*A copy of this letter was also sent to the House of Representatives

April 7, 2020

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 include in phase four of the coronavirus relief legislation the following proposals to promote the health and economic well-being of seniors, people with disabilities and survivors.

SOCIAL SECURITY

Increasing Benefits By $250 Per Month for All Social Security Beneficiaries

Increase by $250 the monthly benefit for all Social Security, Veterans, and Supplemental Security Income (SSI) beneficiaries through the end of 2021.  The additional payment would serve to stimulate the economy and at the same time target relief to those in our society who are most in need of relief.

Additional Funding to Build SSA Capacity for COVID-19-Related Workload Demands

The coronavirus death toll is growing exponentially.  That means, tragically, there will be thousands and thousands of new applications for benefits, like the lump sum death benefit, which while a minor benefit, costs the Social Security Administration (SSA) about as much as a retirement claim to adjudicate.  There will be widow/widower applications which can’t be performed via the internet as well as numerous applications for surviving children.  SSA doesn’t have the staff it needs to perform its already-anticipated workloads much less additional funding to handle applications flowing from coronavirus deaths.  That’s why Congress should appropriate an additional $400 million for SSA’s operating budget, to be made available in the same manner as the $300 million appropriated in the Coronavirus Aid, Relief and Economic Security (CARES) Act (P.L. 116-136) in the sense that the money would carry over into Fiscal Year (FY) 2021.  For FY 2021, we support the $14 billion that Commissioner Andrew Saul requested.  A Marshall Plan for the beleaguered SSA is what is needed, especially considering all of the workloads that currently are being deferred.

Preserve the Earned Right Nature of Social Security

The National Committee urges you to preserve the earned right nature of Social Security by opposing any proposals that would divert Social Security Trust Funds for purposes for which they were not intended, such as a means to stimulate the economy.  Social Security is an earned benefit fully funded by the contributions of workers throughout their working lives.  A payroll tax cut, suspension or deferral chips away at that fundamental idea, making it easier each time it is enacted to turn to it again to meet some future crisis, until the payroll tax is permanently eliminated.  Undermining the program in this manner would help achieve the goals of opponents of Social Security including those who would privatize the program.  This is equally true even if the funds are replaced by general revenues from the Treasury.

Improve Social Security Benefits

The pandemic is hitting seniors and people with disabilities the hardest of the entire population. In good times and in bad, Social Security is their lifeline.  Two-thirds of seniors rely on Social Security for most of their incomes.  One third rely on it for nearly all of their income.  Those percentages are even higher for people with disabilities.  That’s why the National Committee urges Congress to enact the following benefit improvements in Congressman John Larson’s Emergency Social Security Benefits Act, which would, take effect immediately, retroactive to January 1, 2020, and be in force until December 31, 2020:

  • Increase average benefits by 2 percent across the board to all 64 million Americans receiving Social Security benefits;
  • Increase the threshold for the Special Minimum Benefit to 125 percent of poverty;
  • Reduce taxes on Social Security benefits for lower- and middle-income taxpayers;
  • Ensure grandparents are entitled to benefits to care for their grandchildren;
  • Improve the widows’ benefits for lower- and middle- income beneficiaries; and
  • Ensure dependent students are qualified for benefits through age 21.

HEALTH CARE

Covering the Uninsured

While Congress provided much needed emergency assistance to the health delivery system in its initial relief efforts, it missed a chance to fill crucial gaps in our health care system that leave many uninsured.  As many people lose their jobs, they will become uninsured and won’t have access to coverage for COVID-19 testing or treatment.  The uninsured are themselves vulnerable to coronavirus and if they remain untested and untreated pose a threat to others, particularly seniors and individuals with other underlying health conditions.

Many uninsured individuals will receive health care coverage if they live in states that have expanded Medicaid.  But 14 states have not expanded the program.  In those states, subsidies to help pay for health insurance through Affordable Care Act marketplaces are available only to individuals with income between 100 and 400 percent of the federal poverty line.  Congress should allocate resources to allow states that have not yet expanded the program – but will do so going forward – to receive a full federal Medicaid subsidy for the initial years of implementation, as it did for states that already expanded Medicaid.

Bolstering the Health Delivery System

In addition, Medicaid will need to be bolstered to meet the needs of the existing program. Medicaid accounts for approximately half of all long-term care spending.   The CARES Act has authorized a 6.2 percent increase to the federal match rate to assist states during the emergency. Congress should increase the Federal Medical Assistance Percentages payment to 12 percent as the National Governors Association has requested.

Providing for Seniors in Their Homes

Many low-income seniors will not have access to meals at adult day programs and a variety of charitable meal programs while they shelter in place.  That’s why Congress should increase Supplemental Nutrition Assistance Program benefits by 15 percent for the duration of the downturn.  This temporary increase, of just under $100 per month for struggling families, would help families put food on the table and effectively boost the economy.

To ease access to medications for homebound seniors, Medicare and Medicaid should make it easier to fill prescriptions.  The CARES Act gave seniors access to 90-day refills under Medicare Part D.  Further efforts should be made to streamline the appeals process and to make sure that Medicare Advantage plan’s utilization management tools such as prior authorization, step therapy and restrictive formularies do not provide a barrier to seniors accessing medications.

More funding is still required to improve workforce capacity and expand access to home and community-based services.  Congress should incorporate into its next relief package the Coronavirus Relief for Seniors and People with Disabilities Act, which would create a Medicaid grant for states to boost their home and community-based services.  Grants could be used to improve compensation and to provide paid sick leave and paid medical leave for home care workers, important steps to boost the homecare workforce and keep workers and seniors safe from infection.

Congress temporarily extended the Medicaid Money Follows the Person program (a demonstration that helps patients transition from institutional care to home and community-based care) and the spousal impoverishment protections for home and community-based services.  Congress should fund and permanently extend these programs that keep people out of institutions at a time when seniors are safest remaining in their homes.

Access to Medications

Ensure that all prescription drugs for COVID-19 are provided at no cost for all individuals whether insured or not.

Extend the 90-day refill rule applied to Medicare in the CARES Act to all payers.

Improving Testing

Congress should appropriate funds specifically for improving funding for production of COVID tests, testing related items (such as swabs), ventilators and safety equipment to address supply chain issues.

Congress should direct the Centers for Disease Control and Prevention to provide guidance to states to move toward testing with a process for identifying others who have been contacted.  This type of testing and tracing has been credited with reducing infection rates in Taiwan and Germany.

Expanding Sick Leave

Expand paid sick leave to workers who are caring for an adult with a disability or aging family member who loses access to care due to a COVID-related closure.

The public health crisis of the coronavirus is both a health and an economic threat to older Americans, people with disabilities and survivors.  That’s why it was heartening to see the Congress respond to the particular peril faced by older people and those with serious health conditions in the bipartisan CARES Act. But millions of vulnerable Americans will need a more targeted response to ensure their economic and health security.  For that reason, we urge you to include the measures in this letter in the next COVID-19 relief legislation.

Sincerely,

Max Richtman
President and CEO