Trustee Reports predict improved outlook for Social Security and Medicare

Published in RINewsToday on June 6, 2022

On June 2, 2022, following a meeting of the Social Security and Medicare Boards of Trustees, the Social Security Administration (SSA) – joined by the Departments of Health and Human Services and Labor, the Centers for Medicare & Medicaid Services, and the U.S. Department of Treasury — released a 275-page annual report giving us a snapshot of the financial health of the Social Security Trust Funds.

The Trustee reports findings

According to this year’s Trustee Reports, “Social Security and Medicare both face long-term financing shortfalls under currently scheduled benefits and financing. Costs of both programs will grow faster than gross domestic product (GDP) through the mid-2030s primarily due to the rapid aging of the U.S. population. Medicare costs will continue to grow faster than GDP through the late 2070s due to projected increases in the volume and intensity of services provided.”

The Social Security Trustees report that the combined asset reserves of the Old-Age and Survivors Insurance and Disability Insurance (OASI and DI) Trust Funds, paying benefits to 65 million retirees, disabled people as well as survivors of deceased workers, are projected to become depleted in 2035, one year later than projected last year, with 80 percent of benefits payable at that time. The DI Trust Fund asset reserves are not projected to become depleted during the 75-year projection period.

“It is important to strengthen Social Security for future generations. The Trustees recommend that lawmakers address the projected trust fund shortfalls in a timely way to phase in necessary changes gradually,” says Kilolo Kijakazi, Acting Commissioner of Social Security in a statement announcing the released report. “Social Security will continue to be a vital part of the lives of 66 million beneficiaries and 182 million workers and their families during 2022,” she adds.   

The Medicare Board of Trustees note in its 263 page report that the projected depletion date for Medicare’s trust fund for inpatient hospital care (Part A), covering around 64 million retirees and disabled persons, moved from last year’s forecast of 2026 to 2028. At this time Medicare will only be able to pay 90% of the scheduled benefits when the fund is depleted.

“We are committed to running a sustainable Medicare program that provides high quality, person-centered care to older Americans and people with disabilities,” said CMS Administrator Chiquita Brooks-LaSure. In a statement “Medicare trust fund solvency is an incredibly important, longstanding issue and we are committed to working with Congress to continue building a vibrant, equitable, and sustainable Medicare program,” she says.

Thoughts from senior advocacy groups

In a statement, AARP CEO Jo Ann Jenkins said that this year’s Social Security and Medicare Trustee report sends this clear message to Congress: “The Social Security and Medicare Trustees’ reports should send this “clear message” to Congress: “Despite the short-term improvement, you must act to protect the benefits people have earned and paid into both now and for the long-term. The stakes are too high for the millions of Americans who rely on Medicare and Social Security for their health and financial well-being.”

“These reports also underscore the urgent need for Congress to pass legislation allowing Medicare to negotiate for lower prescription drug prices, which would result in billions of dollars of savings for seniors, the Medicare program, and taxpayers,” says Jenkins.

Jenkins also calls on Congress to increase funding to fix serious long-time Social Security customer service problems, which currently impede or keep seniors and people with disabilities from getting their benefits in a timely manner.

Following the release of the Trustees Report, Executive Director Alex Lawson, of the Washington, DC-based Social Security Works, (SSW) a social welfare organization that lobbies for Social Security Reforms, also issued a statement: “Today’s report shows that our Social Security system remains strong. Protecting and expanding benefits is a question of values, not affordability. That this year’s projections are even stronger than last year’s proves once again that Social Security is built to withstand times of crisis, including pandemics.”

We don’t have a Social Security crisis, but we do have a retirement income crisis. With prices rising, seniors and people with disabilities are struggling to afford food and medicine. The solution is to expand Social Security,” says Lawson. 

According to SSW, the 2020 Social Security Trustee’s Report reported that Social Security has an accumulated surplus of about $2.85 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 90 percent funded for the next quarter century, 84 percent for the next half century, and 81 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 the gross domestic product (“GDP”), less than most other wealthy countries spend on their counterpart programs,” says SSW.

Max Richtman, President and CEO of the Washington, DC-based National Committee to Preserve Social Security and Medicare (NCPSSM), throws in his two cents about this year’s Trustee Report. “The takeaway from the latest Social Security Trustees report is this:  Congress must strengthen the program’s finances without delay. The Trustees project that the combined Social Security retirement and disability trust fund will become depleted by 2035, one year later than projected in their previous report. At that point, every Social Security beneficiary will suffer a 20% cut to their benefits.”

“Seniors struggling to meet rising living expenses need Social Security to be boosted and strengthened. The pandemic, runaway inflation and devastating stock market losses serve to remind us how vital a robust Social Security program is to workers, retirees, the disabled and their families. The clock is running down. The time for fair, just, and equitable action that safeguards Social Security’s financial stability is now,” adds Richtman.   

While acknowledging that the trust fund insolvency date may fluctuate from year to year, the urgent need to boost the program’s financing and benefits remains consistent, says Richtman. 

NCPSSM’s Richtman says, over the years, the GOP has opposed the expansion and strengthening of Social Security and has called for raising the retirement age, privatization, and more recently, ‘sunsetting’ Social Security and Medicare every five years.  He calls for passage of Rep. John Larson’s Social Security 2100: A Sacred Trust legislation that would extend trust fund solvency by requiring high wage earners to contribute their fair share through an adjustment in the payroll wage cap. 

A Washington Insider says that House Speaker’s Nancy Pelosi (D-CA) policy staff are concerned about the cost of Larson’s Social Security fix legislation and are seeking a CBO cost estimate. At press time this measure has more than 200 Democratic cosponsors in the House. The Congressional Asian Pacific American Caucus (CAPAC), Congressional Black Caucus (CBC), the Congressional Hispanic Caucus (CHC), the Task Force on Aging and Families, and the Congressional Progressive Caucus have all called on Pelosi to bring the bill to the House floor for a vote.

“Thanks to the American Rescue Plan, our economic recovery has strengthened both the Social Security and Medicare Hospital Insurance Trust Funds and improved financial projections for these vital programs. But to ensure that every American worker, senior, child, and person with disabilities receives the necessary and earned benefits provided by both Social Security and Medicare, we need to act. That’s why I am an original cosponsor of legislation like Social Security 2100: A Sacred Trust, to not only enhance benefits for seniors and some of our most vulnerable neighbors, but to also guarantee access to these programs for generations to come,” said Congressman David Cicilline, (D-RI).  

Congress can step in to financially strengthen the Social Security and Medicare programs. A message from the Social Security and Medicare Boards of Trustees suggest Congress pass legislation to reduce or eliminate the long-term financing shortfalls in both the Social Security and Medicare. “Taking action sooner rather than later will allow consideration of a broader range of solutions and provide more time to phase in changes so that the public has adequate time to prepare,” say the Trustees.

Congress should look for “medium-term solvency” fixes to ensure that Social Security program can pay full benefits for several decades rather than for the full 75-year projection period, suggests Paul N. Van De Water, Senior Fellow at the Washington, DC-based Center for Budget and Policy Priorities, a nonprofit nonpartisan research organization and policy institute that conducts research on government policies and programs. “But shoring up the program’s financing for a substantial period of time is important for assuring both current and future beneficiaries that Social Security will be there for them in the years to come,” he says.

At a crossroad

NCPSSM’s Richtman believes Social Security’s future is now at a crossroads. “We can either cut benefits or expand benefits and pay for it by requiring the wealthiest to pay their fair share,” he says, calling on Congress to hold an up or down votes on Larson’s Social Security legislation.

Polling shows that voters support fixing Social Security and Medicare. Seniors may well go to the polls, sending a message with their vote that strengthening and expanding Social Security is important to them.   

For a copy of the 2022 Social Security Trustee Report, go to https://www.ssa.gov/OACT/TR/2022/tr2022.pdf. For a copy of the 2022 Medicare Trustee Report, go to https://www.cms.gov/files/document/2022-medicare-trustees-report.pdf

“There’s a New Sheriff in Town” at SSA

Published in RINewsToday on June 20, 2020

On June President Joe Biden has asked two political holdovers from the President Trump’s administration, Social Security Commissioner Andrew Saul and his deputy, David Black, who had previously served as the agency’s top lawyer, to resign. Saul ultimately was fired after refusing to resign Friday, July 9, while Black resigned upon the president’s request that day. 

Biden named as acting commissioner, Kilolo Kijakazi, whom he earlier had appointed to a lower-level Social Security Administration (SSA) position, deputy commissioner for retirement and disability policy. 

The White House affirmed its authority to “remove the SSA Commissioner at will” by citing a Supreme Court ruling and a legal opinion from the Justice Department. Previously, under statute, the president could only remove the SSA commissioner for “neglect of duty” or “malfeasance in office.”

Saul’s term as Social Security Administrator ended in 2025 and according to The Washington Post, he states he plans to dispute the White House firing and continue to work remotely at his New York City home.

“I consider myself the term-protected commissioner of Social Security,” Saul told The Washington Post, calling the attempt to unseat him a “Friday Night Massacre.”

Minority Members of Senate Aging Committee Oppose Firing

Ranking Member Tim Scott (R-South Carolina), Senators Susan Collins (R-Maine), Richard Burr (R-North Carolina), Marco Rubio (R-Fla..), Mike Braun (R-Ind..), Rick Scott (R-Fla..), and Mike Lee (R-Utah) sent a letter July 14 to President Biden urging him to reinstate and honor the Senate confirmed, six-year term of Saul as SSA Commissioner. 

Members of the Senate Special Committee on Aging find the politically motivated action especially worrisome as it will have drastic effects on SSA services that help millions of older Americans with basic expenses like housing, food and medicine. 

The letter explains “Commissioner Saul was confirmed by the Senate in an overwhelmingly bipartisan vote in 2019… led the agency through one of the most trying periods in its history during the COVID-19 pandemic… was confirmed by the Senate to serve a full six-year term that expires in 2025 and he should have remained in his position unless removed for cause, as written in federal law.

The committee requested the Biden administration explain what authority an acting commissioner—not confirmed by the Senate—would possess to carry out the statutorily obligated duties of the SSA commissioner. 

 On the Other Side of the Aisle…

“From the beginning of their tenure at the Social Security Administration Andrew Saul and David Black were anti-beneficiary and anti-employee. The Biden Administration made the right move to fire both Saul and Black after they refused to resign, says chairperson John B. Larson (D-CT), of the House Ways and Means Social Security Committee, who had called for Saul and Black’s removal in March 2021. “As [Supreme Court] Justice Alito recently stated, the president needs someone running the agency who will follow their policy agenda,” he says.

According to Larson, since June 17, 2019, Saul’s control over SSA policies have “disproportionately harmed vulnerable Americans like low-income seniors and persons with disabilities, immigrants and people of color.

During Saul’s tenure, Larson noted that the SSA implemented a new rule that denied disability benefits for older, severely disabled workers who are unable to communicate in English, resulting in approximately 100,000 people being denied more than $5 billion in benefits from 2020 to 2029. However, there has been considerable discussion of the misinterpretation of the intent of this change.

SSA also finalized a new regulation that dramatically reduced due process protections for Social Security appeals hearings, by allowing the SSA to use agency attorneys instead of independent judges for the hearings, says Larson.

Larson also expressed concern about SSA proposing to change the disability review process to cut off benefits for some eligible people and proposing to make it significantly harder for older, severely disabled workers to be found eligible for disability benefits. 

According to Larson, Saul also advanced the Trump Administration’s anti-immigrant policies by resuming “no-match letters” to employers with even minor discrepancies between their wage reports and their employees’ Social Security records. These letters effectively serve to harass immigrants and their employers, often leading to U.S. citizens and work-authorized immigrants being fired, he said.

Finally, Larson charged that Saul embraced the Trump Administration’s anti-federal employee policies, including forcing harsh union contracts that strip employees of rights and ending telework for thousands of employees just months before the COVID-19 pandemic started – a particularly ill-fated decision given the critical role telework has played in SSA’s ability to continue serving the public during the pandemic. 

Thumbs Up from Aging Advocacy Groups 

“The Social Security Commissioner should reflect the values and priorities of President Biden, which include improving benefits, extending solvency, improving customer services, reopening field offices, and treating SSA employees and their unions fairly. That was not the case with former Commissioner Saul, and we look forward to President Biden nominating someone who meets that standard,” says Max Richtman, President and CEO, National Committee to Preserve Social Security and Medicare.

Adds Alex Lawson, Executive Director of Social Security Works: “Today is a great day for every current and future Social Security beneficiary. Andrew Saul and David Black were appointed by former President Donald Trump to undermine Social Security. They’ve done their very best to carry out that despicable mission. That includes waging a war on people with disabilities, demoralizing the agency’s workforce, and delaying President Biden’s stimulus checks.”  

Introducing New SSA Commissioner, Kilolo Kijakazi…

Kilolo Kijakazi has a Ph.D. in public policy from George Washington University, an MSW from Howard University, and a BA from SUNY Binghamton University. Kijakazi’s Urban Institute bio notes that she served as an Institute Fellow at the Urban Institute, where she “worked with staff across the organization to develop collaborative partnerships with those most affected by economic and social issues, to expand and strengthen Urban’s agenda of rigorous research, to effectively communicate findings to diverse audiences and to recruit and retain a diverse research staff at all levels” while conducting research on economic security, structural racism, and the racial wealth gap. 

Kijakazi was previously employed as a program officer at the Ford Foundation, a senior policy analyst at the Center on Budget and Policy Priorities, a program analyst at the Food Nutrition Service of the Department of Agriculture, and an analyst at the National Urban League.

According to Wikipedia, before entering the Biden administration, Kijakazi was a board member of the Winthrop Rockefeller Foundation, the National Academy of Social Insurance and its Study Panel on Economic Security, the Policy Academies and Liberation in a Generation, as well as a member of the DC Equitable Recovery Advisory Group, adviser to Closing the Women’s Wealth Gap, co-chair of the National Advisory Council on Eliminating the Black-White Wealth Gap at the Center for American Progress, and member of the Commission on Retirement Security and Personal Savings at the Bipartisan Policy Center. 

“Kilolo has an amazing ability to find and build connections among individuals and institutions that should be working together on critical public policy issues and policy discussions are much better for that inclusionary approach,” says Margaret Simms, an Institute Fellow in the Center on Labor, Human Services, and Population at the Urban Institute.

Using Savings from Drug Pricing Reform to Expand Medicare

Published in RINewsToday on June 7, 2021

Ahead of President Biden’s first address to a joint session of Congress on April 28 and as the Democratic administration considers policies to slash rising drug costs, the U.S. Government Accountability Office (GAO) released a 65-page report finding that the U.S. pays more than two to four times higher prices for a selected sample of 20 single source, brand name drugs than Australia, Canada and France. The latest GAO report, commissioned by Sen. Bernie Sanders (I-Vt.), found that Americans, suffering from blood clots, bronchitis, emphysema and Hepatitis C, were paying more for life-saving treatments than patients in these industrialized countries. 

“This important GAO study confirms what we all already know: the pharmaceutical industry is ripping off the American people,” said Sen. Sanders in a statement announcing the March 29th release of the GAO report, “Prescription Drugs: US Prices for Selected Brand Drugs Were Higher on Average Than Prices in Australia, Canada and France.”

“The time is long overdue for the United States to do what every major country on earth does: negotiate with the pharmaceutical companies to lower the outrageous price of prescription drugs. I would urge the president to put this proposal in the American Families Plan and use the savings to expand and improve Medicare for older Americans. We can no longer tolerate the American people paying, by far, the highest prices in the world for prescription drugs,” says the Vermont Senator who chairs the Senate’s Budget Committee.

U.S. Paying Outrageous Drug Prices

The GAO study found that in 2020, the U.S. paid 4.36 times more than France, 4.25 times more than Australia and 2.82 times more than Canada for the selected drugs, which represent a sample of the drugs with the highest Medicare Part D expenditures and use. The researchers noted that the publicly available data for the comparison countries were gross prices that did not reflect potential discounts. As a result, the actual differences between U.S. prices and those of the other countries were likely much larger than GAO estimates.

According to the GAO report, while France and Australia operate universal, publicly funded health systems that include prescription drug coverage, both Canada and the U.S. have a significant number of people who do not have prescription drug coverage. But even when comparing the full cash retail prices of selected drugs, the prices quoted to individuals without prescription drug coverage, GAO found that prices were two to eight times higher in the U.S. than the same drugs from pharmacies in Canada. 

For instance, GAO found that the cash price of Epclusa (28 tablets), which treats Hepatitis C, or an infection that attacks the liver, is $36,743 in the U.S. but $17,023.63 in Canada. The cash price of Harvoni (28 tablets), which also treats Hepatitis C, is $46,570.33 in the U.S. but $19,084.54 in Canada. In another example, GAO cited that the cash price of Incruse Ellipta Inhalation Powder (30 inhalations), which treats chronic obstructive pulmonary disease (COPD), or a group of lung diseases which block airflow and make it difficult to breath, is $411.33 in the U.S. but $53.31 in Canada.

Because France and Australia have universal health systems that cover prescription drugs, Australians would pay up to a $28.09 copay for a month supply of these medicines, while patients in France would pay anywhere from $0 to $34.03 for the drugs. The maximum copay that high income seniors with prescription drug coverage in Ontario, Canada would pay for the drugs is $4.67.

Robbing Peter to Pay Paul

On April 23, 48, organizations, led by Indivisible, Social Security Works and Public Citizen, called on Biden to include bold drug pricing reforms in American Families Plan to expand Medicare, and the result of a new polls supports this legislative action. 

Drug pricing reform will produce upward of $450 billion in savings over 10 years, note the organizations, urging Biden to use these savings to reinvest in Medicare. The call for adding dental, vision and hearing benefits to Medicare, lowering the Medicare eligibility age to 50 and creating an out-of-pocket cap for medical expenses.

Alongside the letter, the organizations released the findings of a new poll from Data for Progress, widespread public support across party lines for expanding and improving Medicare. The poll’s findings noted that 86% of Americans, including 82% of Republicans, support adding dental, hearing and vision benefits to Medicare. It also found that three-quarters of Democrats, a majority of independents, and nearly half of Republicans support lowering the Medicare eligibility age to 55. 

“Allowing Medicare to negotiate drug prices down saves money for the federal government, which is the largest buyer of prescription drugs in the world,” said Alex Lawson, Executive Director of Social Security Works. “We must pump those savings back into Medicare to expand eligibility and add benefits that equalize Medicare with private insurance,” he says.

“Lowering the Medicare eligibility age to 50, capping out-of-pocket costs, and expanding benefits to include dental, hearing, and vision would improve access to care for millions of Americans. Far too many Americans have lost their insurance or put off needed care due to the COVID-19 crisis,” said Eagan Kemp, Health Care Policy Advocate for Public Citizen. “The Biden Administration and Congress have a chance to deliver important progress at a crucial time,” he says.

Adds Mary Small, Legislative Director for Indivisible, “With the consequences of the COVID-19 pandemic still being felt in our communities, now is a crucial moment to expand public health care coverage and deliver savings on prescription drug prices to the American people. Lowering the Medicare eligibility age to 50 will be an essential step toward reducing the racial health inequities by increasing coverage to communities of color and low-income folks.”  She adds, “Allowing Medicare to negotiate prescription drug prices and then reinvesting those savings back into the program to expand services further strengthens our path toward universal coverage for all.” 

Last Thoughts

Garnering applause, Biden put high drug costs on his Administration’s radar screen at his recent address before Congress. “Let’s give Medicare the power to save hundreds of billions of dollars by negotiating lower drug prescription prices. It won’t just help people on Medicare. It will lower prescription drug costs for everyone,” said the 46th President of the United States. “We’ve talked about it long enough. Democrats and Republicans, let’s get it done this year,” he said.

But actions speak louder than words, say Washington Insiders.  They note that Biden’s American Families Plan, did not include any proposal to slash pharmaceutical costs or lower the Medicare eligibility age. Is it possible for Biden to lower the drug prices in the United States, making the prices more comparable to other industrialized countries and to even expand Medicare, in the face of fierce opposition from Republicans, moderate Senate Democrats and pharmaceutical companies?  

According to the latest KFF Health Tracking Poll released June 3, 2021, the findings indicate that “nearly nine in 10 (88%) favor allowing the federal government to negotiate for lower prices on medications, including three-fourths (77%) of Republicans, nine in 10 independents (89%) and 96% of Democrats.” However, support dwindles “when the public hears argument made by pharmaceutical companies that it could lead to less research and development for new drugs, or that access to newer prescriptions could be limited,” say the researchers.

Will political pressure sway a divided Congress before the upcoming midterm elections to hammer out a bipartisan solution to put the brakes to the nation’s skyrocketing drug costs and to provide more American’s affordable health care through an expanded Medicare program. Its wait and see.