Seniors would benefit in President Biden’s $6 trillion budget

Published in RINewsToday on June 14, 2021

On May 28, with the release of a $6 trillion budget for fiscal year (FY) 2022, President Joe Biden outlined his values and vision as to how he proposes to revive the nation’s sputtering economic engine as it emerges from the devastating impact of the COVID-19 pandemic. The 72-page budget document, “Budget of the United States,” (with more than a 1,400-page appendix) details his spending priorities that begin next Oct. 1. Biden’s generous budget depends on increasing taxes on America’s corporations (from 21 to 28 percent) and high earners, who received significant tax breaks from the President Trump/GOP tax cuts of 2017.

With the FY 2022 Budget pushing federal debt to the highest levels since World War 1I, Republican lawmakers quickly called the proposal “dead on arrival” in Congress.  However, Cecilia Rouse, chair of President Biden’s Council of Economic Advisors says the Biden Administration is willing to live with a budget deficit to invest in the economy now, especially with low interest rates to borrow; deficits can be reduced later. 

President Biden’s new spending under the just released proposed FY 2022 budget, recognizing his Administration’s priorities, reflects the major proposals already outlined under the administration’s $2.3 trillion American Jobs Plan and $1.8 trillion American Families Plan. Provisions in these two proposals would overhaul the nation’s aging infrastructure and invest in education, childcare, paid family and medical leave, fight climate change. 

President Biden’s spending plan also recognizes priorities outlined in the American Rescue Plan passed earlier this year as well as the Administration’s “skinny” discretionary budget request released in April. Most importantly, it reflects a commitment from the president to safeguard Medicare, Medicaid and Social Security.

Loving It or Hating It Depends on Where You Sit

In remarks delivered Thursday in Cleveland, President Biden made the case for his budget request and what he describes as an investment in the country’s future. “Now is the time to build [on] the foundation that we’ve laid to make bold investments in our families and our communities and our nation,” he said. “We know from history that these kinds of investments raise both the floor and the ceiling over the economy for everybody.”

In the FY 2020 Budget proposal’s “Message from the President”, Biden says, “The Budget invests directly in the American People and will strengthen the nation’s economy and improve our long run fiscal health. It reforms our broken tax code to reward work instead of wealth while fully paying for the American Jobs and American Family Plans over a 15- year period. It will help us build a recovery that is broad-based, inclusive, sustained, and strong,”

Of course, response to Biden’s Spending plan depends on which side of the aisle you are sitting.

House Speaker Nancy Pelosi (D-CA) released a statement strongly endorsing Biden’s fiscal blueprint. “Congressional Democrats look forward to working with the Biden-Harris Administration to enact this visionary budget, which will pave the path to opportunity and prosperity for our nation. The Biden Budget is a budget for the people,” she said.

On the other hand, Senate Minority Leader Mitch McConnell strongly opposing Biden’s Budget proposal. “Americans are already hurting from far-left economics that ignores reality,” said McConnell, in a statement. “The Administration’s counterproductive ‘COVID relief bill’ has slowed rehiring. Families are facing painful inflation, just as experts warned the Democrats’ plans might cause. And the Administration wants to triple down on the same mistakes?” said the six-term Republican Kentucky Senator.

With the Democrats holding the slim majorities in the House and Senate and controlling the White House, Biden’s FY 2022 Budget proposal will have more weight than if the Republicans were in the majority, says Dan Adcock, Government Relations and Policy Director at the Washington, DC-based National Committee to Preserve Social Security and Medicare (NCPSSM).

According to Adcock, Biden’s funding numbers will change as his FY 2022 budget proposal goes through the appropriation process in the upcoming months. With its release, Congress can now begin negotiating funding levels and spending bills. Competition for a finite amount of funding will ultimately result in funding level ultimately allotted to programs and agencies by each of the 12 appropriations under their jurisdiction. Funding for most programs important to older Americans is under the jurisdiction of the Subcommittee on Labor, Health and Human Services and Education.

“With 10,000 Baby Boomers turning 65 every day – and the number of seniors projected to double by 2050 – it’s clear that President Biden understands the need to safeguard the older Americans he calls ‘pillars of every community – now and into the future.” Says Max Richtman, NCPSSM’s President and CEO.

Slashing Drug Costs to Pay for Expanding Medicare Coverage

Richtman says that Biden’s fiscal blueprint calls on Congress to allow Medicare to negotiate prices for certain high-cost, life-saving drugs that many seniors currently cannot afford and to require manufacturers to pay rebates when drug prices rise faster than inflation. These reforms could yield over half a trillion in federal savings over 10 years, which could help pay for coverage expansions and improvements, including access to dental, hearing, and vision coverage in Medicare,” he notes. Today, traditional Medicare does not cover routine care like dental checkups or hearing aids.

According to Richtman, President Biden’s budget also includes more than $400 billion in new spending over ten years to expand Home and Community-based Services (HCBS) for low-income seniors and people with disabilities who prefer to receive skilled care in the comfort of their homes and communities, even moreso after the devastation COVID wrought on nursing homes.  

In states that have not taken advantage of Affordable Care Act (ACA) opportunities to expand Medicaid, the budget proposes providing premium-free, Medicaid-like coverage through a federal public option, along with incentives for states to maintain their existing expansions. 

Biden’s FY 2022 budget also urges Congress to improve customer service for Social Security beneficiaries to prescription drug pricing reform to expanded HCBS, adds Richtman.  It also proposes a $1.3 billion (or 9.7%) funding increase for the Social Security Administration.  The increase seeks to improve customer service, including services at SSA’s field offices, state disability determination services, and teleservice centers.

 The Older Americans Act (OAA) provides funding for a wide range of home and community-based services, such as meals-on-wheels and other nutrition programs, in-home services, transportation, legal services, elder abuse prevention and caregivers’ support. These programs help seniors stay as independent as possible in their homes and communities. 

For details about Biden’s FY 2022 Budget proposal and OAA funding levels, made available from the Washington, DC-based National Association of Area Agencies on Aging, go to: https://www.n4a.org//Files/FY22%20PresBudget%20and%20historical%20Labor-HHS%20Appropriations%20Chart.pdf

 Stay Tuned 

The House continues its work on hammering out appropriation bills through subcommittees in June and in the full House in July.  The Senate’s work is expected to begin in mid-Summer and to continue well into September. If the appropriate bills are not passed and signed into law by Oct. 1, Congress will need to pass a continuing resolution to fund the federal government into the first months of FY 2022.

Like most Budget proposals, especially in a partisan Congress, Biden’s spending plan will need to be rewritten to win support from lawmakers on both sides of the aisle. However, it will serve as a roadmap for a Democratic controlled Congress in crafting 12 appropriation spending bills. Partisan bickering during the appropriations process may well force passage of a continuing resolution before Oct. 1 to block a government shutdown. 

Whitehouse Pushes for COVID-19 Senate Proposal to Protect Residents, Employees

Published in the Pawtucket Times on March 1, 2021

As the one-year anniversary of the coronavirus disease (COVID-19) pandemic approaches, U.S Senator Sheldon Whitehouse (D-RI) joins Senators Bob Casey (D-PA), Raphael Warnock (D-GA), Richard Blumenthal (D-CT), and Cory Booker (D-NJ) in introducing a legislative proposal to save lives of nursing home residents and employees and assist with vaccinations.   At press time, over 1.3 million nursing residents and workers in long-term care facilities have been infected with COVID-19 and more than 170,000 have died so far, accounting for approximately 35 percent of COVID-19 deaths nationwide.

Taking a Close Look at S.333

Last week, S.333, “The COVID-19 Nursing Home Protection Act,” was thrown into the legislative hopper.  Initially introduced last Congress, the latest version, now being considered by the Senate Finance Committee, would provide funding to give nursing homes the needed resources to keep residents and workers safe; funding would go towards providing vital infection control assistance and organizing local health and emergency workers – known as “strike” or “surge” teams – to manage COVID-19 outbreaks and care for residents.  At this time no House companion measure has been introduced.

S. 333, introduced on Feb. 22, would provide $210 million for the Secretary of HHS to contract with quality improvement organizations to provide essential infection control assistance to nursing homes. 

Moreover, the legislative proposal would also send $750 million in funding to states to implement “strike” or “surge” teams. States are using “strike” or “surge” teams to ensure a sufficient number of aides, nurses and other providers are available to care for residents. Such teams also help manage COVID-19 outbreaks within a facility, particularly as vaccinations proceed in these settings. Since August, approximately 20 percent of nursing homes have reported each week that they do not have a sufficient workforce to care for residents.”

The impact of the pandemic has been devastating to minority communities, where reports have indicated that facilities serving significant numbers of Black and Hispanic residents were twice as likely to have COVID-19 infections. S. 333 would require the HHS Secretary to collect and make public demographic data on COVID-19 cases and deaths, including information on age, race, ethnicity, and preferred language. 

Whitehouse supports President Joe Biden’s call for the implementation of strike teams in his American Rescue Plan to help address these persistent shortages as well as the collection and dissemination of data on suspected and confirmed COVID-19 cases and deaths by race, ethnicity and preferred language.

Controlling COVID-19 Outbreaks in the Nation’s Nursing Homes

“Nursing home residents and staff have been through a traumatic year,” said Whitehouse who sites on the Senate Finance Committee.  “We need to prioritize vaccinating and caring for the Americans who live and work in these settings.  That means providing additional staff as needed to control outbreaks and making sure every resident and care worker who wants a vaccine can get one.,” said the Rhode Island’s junior Senator who has served since Jan. 4, 2007.

“As more than 170,000 residents and workers in nursing homes and other long-term care facilities have died from COVID-19, it is critical that Congress pass the COVID-19 Nursing Home Protection Act,” says Sen. Bob Casey, Chair of the U.S. Special Committee on Aging.

“This bill would address persistent staffing shortages in nursing homes by utilizing strike teams, promote infection control protocols and require that demographic data is collected on COVID-19 cases and deaths,” notes Casey.

Adds Casey, “The challenge this terrible virus poses are unprecedented and requires an immediate and extraordinary response. That is why my colleagues and I are advancing strategies to give states what they need – funding for ‘strike’ teams to help address staffing shortages in nursing homes and assist with vaccinations in these settings. We have an obligation to protect our most at-risk citizens.”

 “We applaud the efforts of Senator Whitehouse and his colleagues to provide funding for the protection of nursing home residents and staff,” said Scott Fraser, President and CEO of the Rhode Island Health Care Association, an affiliate of the Washington, DC-based American Health Care Association.  “We are especially pleased with the creation of strike teams to address the critical issue of staffing shortages during times of crisis.  This is a suggestion that RIHCA brought to Senator Whitehouse’s attention this past Spring when our homes were in critical need of additional staff due to the pandemic.  We thank him for listening and taking action,” he says.

At press time, 12 Democratic Senators join Sens. Whitehouse, Casey, Warnock, Blumenthal, and Booker, becoming cosponsors to this legislation.  They are: Sens. Maria Cantwell (D-WA), Bob Menendez (D-NJ), Jeanne Shaheen (D-NH), Tina Smith (D-MN), Amy Klobuchar (D-MN), Tammy Duckworth (D-IL), Chris Van Hollen (D-MD), Sherrod Brown (D-OH), Catherine Cortez Masto (D-NV), Jack Reed (D-RI), Maggie Hassan (D-NH) and Mazie Hirono (D-HI). 

A Call for Bipartisan Support

With the Senate now under Democratic control, there is a good chance that S. 333 will be considered by the Senate Finance Committee and if passed sent to the floor for consideration.   During the 116th Congressional session, the former Senate GOP Majority Leader, Mitch McConnell, of Kentucky, who often called himself the “Grim Reaper,” sent Democratic legislation to a legislative graveyard, refusing to act on Democratic legislation, even proposals with bipartisan support.

It’s time for Senate Republicans to support a Democratic proposal that protects the health and safety and the wellbeing of nursing home residents and workers in the nation’s 15,600 nursing homes. 

Partisan politics shouldn’t play a role in Senate Minority Leader Mitch McConnell’s decision to not urge his caucus to support this worthy legislative proposal.  S. 333 truly deserves bipartisan support and enactment, especially during the ongoing COVID-19 pandemic.

Ramping up COVID-19 Vaccine Plans

Published in RINewsToday.com on January 17, 2021

As state health officials say they are clamoring for more doses of COVID-19 vaccine, just days ago, Health and Human Services Secretary Alex Azar said in an interview with NBC’s Lester Holt there is no “reserve stockpile” of COVID-19 vaccine doses left to release to states, and all vaccine has now been released to fulfill orders by the states. Azar’s comments come after his announcement on January 12th that the states no longer need to hold back a second shot because there is confidence that Pfizer and Moderna, manufacturers of the vaccine, could keep up with the demand.

In the January 12th announcement, Azar noted several steps the states should take immediately, and the federal government was taking:

Expand groups getting vaccinated to include all those over the age of 65 – Vaccinate those 16-64 with co-morbidities – Expand channels to include those more familiar with people to reach them where they are, such as pharmacies – release all supply to order by states.

Azar encouraged states that are holding back “second shots” to not do so, saying, “Every vaccine dose that is sitting in a warehouse means another life lost…”

In response to the rollout of COVID-19 vaccines, Katie Smith Sloan, president and CEO of Washington, DC-based Leading Age and acting President and CEO, of the Visiting Nurse Associations of American, had some thoughts. “With COVID-19 death tolls topping 4,000 a day, it’s chilling to hear that vaccine stockpiles may have been misrepresented, and that older Americans who have been dying in record numbers might suffer as a result,” she said in a Jan. 15 statement.

Making it a Priority of Giving COVID-19 Vaccines to Seniors

“We hope these reports are not true. For weeks, state policy makers, distribution partners and aging services providers have been basing their vaccine allocations and strategies on vaccine stockpile estimates,” Sloan noted.    

“Because more than 265,000 people 65 or over have died of COVID, we have been pleased that many states have made the right decision to prioritize older Americans and their caregivers for immunizations, and that the process is underway in long-term care.  We hope this news is not a setback for those people, as well as others waiting for vaccinations in home health, hospice, PACE programs, adult day or other settings,” says Sloan.  

Rhode Island’s plan not changing

However, Rhode Island has chosen not to prioritize the distribution of it COVID-19 vaccine to older Rhode Islanders. The Rhode Island Department of Health (RIDOH) expects residents age 75 and older who reside in the community to be vaccinated in February or possibility March. Specifics as to vaccinating residents ages 50 to 74 have not been announced. While other states are beginning mass vaccination sites at stadiums, no such plans exist in Rhode Island.

AARP Advocates for those over 50

“Since the start of the pandemic, over 95 percent of the deaths from COVID-19 have been among people 50 and older,” AARP Rhode Island State Director Kathleen Connell and State President Phil Zarlengo said in a Jan. 8 letter to Gov. Gina Raimondo, urging the state’s top official to “ensure that Rhode Islanders age 50 and older are prioritized to receive a vaccine.”  (see Weiss Commentary printed here on January 11). 

AARP is fighting for older Americans to be prioritized in getting COVID-19 vaccines because the science has shown that older people are at higher risk of death.  On Jan. 11, the Washington, DC-based AARP sent a letter to HHS Secretary Alex Azar calling for his agency to take immediate action to address the issues that have slowed down vaccinations across the country.

RIDOH’s plans

On Jan. 15, in a Vaccine Update, Nicole-Alexander Scott, MD, MPH, Director, Rhode Island Department of Health, stated: “There was a lot of news this week about the federal government urging states to vaccinate people who are 65 years of age and older. We want to get vaccine to people older than 65, too. The limiting factor is not federal rules, or our approach in Rhode Island. The limiting factor is the amount of vaccine we are getting. We are getting 14,000 first doses of vaccine a week. There are close to 190,000 people in Rhode Island who are 65 years of age and older. It would not be honest or fair of us to say that all Rhode Islanders older than 65 can get vaccinated tomorrow, because we just don’t have the vaccine.” 

It is unclear if RI is holding “second shot” vaccine doses in storage. There is about a week’s lag from receiving the doses and distributing them. On January 15th, the state said they had administered a total (first and second shots) of 51,220 shots. On January 12th, the most recent report provided, the state says it has received 72,175 doses from the federal government.

Scott added:” We’ve seen the confusion and frustration that has resulted in states that have opened eligibility to groups that they did not have enough vaccine for. In Rhode Island, we are vaccinating older adults incrementally and thoughtfully. That means that when we tell you you can get vaccinated, you know that there is a real, physical vaccine waiting for you – not just that you fall into a broad category that is eligible to get a vaccine when we eventually have one. Please know that if we could, we would make sure that everyone got vaccinated immediately. But we’re just not getting enough vaccine right now, so we’re doing the best we can with what we have.”

Rhode Island’s report

After listening to the state’s reports on plans for getting out the vaccine to the group the Centers for Disease Control and Prevention is recommending, those over 65, and those under 65 with underlying medical conditions, there seems to be an overall lack of urgency in ramping up for this new directive, said Nancy Thomas, Publisher of the RINewsToday.com, who was on the update webinar this week, with other reporters. “There are no plans – or none they are willing to announce – for how people will register, or sign up, for when the 65 and over category is ready to go. Questions about how people will identify themselves at the site also were yet to be determined. When asked about mass vaccination sites, officials said they may consider schools, but had no plans for using McCoy Stadium or other large sites. We’ve seen states all around us opening up stadiums – many of whom are still vaccinating medical workers – but ramping up to do as many as they can until supplies are exhausted for that day. Massachusetts even has swag – pins, wristbands, and banners – to build up the sense of excitement, which also builds compliance. We have asked RIDOH about public education campaigns and they say they have a campaign coming.  

With such a large percentage of seniors in Rhode Island, are we ready to ramp up? Some states are vaccinating 24/7, with appointments at 2am and such. I guess a sense of frustration weighs on me and on others who do not see big plans, forward looking plans in the near future. Meetings with the public focus more on reporting of what has been done and where we’ve been, rather than where we’re going,” Thomas said.

Biden Releases COVID-19 Vaccination Plan

President-elect Joe Biden, speaking a day before he unveiled his COVID-19 Vaccine Plan on Jan. 15 in Wilmington, Del, unveiled a $1.9 trillion “American Rescue Plan” to combat COVID-19 and to shore up a wobbly economy. The emergency vaccination and relief package combine funding to reduce the economic impact of the pandemic (including direct stimulus payments of $1,400 per person, extending unemployment compensation, raising the minimum wage, continuing eviction and foreclosure moratoriums to increasing the Child Tax Credit) with strategies to fight to combat the virus itself.

About $400 billion of Biden’s “American Rescue Plan” is directed to controlling the virus by setting up mass vaccination centers, funding more sophisticated scientific analysis of new strains and creating teams of local health workers to trace the contacts of infected people.

President-elect Joe Biden’s Jan 15 press conference, lasting a little more than 19 minutes, warned that “We remain in a very dark winter. He noted that COVID-19 infection rates are creeping up 34 percent, COVID-19 related hospitalizations are increasing, and 3,000 to 4,000 people are dying every day of COVID-19.  “Things will get worse before they get better,” he said.

When releasing his five step COID-19 Vaccination Plan, Biden stated, “This is the time to set big goals and to pursue them with courage and conviction because the health of the nation is at stake.”  His strategy of getting 100 million Americans vaccinated during his first 100 days in office relies on the following steps: encourage states to vaccine more people age 65 and over including front line workers; creating thousands of community vaccination centers at gyms, sports stadiums and community centers; activating local pharmacies to give vaccines; ramping up supplies of vaccines by triggering the Defense Production Act and distributing vaccines quickly; and regularly updating state and local officials as to how much vaccine they are getting and when to expect the delivery.  Biden promised to give regular updates pertaining to the meeting of his goals, “both the good news and the bad.”

Mask Mandate – Wear that mask

During his first 100 days, Biden will be issuing an executive order to require masks for federal workers, on federal property, and on interstate travel, like trains and planes.  He is also urging governors to require masks in cities and states.

“I know masks have become a partisan issue,” says Biden, stressing “it’s a patriotic act.  Experts say that wearing a mask from now until April will save more than 50,000 lives, he noted.

Biden called on Congress to make his COVID-19 Vaccination Plan happen. “I’m optimistic. I’m convinced the American people are ready to spare no effort and no expense to get this done,” he said, stressing it “will take many months to get where we need to be.”