Bill Protects Nursing Home Residents, Providers

Published in the Pawtucket Times on June 1, 2020

This month, U.S. Senator Bob Casey (D-PA) and Senator Sheldon Whitehouse (D-RI) throw a bill in the legislative hopper to slow the spread of novel coronavirus (COVID-19) in nursing homes. It’s a common-sense legislative proposal and needed.

A recently released Kaiser Family Foundation study reported, “COVID-19 has had a disproportionate effect on people who reside or work in long-term care facilities, including the 1.3 million individuals in nursing homes; 800,000 in assisted living facilities; 75,000 in intermediate care facilities; and 3 million people who work in skilled nursing or residential care facilities.”

Combatting COVID-19 in Congregate Settings

With COVID-19 quickly spreading throughout the nation’s nursing homes and intermediate care facilities, Casey and Whitehouse’s legislative proposal, S. 3768, The Nursing Home COVID-19 Protection and Prevention Act, seeks to provide needed resources to facilities to protect frail residents and staff. Residents in these facilities are among the most vulnerable because of their age and underlying medical conditions. According to an analysis conducted by Gregg Girvan for the Foundation for Research on Equal Opportunity, as of May 22, in the 39 states that currently report such figures, 43 percent of all COVID-19 deaths have taken place in nursing homes and assisted living facilities

As more than 20,000 nursing homes residents and workers have died due to COVID-19, according to the latest reports, on May 19, 2020, Casey and Whitehouse introduced S.3768 to help states, nursing homes and intermediate care facilities put the brakes on the spreading of the deadly COVID-19. The legislative proposal, with 14 Democratic cosponsors (including Rhode Island Senator Jack Reed}, would help states implement strategies to reduce the spread of COVID-19 in congregate settings, including through the purchase of personal protective equipment (PPE) and testing and to support nursing home workers with premium pay, overtime and other essential benefits.

S. 3768 was referred to Senate Health, Education, Labor, and Pensions. As of March 30, 2020, a Congressional Budget Office cost estimate or this measure has not been received.

Days after the introduction of 25-page Senate legislative proposal, a House version (H.R. 6972) was introduced by Rep. Ana G. Eshoo (D-CA), cosponsored by Reps. Janice D. Schakowsky (D-IL), Donna E. Shalala (D-FL), Madeleine Dean (D-PA), Seth Moulton (D-MA) and David N. Cicilline (D-RI). The House bill was referred to House Energy and Commerce

“This virus spares no state, no county, no facility. The unprecedented crisis unfolding in our Nation’s nursing homes demands an immediate, extraordinary response. Reports indicate nursing home residents and workers account for roughly 1 in 4 deaths from COVID-19 in the United States,” said Casey, who serves as Ranking Member of the U.S Senate Special Committee on Aging, in a statement announcing the bill’s introduction. “The Nursing Home COVID-19 Protection and Prevention Act would provide $20 billion in emergency funding [for staffing, testing, Personal Protective Equipment, etc.] to devise a sorely needed national, coordinated response to stem the spread of this terrible virus in nursing homes and intermediate care facilities,” notes Casey.

According to Casey, the Senate bill would also require the U.S. Department of Health and Human Services (HHS) to develop guidance on cohorting best practices, including on how to safeguard resident rights. It would also instruct HHS to collect and publish data on COVID-19 cases and deaths in nursing homes and intermediate care facilities, and finally fund surge teams of nurses, aides, and other critical staff to fill in at facilities where multiple residents and staff members have been infected.

“COVID-19 poses an immediate threat to the more than 1.3 million Americans, including more than 7,000 Rhode Islanders, who live in nursing homes,” says Whitehouse, noting that frontline staff across the nation are “doing heroic work under very challenging circumstances.”

“We need to get vastly more personal protective equipment and tests to nursing homes, which care for the patients who are most vulnerable to the coronavirus. Our legislation would also help states fund surge teams, sending additional staff reinforcements to facilities where they are needed to care for patients and prevent infection,” adds Whitehouse.

Before S. 3768 was officially introduced, in early March, Washington, DC-based AARP announced its support for the Senate proposal. “AARP supports the draft of the Nursing Home COVID-19 Protection and Prevention Act that would help protect the health and save the lives of people in nursing homes and other facilities by supporting testing, personal protective equipment, staffing and more,” said Megan O’Reilly, Vice President of Government Affairs for AARP. “The proposal would also improve public transparency and help protect the rights of residents and their families, adds O’Reilly, calling on Congress “to act immediately to stem the loss of life and slow the spread of the virus.”

In the House Chamber, Rhode Island’s Cicilline, a member of the House Democratic Leadership as Chair of the Democratic Policy and Communications Committee, has also pushed for Congressional funding to stop the spread of COVID-19 in nursing homes. The fifth term Congressman has called for additional funding for the Public Health and Social Services Emergency Fund in the next package for congregate care facilities, including nursing homes. He also signed a letter to HHS Secretary Azar and Administrator Verma, of the Centers for Medicare and Medicaid Services (CMS), urging that HHS and the CMS to ensure that a significant portion of the newly allocated $25 billion for testing in the recently passed CARES Act be utilized for testing in nursing homes and other congregate living facilities.

State-wide Efforts to Combat COVID-19 in Nursing Homes

With Governor Gina Raimondo declaring a state of emergency on March 9, 2020, with the COVID-19 arriving in Rhode Island, the deadly pandemic virus spread quickly throughout the state’s nursing homes. At press time, it has been reported that 75 percent of all related COVID-19 deaths are in nursing homes.

According to Joseph Wendelken, Public Information’s Officer for the Rhode Island Department of Health (RIDOH), the state moved quickly to stop the spread of the COVID-19 virus in the community and in nursing homes. He stated: “We curtailed and then prohibited visiting early on, and we have been doing extensive testing in every assisted living facility in the state. We are doing cyclical testing, meaning that we are continually testing all residents in all homes on a rotating basis. We are giving tailored infection control guidance to specific homes, and we are helping them procure additional PPE.”

Adds Wendelken, RIDOH has established two COVID-19 Specialty Nursing Homes [at Oak Hill Center in Pawtucket and Oakland Grove Health Care Center in Woonsocket] to be a COVID-19 Specialty Nursing Home. “These are centralized facilities to accept patients who are being discharged from the hospital and who are COVID-19 positive but no longer require acute-level care. This strategy allows COVID-19 positive patients leaving the hospital to receive specialized rehabilitation and step-down, post-acute care while reserving hospital beds for patients who need acute-level care,” he said.

On Smith Hill, the Rhode Island House Republican Caucus has recently called for members of the House Committee on Oversight to meet to address the increasing COVID-19 death rate in the state’s nursing and assisted living facilities.

Putting Politics Aside…

With less than 156 days until the upcoming 2020 Presidential election, will S. 3768 reach the Senate floor for a vote. Since the beginning of 2019, more than 350 House-passed bills—including hundreds that have bipartisan support—have been buried by Senate Majority Leader Mitch McConnell (R-Kentucky) in his legislative graveyard. With no Republican Senators supporting Casey and Whitehouse’s COVID-19 bill, will it even reach the Senate floor for a vote?

It’s time for McConnell, who has called himself the “grim reaper” of Democratic legislation, to lay down his deadly scythe, making the safety of millions of residents who reside in the nation’s 15,583 skilled nursing facilities a legislative priority. The GOP Senator from Kentucky, who is in a close Senate race with Democratic opponent Amy McGrath, might consider putting politics aside during a raging COVID-19 pandemic sweeping across the nation to work with Senate Democrats to protect frail residents and nursing home staff. Kentucky voters might view protecting residents against COVID a bipartisan issue.

Senate Aging Committee Tackles COVID-19’s Devastating Impact on Seniors

Published in the Woonsocket Call on May 24, 2020

In the midst of bipartisan bickering on Capitol Hill as to what should be included in the fifth coronavirus (COVID-19) stimulus package, the Senate Aging Committee holds Congress’s first hearing in Senate Russell Office Building 301 on the disproportionate toll the COVID pandemic is having on the nation’s seniors, particularly those who reside in nursing homes.

Adults ages 65 years and older represent two out of every five hospitalizations and eight out of every 10 deaths from the virus. The 1.5 million nursing home residents and seniors residing in group care settings (including assisted living facilities) are especially at risk. Nationwide, residents and workers in nursing homes and other long-term care settings represent more than one-third of all COVID-19 deaths. According to reports, to date more than 34,000 nursing home residents have died from COVID-19.

COVID-19’s Deadly Toll on Seniors

The Senate hearing, “Caring for Seniors Amid the COVID-19 Crisis,” held on Thursday, March 21, 2020, explored what can be done to better protect this vulnerable population. Over two hours, Senators heard testimony from a panel of experts who are supporting older adults in hospitals, nursing homes, home health settings, and the community. (Due to the limited access to the Capitol Complex, the public is only able to view the morning hearing live on the committee’s website at https://www.aging.senate.gov/hearings/caring-for-seniors-amid-the-covid-19-crisis.

“COVID-19 has brought tremendous hardship and tragedy, placing a heavy burden on the frontline workers, straining our healthcare and distribution systems, and imposing a deadly toll on our seniors in particular,” said Senator Susan Collins (R-Maine), who chairs the Senate Aging Committee. “Those in nursing homes and congregate care centers are especially at risk. Nationwide, nursing home residents represent one-third of all coronavirus deaths. In Maine, the toll on nursing home residents is even higher,” adds Collins.

“Our nation is facing the greatest public health crisis it has seen in a century. This terrible virus is causing death and destruction at lightning speed, especially among older Americans who are most vulnerable for complications from COVID-19,” added Ranking Member Bob Casey (D-Pennsylvania). “We have added unprecedented amounts of funding to purchase personal protective equipment, testing and ensure seniors in the community have access to home and community-based services that keep them out of congregate settings, but this is not nearly enough. We cannot stop working we cannot stop legislating, we cannot stop appropriating dollars to help our seniors,” says Casey.

“This unprecedented time calls for equally unprecedented action. The Administration has to do more and Congress has to do more to help our seniors and their families at every turn,” said Casey. During the hearing, the Senator highlighted his bill (S.3768), the Nursing Home COVID-19 Protection and Prevention Act, introduced with Senator Sheldon Whitehouse (D-Rhode Island, which would help mitigate the pandemic’s disproportionate impact on nursing homes by helping states purchase personal protective equipment (PPE) and testing and fund premium pay, overtime and other essential benefits for nursing home workers.

Taking a Look at Universal Testing of Nursing Home Residents

Collins directed her first question at the hearing to Dr. Tamara Konetzka, a professor of health services research at the University of Chicago, who has conducted research on the disproportionate impact of COVID-19 on nursing home residents and staff. She asked Dr. Konetzka to explain how universal testing can protect residents and eventually allow family members to safely visit their loved ones.

“Dr. Konetzka, I want to have you expand a little bit more on what we can do,” said Collins. “I believe that you recommended universal testing for every nursing home resident and staff, which I think is a good idea and have been recommending. How often, however, would you have to do that, and would that allow family members who have been tested to finally be able to visit their loved ones?”

“[I]t is very important to test all residents, and not wait until residents are…symptomatic, because by then it’s too late,” replied Dr. Konetzka. “[W]hat I’ve heard from geriatricians is generally weekly [testing] would be good or at least biweekly, so that residents can then be separated and the transmission can be stopped.”

Collins also emphasized that testing was needed at every long-term care facility, since even the highest rated nursing homes have been susceptible to outbreaks.

At the hearing, Senator Collins called for the release of additional health care provider funding that was made available through the CARES Act and the Paycheck Protection Program and Health Care Enhancement Act.

“[T]he ratings by CMS, the number of stars, has not proven to be a reliable indicator of which nursing homes are safest in this environment. And indeed, one of the worst outbreaks in Maine was at a nursing home that had five stars,” remarked Collins. “[W]hen we hear the statistics, which are so devastating…my heart just goes out not only to these patients, but to their families and to the staff of nursing homes and other assisted living facilities, congregate care settings. They’re all praying that COVID-19 does not find its way into their facility,”she said.

As the chief infectious disease specialist for New York University, Dr. Mark J. Mulligan oversees the treatment of COVID-19 patients at the University’s health system hospitals. At the hearing, he explained that seniors are at increased risk due to aging-related decline of the immune system as well as chronic conditions such as cancer, heart disease, lung disease, and diabetes, and that older adults who reside in nursing homes are the most vulnerable.

Medical Countermeasures to Combat COVID-19

Dr. Mulligan provided an overview of the medical countermeasures under development—diagnostics, monoclonal antibodies, and potential treatments such as remdesivir.

“For physicians, scientists, and leaders, the virus has continued to humble us. There’s so much we don’t know yet about diagnosis, prevention, and treatment,” said Dr. Mulligan. “The nurses and doctors I have worked with are incredibly dedicated and caring, but they have not had the medical countermeasures needed to effectively help many vulnerable seniors who have died of this disease,” he adds.

Finally, the final panelist, Dr. Steven Landers, the President and CEO of Visiting Nurse Association Health Group who oversees a team of 3,000 caregivers that cares for 9,000 people daily, provided a home health perspective on the public health crisis. According to Landers, maintaining this a supply of Personal Protective Equipment (PPE) is both challenging and expensive. “We are using over 17,000 surgical masks and over 3,500 N95 masks each week and we are also using thousands of isolation gowns, gloves, goggles and face shields. We have had to pay 7-10 times the usual prices and reach out to vendors all over the world, vendors who we couldn’t fully vet and verify, sometimes just hoping that shipments would arrive,” he say, calling on Congress to find ways prioritize home health and hospice agencies getting needed PPE.

“I have never seen the system so strained, but I also have never felt prouder of the skilled, compassionate, and courageous people I work with,” he said.

Herb Weiss, LRI’12, is a Pawtucket writer covering aging, health care and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.

Social Security – the Third Rail in Politics

Published in RINewsToday.com on May 17, 2020

As Congress begins to hammer out the fifth coronavirus stimulus package to continue its efforts to jump start the nation’s economy, President Donald Trump warns he will not sign any bill that does not include a payroll tax cut.

“We’re not doing anything without a payroll tax cut,” President Trump said at a two-hour “virtual town hall” event hosted by Fox News, at the Lincoln Memorial in Washington, D.C. According to Nielson Media Research, nearly 4 million viewers tuned into this the town hall, titled “America Together: Returning to Work,” on May 3rd, that focused on COVID-19 and the reopening of the nation’s economy.

Aging advocates and Democratic lawmakers charge that President Trump is using the virus pandemic as an excuse to slash payroll contributions, Social Security’s dedicated funding. Cutting the Social Security payroll taxes would reduce the amount of money withheld from employee paychecks, increasing their take-home pay. Republican lawmakers see it as a much-needed relief for hurting Americans. And so it goes…

Payroll Tax Cuts: Reducing Social Security’s Financial Stability

The Washington, DC-based National Committee to Preserve Social Security and Medicare (NCPSSM) quickly released a statement warning that removing the payroll tax by a provision in the next COVID-19 stimulus package will ensure the fiscal insolvency of Social Security. 64 million Americans depend on Social Security benefits in their retirement years.

“President Trump set off alarm bells for America’s seniors and their advocates by insisting once again on eliminating Social Security payroll taxes – both employer and worker contributions. The President even threatened to hold hostage the next phase of badly needed Coronavirus relief legislation unless he gets his reckless payroll tax cuts. Make no mistake: by pushing to cut off the program’s funding stream, President Trump is taking the first step toward dismantling Social

“While we agree that providing tax relief to middle class Americans is an important consideration as we respond to the coronavirus pandemic, we do not believe that cutting, eliminating or deferring the Social Security payroll tax is an appropriate way to accomplish this goal, says Richtman, reminding the president in a letter that Social Security is an earned benefit fully funded by the contributions of workers throughout their working lives.

He pointed out that a payroll tax cut is an assault on that fundamental idea, equally true even if the funds are replaced by general revenues from the Treasury.

In his correspondence, Richtman suggests that a payroll tax cut should not be viewed as an economic stimulus because it leaves out large segments of the population. “Large numbers of federal, state and local government workers do not pay into Social Security, and therefore would not benefit from the payroll tax cut. Ironically, the senior population, those who are directly affected by taking their money from the trust fund, will not see a single dime of relief since most of them are not working,” he notes.

Richtman identified alternatives to the payroll tax cut that he believes would be more targeted and effective to fire up an economy slowed by the spread of the coronavirus. “Another one-time payment by the federal government can put money in the hands of taxpayers quickly, and the Making Work Pay Tax Credit can be passed by Congress rapidly as can an expansion of the Earned Income Tax Credit. Spending in other programs that directly help those who lose employment as a result of the virus can be the most targeted relief of all,” he suggests.

“In light of the recent Social Security Trustees report, it is clear that Social Security needs more revenue – not less,” observes Richtman, who served as a former staff director of the Senate Special Aging Committee.

While Democratic lawmakers push for strengthening and expanding the Social Security Program, GOP lawmakers are signaling their opposition to risking political capital on supporting the effort to cut the payroll tax. Sen. Chuck Grassley (R-Iowa), the Senate Finance Committee chair, responded, when asked by Politico, if he supports the tax cut, “Right now, not much.”

“I’m going to give it due consideration, if I can see a strong group of people who think it’s the right thing to do,” added Grassley, whose Senate committee oversees federal tax policy.

Although Senate Majority Leader Mitch McConnell (R-Kentucky) is not ruling out payroll tax cuts, he is focusing his efforts to put liability protections provisions in the next major stimulus package to protect businesses against virus-related lawsuits from workers, stockholders, and consumers.

Political insiders consider Social Security to be the “third rail of a nations politics.” Wikipedia states that this metaphor comes from the high-voltage third rail in some electric railway systems. Stepping on it usually results in electrocution and the use of the term in the political arena refers to “political death.”

Can President Trump politically survive, keeping his loyal voter base, if he steps on the “third rail” by continuing his efforts to cut payroll taxes, some say seen as pushing the Social Security program toward fiscal insolvency? When the dust settles after the upcoming November 2020 elections, we’ll see if the older voters consider Social Security an untouchable program.

Study: One in Five Americans Are Unpaid Family Caregivers

Published in the Woonsocket Call on May 17, 2020

As the nation sees a growing number of aging baby boomers, workforce shortages in health care and long-term care settings, increased state funding for community-based services, and a growing number of seniors requiring assistance in their daily activities, caregivers are needed more than ever. According to a recently released report from National Alliance for Caregiving (NAC) and AARP, an increasing number of unpaid family caregivers are stepping up to the plate to care for their older family members or friends. The caregiver report’s findings indicate that the number of family caregivers in the United States increased by 9.5 million from 2015 (43.5 million) to 2020 (53 million) and now encompasses more than one in five Americans (19 percent).

First conducted in 1997, with follow up surveys in 2004, 2009 and 2015, the Caregiving in the U.S. studies are one of the most comprehensive resources describing the American caregiver. Caregiving in the U.S. 2020 was conducted by Greenwald &a Associates using a nationally representative, probability-based online panel. More than 1,700 caregivers who were age 18 or older participated in the survey in 2019.

Demand for Caregiving Rising as Nation’s Population Gets Older

The 107-page Caregiving in the U.S. 2020 report also reveals that family caregivers are in worse health compared to five years ago. As the demand for caregiving rises with the graying of the nation’s population, the report calls for more be done to support this vital work.

“As we face a global pandemic, we’re relying on friends and family to care for the older adults and people living with disabilities in our lives,” notes C. Grace Whiting, JD, President and CEO of NAC, in a May 14 statement announcing the release of this report. “Caregivers are essential to the nation’s public health, and the magnitude of millions of Americans providing unpaid care means that supporting caregivers can no longer be ignored, she says, noting that report’s findings reveals that growing need.

According to Whiting, family caregivers care for more people than five years ago and they take on more care responsibilities as roughly one in four care for two or more people. “Many individuals are caring for a longer time, with nearly a third (29 percent) of caregivers nationwide reporting they have been caregiving for five years or more—up from 24 percent in the last study,” states Whiting.

Who are today’s caregivers?

This new caregiver study shows that 39 percent are men and 61 percent are women. The average age is 49.4 years. The profile of the family caregiver is also changing, too. While caregiving spans across all generations, Caregiving in the U.S. 2020 found more young people providing care, including 6 percent who are Gen Z and 23 percent who are Millennials. Nearly half (45 percent) are caring for someone with two or more conditions—a significant jump from 37 percent in 2015.

As to ethnicity, the caregiver report notes that six in 10 are non-Hispanic White (61 percent), 17 percent are Hispanic, and 14 percent are African American.

The report’s findings indicate that one in 10 of the caregiver survey respondents are enrolled in college or taking classes (11 percent), 9 percent have served in the military and 8 percent self-identify as lesbian, gay, bisexual, and/or transgender.

Caregivers in Poorer Health, Feeling Financial Strain

Caregiving in the U.S. 2020 also found that caregivers face health challenges of their own with nearly a quarter (23 percent of caregivers find it hard to take care of their own health and 23 percent say caregiving has made their health worse. The report also notes that personal finances are a concern for family caregivers: 28 percent have stopped saving money, 23 percent have taken on more debt and 22 percent have used up personal short-term savings.
Sixty one percent of the caregiver respondents work and have difficulty in coordinating care.

The May 2020 caregiver report states on average, caregivers spend 23.7 hours a week providing care, with one in three (32 percent) providing care for 21 hours or more, and one in five (21 percent) providing care for 41+ hours—the equivalent of a full-time unpaid job.

“The coronavirus pandemic is exacerbating the challenges family caregivers were already facing from a personal health, financial and emotional standpoint,” said Susan Reinhard, RN, PhD, Senior Vice President at AARP. “Family caregivers provide vital help and care for their loved ones, yet this survey shows that they keep getting stretched thinner and thinner. We must identify and implement more solutions to support family caregivers—both in the short term as we grapple with coronavirus and in the long term as our population ages and the number of family caregivers declines.”

: “Without greater explicit support for family caregivers in coordination among the public and private sectors and across multiple disciplines overall care responsibilities will likely intensify and place greater pressure on individuals within families, especially as baby boomers move into old age,” warns the report’s authors, calling on Congress and state lawmakers to develop policies that ensure that caregivers do not suffer deteriorating health effects and financial insecurity.

Thoughts from AARP Rhode Island…

“The wealth of information in this report is an essential guide to policymakers,” said AARP Rhode Island State Director Kathleen Connell. “It reveals important trends and underlines future needs. For AARP, it provides information on how, as an organization, we can best serve Rhode Island’s 136,000 family caregivers. The challenges they face vary, making it very important that we can provide focused resources that meet any one caregiver’s needs. The report’s overall takeaway – that the number of caregivers is rising dramatically – is a call for increased awareness and support. This responsibility starts at the very top of federal, state and municipal government and flows all the way down to family members who can better share caregiving responsibilities. Many will be asked to step outside their comfort zone, so we all will have to work together,” adds Connell.

Connell noted that the report points out the shift from traditional residential health care settings to community-based settings. “The research reaches a clear conclusion,” Connell observed. “Families will have to fill new roles, learn new skills and absorb more out of pocket caregiving expenses. This will create additional the stress for many family caregivers. That’s why it is so important that we develop the training, tools and other resources caregivers require.”

A 2019 AARP report, Valuing the Invaluable, calculated that Rhode Island family caregivers provide 114 million unpaid hours of care annually. Based on the average $15.76 per hour wages of paid caregivers, family caregivers represent an economic value of an estimated $1.8 billion.

The 2020 study was funded by AARP, Best Buy Health Inc. d/b/a Great Call, EMD Serono Inc., Home Instead Senior Care®, The Gordon and Betty Moore Foundation, The John A. Hartford Foundation, TechWerks, Transamerica Institute, and UnitedHealthcare.

For a copy of Caregiving in the U.S. 2020, go to
https://www.aarp.org/content/dam/aarp/ppi/2020/05/full-report-caregiving-in-the-united-states.doi.10.26419-2Fppi.00103.001.pdf.

Can Trump Politically Survive Cutting Social Security’s Payroll Tax?

Published in the Pawtucket Times on May 11, 2020

As Congress begins to hammer out the fifth coronavirus stimulus package to continue its efforts to jump start the nation’s economy, President Donald Trump warns he will not sign any bill that does not include a payroll tax cut.

“We’re not doing anything without a payroll tax cut,” Trump bluntly warns at a two-hour “virtual town hall” event hosted by Fox News, at the Lincoln Memorial in Washington, D.C. According to Nielson Media Research, nearly 4 million viewers tuned into this the town hall, entitled “America Together: Returning to Work,” aired on May 3, that focused on COVID-19 and the reopening of the nation’s economy.

Aging advocates and Democratic lawmakers charge that trump is using the virus pandemic as an excuse to slash payroll contributions, Social Security’s dedicated funding. Cutting the Social Security payroll taxes would reduce the amount of money withheld from employee paychecks, increasing their take-home pay.

Payroll Tax Cuts: Reducing Social Security’s Financial Stability

The Washington, DC-based National Committee to Preserve Social Security and Medicare (NCPSSM) quickly released a statement warning that Trump’s efforts to remove the payroll tax by a provision in the next COVID-19 stimulus package will ensure the fiscal insolvency of Social Security, threatening the program’s ability to continue paying benefits to 64 million Americans who depend on those benefits to financially survive their retirement years.

“President Trump set off alarm bells for America’s seniors and their advocates by insisting once again on eliminating Social Security payroll taxes – both employer and worker contributions. The President even threatened to hold hostage the next phase of badly-needed Coronavirus relief legislation unless he gets his reckless payroll tax cuts. Make no mistake: by pushing to cut off the program’s funding stream, President Trump is taking the first step toward dismantling Social Security, says NCPSSM’s president and CEO, Max Richtman in a statement.
.
“While we agree that providing tax relief to middle class Americans is an important consideration as we respond to Coronavirus pandemic, we do not believe that cutting, eliminating or deferring the Social Security payroll tax is an appropriate way to accomplish this goal, says Richtman.

In an April 24 correspondence to Trump, NCPSSM’s top official reminded the president that Social Security is an earned benefit fully funded by the contributions of workers throughout their working lives. He pointed out that a payroll tax cut is an assault on that fundamental idea, equally true even if the funds are replaced by general revenues from the Treasury.

In his correspondence, Richtman suggests that a payroll tax cut should not be viewed as an economic stimulus because it leaves out large segments of the population. “Large numbers of federal, state and local government workers do not pay into Social Security, and therefore would not benefit from the payroll tax cut. Ironically, the senior population, those who are directly affected by taking their money from the trust fund, will not see a single dime of relief since most of them are not working,” he note.

Richtman also identified alternatives to the payroll tax cut that he believes would be more targeted and effective to fire up an economy slowed by the spread of the coronavirus. “Another one-time payment by the federal government can put money in the hands of taxpayers quickly, and the Making Work Pay Tax Credit can be passed by Congress rapidly as can an expansion of the Earned Income Tax Credit. Spending in other programs that directly help those who lose employment as a result of the virus can be the most targeted relief of all,” he suggests.

“In light of the recent Social Security Trustees report, it is clear that Social Security needs more revenue – not less,” observes Richtman, who served as a former staff director of the Senate Special Aging Committee.
S
“The President’s campaign to eliminate payroll taxes is a violation of his patently false promises to seniors ‘not to touch’ Social Security. This proposal goes way beyond ‘touching.’ Choking off Social Security’s funding stream is an existential threat to seniors’ earned benefits,” charges Richtman.

Nancy Altman, president of Social Security Works, came out swinging when she heard Trump stating that he will block all coronavirus response measures unless they include cuts to the payroll tax, whose revenue is dedicated to Social Security.

In a statement, Altman stated: “More than 30 million Americans are newly unemployed due to the coronavirus pandemic. Their paychecks are gone, but their rent, utility, grocery bills and other expenses still must be paid. Seniors in nursing homes are dying at alarming rates. Hospitals are desperate, as are state and local governments.”

Dead on Arrival on Capitol Hill????

“Trump made it clear weeks ago that his obsession with cutting payroll contributions has nothing to do with the coronavirus or the resulting economic fallout,” says Altman, noting that he said he’d like a “permanent” reduction in payroll contributions, and that he’d support it “regardless” of the current situation. He has also said he wants to cut Social Security once he is re-elected, she added.

While Democratic lawmakers push for strengthening and expanding the Social Security Program, GOP lawmakers are signaling their opposition and aversion to risking political capital on supporting Trump’s efforts to cut the payroll tax. Trump’s calls for this tax policy change are falling on deaf ears. According to Politico, when asked if he supports Trump’s ultimatum that a payroll tax must be placed in the next stimulus package, Sen. Chuck Grassley (R-Iowa), the Senate Finance Committee chair, responded, “Right now, not much.”

“I’m going to give it due consideration, if I can see a strong group of people who think it’s the right thing to do,” added Grassley, whose Senate committee oversees federal tax policy, in the May 5 Politico article. “The president proposes, we dispose,” he quips.

Although Senate Majority Leader Mitch McConnel (R-Kentucky) is not ruling out payroll tax cuts, he is focusing his efforts to put liability protections provisions in the next major stimulus package to protect businesses against virus-related lawsuits from workers, stockholders, and consumers.

Stepping on the “Third Rail”

Political insiders consider Social Security to be the “third rail of a nations politics.” Wikipedia states that this metaphor comes from the high-voltage third rail in some electric railway systems. Stepping on it usually results in electrocution and the use of the term in the political arena refers to “political death.”

At an Iowa campaign rally in 2016, Republican presidential candidate Trump boasted that his loyal voter base would still standby him even if he shot someone in the middle of 5th Avenue in New York City. Many political pundits responded to his comment by rolling their eyes and chuckling.
Can Trump politically survive, keeping his loyal voter base, if he steps on the “third rail” by continuing his efforts to cut Social Security’s payroll taxes, pushing the program toward fiscal insolvency. When the dust settles after the upcoming November 2020 elections, we’ll see if the older voters consider Social Security an untouchable program.

Tele-Town Hall Gets the Word Out About COVID-19

Published in Woonsocket Call on May 3, 2020

This week alone, AARP in some 30 states conducted tele-town halls and 123 state calls have taken place since the pandemic surfaced. AARP Rhode Island, representing 132,000 members age 50 and over, was among the very first states to address the pandemic in a tele-town hall over two weeks ago.

At the AARP Tele-Town Hall, held Wednesday, April 22, during the 56-minute live event, state officials came to answer questions about how to cope with the devastating COVID-19 pandemic and how seniors can protect their health and stay safe. AARP Rhode Island’s John Martin, Communication Director, served as host and the panel of experts featured Office of Healthy Aging (OHA) Director Rosamaria Amoros Jones and Rhode Island Department of Health Medical Director Jim McDonald.

“We had 3,050 participants and, at one time, 974 people were on at the same time,” says Martin, who hosted the call. “We took 18 live calls in 55 minutes and, unfortunately had close to 20 people waiting to speak when time expired,” he adds, noting that it was AARP Rhode Island’s largest tele-town hall audience ever.

According to Martin, “Our in-call interactive poll revealed that nearly three quarters of those who cast votes were most interested in local resources and information on how to prevent the spread of the coronavirus, About a quarter said they were looking for help caring for family and loved ones, and information on insurance.”

Adds AARP State Director Kathleen Connell, “We were extraordinary pleased with the response to the tele-town hall,” who said she expects more statewide calls. “Just as important, however, is our virtual engagement with members and especially our volunteers. We are getting used to communicating online because that is where all of our ‘personal’ contact will be taking place, at least in the next few months — and that will include video conferencing, which we are testing now. We are impressed at how eager people 50 and older are ready to master the technology and join in.”

State Officials Talk COVID-19

“We are at a point where we are starting to see the benefits of our collective efforts of [maintaining] physical distancing, states OHA Director Jones. It is flattening the curb where the peak number of people requiring care at a time is reduced and the health care system is not overwhelmed, she says.

“It is really important for us that social or physical distancing as we also refer to it does not equal social isolation,” says Jones, noting that innovative approaches can keep people engaged with each other during this time of physical distancing.

Jones also gave a plug for Project Hello (http://oha.ri.gov/get-involved/volunteering/), a program that matches older adults with someone in the community for regular chats and for mutual support. “We’re in it for the long haul and it is going to take all of us working together neighbors helping neighbors,” she says.

“Effective quarantine and isolation efforts are critical today,” says Jones. “Our focus is on making it as easy and as comfortable as possible right now to stay home as we ready ourselves for the new normal that is on the other side of the pandemic,” she adds.

Jones called for those in quarantine and self-isolation reach out to Shopping Angels (www.facebook.com/shoppingangelsinc/) for assistance in personal shopping.

One caller expressed strong concern about Governor Gina Raimondo’s comment that people over age 60, at greater risk of severe COVID-19 illness, would be required to stay home for a longer period of time before being allowed to return to work or participate in community activities. “There have been no definitive decisions to implement restrictions at this time,” said Jones trying to reassure the caller.

Although there are programs and services detailed on the internet that can assist older Rhode Islanders to cope with the COVID-19 pandemic, one caller asked how these could be accessed without a laptop, computer or smart phone. Jones noted that The Point (http://oha.ri.gov/get-help/), operated by United Way Rhode Island and linked through 211 or by dialing (401) 462-4444, could provide information, referrals to needed programs and services.

How would people age 60 and over be protected against age discrimination when the governor is stating that it might take a longer time for these individuals to return to work? asked a caller. “It’s something we are thinking a lot about and a lot more [will] come as we talk about what the new normal is going to look like as we come through the peak of the pandemic, says Jones, stressing that age discrimination would not be tolerated.

Jones called for listeners to visit NextDoor.com, a website that promotes volunteer opportunities (including the delivery of groceries for seniors and those in quarantine), to see how they could help those impacted by COVID-19. For those seeking information about housing, Jones recommended a site, RI Havens, that provides a listing of hotels with affordable room rates for front line workers and for those persons stranded because of the virus and might need a safe place to stay. Details about food delivery options and food assistance programs can be found at the site, RI Delivers, that connects those in quarantine or isolation due to COVID-19 with opportunities to have food delivered by local and big-box grocery stores.

One caller asked Dr. James McDonald, Medical Director at RI Department of Health (DOH), about how a person could improve their immunity to assist them to successfully combat COVID-19. “You can’t always control the virus but you can control yourself,” says McDonald, stressing the importance of eating a healthy diet, regularly exercising and losing weight are actions to take to improving your health.

Making COVID-19 Transparent in Rhode Island’s Nursing Homes

During the Tele-Town Hall, McDonald was asked a question, “Why can’t the Health Department provide a list of long-term care and assisted living facilities that will show the number of patients/residents who have tested positive for COVID-19 and the number of facilities.” Twenty-four hours later this list appeared on the DOH Coronavirus Data Hub. (https://ri-department-of-health-covid-19-data-rihealth.hub.arcgis.com/).

McDonald noted that this particular virus has been so effective in causing the pandemic because it takes so long for a person to show symptoms and that other people who have it sometimes spread the virus before they even have symptoms and they don’t even know they should isolate because they don’t feel ill. It becomes important for a person to wear a mask when going outside to stop the spread of the virus, he says.

MacDonald says that it is highly unlikely to catch COVID-19 by touching grocery bags placed on your porch or through picking up a letter or package. He suggests constantly using hand sanitizer and washing your hands before and after picking up items touched by others.

AARP has created a special web page, http://www.aarp.org/RICOVID for coronavirus information and resources,” says AARP Rhode Island’s Martin added. “There you will find information about our ‘Community Connections’ program, aimed at combating isolation and loneliness, and a direct link to http://www.aarp.org/coronovirus, where all of AARP’s resources can be found.

Report: Congress Warned to Shore Up Social Security Reserves

Published in the Woonsocket Call on April 26, 2020

Each year, starting in 1941, the Social Security Board of Trustees has presented a required report on the financial status of the program to the Congress. Now amidst the world-wide coronavirus (COVID-19) pandemic forcing the shuttering of the nation’s businesses triggering the worst economic downslide since the 1930s Great Depression, the Social Security Board of Trustees releases its 276-page 2020 annual with a warning that Social Security could deplete its trust funds reserves by 2035, if Congress does not act to increase the trust fund reserves. However, because of payroll taxes, revenue to the program would ensure that at least 79 percent of benefits would be paid after 2035 if Congress fails to address solvency.

During the last five weeks, about 24 million Americans have lost their jobs due to COVID-19 Pandemic. With fewer people paying payroll taxes, this will further reduce revenue to Social Security, the impact depending upon how length and severity of the economic downturn. During the pandemic, the number of Americans who pass away, become disabled or survivors will also affect the actuarial accounting of the trust fund’s finances.

“The projections in this year’s report do not reflect the potential effects of the COVID-19 pandemic on the Social Security program. Given the uncertainty associated with these impacts, the Trustees believe it is not possible to adjust estimates accurately at this time,” said Andrew Saul, Commissioner of Social Security. “The duration and severity of the pandemic will affect the estimates presented in this year’s report and the financial status of the program, particularly in the short term.” says Saul.

“Today’s report confirms that Social Security’s financing is strong in the near term, but it will not have enough to pay 100 percent of promised benefits in long term. The report underscores why it is so important that Congress take action now to prevent a 21 percent cut from occurring in 2035, by ensuring Social Security is fully funded and strengthened for today’s seniors and future generations, who will need it even more,” said Chairman John B. Larson (D-CT), House Ways and Means Social Security Subcommittee in a statement.

“As we face the COVID-19 pandemic, Social Security’s role is even more important than ever. During this volatile time of economic uncertainty, Social Security remains the one constant that all current and future beneficiaries can count on. It has never missed a payment. That’s why we must act now to expand and enhance Social Security with the Social Security 2100 Act,” states Larson. “His legislation will ensure Social Security remains solvent for the next 75 plus years, while expanding benefits. Moreover, the expansion of Social Security’s steady monthly payments would be an automatic boost to the economy,” he adds.

Gauging the Financial Health of Social Security

According to the Washington, DC-based National Committee to Preserve Social Security and Medicare (NCPSSM), at the end of 2019, about 64 million people were receiving benefits: 48.2 million retired workers and their dependents; 6 million survivors of deceased workers; and 9.9 million disabled workers and their dependents. About 178 million workers had earnings covered by Social Security and paid payroll taxes in 2019.

By 2035, (which is the same as last year’s estimate) when today’s 51-year-olds reach the retirement age and today’s youngest retirees turn 78, retirees will face a 21-percent across-the board benefits cut (that could grow to 25 percent over time) if Congress does not make significant changes to revenue, benefits, or both to shore up the depleted trust fund.

This year’s report announces that Social Security has an accumulated surplus of approximately $2.9 trillion. It projects that, even if Congress took no action whatsoever, Social Security not only can pay all benefits and associated administrative costs until 2035, it is 91 percent funded for the next quarter century, 85 percent for the next half century, and 82 percent for the next three quarters of a century. At the end of the century, in 2095, Social Security is projected to cost just 5.86 percent of gross domestic product.

The newly released Trustees report notes that the Disability Insurance (DI) Trust Fund, which pays disability benefits, will be able to pay scheduled benefits until 2065, 13 years later than in last year’s report. At that time, the fund’s reserves will become depleted and continuing tax income will be sufficient to pay 92 percent of scheduled benefits.

As to the Hospital Insurance (HI) Trust Fund, which pays Medicare Part A inpatient hospital expenses, the Trustee’s report says that this program will be able to pay scheduled benefits until 2026, the same as reported last year. At that time, the fund’s reserves will become depleted and continuing total program income will be sufficient to pay 90 percent of total scheduled benefits.

Finally, the Trustee’s report noted that the Supplemental Medical Insurance (SMI) Trust Fund, consisting of Part B, which pays for physician and outpatient services, and Part D, which covers prescription drug benefits, is adequately financed into the indefinite future because current law provides financing from general revenues and beneficiary premiums each year to meet the next year’s expected costs. Due to these funding provisions, the rapid growth of SMI costs will place steadily increasing demands on both taxpayers and beneficiaries, says the Trustee’s report.

Social Security Advocates Weigh in

“Medicare and Social Security are more crucial than ever as Americans face the one-two punch of the coronavirus’s health and economic consequences, says AARP CEO Jo Ann Jenkins in a statement following the release of the Trustees report, noting that the security provided by Social Security’s guaranteed benefits and Medicare’s health coverage is indispensable.

“Today’s reports show that both programs remain strong. However, it is crucial for Congress to come together in a bipartisan way to address the long-term funding challenges to ensure individuals will get the benefits they have earned. One way to protect Medicare is to lower the cost of health care and prescription drug prices, suggests Jenkins.

“Social Security is strong. But its long-term fiscal health cannot be guaranteed if the White House and Congress continue to use the program’s financing structure for economic stimulus during the COVID-19 crisis,” says Max Richtman, NCPSSM’s President and CEO. “Those who would like to dismantle Social Security are using the pandemic to launch a stealth attack. A broad-based payroll tax cut, as the President has proposed, would interfere with Social Security’s traditional revenue stream while failing to deliver effective or equitable stimulus,” he warns.

According to Richtman, Social Security already provides more than $1.6 trillion in annual economic stimulus as seniors spend their benefits for essential goods and services in their communities. “Now is not the time – in fact, it is never the time – to tamper with a program that more than 40% of retirees rely upon for all of their income,” he says.

Richtman notes that the Trustees estimate that the Social Security cost-of-living adjustment (COLA) for 2021 will be 2.3 percent. However, that projection does not reflect the impact of the pandemic on inflation, and the actual COLA for next year could be lower, he says.

“We do not know the extent of the pandemic’s impact on Social Security, but we do know that seniors need a boost in their benefits. Let’s strengthen the program now by eliminating the payroll tax wage cap and demanding the wealthy pay their fair share. That way, we can expand benefits and adopt a more accurate cost-of-living inflation formula for seniors,” suggests Richtman.

As for Medicare, says Richtman, the program’s financial future is relatively unchanged from last year’s report, but the impact of the pandemic is not reflected. “The Medicare Part A Trust Fund will become exhausted by 2026, after which the program still could pay 90 percent of benefits, if Congress does nothing to strengthen Medicare’s finances,” he adds.

Adds Richtman, the Trustees estimate that the Medicare Part B premium will rise to $153.30 per month in 2021, an $8.70 increase over last years.

Nancy Altman, President of Social Security Works and the Chair of the Strengthen Social Security Coalition, agrees with Jenkins and Richtman that the Trustee’s report shows Social Security will remain strong through the rest of the 21st century and beyond, notwithstanding current circumstances. “Though the exact impact of today’s pandemic and economic conditions will not be clear until next year’s report, Social Security’s strength will shine through next year, as well. Social Security is built to withstand today’s events,” says Altman.

Altman believes that Social Security is a solution and the program continues to pay benefits automatically on time, especially with retiree’s 401(k)s taking a hit because of the pandemic crisis. “It is past time to increase Social Security’s modest but vital benefits, while requiring the wealthy to pay their fair share,” she says.

Stimulating the Economy by Slashing Payroll Taxes

Congress has passed payroll tax cuts –in 2011 and 2012 – in an attempt to stimulate the economy during a downturn. The recently enacted $2.2 trillion economic stimulus legislation passed last month, called the CARES Act, does allow for employers to defer their payroll tax payments but does not actually cut the levies, which are used to fund Medicare and Social Security.

Now GOP lawmakers led by President Donald Trump are using the virus pandemic as an excuse to slash payroll contributions, Social Security’s dedicated funding. Cutting the Social Security payroll taxes would reduce the amount of money withheld from employee paychecks, increasing their take-home pay.

Using a payroll tax cut to provide a financial stimulus in an effort to forestall a recession caused by COVID-19 pandemic “undermines the earned benefit nature of the program,” warns Dan Adcock, NCPSSM’s Director of Government Relations & Policy.

“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 not just cut but is eliminated, undermining the program in this manner would help achieve the goals of opponents of Social Security including those who would privatize the program,” says Adcock.

Adcock says that NCPSSM opposes a Congressional effort to alter the payroll tax that reduces revenue flowing into the Social Security trust fund or undermines the “earned right” nature of the benefit. “We support the enactment of tax incentives – other than cutting, suspending or deferring the Social Security and Medicare payroll taxes – to encourage employers to keep their workers during this emergency,” he says.

Congressional lawmakers can extend the long-term solvency of the Social Security while improving earned benefits through passing legislation like Congressman John Larson’s H.R. 860, the Social Security 2100 Act, says Adcock. At press time, the House bill has over 208 cosponsors and its Social Security Subcommittee has held several hearings on the bill.

Several other bills to protect and expand Social Security benefits have also been introduced in both House and Senate chambers The presumptive Democratic nominee for President, former Vice President Joe Biden, has endorsed a Senate proposal sponsored by Senators Elizabeth Warren (D-MA) and Ron Wyden (D-OR) that would provide all Social Security beneficiaries with an extra $200/month during the coronavirus health crisis.

As to Medicare, lawmakers can take action to cut beneficiaries’ out of pocket costs and boost Medicare’s fiscal health by passing H.R. 3, The Lower Drug Costs Now Act — which would save the program some $400 billion in projected prescription drug costs by allowing the government to negotiate prices directly with Big Pharma.

Simply put, one sure method of ensuring the financial viability of Social Security is to require millionaires to pay their fair share of payroll taxes by removing or increasing the current income cap on payroll taxes, suggests Adcock.

Shoreing Up Social Security

With over 90 days until the upcoming 2020 Presidential elections, seniors might reach out to those running for Congress and the White House and call for the strengthening and expansion of Social Security. It’s time to protect the viability of the program for those currently receiving benefits and for the younger generations who follow.

View the 2020 Trustees Report at http://www.socialsecurity.gov/OACT/TR/2020/.

View an infographic about the program’s long-term financial outlook at http://www.socialsecurity.gov/policy/social-security-long-term-financial-outlook.html

Herb Weiss, LRI’12, is a Pawtucket writer covering aging, healthcare and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.