The fiscal year (FY) 2022 budget recommendations submitted by President Biden to Congress on May 28, 2021 affirm his commitment to America’s seniors in major ways – from improved customer service for Social Security beneficiaries to prescription drug pricing reform to expanded home and community-based services (HCBS). With 10,000 baby boomers turning 65 every day – and the number of seniors projected to double by 2050 – it’s clear that this budget is mindful of the need to safeguard our older Americans now and into the future.
Social Security
The President proposes $14.2 billion for SSA’s FY 2022 appropriation for administrative funding. This is an increase of $1.3 billion — nearly 10 percent – over the FY 2021 enacted level and is a badly needed increase to address years of underfunding. It represents a first step in stabilizing SSA’s continued customer service deterioration, which since FY 2010 saw Social Security’s core operating budget decline 13 percent while its workloads rose by 22 percent. The effects of the COVID pandemic on SSA’s service delivery have magnified the effects of this long-standing disinvestment of Social Security’s core public services.
The National Committee applauds the Administration’s budget proposal and urges Congress to give it careful consideration in formulating its own appropriations legislation for FY 2022. It provides additional funding to eliminate the backlogs that have developed during the pandemic in both the Disability Determination Services and the Offices of Hearings Operations and is clearly necessary to expedite the processing of the current backlog. And, it addresses what is believed to be a significant pent-up demand for disability claims filing that developed during the COVID pandemic. The President’s budget provides the additional funding to deal with these problems, and we applaud the Administration for its initiative in this area.
Regarding the adjudication of requests for hearings, we continue to be concerned about the effect of Trump-era regulations that authorizes the Commissioner of Social Security to use Administrative Appeals Judges (AAJ) to conduct hearings on appeals of denied disability claims. We are concerned that AAJs do not have the decisional independence of Administrative Law Judges, which could compromise the integrity of the appeals process. We urge appropriators to bar the expenditure of appropriated funds for the purpose of using AAJs in the hearing process.
We support the Administration’s proposal to provide additional funding to improve the level of service provided by SSA’s toll-free telephone service. Here too, misguided underfunding has led to a decline in service delivery. Since 2010, SSA’s national toll-free telephone service staff shrank by 12 percent, even as call volume grew 6 percent. The results were more busy signals, more hang-ups, longer wait times and fewer calls handled. The President’s budget provides additional resources that will enable SSA to significantly improve the level of telephone service it provides, and we thank the Administration for proposing to strengthen the adequacy of this vital service. As a result of the closure of SSA field offices during the pandemic, the 800 number was the lifeline that remained available to those seeking SSA’s services.
With 10,000 baby boomers reaching age 65 every day, SSA needs substantial yearly increases just to keep pace with increased workloads. Toward that end, the National Committee has in the past proposed significant increases in funding over the levels included in Administration budgets. Usually, those calls for increased funding were based on spending levels proposed by Commissioners of Social Security in their own budget submissions.
We note two concerns. First, the President’s FY 2022 budget provides very little in terms of additional funding for SSA’s network of 1,200 local field offices. As best as we can tell, the budget supports some increases in overtime hours for field offices, but otherwise provides no additional funding for increases in field office staffing. We find this astonishing, given that the additional Disability Insurance workloads projected for the DDSs and the hearing offices must, of necessity, originate in the local field offices. Flat level funding seems to us to be an inadequate response.
Accordingly, we urge Congressional appropriators to carefully consider Commissioner Andrew Saul’s budget request. In it, he called for a budget of $14.678 billion, an increase of $478 million over the level called for in the President’s budget. These additional resources should be appropriated and used to strengthen staffing in local field offices. Even before the pandemic, we heard repeatedly from National Committee members of the difficulties they experience in receiving services in their local offices. Now is the time to make significant investments to improve the services these facilities provide.
We also note that the President’s FY 2022 budget includes $225 million to fund costs associated with the establishment of a nationwide system of paid family and sick leave. While the National Committee generally supports such proposals, we are concerned with the impact on SSA of administering such a program. We urge the Administration to carefully consider the existing needs of SSA in developing plans for a new system of paid family and sick leave.
President Biden’s budget proposal funds the production and mailing of only 15 million hard-copy Social Security statements. This proposal is part of SSA’s overall plan to limit the distribution of statements only to individuals who are 60 or older rather than sending them to all workers every year. The National Committee urges the Administration to develop plans to send these important financial planning documents to all workers 25 and older, as is required in section 1143 of the Social Security Act. According to the Congressional Justification for the President’s request, this will cost $81 million annually. We urge appropriators to include an earmark within SSA’s administrative budget requiring that section 1143 of the Social Security Act be fully funded.
While the President’s budget includes no proposals that directly affect Social Security cost-of-living adjustments (COLAs), we are concerned that the appearance of inflation in the national economy raises the specter that the inadequacies of the consumer price index (CPI) used to adjust Social Security benefits for inflation will undercut the purchasing power of seniors’ benefits. All of America’s seniors deserve the full protection that COLAs provide against the ravages of inflation. That’s why the National Committee continues to advocate for the adoption of a CPI that more accurately gauges the effects of inflation on seniors’ purchasing patterns. We believe that the CPI for the Elderly, or the CPI-E, which more accurately measures the effects of inflation on seniors’ purchasing patterns, should be adopted as the official measure of inflation for Social Security and other income security programs.
Lastly, we note the absence of any legislative proposals in the President’s FY 2022 budget. We understand that this is the Administration’s first budget and support their determination to move cautiously in developing legislative proposals that affect Social Security. We look forward to working with the Administration in developing such proposals.
Medicare
The National Committee supports Medicare legislative proposals in the President’s budget that would:
- Allow Medicare to negotiate drug prices with pharmaceutical manufacturers.
- Add hearing, dental and vision coverage to Medicare.
- Require drug manufacturers to rebate to the government the amount by which drugs used under Part B and Part D rise faster than inflation.
While President Biden did not include these long overdue health care proposals in the American Jobs Plan or the American Families Plan, we urge Congress to make them a priority by adding them to budget reconciliation legislation this year. As Congress moves forward with Medicare prescription drug price and benefit improvement legislation, we plan to work with lawmakers and the Administration on details of how these proposals will be implemented.
We further support the Biden Administration’s proposals to expand the net investment tax by closing loopholes that allow high-income taxpayers to avoid the 3.8 percent Medicare tax and apply revenues from these taxes to the Medicare Part A Hospital Insurance Trust Fund.
Medicaid
The COVID pandemic has highlighted the importance of allowing people to stay in their own homes instead of a nursing home, where they are much safer from infections and where most people prefer to be. The National Committee supports the Biden budget’s investment in home and community-based services (HCBS). The budget includes $400 billion in funding to bolster Medicaid HCBS that was proposed in the American Jobs Plan.
While we support the Administration’s proposal to invest in Medicaid HCBS, we urge the President and Congress not to leave behind many middle-class seniors who will not directly benefit from them. Older Americans and people with disabilities should not have to impoverish themselves to become eligible for long-term services and supports as required by Medicaid. To that end, the National Committee urges the President and lawmakers to support broad-based reforms that will benefit more seniors including improvements to Medicare’s home health services.
We support the Administration’s legislative proposal to close the Medicaid coverage gap, extending coverage to an additional 2.2 million uninsured in states that did not expand Medicaid under the Affordable Care Act.
Affordable Care Act (ACA)
The National Committee also supports the President’s budget proposal to create a state public option under the ACA marketplaces and a federal public option for states that did not expand Medicaid.
In addition, we support the Administration’s recommendation to make permanent the enhanced marketplace premium tax credits in the American Rescue Plan Act (P.L. 117-2).
Discretionary Programs Affecting Older Americans
The Older Americans Act (OAA) supports a range of home and community-based services, such as home delivered meals and other nutrition programs, in-home services, transportation, legal services, elder abuse prevention and caregiver support. Up until recently, however, the Act’s broad and critical mission has been undermined by inadequate funding. Over the past 20 years, the OAA has lost ground due to federal funding that has not kept pace with either inflation or growth in the older population.
Annual OAA discretionary funding declined over the 10-year period from FY 2009 to FY 2019, and funding levels each year remained below the FY 2010 level when funding was at its highest level ($2.328 billion). However, for FY 2020, total OAA funding, including supplemental funding to respond to the needs of seniors during the COVID pandemic, reached its highest level ($3.220 billion) in the Act’s 55-year history. This trend continued into FY 2021 with an increase of $96 million.
The National Committee supports recommendations in the President’s budget to further increase funding – by 33 percent in FY 2022 – for Older Americans Act programs, including:
- $1.341 billion for nutrition programs, a $390 million or 41 percent increase over the FY 2021 enacted level.
- $550.5 million for support services, a $158 million or 40 percent increase over the FY 2021 enacted level.
- $249.9 million for the National Family Caregiver Support Program, a $61 million or 32 percent increase over the FY 2021 enacted level.
- $70.2 million for Native American nutrition and supportive services, a $35 million or 99 percent increase over the FY 2021 enacted level.
- $34.9 million for the Long-Term Care Ombudsman Program, an $11 million or 46 percent increase over the FY 2021 enacted level.
- $14.2 million for the Lifespan Respite Program, a $7 million or 97 percent increase over the FY 2021 enacted level.
- $55.2 million for the Medicare State Health Insurance Assistance Program (SHIP), a $3 million or 6 percent increase over the FY 2021 enacted level. SHIPs offer Medicare-eligible individuals, their families, and caregivers unbiased counseling to make informed health insurance decisions that optimize access to care and benefits.
Fast-track Budget Process Legislation
As Congress begins the process of designing a Budget Resolution, we take this opportunity to emphasize again our strong opposition to the inclusion of any provisions authorizing a fast-track legislative process for Social Security and Medicare in the guise of ‘fiscal responsibility”. Legislative proposals such as The TRUST Act create a back-door mechanism for cutting these essential programs that would not be possible through the normal legislative process because of their popularity and importance to the public. We urge Congress to consider legislation that would expand these essential programs, not create a fast-track process to facilitate benefit cuts that would be devastating to hard-working middle-class Americans who rely on their protections.