.   A third town hall will take place in Lansing, Michigan on December 9th.  At each town hall, local seniors have the opportunity to dialogue with elected leaders, in order to become educated and empowered to lower prescription prices.

Attendees of these town halls have shared heartbreaking stories about soaring drug costs.

“The inhalers for my lung cancer cost $200 a month. We pay $270 a month for Medicare. My husband cuts his pills.”

“A medicine that helps me with chronic pain is unaffordable. It’s only $170 a month, but on a Social Security income, I can’t pay for it.”

“My medication costs put a major strain on my monthly Social Security checks.”

Crushing medical costs have negative consequences for seniors’ physical and financial health, according to the new study.  More than one third of respondents said they had exhausted “all or most” of their savings to pay medical bills.  Twenty-seven percent indicated they had been contacted by a collection agency.  Nearly one-quarter of the seniors surveyed said they were not able to pay for essentials such as food, utility bills, and housing. 

To mitigate the financial strain on seniors, the National Committee advocates catastrophic caps on out-of-pocket costs for Medicare Part B and Part D beneficiaries, improved supplemental Medigap coverage, and the passage of legislation to allow Medicare to negotiate drug prices with Big Pharma, which would produce some $345 billion in cost savings over seven years. These represent reasonable, common sense solutions to stop seniors from going broke because of soaring health care costs in the world’s wealthiest nation. 

Sen. Mitt Romney (R-UT) proposes “rescue committee” for Social Security trust fund

On Tuesday, Senator Mitt Romney (R-UT) unveiled legislation that would put the future of Social Security in the hands of a special committee, claiming that “if you ever want to see a balanced budget, if you ever want to get out of debt, you have to deal with these trust funds.”  National Committee president and CEO Max Richtman pushed back on Romney’s proposal yesterday as yet another attempt at “entitlement reform” that would hurt seniors.

“The last thing seniors need is for Mitt Romney to get his hands on Social Security.  The Utah Senator intends to introduce a bill establishing a ‘Rescue Committee’ which would write legislation to keep the Social Security trust fund solvent for 75 years.  We need only look to recent history to determine what Romney has in mind. During his failed 2012 presidential campaign, Romney proposed to raise the Social Security retirement age and slow the growth of benefits for some retirees.   Romney’s 2012 running mate, Paul Ryan, fought to privatize Social Security throughout his two decades on Capitol Hill.  Fortunately, Americans rejected Romney and Ryan’s bleak vision for Social Security’s future. 

Like an earlier, failed proposal in the 115th Congress to establish a special Social Security commission, Senator Romney’s ‘rescue committee’ would set up a process that puts benefits at risk, forcing millions of older Americans onto a pathway toward poverty.   

The Senator’s bill also ignores legislation already introduced by Democrats that doesn’t ask seniors to bear the cost of strengthening Social Security’s finances.  Rep. John Larson’s Social Security 2100 Act would keep the program financially sound for more than 75 years without raising the retirement age or cutting benefits. It even includes a modest benefit boost.  Bernie Sanders (I-VT) has introduced a similar bill in the Senate. As for Romney’s latest “entitlement reform” plan, we’ve seen this pitch before – and seniors aren’t buying it.” – Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare 

For 16 years, the National Committee and other seniors’ advocates have been pressuring Congress to pass legislation empowering Medicare to negotiate prescription drug prices with Big Pharma.  That goal finally appears within reach.  Speaker Nancy Pelosi’s Lower Drug Costs Now Act (H.R. 3) will get a floor vote by the end of this month, according to several news reports.  The bill was approved by the House Ways and Means Committee yesterday, teeing up a vote by the full House.

“After years of Congressional inaction, we’re moving legislation to lower drug prices and save American families money. H.R. 3 levels the playing field for U.S. consumers who, on average, pay four times more than patients in other countries for the exact same drugs.” – Rep. Richard Neal (D-MA), House Ways and Committee chairman 

On Tuesday, House Ways and Means Committee chair Richard Neal (D-MA) announced that the bill would be re-named in honor of Rep. Elijah Cummings, a champion for seniors, who passed away last week.

The National Committee has endorsed the bill as an “important step toward lowering prescription drug costs for seniors.” The legislation not only authorizes Medicare to negotiate prices, but includes punitive measures for pharmaceutical companies who don’t play ball – and significantly reduces beneficiaries’ drug expenses.  The bill features:

*A substantial penalty (starting at 65% of the gross sales of the drug) if a drugmaker refuses to negotiate or doesn’t reach an agreement on price.

*A $2,000 cap on seniors’ Medicare out-of-pocket costs for prescription drug spending.

*An inflation cap on drug reimbursement to curb excessive drug price escalation.

The Congressional Budget Office estimates that the bill would save Medicare $345 billion over seven years – money that Speaker Pelosi says could be put toward (among other things) expanding benefits to include dental, vision, and hearing coverage.

Speaker Pelosi says the bill represents “bold action to level the playing field” for Medicare patients.

Progressives in the committee markups won concessions to better reflect their vision.  Amendments were added to increase the minimum number of drugs Medicare must negotiate each year from 25 to 35 — and to require that a new drug must have at least two generic competitors before being excluded from price negotiations, instead of one.  The National Committee lobbied legislators to pass both amendments.

“Typically, the entry of one generic competitor produces only a slight reduction in prices. It is the entry of a second generic competitor that really drives down a drug’s cost – to nearly half the brand name price.” – National Committee letter to Speaker Pelosi, 10/15/19

Many Republicans complain that Pelosi’s bill interferes with the free market — and that it amounts to a federal “takeover” of prescription drug pricing.  Democrats counter that the free market has clearly failed to produce affordable drug prices, with cash-strapped seniors skipping medications or cutting pills in half.   They also point out that price negotiation is an important facet of free markets.

With Democrats holding a 234-197 majority in the U.S. House, The Lower Drug Costs Now Act is expected to pass when it comes to the floor later this month.  On the other side of the Capitol, the Senate Finance Committee has approved a bipartisan drug pricing bill introduced by Sen. Ron Wyden (D-OR) and Sen. Charles Grassley (R-IA).  The Grassley-Wyden bill features reasonable measures to lower drug prices, but does not include price negotiation.  Some Senate Republicans have already come out against Grassley-Wyden.  Predictably, Big Pharma opposes both bills – House and Senate – and spent $6.2 million on lobbying in the third quarter of 2019, a quarter million dollars more than the same period last year.

Rep. Elijah Cummings (D-MD), 1951-2019

America’s seniors have lost a true champion with the passing of Rep. Elijah Cummings (D-MD) at the age of 68.  The Congressman, who was chairman of the House Oversight Committee, forcefully and eloquently advocated for Social Security, Medicare, Medicaid and lowering prescription drug prices.  His staunch support of seniors’ priorities repeatedly earned Rep. Cummings a 100% rating from the National Committee to Preserve Social Security and Medicare.  He served in Congress for more than twenty years, representing a diverse constituency in Baltimore and its suburbs.

“We mourn the passing of a great leader for all people. Congressman Elijah E. Cummings maintained a deep understanding of the complexities of aging and knew that social policy programs like Medicare, Medicaid and Social Security were not only safety nets for individuals, but they also strengthened families and communities.” – Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare.

During an era when Social Security has come under sustained attack from conservatives, Rep. Cummings unabashedly fought for strengthening and expanding the program.  He cosponsored Rep. John Larson’s Social Security 2100 Act, and opposed the closures of Social Security Administration field offices in underserved neighborhoods, including one in the city of Baltimore.

“I believe that Social Security is a binding promise between government and its citizens, and I oppose any effort to reduce benefits.  Social Security is not just a cushion, it is the single lifeline keeping [seniors] out of poverty… particularly low-wage and manual laborers who may be in poorer physical health.” – Rep. Elijah Cummings

A dedicated advocate for affordable and accessible health care for all Americans, Congressman Cummings championed the Affordable Care Act and fought attempts in Congress to repeal it.  He made lowering prescription drug prices a priority, as well, cosponsoring the Affordable and Safe Prescription Drug Importation Act and the Medicare Price Negotiation Act.  As House Oversight Committee chair, Congressman Cummings launched an investigation “to determine why drug companies—including insulin makers—are increasing prices so dramatically and what they are doing with the proceeds.”

Rep. Cummings with colleague Rep. John Sarbanes (Left) in 2017

Today, colleagues and constituents remember Rep. Cummings as a compassionate, engaged, and eloquent leader who will not be easy to replace.

“Congressman Cummings voted with his head and his heart on issues of concern to millions of our organization’s members… We will always be grateful to this humble, hardworking and dedicated public servant and will deeply miss his passionate support for a better quality of life for older Americans.” – Max Richtman, 10/17/19

Sen. Elizabeth Warren: “After a lifetime of hard work, people are entitled to retire with dignity.”

Major kudos to Elizabeth Warren for being the first candidate to mention Social Security on the 2020 Democratic primary debate stage.  The moderators of last night’s CNN/New York Times debate failed to ask a single question about Social Security, but Senator Warren raised the issue in response to the topic of Universal Basic Income.  

“I understand that what we’re all looking for is how we strengthen America’s middle class. And actually, I think the thing closest to the universal basic income is Social Security. It’s one of the reasons that I’ve put forward a plan to extend the solvency of Social Security by decades and add $200 to the payment of every person who receives Social Security right now and every person who receives disability insurance…”

Senator Warren unveiled her Social Security proposal last month.  It tracks pretty closely with Rep. John Larson’s Social Security 2100 Act and Senator Bernie Sanders’ Social Security Expansion Act, though Sanders did not mention his own proposal in last night’s debate.

In fact, none of the other candidates took the time to follow-up on Senator Warren’s Social Security comments, nor did the moderators.  National Committee president Max Richtman had implored moderators Anderson Cooper, Erin Burnett, and Mark Lacey to include a question about Social Security in last night’s debate, writing letters to all three in advance.  Last week, Richtman argued in the online publication, Common Dreams:

“How long do seniors have to wait until they hear the Democratic presidential candidates’ positions on Social Security during a primary debate?  Older Americans are the country’s largest voting bloc, but during the first four Democratic presidential debates, the moderators didn’t ask even one question about Social Security.  This makes no sense.” – Max Richtman, National Committee President and CEO, 10/10/19

Last night’s debate moderators did not ask candidates any questions about Social Security

In his letters, Richtman suggested that the debate moderators ask a question about how the candidates would keep Social Security financially sound, with the trust fund facing insolvency in 2035. Both Warren’s and Sanders’ plans fix that problem while modestly boosting benefits, as does Rep. Larson’s.

What’s more, some Democratic candidates do address Social Security on the campaign trail.  Joe Biden told a seniors’ forum in Iowa that “we should be increasing, not decreasing, Social Security.” Beto O’Rourke, Kamala Harris, Pete Buttigieg and Corey Booker have all advocated boosting and strengthening the program.  But except for one mention by Senator Warren last night, viewers of the Democratic debates this primary campaign season could be forgiven for not knowing the candidates’ positions on Americans’ earned benefits.

The next Democratic debate is scheduled for November 20th in Atlanta, hosted by MSNBC and the Washington Post.  Let’s hope the moderators of that debate recognize the importance of Social Security to millions of Americans and will include a question about how to safeguard the program’s future.  As Senator Warren said last night, “After a lifetime of hard work, people are entitled to retire with dignity.”  Debate viewers deserve to know how the candidates plan to uphold that promise.