*a copy of this letter was also sent to the House of Representatives
September 22, 2020
On behalf of the National Committee to Preserve Social Security and Medicare’s millions of members and supporters, I am writing to urge you and your colleagues in the Senate to resume meaningful negotiations of an urgently needed robust COVID relief package that fills gaps in Medicare coverage, improves nursing safety, enhances Social Security, ensures access to needed protective equipment and therapies for COVID and bolsters Medicaid funding.
The following are the National Committee’s priorities for any COVID relief legislation:
The National Committee strongly opposes S. 4323 and H.R. 4907, the Time to Rescue United States (TRUST) Act which has been included in the Health, Economic Assistance, Liability Protection and Schools (HEALS) Act. The TRUST Act would create so-called “Rescue Committees” to draft legislation — for expedited consideration — to address the solvency of federal trust funds, including the Social Security and Medicare funds. This process would open these programs to a broad array of across-the-board cuts that the proposed committees may choose to offer. What’s more, the bill fails to require the committees to consider the importance of benefit adequacy given the growing number of working and middle-class Americans who depend on Social Security for all or most of their income in retirement or how Medicare benefit cuts would undermine the health security of seniors and people with disabilities.
We urge you to exclude the TRUST Act from the agreement on COVID relief legislation and instead allow the committees of jurisdiction to hold hearings, develop legislation and vote on the consensus package that they develop under the regular rules of the House and Senate. Adhering to regular order would ensure that the public has an opportunity to express their overwhelming support for Social Security and Medicare and opposition to unpopular benefit cuts.
While not included in either the HEALS Act or the House-passed H.R. 6800, the Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act, the National Committee urges you to include H.R. 7499, the “Social Security COVID Correction and Equity Act,” in the next coronavirus relief legislation. Absent action by Congress, a coronavirus-related glitch in current law will result in a sizable lifetime benefit cut – or “notch” – in Social Security retirement income for individuals born in 1960 and 1961. H.R. 7499 fixes the notch without cutting benefits for any other beneficiaries. And the temporary benefit improvements in H.R. 7499 would greatly enhance income security for older adults when they need it the most during the current pandemic.
In addition, we urge you to add H.R. 8171, the Save our Social Security Now Act to COVID relief legislation. H.R. 8171 would reverse President Trump’s executive order deferring payroll taxes for the rest of the year. The President was wrong to circumvent Congress in the face of bipartisan opposition to his reckless proposal to interfere with Social Security’s funding stream. And it is right for Congress to undo an executive action that not only threatens Americans’ earned benefits, but overwhelmingly favors high earners while doing little to provide relief to people suffering the most from the COVID recession. American workers do not want the President tampering with their earned benefits. Congress can – and should – stop him by including H.R. 8171 in the next COVID bill.
Medicare Part B premium
The National Committee supports the goal of preventing seniors from experiencing a large Medicare Part B premium spike in 2021 by keeping the monthly Part B premium at the 2020 amount of $144.90. However, legislating this protection now could be premature before knowing what the Social Security cost-of-living adjustment (COLA) will be as determined by the Bureau of Labor Statistics release of the October 13 Consumer Price Index. At that time, we urge you to ensure that the Part B premium hold harmless protection in current law is extended to Medicare beneficiaries who do not receive Social Security (mainly certain federal, state and local government retirees) and lower-income beneficiaries who are dually eligible for Medicare and Medicaid. We urge you to protect seniors from Part B premium hikes in ways that will not unfairly disadvantage the minority of beneficiaries.
The National Committee supports provisions in the HEALS Act that extend telehealth flexibilities through the end of the pandemic so that seniors get care in the safest possible setting for the duration of the pandemic. While we support the required MedPAC study on the impact on access, quality and cost on telehealth flexibilities, we oppose the 5-year extension of telehealth waivers for Federally Qualified Health Centers and Rural Health Clinics. The impact of telehealth on quality and access should be understood before expanding them beyond the current public health emergency.
Infection Control in Nursing Homes
COVID response strike teams
We support the creation of strike teams authorized to conduct testing and assist with infection control to respond to COVID outbreaks in nursing homes. The National Committee supports H.R. 6698 and S. 3644, the Quality Care for Nursing Home Residents and Workers During COVID-19 Act which authorizes $500 million for states to establish expert strike teams for resident and worker safety to be deployed within 72 hours of 3+ confirmed or suspected COVID-19 cases in a facility. In contrast, the HEALS act simply authorizes federal teams to supplement state strike teams without providing new funding.
Online COVID response training
Congress needs to develop and implement a national strategy for development and distribution of test kits and personal protection equipment. This is necessary for both staff and residents in nursing homes and for seniors who live in the community and their caregivers. Congress must allocate more than the $16 billion in the HEALS Act to adequately fund the manufacturing of COVID test kits and testing that reflects the recent surge in infections to ensure accurate and timely routine testing of nursing home residents and direct care workers.
The National Committee supports the provisions in the HEROES Act that allocate $75 billion for testing and contact tracing and requires the Centers for Disease Control and Prevention to coordinate with, and award grants to, state and local health departments to establish and implement a national evidence-based system for testing, contact tracing, surveillance, containment, and mitigation of COVID-19.
Congress must further require that the Department of Health and Human Services (HHS) develop and enforce robust safety protocols for nursing home facilities and allocate additional funding to monitor and facilitate management of COVID outbreaks. HHS must collect, analyze and report demographic data on COVID in nursing homes. We urge Congress to include H.R. 6698 and S. 3644, and H.R. 6487 and S. 3517, the ACCESS Act in the agreement on coronavirus relief legislation. H.R. 6698 and S. 3644 provides for robust funding and oversight of infection control measures in nursing homes during the pandemic. H.R. 6487 and S. 3517 requires that residents have access to telehealth visitation during the pandemic. Finally, Congress should ensure that appropriate tracking of funding to make sure that recipient facilities demonstrate improved outcomes in infection control.
Reporting COVID cases
The National Committee encourages adoption of the HEROES Act’s stronger provisions around reporting test results to HHS and publicly reporting nursing home data.
The level of funding in the HEALS Act is inadequate to meet the needs of nursing home residents and direct care workers. Congress must provide adequate funding for manufacturing of test kits and testing, infection prevention, and reporting capacity that reflects the recent surge in infections to ensure accurate and timely routine testing of nursing home residents and direct care workers.
We support additional funding for the National Institutes of Health and a comprehensive national plan for vaccine development and distribution. However, more transparency is needed around the agreements the government makes through the Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV) partnership, the Biomedical Advanced Research and Development Authority (BARDA), and with private manufacturers to make sure that the government is retaining an appropriate level of ownership of publicly funded research. Congress should include H.R 7288, the Taxpayer Research and Coronavirus Knowledge Act, in an agreement on coronavirus relief legislation, since it requires establishing a database of federal biomedical investment information related to COVID-19 treatments.
Further, in exchange for increased funding for vaccine development, you should require reasonable pricing of any treatments or vaccines developed using public funding. Expansive patent and regulatory monopolies – including additional ones for existing therapies that can be used to treat COVID – should not be granted. The global scale of the pandemic will enable drug manufacturers to make large profits from fairly priced products on volume alone. Congress should add H.R. 7296, the Make Medications Affordable by Preventing Pandemic Price-gouging Act, to an agreement on a coronavirus relief package because it prohibits companies from exclusive licensing of drugs used to treat or prevent COVID-19.
Home and Community based Services
The National Committee supports the HEROES Act’s allocation of $100 million to the Administration for Community Living “for services targeted to older Americans and the disability community, including caregiver support, protection and advocacy, and home and community-based support services which is $25 million more than the HEALS Act provides. We also support direct funding for home and community-based services, such as a dedicated enhanced Medicaid match for these services (described below) included in The HEROES Act.
The National Committee’s supports the following key provisions in the HEROES Act that have not been addressed in Senate legislation:
- No Medicare beneficiary cost sharing for COVID-19 treatment:Establishes zero cost sharing (out-of-pocket costs) for COVID-19 treatment under Medicare Parts A and B and under Medicare Advantage during the coronavirus public health emergency. Requires coverage under Medicare prescription drug plans (PDPs) and MA-PDPs without cost-sharing or Utilization Management Requirements for drugs intended to treat COVID-19 during the public health emergency.
- Easing Medicare Enrollment barriers: Creates a new special enrollment period for Medicare Parts A and B eligible individuals during the coronavirus public health emergency.
- Federal Medicaid payment: Boosts the share of federal Medicaid funding known as the Federal Medical Assistance Percentage (FMAP) to a total of 14 percent through June 30, 2021. Prevents the Secretary of HHS from finalizing a proposed rule that would limit the ability of states to raise their state share of Medicaid funding needed. While we support the HEROES Act, the National Committee urges Congress to include S. 4108 and H.R. 6539, the Coronavirus Medicaid Response Act, in an agreement on COVID-19 relief legislation because it automatically ties FMAP funding increases to a state’s unemployment rate.
- Medicaid home and community-based care: Increase the federal payments to state Medicaid programs by an additional 10 percentage points starting July 1, 2020 through June 30, 2021 to support activities that strengthen their home- and community-based services (HCBS) benefit.
- Nutrition Assistance: 15 percent increase in Supplemental Nutrition Assistance Program benefits. This benefit improvement will help many low-income seniors receive basic nutrition to replace free congregate meals normally available at senior centers.
- Support for the Postal Service: Provide the U.S. Postal Service (USPS) with $25 billion for revenue forgone due to the coronavirus pandemic and includes language providing additional protections to Postal workers. Seniors and people with disabilities rely on the USPS to deliver their lifesaving prescription medications and other necessities, allowing them to remain safely at home.
The coronavirus public health crisis is both a health and an economic threat to older Americans, people with disabilities and survivors. Millions of vulnerable Americans need an additional targeted response to ensure their economic and health security. I urge you to include the National Committee’s priorities in a robust COVID relief legislative package.
President and CEO