March 24, 2015

United States Senate
Washington, D.C. 20510

Dear Senator:

On behalf of the millions of members and supporters of the National Committee to Preserve Social Security and Medicare, I urge you to oppose S. Con. Res. 11, the Fiscal Year 2016 Budget Resolution, currently being considered by the Senate. This budget, introduced by Senate Committee on the Budget Chairman Michael B. Enzi, would be devastating to today's seniors and future retirees, people with disabilities and children due to the proposed changes it makes to Medicare, Medicaid and the Affordable Care Act.

The Enzi budget threatens to shift costs to Medicare beneficiaries. S. Con. Res. 11 contains $435 billion over ten years in unnamed Medicare cuts. The National Committee is concerned that the scale of these unspecified cuts would likely result in Medicare benefit cuts being included in Budget Reconciliation legislation. Over half of Medicare beneficiaries had incomes below $23,500 per year in 2013, and they are already paying 23 percent of their average Social Security check for Parts B and D cost-sharing in addition to paying for health services not covered by Medicare. When coupled with plans to shift costs to beneficiaries in the House Sustainable Growth Rate bill, the unspecified Medicare benefit cuts included in S. Con. Res. 11 would be burdensome to millions of seniors and people with disabilities.

In addition, S. Con. Res. 11 calls for repealing provisions in the Affordable Care Act (ACA), which would make health insurance inaccessible for seniors age 64 and younger. Without the guarantees in the ACA, such as requiring insurance companies to cover people with pre-existing medical conditions and to limit age rating, younger seniors may not be able to purchase or afford private health insurance.

Repealing the ACA would also take away improvements already in place for Medicare beneficiaries – closing the Medicare Part D coverage gap, known as the “donut hole”; providing preventive screenings and services without out-of-pocket costs; and providing annual wellness exams. The Centers for Medicare and Medicaid Services recently reported that since the passage of the ACA, over 9.4 million Medicare beneficiaries in the Medicare Part D donut hole have saved $15 billion on their prescription drugs, an average of $1,595 per person. An estimated 39 million people with Medicare took advantage of at least one preventive service with no cost sharing in 2014.
The Enzi budget plan includes reductions to Medicaid funding that would affect low- income seniors. Medicaid provides funding for health care to help the most vulnerable Americans, including low-income seniors, people with disabilities, children and some families. The Enzi budget would end the current joint federal/state financing partnership and replace it with fixed dollar amount block grants, giving states less money than they would receive under current law. In exchange, states would have additional flexibility to design and manage their Medicaid programs. The proposed block grants would cut federal Medicaid spending by $400 billion over the next 10 years. Giving states greater flexibility in managing and designing their programs in no way compensates for the significant reductions that beneficiaries, including nursing home residents and their families, could face by turning Medicaid into block grants.

S. Con. Res. 11 also would repeal the Medicaid expansion in the ACA. Beginning in 2014, states have had the option to receive federal funding to expand Medicaid coverage to uninsured adults with incomes up to 138 percent of the federal poverty level ($16,242 for an individual in 2015). Over half of the states have expanded their Medicaid programs, and some others will likely participate in the future. The Enzi budget would hurt states and low-income individuals by repealing Medicaid expansion, taking away $900 billion from the program over 10 years. Altogether, S. Con. Res. 11 cuts the Medicaid program by more than $1.3 trillion over 10 years, compared to current law.

The Enzi budget could lead to cuts in Supplemental Security Income (SSI). About $500 billion in unspecified cuts in other mandatory programs could mean large reductions in SSI. SSI provides vital and much needed economic security for 8.2 million low-income seniors and people with disabilities, including children with marked and severe functional limitations. Congress has failed to keep the SSI program up-to-date to meet the basic needs for our nation’s most vulnerable and cutting SSI would make their situation worse.

The National Committee urges you to oppose S. Con. Res. 11, which would be harmful to seniors, people with disabilities and children. We look forward to working with you on proposals to strengthen Medicare and Medicaid that do not shift burdensome health care costs to beneficiaries, as well as proposals to provide adequate funding for programs critical to the retirement and health security of middle- and lower-income Americans.


Max Richtman
President and CEO