Dr. Carroll Estes, former board chair of the National Committee to Preserve Social Security and Medicare, has received a prestigious award for individuals who’ve made “a significant impact on the U.S. social insurance system.” Last week, the National Academy for Social Insurance (NASI) honored Dr. Estes with the 2019 Robert M. Ball Award for Outstanding Achievements in Social Insurance.
“Dr. Estes is regarded as one of the foremost innovative thinkers and educators on the interaction of social insurance with gender, race/ethnicity, and class issues, and she has used this work to inform policymaking in the fields of health, aging, and social insurance.” – National Academy for Social Insurance
Dr. Estes was a member – and also chaired the board of – the National Committee to Preserve Social Security and Medicare, and later, the board of the National Committee Foundation. She is currently Professor Emerita of Sociology at the University of California, San Francisco (UCSF), where she founded and directed the Institute for Health & Aging, and chaired the Department of Social and Behavioral Sciences in the School of Nursing.
The NASI award is named after former Social Security Commissioner Robert Ball, who “worked tirelessly to advance the nation’s social insurance programs.”
On June 27th, nearly 20,000 Americans had the opportunity to learn that the timing of retirement and claiming Social Security benefits can seriously affect their future financial health. That’s how many participants signed-up for a live webinar produced by AARP, featuring Webster Phillips, senior policy analyst at the National Committee to Preserve Social Security and Medicare. Phillips is one of the nation’s foremost experts on Social Security and a 31-year veteran of the Social Security Administration (SSA).
Phillips joined AARP’s host, Kathy Stokes, and longtime SSA staffer Rob Clark for the webinar, entitled, “Social Security – Why It Pays to Wait.” (It’s still available for viewing here.)
The webinar is part of the National Committee’s “Delay and Gain” project to educate the public about the benefits of waiting until normal retirement age to file a Social Security claim. Workers can receive their full retirement benefit amount at age 66 (rising soon to 67), but many choose to claim as early as 62 – meaning they receive a reduced monthly benefit, up to 30% less, for the rest of their lives.
“For many workers, the strong desire to stop working may cloud their decision about when it’s best, financially speaking, to call it quits. This could cause retirees… to lose thousands of dollars of Social Security income over the course of their retirement, putting them in potential financial peril.” – Webster Phillips, NCPSSM, 6/27/19
By the same token, a worker’s permanent monthly benefit increases for every year he/she waits to claim past full retirement age – up to age 70. In fact, beneficiaries can receive up to 44% more in their monthly checks by postponing retirement until then. As an added advantage, their annual cost of living adjustments (COLAs) will be based on the higher benefit amount.
“Life expectancy is much longer now than it was when Social Security was created. Seniors of today must survive on their fixed incomes even longer.” – Webster Phillips, NCPSSM, 6/27/19
The day after the webinar, Bloomberg reported on a new study which found that American retirees “will collectively lose $3.4 trillion in potential income that they could spend during their retirement because they claimed Social Security at a financially sub-optimal time.”
To illustrate the stakes for individual workers more clearly, the webinar included a video presentation featuring two fictitious twin brothers, Tony and Victor, who claim Social Security at different ages. Each brother has earned a $1,600 monthly benefit at full retirement age. Tony claims early, at 62, lowering his permanent Social Security check to $1,200 per month. Victor, on the other hand, waits until age 70, increasing his monthly benefit to $2,100. With the extra income, Victor can not only pay his bills, but visit his grandchildren who live out-of-town.
During the webinar, Phillips re-iterated an important caveat in the “Delay and Gain” project, which is that not everyone is able to postpone retirement. Failing health, physical limitations, lack of employment opportunities, and caregiving responsibilities are some of the factors that can make it difficult to wait to file for Social Security, Phillips explained. “But for people who are able to continue working until at least their full retirement age, if not longer, it pays to wait.”
Seniors depend on drugs derived from living organisms – known as ‘biologics’ – to treat a plethora of serious health conditions, including multiple sclerosis, Crohn’s disease, asthma, rheumatoid arthritis, chronic pain and cancer. But for many older Americans, biologics are simply out of reach because they cost too must. Today, Rep. Jan Schakowsky (D-IL) and four other members of Congress are introducing legislation to cut those prices by curtailing anti-competitive behavior among biologics makers.
The PRICED Act limits of “one of Big Pharma’s most effective price gouging tools” by reducing the period during which drug companies have exclusive marketing rights for biologics. The legislation would cut the exclusivity period from the current twelve years to five. Such a change could save Medicare upwards of $7 billion over ten years.
National Committee President Max Richtman joined Rep. Schakowsky, Rep. Rosa DeLauro (D-CT), Rep. Angie Craig (D-MN), Rep. Lloyd Doggett (D-TX), and Rep. Raja Krishnamoorthi (D-IL), at a press conference today to endorse the PRICED Act.
“This legislation is a fair compromise for the manufacturers, and a fair deal for consumers since, once that 5-year limit is reached, generic manufacturers can develop biosimilar drugs at a much lower cost for patients.” – National Committee President Max Richtman, 6/20/19
Biologics account for roughly 2% of prescriptions but a whopping 38% of drug spending. Virtually all the top 10 Medicare Part B drugs are biologics, which indicates how much seniors rely on these medications. Drug-makers have been hiking prices for biologics every year, often in lockstep with each other. In January, Big Pharma jacked up the cost of each of these biologics, which treat everything from rheumatoid arthritis to heart failure:
2019 Price Increases
Entresto + 9.9%
Humira currently retails for $40,000/year – up from $19,000 in 2012. Fortunately, Medicare Part D beneficiaries do not have to pay the entire cost of these drugs, but are responsible for copays and deductibles that can quickly become unmanageable. This presents seniors with a cruel choice between taking life-saving medications or paying bills like rent and groceries. Legislation such as the PRICED Act would increase competition and exert downward pressure on the price of biologics for seniors and patients of all ages.
The PRICED Act is part of a broader effort in the House to take serious action on prescription drug prices by cracking down on Big Pharma’s anti-competitive practices. Price transparency and the ability to re-import drugs from other countries are also key. But, as we wrote last week, the most powerful method for reducing costs is allowing Medicare to negotiate prices directly with pharmaceutical companies, as the Veterans Administration already does.
“These are smart, strategic approaches to lowering drug costs that we have been fighting to achieve in the Medicare program since the passage of the Medicare Modernization Act of 2003,” says Richtman. “It’s past time for Congress to show Big Pharma that patients must always come before profits.”
Four influential Democratic Senators delivered a message to their Republican colleagues and President Trump today: allowing Medicare to negotiate directly with Big Pharma is the best way to bring down prescription drug prices. In a press conference at the U.S. Capitol, Sens. Debbie Stabenow (D-MI), Amy Klobuchar (D-MN), Patty Murray (D-WA), and Chris Murphy (D-CT) emphasized the importance of Medicare drug price negotiation as the Senate considers multiple proposals to lower prescription costs.
“Prescription drug pricing is the ultimate example of a rigged system that needs to be unrigged to bring costs down.” – Sen. Debbie Stabenow (D-MI), 6/12/19
National Committee president Max Richtman joined the Senators at the podium as the prime spokesperson for the seniors’ advocacy community – accompanied by a group of yellow t-shirted volunteers from the organization’s Capital Action Team.
“People are dying — or their quality of life is poor — because high drug prices are forcing seniors to go without life-saving medications. It’s time to end pharma’s drug price gouging. It’s time to stop forcing seniors to cut their pills in half or skip a dose. That’s why the National Committee urges the Senate to approve legislation that would allow Medicare to negotiate prescription drug prices.” – National Committee president Max Richtman, 6/12/19
Richtman cited the anti-inflammatory Humira as an example of “out of control drug pricing.” The medication, which treats conditions including arthritis, Crohn’s disease, and colitis, retailed for $19,000 in 2012. Today, it costs a little over $40,000. The price essentially doubled in 7 years.
“Thankfully, seniors with Medicare Part D don’t have to shoulder the full cost. But at over $5,400 a year – their out of pocket cost for Humira is not cheap. Given that the income of half of Medicare beneficiaries is less than $26,200 a year, the cost of Humira alone is 22% of their income.” – Max Richtman, 6/12/19
John Glaser, an 80 year-old National Committee volunteer who suffers from diabetes, told the Senators that his prescription drug costs were so high in 2017 – over $5,000 – that he went through the Medicare Part D coverage ‘donut hole’ and soon hit the program’s catastrophic cap. “Allowing Medicare to negotiate prices [with Big Pharma] would be a benefit for me and millions of other seniors,” Glaser said.
One of the other Capital Action Team volunteers, Pat Cotton, told Entitled to Know that she takes a relatively new drug for myelofibrosis called Jakafi. Cotton said when she started the medication three years ago it cost $10,000 per month but now has jumped 40% to $14,000. She relies on Medicare, supplemental insurance, and a manufacturer’s subsidy to afford the drug. When the insurance company tried to take the subsidy away, she told them, “This drug is saving my life. If you take away the subsidy, you’re killing me.” (The subsidy was restored – but the drug no doubt will continue to climb in price.)
Glaser and Cotton are among the 43 million seniors and disabled in Medicare Part D whose purchasing power the Senators would like to leverage. Senator Klobuchar insisted that by allowing the Secretary of Health and Human Services to negotiate drug prices for Medicare, costs would eventually fall for patients of all ages. Klobuchar has introduced legislation in the Senate to lift the ban on Medicare negotiating with Big Pharma. The bill already has more than 30 cosponsors, but cannot pass without Republican support.
“I thought Republicans liked negotiation, competition, and free markets. This bill unleashes the market power of Medicare and evens the playing field.” – Sen. Amy Klobuchar (D-MN), 6/12/19
Klobuchar said that Republicans are under pressure from the electorate to lower prescription drug prices in the wake of the 2018 midterm elections. She also noted that during the 2016 campaign, President Trump voiced support for Medicare negotiating drug prices with pharmaceutical companies – but has yet to embrace any proposal to allow it.
Max Richtman insisted that it’s something the public clearly supports, pointing to polling that indicates over 90% of Americans want Medicare to be allowed to negotiate drug prices. According to AARP, Medicare could have saved more than $14 billion dollars on the top 50 prescription drugs in 2016 had the policy been in place.
As part of a bipartisan movement on Capitol Hill to confront “surprise medical bills,” Senators Patty Murray (D-WA) and Lamar Alexander (R-TN) are crafting legislation that would protect patients against unexpected health care expenses. But the Senators’ bill currently does not address one of the rudest surprises of all: when Medicare patients discover that they are on the hook for thousands of dollars in skilled nursing care costs because of the way they were classified during a hospital stay.
Hospitals often deem seniors who are – for all intents and purposes – inpatients as being on “observation status” – even if they remain in the hospital for several days. Those patients are then ineligible for Medicare coverage of skilled nursing care once they are discharged.
“The classification as observation patient is significant… because the Medicare statute covers a post-hospital stay in a skilled nursing facility only if the patient was hospitalized for three consecutive days as an inpatient.” – National Observation Stays Coalition, 6/5/19
Many hospital patients do not realize they were placed on “observation status” – or even know to ask. They often don’t learn that they’re liable for the full cost of skilled nursing care until a bill arrives weeks or months later. Those bills can total $10,000 per month – and in some cases, more. That’s an untenable burden for seniors on fixed incomes.
The National Observation Stays Coalition (of which the National Committee to Preserve Social Security and Medicare is a member) is pushing Congress to protect Medicare patients from these surprise bills as it moves forward with bipartisan legislation. The Coalition supports the provisions of the Improving Access to Medicare Coverage Act, sponsored by Senators Sherrod Brown (D-OH), Susan Collins (R-ME), Sheldon Whitehouse (D-RI) and Shelley Moore Capito (R-WV).
“The Improving Access to Medicare Coverage Act would allow for the time patients spend in the hospital under ‘observation status’ to count toward the requisite three-day hospital stay for coverage of skilled nursing care. [This] is a common sense policy that does not affect hospital care – but does protect the ability of beneficiaries to receive needed post-acute nursing home care.” – National Observation Stays Coalition, 6/5/19
The Coalition sent a letter today to Senators Murray and Alexander, urging them to incorporate these protections into their ‘surprise medical billing’ legislation. “It is simply not right to limit access to quality care for those most in need,” says the Coalition’s letter, which was signed by the National Committee. “Now is the time for Congress to pass legislation that addresses this issue once and for all.”