December 11, 2015

U.S. House of Representatives
Washington, D.C.   20515

Dear Representative:

On behalf of the millions of members and supporters of the National Committee to Preserve Social Security and Medicare, I am writing to strongly oppose cuts to Medicare and Medicaid to finance the reauthorization of the World Trade Center Health Program. The World Trade Center Health Program provides critical health care services to first responders to the September 11 attacks on the World Trade Center.  The National Committee supports its reauthorization.  We object, however, to cuts to Medicare and Medicaid to pay for unrelated programs.

Specifically, we object to proposals put forward by House Committee on Energy and Commerce Chairman Fred Upton to offset the costs of reauthorization of the World Trade Center Health Program by expanding means testing of Medicare premiums.

Additional means testing would undermine the social insurance nature of Medicare. It is important to note that wealthy individuals already pay more than other beneficiaries.  The Medicare Hospital Insurance (Part A) Trust Fund is financed with payroll taxes of 1.45 percent on employees, matched by employers, with self-employed individuals paying the full 2.9 percent. This payroll tax is levied on all covered wages and self-employment without a limit. As a result, the higher an individual's earnings, the more he or she will contribute to Medicare Part A during their working years. In addition, the Part A payroll tax assesses an additional 0.9 percent on taxpayers earning above $200,000 for an individual and $250,000 for a couple. These same income thresholds also trigger a 3.8 percent surtax on unearned income, such as interest, dividends and capital gains, which will be applied to Medicare.

We are concerned that the trend toward ever more means testing may cause higher earners to opt out of Medicare altogether. The departure of higher-income beneficiaries, who tend to be younger and healthier, would increase overall costs and could erode public support for the program.

The National Committee further objects to the $1.9 billion this provision is estimated to save being directed away from the Medicare program.  Savings from changes in Medicare and Medicaid policy should be used to improve these programs that are so vital to seniors – not for other purposes.

We also oppose offset proposals that would make it harder for individuals to qualify for Medicaid’s long term care benefits.   The National Committee believes changes to Medicaid’s income and asset provisions for purposes of determining eligibility for long term care should be considered as part of a sorely needed comprehensive national long term services and supports strategy.

The National Committee vehemently objects to the repeated attempt during the 114th Congress to use social insurance programs as an ATM to pay for non-related items. That is why I urge you to oppose offsetting the cost of the World Trade Center reauthorization with Medicare and Medicaid cuts. Instead, this urgently needed program should be reauthorized without offsetting its costs.


Max Richtman