We Need Congress to Step Up and Fix Social Security, Medicare

Published in Woonsocket Call on July 3, 2016

Expect the nation’s Social Security program to be fully funded for nearly two decades, and Medicare’s solvency to continue courtesy of health care reforms. Social Security beneficiaries may even get a very small .2 percent cost of living (COLA) adjustment next year but will get wacked with a Medicare premium increase. These facts are reported in the recently leased 262 page report issued by the Trustees of the Social Security and Medicare funds, transmitted to Congress and President Obama. This is the 76th report issued by the Trustees that financially reviews these two of the nation’s largest entitlement programs.

This 2016 Trustee Report, released on Jun 22, should be of interest to Rhode Island’s retirees who receive checks from Social Security, According to AARP, 153,349 Rhode Islanders received Social Security checks as of the end of 2014. Also, 22 percent of Rhode Island retirees depend on their Social Security check for 90 percent or more of their income. Their average benefit is $1,341 per month.
The Devils in the Details

The recently released 2016 Trustees Report notes there is now $2.81 trillion in the Social Security Trust Fund, which is $23 billion more than last year and that it will continue to grow by payroll contributions and interest on the Trust Fund’s assets.

Meanwhile, Social Security remains well-funded. In 2016, as the economy continues to improve, Social Security’s total income is projected to exceed its expenses. In fact, the Trustees estimate that total annual income will exceed program obligations until 2020.

The Trustees say that Social Security will be able to pay full benefits until the year 2034, the same as projected in last year’s Report. After that, Social Security will still have sufficient revenue to pay about 79% of benefits if no changes are made to the program.

Although the Trustees project a .2% Cost of Living Adjustment increase, retirees will be hit with a premium increase next year. Medicare Part B premiums are projected to increase by only a very small amount for about 70 percent of beneficiaries in 2017 from $104.90 to $107.60. The standard monthly premium is projected to increase from $121.80 to $149.00 while the annual deductible is projected to increase from $166 to $204 for all beneficiaries.

The Trustees peg Medicare solvency to the passage of healthcare reform, with the program paying full benefits until 2028, 11 years later than was projected prior to passage of the Affordable Care Act. However, this is two years earlier than projected in 2015.

Congress Must Step to the Plate

Responding to the Social Security Trustees report, recently released report, AARP CEO Jo Ann Jenkins, said, “While the Trustees once again report that the combined Old Age, Survivor and Disability Insurance Trust can pay full retirement, survivor and disability benefits for some time, we know that if no action is taken, benefits could be cut by nearly 25 percent in 2034, and families could lose up to $10,000 per year in benefits.”

“Social Security remains a critical part of the fabric of our lives to protect us from both expected and unexpected challenge,” says Jenkins.

Jenkins calls on Presidential candidates and those running for Congress and the Senate to make a commitment to strengthening Social Security and outline their plans for the fix. “Throughout the 2016 election, we’ll continue to push candidates to take action if elected,” she says.

As to Medicare, Jenkins adds, “This year’s Medicare Trustees report reinforces the recent progress that has been made through greater Medicare savings and lower costs per enrollee. The report also highlights the financial challenges that continue to face the Medicare program, which is projected to provide critical health coverage to 64 million Americans by 2020.”

“A typical senior today has an annual income of just under $25,000 and pays roughly one out of every six dollars of this in out-of-pocket health care costs. The more than 55 million older Americans who today depend on Medicare for guaranteed, affordable health coverage simply cannot afford more than they already pay,” says Jenkins.

The Solution Could Be Simple

Jenkins urges Congress to make simple solutions to bring stability to the nation’s Medicare program. She suggests Congress find ways to reduce high prescription drug costs, improve the nation’s health care outcomes, eliminate unnecessary diagnostic testing, curb excess paperwork, and identify waste and fraud in the program.

Adds, Max Richtman, President/CEO of the National Committee to Preserve Social Security and Medicare, “What’s likely to be missing in headlines about today’s Social Security Trustees Report is that the program remains well-funded with total income, again, projected to exceed expenses. However, in order to head off a benefit cut in 2034 Washington should embrace the growing movement to lift the payroll tax cap and expand benefits for the millions of seniors struggling to get by on an average $1,300 retirement benefit.

The Trustees also project a tiny .2% cost of living adjustment next year yet Medicare premiums will increase in 2017, says Richtman. “Seniors continue to see their modest Social Security benefits eaten away by growing healthcare costs which illustrates, once again, that the current Social Security COLA formula isn’t accurately measuring seniors’ expenses. Congress needs to adopt a fully developed CPI for the elderly (CPI-E) and begin work on the many Social Security expansion bills now languishing in the House and Senate,” he adds.

This [Trustee’s] report reinforces the importance of ensuring that Social Security and Medicare are preserved and guaranteed, especially for working and middle class Rhode Islanders,” said Rep. David Cicilline (D-Rhode Island) who is a co-sponsor of the Protecting and Preserving Social Security Act. “Reasonable measures, such as raising the cap on high-income contributions, should be considered by Congress to extend the solvency of these programs. I will continue to advocate for commonsense legislation that strengthens benefits for working families and ensures the long-term stability of Social Security and Medicare,” he says.

RI. Reps Protect Social Security

Like Cicilline, Rep. Jim Langevin and Democratic Senators Jack Reed (D and Sheldon Whitehouse both view Social Security as an earned benefit and the primary source of income to millions of retirees that must be protected. The Rhode Island Congressional Delegation has fought off Republican efforts to privatize Social Security and have supported legislation to strengthen this program and Medicare.

It is very clear to aging advocates and to the Trustees of the Social Security and Medicare trust funds that the next President and Congress put political differences aside to make legislative fixes to strengthen and ensure the long-term stability of Social Security and Medicare.

The Trustees say this very clearly in their report, “Lawmakers have many policy options that would reduce or eliminate the long-term financing shortfalls in Social Security and Medicare. Lawmakers should address these financial challenges as soon as possible. Taking action sooner rather than later will permit consideration of a broader range of solutions and provide more time to phase in changes so that the public has adequate time to prepare.”

Political compromise will be the way to hammer out Social Security and Medicare reforms. When the dust is settled after the upcoming November president elections hopefully this message was delivered at the ballet box.

LTC Must Be Placed on Candidates’ Radar Screen

Published in the Woonsocket Call on May 29, 2016

Presidential candidates might just think twice about their political campaign positions on long-term care. With the graying of nation’s voters, Congress will be pushed to put long-term care on its policy agenda. When the dust settles after the Democratic and GOP conventions, the winning candidates must address long-term care issues in their debates before the November election.

In 2013, America’s age 65 or older population made up only 14 percent of the total population, but by 2040, this demographic group will nearly double to comprise about 22 percent. According to the U.S. Department of Health and Human Services the majority of these individuals will require some form of long-term care services (specifically, help with activities of daily living—such as cooking, bathing, or remembering to take medicine—that can be provided in a home or institutional setting.)

Misconceptions About Medicare and Social Security

Survey results in a 17 page report, “Long-Term Care in America: Expectations and Preferences for Care and Caregiving, released by Associated Press (AP)-NORC Center for Public Affairs Research, notes that most older Americans expect Medicare and Social Security to pay for long-term care services while these federal programs generally do not. The survey findings also indicate that respondents, age 40 and over, strongly supported public policies that help a person save for long-term care services and for those that defray the cost of care giving, including state paid family leave programs.

“This survey provides much-needed data on how people perceive the issue of long-term care in the United States,” says Trevor Tompson, director of The AP-NORC Center, in a statement released on May 16, 2016 with the survey findings… “The need for long-term care services and support to assist seniors with activities of daily living is increasing exponentially. Financing high-quality services so that the costs are manageable for families and governments will remain a big challenge for decision-makers,” he added.

“Older Americans of today and tomorrow have a 50 percent chance of living with substantial and often expensive daily needs,” adds Dr. Bruce A. Chernof, President and CEO of The SCAN Foundation. “Medicare and Social Security were not built to cover long-term care, leaving American families unprotected, and as the survey shows, unaware of this fact,” he says.

The AP-NORC survey found that while older Americans’ confidence in being financially prepared to pay for long-term care services remains low overall, there has been a slight increase in public confidence over the past four years, consistent with other measures of consumer confidence post-recession, according to the Consumer Confidence Index. In 2013, 27 percent reported feeling very or extremely confident in their ability to pay for long-term care, increasing to 29 percent in 2014, 32 percent in 2015, and 36 percent in 2016.

The polling finds reveal that a widespread misconception as to what Medicare covers for long-term care services. Older respondents, with an annual household incomes less than $50,000, are more likely to expect to rely on government programs such as Social Security, Medicare, and Medicaid, while those with higher incomes expect to rely more on personal savings to pay for their needed long-term care services. Still, 3 in 10 of these wealthier older Americans report that they will rely on Medicare to support their care as they age. This reflects common misperceptions among older Americans about the long-term care services that Medicare covers, notes the AP-NORC survey.

Thumbs Up to Aging in Place

Seventy seven percent of the survey respondents would prefer to “age in place” and receive care in their own home, w with far fewer preferring to receive care in a senior community (11 percent), a friend or family member’s home (4 percent), or a nursing home (4 percent). Among those respondents who prefer to receive care at home, there are gender differences in preferences for who provides that care: men would prefer to receive care from a spouse (51 percent vs. 33 percent), and women would prefer to receive care from their children (14 percent vs. 35 percent).

There is widespread support for policies to help caregivers face the costs of providing long-term care, with 72 percent supporting state programs to provide paid family leave, 83 percent supporting tax breaks for caregivers, and 73 percent supporting a Social Security earnings credit for caregivers taking time out from the workforce to provide care.

According to the AP-NORC survey, forty-three percent of the survey respondents have either been caregivers in the past or currently providing long-term care to a family member or close friend. Among those with experience as caregivers, 4 in 10 report having to miss work to provide care.

The researchers found that prior experience with long-term care is associated with greater support for several public policies to help people finance long-term care and to help alleviate costs for caregivers. These individuals expressed higher levels of concern about aging and are more likely to anticipate that it is at least somewhat likely that a loved one will need care in the next five years, compared to those without direct care giving experience.

Finally, one-third of the survey respondents reported having done no planning at all for their own long-term care needs. This 2016 finding is similar to the 31 percent who said the same in 2015 and remains lower than the 47 percent and 44 percent who said they had done no planning in 2014 and 2013, respectively.
One Size Does Not Fit All

Meghan Connelly, Chief Program Development at Rhode Island’s Division of Elderly Affairs, provides some thoughts about the findings of the AP-NORC survey. “Long-term care options are not “one-size-fits-all”. In Rhode Island, there are a number of choices one can make, ranging from living independently and receiving care at home to nursing home care. This report highlights that consumers want options when it comes to making these decisions for themselves, or assisting loved ones with long term care choices,” she says…

Connelly adds, the AP-NORC survey “supports the findings of past research: that the overwhelming majority of people want to receive long term care services at home,” noting that in the Ocean State there are many home- and community-based care options. She says that”home care may be available through a physician’s office; at the time of discharge from a hospital or nursing home; or through referrals to state-subsidized programs administered by agencies under the Executive Office of Health and Human Services.”

“The AP-NORC survey also underscores the need to adopt progressive financial policies that support family caregivers who provide the greatest percentage of needed long term care to their elderly or disabled loved ones at home,” warns Connelly.

Greg Crist, Senior Vice President of Public Affairs at the Washington, D.C.-based American Health Care Association (AHCA), notes, “This data generally tracks what our own research has shown: Americans don’t think of this topic every day, and honestly, this is a topic they’d rather avoid. No one likes the thought of aging, and with that aging, the increasing likelihood they will help in their later years. No one welcomes a loss of independence. But here’s the good news – the sector is adapting and innovating.”

Crist asserts nursing homes are meeting the challenge of caring for aging baby boomers. “We’re meeting the growing demands of Boomers, particularly as clinical needs grow, but also in offering amenities such as custom dietary menus, social media communities, and personal rehab care plans that speed recovery times. Whether in Rhode Island or elsewhere, this is an evolving health practice, recognizing that change is needed to meet the new preferences of older Americans,” notes Crist.

Listen to the Older Voters

The AP-NORC survey findings mirror other “long-term care perception” studies released by AHCA and AARP. Democratic presidential candidates Hillary Clinton, Bernie Sanders, and GOP standard bearer Donald Trump must not forget the needs of America’s exponentially growing older population. These older voters do not want to fall through the nation’s public policy safety net when they require the most assistance, paying for costly long-term care services. As the survey report notes, older Americans strongly support Family Leave programs and also call for government administered Long Term Care Insurance programs.

For a copy of the report go to http://www.longtermcarepoll.org/Pages/Polls/long-term-care-in-america-expectations-and-preferences-for-care-and-caregiving.aspx..

AOA Reauthorization Bill Goes to President Obama for Signing

Published in Woonsocket Call on April 10, 2016

The Older American’s Act (OAA) current authorization expired in fiscal year 2011 because lawmakers were unable to reach an agreement on its reauthorization. On a bipartisan basis, Congress has finally passed the long-stalled legislation reauthorizing the OAA when the Senate passed the House-amended bill on April 7. Three weeks earlier the House had passed an amended version of S. 192, the Older Americans Act Reauthorization Act of 2016, by a unanimous voice vote. This legislative proposal amended the bill passed by the Senate on July 16, 2015. Now the passed legislation goes to President Obama, once signed it becomes law.

The very bi-partisan Senate reauthorization bill was sponsored by Chairman Lamar Alexander (TN) and Ranking Member Patty Murray (D-WA), of the Senate Committee on Health, Education, Labor and Pensions, and had 27 co-sponsors from each party.

OAA Authorization Has Lots of Positives

OAA’s latest reauthorization offers new support for modernizing multipurpose senior center, highlights the importance of addressing senior’s economic needs, permanently requires health promotion and disease prevention initiatives to be evidence-based, and promotes chronic disease self-management and fall prevention.

The law also includes: stronger elder justice and legal services provisions; needed clarity for caregiver support and Aging and Disability Resource Centers; new opportunities for intergenerational shared sites, and promotes efficient and effective use of transportation services.

Legislative inertia and a general undercurrent of opposition to any government programs by some members of Congress slowed consideration of the bill , says Dan Adcock, Director of Government Relations and Policy for the National Committee to Preserve Social Security and Medicare (NCPSSM). “You need champions to break through the ‘legislative inertia’ and OAA just did not have enough,” he says.

Senators Lamar Alexander (R-TN), Patty Murray (D-WA) and Bernie Sanders (I-VT) along with Reps. John Kline (R-MN) and Bobby Scott (D-VA) worked hard to finally get the Senate and House to pass this year’s OAA reauthorization, Adcock noted, stressing that there was no opposition to the bill when it passed the House and Senate on voice votes

While the passed OAA reauthorization bill has many positives, its chief weakness is that it does not raise the funding authorization level enough, says Adcock. “Unfortunately, the Older Americans Act has suffered under flat funding and sequestration cuts for several years and will need significant increases in appropriations to meet the critical demands of a senior population that will nearly double by 2030, warns Adcock, noting that that an increase of 12 percent a years is needed for the next several years to raising funding to an acceptable level.

“AARP urges President Obama to quickly sign this bill,” said AARP CEO Jo Ann Jenkins. “We are appreciative of the bipartisan work to get this bill passed. Reauthorizing the OAA will help the millions of vulnerable older Americans who depend on the programs and services that the OAA helps to fund.

“Reauthorizing the OAA is as important as ever to modernizing and improving the aging services network in our country. It’s passage reflects the heroic efforts of many advocates working together to educate Congress about how programs funded by the OAA support older Americans,” observed Steven R. Counsell, MD, AGSF, American Geriatrics Society President.

Adds Senator Sheldon Whitehouse (D-RI), who serves on the Senate Select Committee on Aging, “I am glad we were able to reauthorize and improve the Older Americans Act. This legislation authorizes more funding for meals and social services seniors depend on. It includes new protections against elder abuse, which I’ve been fighting to pass. And it gives residents of long-term care facilities-who often can’t communicate their wishes-a stronger advocate to speak on their behalf.”

Ratchet Up AOA Funding

For more than 50 years the Administration on Aging with its National Aging Network (State Units on Aging and Area Agencies on Aging) has provided federal funding, based on the percentage of the locality’s population 60 and older, for nutrition and supportive home and community-based services, disease prevention/health promotion services, elder rights programs, the National Family Caregiver Support Program and Native American Program.

Aging advocates will tell you that Congressional funding has not kept with the rising inflation or the increased demands of an aging society. Deep Congressional budget cuts, push by the GOP, have significantly reduced OAA’s ability to provide services to those on increased waiting lists. Being “penny-wise and pound foolish” should not be the way Congress looks at future OAA reauthorizations. NCPSSM’s Adcock will tell you that programming geared to helping seniors to age in place at home in their communities can save billions by reducing costly nursing facility and hospital stays.

Hopefully, the President is expected to sign it in a week or two. Hopefully he signs this it quickly on Monday .