House Subcommittee Panel Makes Call for Expanding, Strengthening Social Security

Published in the Woonsocket Call on March 23, 2019

So it goes, to the victor goes the spoils. Over a week ago, House Democratic leadership, now controlling the legislative agenda, pushed to strengthen and expand benefits for the nation’s Social Security program.

With the 116th Congress kicking off on Jan. 2, 2019, as the majority party, the Democrats took over the legislative reins of the House of Representatives from the Republicans, who had held the majority and legislative control of the lower chamber since 2011. Now being in power allows Democratic leadership to control which bills reach the floor for a vote. In this new Congress, legislation reflecting the GOP’s philosophy as to how to fix Social Security (by privatizing the retirement program, cutting benefits, raising the retirement age, even reducing cost-of-living adjustments or lowering earned benefits) would be blocked by Democratic leadership.

Congress Puts Spotlight on Social Security

Last week, Social Security got a full and fair hearing before the House Ways and Means Social Security subcommittee.

Rep. John B. Larson (D-Conn.), chairing the House Ways and Means Social Security subcommittee, held a series of panel hearings, calling for the strengthening and protecting the nation’s Social Security program.

“What we’re addressing in these hearings is that Congress hasn’t paid enough attention to Social Security to make sure it’s actuarially sound,” he said, in his opening statement for the March 12th hearing, entitled “Protecting and Improving Social Security: Enhancing Social Security to Strengthen the Middle Class.”

According to Larson, more than 62 million Americans are already receiving Social Security benefits.

“We have a responsibility to act to strengthen this program for them,” he added. “Not to act will amount to a 25 percent benefit cut come 2034. In other words, for the person who was making $50,000 a year throughout their working career, they would actually be living at a poverty level in terms of a benefit that they would receive after these cuts,” he said.

“Not only do we need to work to protect the program, but we need a solution to make the program, as the actuaries say, “sustainably solvent,” or in other words, making sure Social Security remains strong throughout this century, not just for seniors, but for millennials too,” added Larson.

Joan Ruff, AARP’s chair of the Board, testified, saying, “Social Security is the only lifetime, inflation-protected, guaranteed source of retirement income that most Americans will have. It is the foundation of retirement security that keeps millions of older Americans out of poverty and allows them to live independently. But Social Security also provides some measure of economic security for families who face a loss of income because of the disability or the death of a wage earner. We often do not think of Social Security as a family income protection plan—yet that is exactly what it is.”

Other witnesses testified on the importance of Social Security benefits and how it provides the middle class with economic security, especially women and minorities.

One day later, Larson convened a second hearing entitled, “Protecting and Improving Social Security: Benefit Enhancements.” The purpose of holding the hearings, said Larson, was to “shine a bright light on all of the proposals to secure Social Security that will help the American people.”

Democrats Unveil Fix for Social Security

Larson also used the subcommittee panel hearing as a bully pulpit to promote his legislation, H.R. 860, “The Social Security 2100 Act.” Specifically, the bill’s eight provisions expand benefits for 62 million Social Security beneficiaries. Larson’s bill would provide an across-the-board benefit increase for current and new beneficiaries that is the equivalent of 2 percent of the average benefit. It also calls for an improved cost-of-living adjustment (COLA), through adopting a CPI-E formula, that takes into account the true costs (include health care expenses) incurred by seniors and a stronger minimum benefit set at 25 percent above the poverty line, tied to their wage levels to ensure that the minimum benefit does not fall behind. Finally, the bill would ensure that any increase in benefits from the bill do not result in a reduction in SSI benefits or loss of eligibility for Medicaid or Children’s Health Insurance Program. Finally, 12 million Social Security recipients would receive a tax cut through the eliminating the tax on their benefits.

At this time, H.R. 860 has 203 House Democrats cosponsors (including Rhode Island Representatives David N. Cicilline and James R. Langevin). Passage of the legislation requires only a simple majority vote of 218 lawmakers. With 235 Democratic lawmakers sitting in this chamber, it is expected to pass.

But, with the Senate-controlled by Republican Majority Leader Mitch McConnell of Kentucky and his GOP caucus, it will be difficult for Senators Chris Van Hollen (D-MD) and Richard Blumenthal (D-CT) to see their companion measure make it reach the Senate floor for consideration.

Larson’s first two hearings are the first in a series of hearings on Protecting and Improving Social Security. One more hearing will be scheduled with the date to be determined. After these hearings, H.R. 860 will most likely be marked up by the Ways and Means Social Security Subcommittee and full Committee before it heads to the House floor for a vote.

Enhancing Social Security Benefits

Lead-off witness Max Richtman, president of the Washington, D.C.-based National Committee to Preserve Social Security and Medicare (NCPSSM), restated his aging advocacy group’s support for Larson’s Social Security bill, H.R. 860, which enhances the retirement programs benefits and ensures its long-term solvency.

“Since the program’s creation 84-years ago, Social Security has been – and is- and enormously successful program which is essential to the retirement of the vast majority of Americans. While [the] benefits are modest, Social Security is still the single largest source of income for retired American’s. To ensure the program’s continued success, it is vitally important that long-term solvency be restored, and that Social Security benefits be improved to meet the needs of all Americans,” says Richtman.

Social Security Advocates joined Richtman at the witness table, too.

Elizabeth Marafino, president of the Connecticut Alliance of Retired Americans (from Larson’s home state), stated that Social Security is important to older Connecticut residents, making this statement more personal by sharing how her maternal grandmother, mother of six and a widow at the age of fifty, was glad to receive her husband’s social security check because it literally kept her out of the poor house.

Marafino noted, “The traditional three-legged stool of pension, personal savings, and social security is deteriorating. The ‘pension’ leg of the stool has been disappearing, eroding retirement security and making Social Security even more important. Along with the high cost of prescription drugs putting pressure on seniors’ finances, (these factors make) the need to increase Social Security benefits urgent.”

Abigail Zapote, Director of Latinos for a Secure Retirement, testified that boosting Social Security benefits is crucial to the Latino population, whose average Social Security checks are lower than other Americans. “Latinos depend on Social Security more than other groups because they tend to have lower lifetime income, longer life expectancies, higher incidence of disability and larger families,” she said.

Enhancing benefits can help older women, too, testified Joan Entmacher, a Senior Fellow at the
National Academy of Social Insurance. “Social Security is the foundation of retirement security for most Americans, but it is especially important for women,” she says, noting that women rely more on their Social Security checks than men do, even though their Social Security benefits are lower. She pointed out that the average retirement benefit for women is only 80 percent of men, making women even more reliant on Social Security, she said.

“Adjusting the regular benefit formula to make it more progressive would increase benefits for all workers, but lower lifetime earners, including women and people of color, would receive the largest percentage increases,” says Entmacher. To boost retirement benefits, she calls for the creation of caregiver credits (the majority of caregivers are women) who take off from their jobs to care for family members.

Finally, Donna Butts, the Executive Director of Generations United, testified that Social Security was important for all generations. ““For more than 80 years Social Security has been the premier example of a policy designed to secure and insure the well-being of individuals and their families. “For many it makes the difference between putting food on the table and deciding whether grandma or junior eat tonight,” she says.

The Beginning of an Honest Policy Debate

According to a NCPSSM blog posted on March 15th, “Republicans on the subcommittee, now in the minority for the first time in 8 years, appeared to be less combative than in the past.”

“This was a richer dialogue about the philosophical differences about Social Security than we’ve had in a long time,” observed National Committee legislative director, Dan Adcock in the blog posting. “There was a quest to figure out what each side could live with,” he says.

Stay tuned.

Trump Spending Priorities Would Fray Social Safety Net Programs

Published in the Woonsocket Call on March 16, 2019

Last Monday, President Donald Trump released his proposed FY 2020 budget request to Congress. Lawmakers, who rejected many of these budgetary spending requests in the president’s previous two submitted budgets proposals, consider his latest to be “dead-on-arrival.”

But, Trump’s $4.7 trillion fiscal blueprint, outlined in the 150-page “Budget for a Better America,” gives us a clear picture of his spending priorities and policies he seeks to implement through executive orders and regulator changes.

Trump’s FY 2020 spending plan proposes funding increases for combating the opioid epidemic, improving veteran’s health care, fixing the nation’s crumbling infrastructure ($200 billion increase), even giving the Pentagon a 5 percent increase in spending exceeding what the military asked for. White House senior advisor Ivanka Trump successfully pushed for the FY 2020 budget to include $750 million to establish a paid parental leave program and a $1 billion one-time fund to provide childcare to under served populations.

Trump’s budget proposal makes a commitment of $291 million to eliminate the spread of HIV within a decade, it slashes the National Institutes of Health’s funding by 12 percent, and the budget for the Centers of Disease Control and Prevention by about 10 percent.

Trump does not back away from his controversial stance of building a wall, putting in an additional $8.6 trillion for the construction of a U.S. Mexico border barrier. Congress had earlier opposed his demand for $5.7 billion for the construction project.

Trump Budget Proposal Puts Senior’s Earned Benefits at Risk

In 2016, Presidential candidate Trump had pledged not to cut Medicare, Medicaid or Social Security, but he does in his submitted FY 2020 budget proposal.

Trump calls for a 5 percent cut in non-defense federal agencies, including a whopping $ 1.5 trillion in Medicaid over 10 years. The budget plan instead allocates $1.2 trillion to create “market-based health care grants,” (a.k.a block grants) for states that would start in 2021. This gives states the power to set their own rules for this program.

Medicaid expansion under the Affordable Care Act (ACA) would be eliminated by Trump’s FY 2020 budget proposal by ending ACA’s protections for people with pre-existing conditions and causing millions of people to join the ranks of the uninsured. About 15 million more Americans have joined Medicaid since the ACA expansion was enacted.

Trump’s budget proposal also cuts Medicare by $845 billion over the next decade by cutting payments to hospitals and physicians, rooting out fraud and abuse, and by lowering prescription drug costs.

Meanwhile, the Social Security Disability Insurance program takes a huge budgetary cut of $25 billion and the Social Security Administration’s (SSA) operating budget is slashed by 1 percent, at a time when the agency is working hard to ratchet up its customer service provide to SSA beneficiaries.

Trump’s budget proposal would cut $220 billion from the Supplemental Nutrition Assistance Program (SNAP), popularly referred to as the food stamp program. The program currently serves 39 million people. Under this budget, beneficiaries would be required to be employed for 20 hours a week to be eligible for assistance and replacing the EBT-debit card used to purchase groceries with the delivery of a “Harvest Box” filled with non-perishable foods like cereal and pasta, canned goods and surplus dairy products.

Housing and Urban Development’s 202 housing program for seniors and people with disabilities takes a $36 million hit, says long-time aging advocate Bill Benson, principal of Washington, D.C.-based Health Benefits ABC, in the March 15th issue of Aging Policy and Public Health News.

According to Benson, several Older Americans Act programs including the Family Caregiver Support program would be cut in Trump’s budget proposal. The Long-Term Care Ombudsman Program would be cut by $1 million. Elder Justice Programs would also be cut under the President’s budget including a $2 million cut to the Elder Justice Initiative at Administration for Community Living.

” Cruelest of all [budgetary cuts] is the proposed out-right elimination of the Social Services Block Grant (SSBG) which is the only source of sustained federal funding to states for Adult Protective Services (APS),” says Benson. Some 37 states use SSBGs to support their APS programs. SSBG is also used by states for a number of other services benefiting older adults including home-delivered meals and case management.

Shortchanging Seniors

Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare (NCPSSM) warns that Trump’s budget proposal shortchanges seniors. “In combination with 2017’s tax cuts for the wealthy and the administration’s failure to allow Medicare to negotiate with Big Pharma, the Trump budget shows that his administration is not plugged into the realities of being elderly in America,” he says.

Richtman says that Trump’s budget plan also proposes to eliminate federal grants that help pay for programs under the Older Americans Act, such as Meals on Wheels and home heating assistance for the elderly poor.”

According to Richtman, the 116th Congress gives seniors hope with introduced legislation that would boost Social Security benefits and expand Medicare coverage to include dental, hearing and vision services, changes that an overwhelming majority of Americans support. He calls on Congress to “quickly reject this callous budget proposal — and take decisive action to enhance the well-being of older Americans.

Robert Greenstein, president of the Center on Budget and Policy Priorities, sees Trump’s newly released budget proposal as very troubling, too. “It sharply cuts funding in the part of the budget that invests in future economic growth through education and training, scientific research, infrastructure, and the like,” he says.

“It reverses progress in making affordable health care available to people who don’t have employer coverage or can’t afford private coverage. It cuts basic assistance substantially for families, children, and elderly and disabled people who are in need and struggle to get by. And, it doubles down on policies that take away health care, food, and housing when adults aren’t able to meet a work requirement,” says Greenstein.
“Despite bemoaning deficits, it calls for making the costly 2017 tax cuts — which largely benefit those who already have high incomes and wealth — permanent,” he adds.

Richtman believes that Trump’s 2020 spending proposal serves as a warning of what the administration would do if it were not for the firewall known as the Democratic-led House of Representatives. “These draconian ideas – though rejected by voters in the 2018 mid-terms – remain in the conservative political bloodstream, requiring continued advocacy on the part of seniors and their champions in Congress,” he says.

The release of Trump’s FY 2020 budget program begins the Democratic party’s efforts to retake the White House and Senate in the 2020 presidential election, just over 598 days away. By making major cuts in Social Security and Medicare and turning Medicaid into a state block grant program, Trump is giving Democratic challengers in the 2020 presidential election fodder to create politically-charged themes for ads to turn senior voters against him for seeking cuts in these popular domestic programs.

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.

New Report Puts Spotlight on the Devastating impact of Alzheimer’s

Published by Woonsocket Call on March 10, 2019

It’s hot off the press. Last Tuesday, the Chicago-based Alzheimer’s Association announced the release of its long-awaited 2019 Alzheimer’s Disease Facts and Figures. The 90-page report is chock full of national and state specific statistics and again puts a spotlight on Alzheimer’s disease, often referred to as the nation’s silent epidemic. Every 65 seconds someone in the United States develops the devastating cognitive disorder. This year, an estimated 5.8 million Americans of all ages are living with Alzheimer’s and related dementia. This number includes an estimated 5.6 million people age 65 and older and approximately 200,000 individuals under age 65 who have younger-onset Alzheimer’s.

Painting a Picture of Alzheimer’s Impact

According to the Alzheimer’s Association, the annual report, first released in 2007, is a compilation of state and national specific statistics and information detailing the impact of Alzheimer’s disease and related dementias on individuals, families, state and federal government and the nation’s health care system. For the third consecutive year, total payments to care for individuals with Alzheimer’s or other dementias is skyrocketing, say the report’s authors. In 2018, these costs were estimated to be over $ 277 billion. This year’s costs are expected to surpass $290 billion, an increase of nearly $13 billion from last year’s figure, according to data gleaned from the latest Facts and Figure report.

Yes, the 2019 Alzheimer’s Disease Facts and Figures report is a must read for congressional staff, state lawmakers, and federal and state officials.

New findings from the report released on March 5, 2019 reveal the growing burden on 16. million caregivers providing 18.5 billion hours of care valued at over $ 234 billion to 5.8 million people with cognitive disorders. By 2050, the new Alzheimer’s Association report projects that the number of persons with Alzheimer’s and other dementias will rise to nearly 14 million, with the total cost of care reaching over $1.1 trillion.

Between 2000 and 2017, the number of deaths from Alzheimer’s disease as recorded on death certificates has more than doubled, increasing 145 percent, while the number of deaths from the number one cause of death (heart disease) decreased 9 percent, says the new data in the 2019 Facts and Figures report. Alzheimer’s disease kills more than breast cancer and prostate cancer combined.

The latest Alzheimer’s Disease Facts and Figures report notes that 83 percent of care provided to the nation’s older adults comes from unpaid caregivers. Specifically, about one in three caregivers (34 percent) is age 65 or older. Approximately two-third are woman. Over one-third of dementia caregivers are daughters, one quarter of these individuals also care for children under age 18. Most caregivers (66 percent) live with the person with dementia in the community.

Of the total lifetime cost of caring for persons with Alzheimer’s and other dementias, 70 percent of these expenses are borne by families, either by out-of-pocket or from the value of unpaid care,” says the Alzheimer’s report.

Taking a Look at Cognitive Assessments

Although the 2019 Alzheimer’s Disease Facts and Figures provides the latest national stats on Alzheimer’s prevalence, incidence, mortality, costs of care, and impact on caregivers, it also takes a close look at awareness, attitudes, and utilization of brief cognitive assessments (obtained by asking questions, observations, input from family and friends, or short verbal or written tests given in a clinical setting), among seniors age 65 and older and primary care physicians.

Although an evaluation of cognitive functioning is a required component of the Medicare Annual Wellness Visit, the report’s findings show that only 1 in 3 seniors are aware these visits should include this assessment.

“While it’s encouraging to see that the vast majority of seniors and physicians understand the value of brief cognitive assessments, we’re still seeing a significant gap in those that actually pursue, perform or discuss these assessments during routine exams,” said Joanne Pike, Dr.P.H., chief program officer for the Alzheimer’s Association in a statement released with this report. “Early detection of cognitive decline offers numerous medical, social, emotional, financial and planning benefits, but these can only be achieved by having a conversation with doctors about any thinking or memory concerns and through routine cognitive assessments.,” says Pike.

While the Alzheimer’s report noted that 82 percent of seniors and 94 percent of physicians believe it is important to have their thinking and memory checked, the findings indicated that just 16 percent of the senior respondents say they receive regular cognitive assessments for memory or thinking issues during routine health checkups, compared with blood pressure (91 percent), cholesterol (83 percent), vaccinations (80 percent), hearing or vision (73 percent), diabetes (66 percent) and cancer (61 percent).

The report’s authors also found a very “troubling disconnect” between seniors and their primary care physicians regarding who they believe is responsible for initiating these cognitive assessments and silence from seniors in discussing their concerns.

According to the report’s nearly all physicians said the decision to assess patients for cognitive impairment is driven, in part, by reports of symptoms or requests from patients, family members and caregivers. Those who choose not to assess cognition cited a lack of symptoms or complaints from a patient (68 percent), lack of time during a patient visit (58 percent) and patient resistance (57 percent) as primary factors.

In addition, the Alzheimer’s report says most physicians welcome more information about assessments, including which tools to use (96 percent), guidance on next steps when cognitive problems are indicated (94 percent) and finally steps for implementing assessments efficiently into practice (91 percent).

The Alzheimer’s Association is working to help educate physicians on best practices for conducting brief cognitive assessments and to ensure that all seniors understand what to expect from an assessment, as well as how to navigate an Alzheimer’s diagnosis and care planning when needed,” said Pike. “As the number of individuals living with Alzheimer’s continues to increase, we need to detect the disease early and give individuals the best opportunity to plan for the future,” she says.

The survey found that while 51 percent of the older respondents are aware of changes in their cognitive abilities — including changes in their ability to think, understand or remember — only 40 percent have ever discussed these concerns with a health care provider, and fewer than 15 percent report ever having brought up cognitive concerns on their own.

Instead, 93 percent of the senior survey respondents say they trust their primary care physician to cognitive testing for thinking or memory problems if needed. Yet, 47 percent of these physicians say it is their standard protocol to assess all patients age 65 and older for cognitive impairment. But, only 26 percent of the senior’s report having a physician ever ask them if they have any concerns about their cognitive function without them bringing it up first.

“The findings indicate there are missed opportunities for seniors to discuss cognitive concerns and problems in the exam room,” said Pike. “We hope the report will encourage seniors and physicians both to be more proactive in discussing cognitive health during the Medicare Annual Wellness Visit and other routine exams,” she says.

Combating Alzheimer’s in the Ocean State

On the heels of the release of Rhode Island’s updated State Plan on Alzheimer’s Disease and Related Disorders by Lt. Governor Dan McKee on February 26th, the released 2019 Facts and Figures reinforces the need to implement the recommendations of the State Plan.

“These facts and figures truly demonstrate the public health crisis we are in both nationally and here in Rhode Island with Alzheimer’s disease,” said Donna M. McGowan, Executive Director with the Alzheimer’s Association Rhode Island Chapter. “We are projecting cases of the disease to increase by 17% in this state by 2025. Having this data helps us to understand the scope of the issue and what we need to do to address peoples’ needs long term.”

“With Medicaid costs rising almost 23% to care for someone with Alzheimer’s, caregivers and families need to be provided resources that they need. Our updated State Plan helps to provide the framework to address some of those concerns,” said McGowan. “I commend our state lawmakers for recognizing how deeply Alzheimer’s disease and related disorders affects our citizens here and for their support in trying to address it with legislation.”

Andrea Palagi, Director of Communications for Lt. Governor Dan McKee, says that there are several Alzheimer’s-related bills being consider by state law makers this year. “It’s the year for Alzheimer’s” she says.

With the newly released 2019 Alzheimer’s Disease Facts and Figures report we hopefully won’t see the state’s updated Alzheimer’s Plan sitting on a bureaucrat’s dusty book shelf.

For a copy, go to www.alz.org/media/Documents/alzheimers-facts-and-figures-2019-r.pdf.