Tag Archives for House Appropriations Committee

Ratcheting up SSA’s customer service will take more funding 

Published in RINewsToday on May 1, 2023

Over two months ago, as required by law, Kilolo Kijakazi, Acting Commissioner of Social Security Administration (SSA) released the fiscal year 2023 operating plan to Sen. Patty Murray (D-Wash.), chair of the Senate Appropriations Committee. The report, released on Feb. 10, 2023, details how SSA plans to use its $14.1 billion budget allocation for the year. 

Kijakazi wrote in the report’s transmittal letter: “In FY 2023, we will build the foundation for improved services by rebuilding our workforce after ending FY 2022 at our lowest staffing level in over 25 years.”

According to Kijakazi, at the end of Dec. 2022 the initial SSA claims-pending level soared to almost 975,000 cases.  This was more than 380,000 cases higher than at the end of FY 2019. “The average initial claims wait time through Dec. 2022 was 206 days compared to 120 days in FY 2019.  It will take a multi-year effort and sustained funding to restore our average initial disability claims wait times to pre-pandemic levels,” she says.

While Kijakazi anticipates processing 129,000 or 7% more initial disability claims in FY 2022 (52 weeks), she expects wait times for a disability decision at the initial and appeal levels to increase for a period of time because backlogs will continue to grow while the agency hires and trains new staff. 

Although the FY 2022 outlay represents $785 million of the agency’s budget of $13.34 billion, it was less than the $14.8 billion President Joe Biden requested for administration funding. In February 10th correspondence to the House and Senate Appropriation Committees, Kijakazi stated that while budget increases will cover fixed costs and support staffing in the upcoming fiscal year, “some performance will show improvement in FY 2023, while others will show temporary degradation.” 

Conversations regarding SSA’s customer service challenges

In February 28th correspondence to SSA’s Kijakazi, AARP’s Nancy LeaMond, Executive Vice President and Chief Advocacy and Engagement Officer, recognized increased funding was necessary for SSA to address its customer service problems. AARP recognizes that federal funding has not kept pace with increases in operational cost and demands, but the agency “needs to do more to constrain operating costs and increase productivity,” Kijakazi says.

LeaMond called the “expected decline in service troubling, given multiple assurances from SSA that the funding level received would be sufficient to at least maintain the modest customer service improvements made last year.”

“Your operating plan asserts that the already unacceptable average of call wait time of 33 minutes will be longer this year, increasing to 35 minutes, and people trying to call the agency will get a busy signal 15 percent of the time, more than double the rate last year.  This is an unacceptable step backward,” wrote LeaMond.

LeaMond says that SSA’s operating plan doesn’t address several customer service areas, especially the challenges of beefing up staff to improve in-person services and reducing wait times and busy rates that the public should expect when calling their local office.  She called for more details and when beneficiaries can expect improvements to online services.

“Even more concerning is the fact that the operating plans note that disability-related service improvements are not expected to occur before 2024 fiscal year,” adds Leamond. While the plan provides details about disability claims, and appeal workloads, as well as prioritization of claimants who have been waiting the longest, she calls on SSA to “act more quickly to improve the disability process.”

“The Social Security Administration (“SSA”) has large fixed costs, such as rent on its network of 1200 field offices, and those fixed costs increase every year. SSA’s funding does not come from the general government budget, but rather from Social Security’s accumulated reserve of $2.8 trillion. Yet for over a decade, Congress has restricted SSA from spending the funds necessary for adequate service,” says Nancy Altman, President of Social Security Works (SSW).

Adds Altman, “While Congress this year allowed SSA to spend more, the additional dollars did not even cover all the fixed costs. They certainly did not correct the many years of underfunding. Service will not significantly improve unless Congress allows SSA to spend more of  Social Security’s accumulated reserve  — at the bare minimum,  the $15.5 billion that President Biden has requested — but ideally significantly more.”

Biden budget seeks to fix SSA’s customer service issues

In a blog article penned on March 30, 2023, Kathleen Romig, Director of Social Security and Disability Policy at the Washington, DC-based Center for Budget and Policy Priorities, says that SSA has an opportunity to ratchet up its consumer service impacted by decades of restricted funds by receiving increased funding. “With additional funding in for the coming year, the agency could invest in the staff and technology it needs to better serve the public,” she says.

“Since 2010, SSA’s customer service budget has fallen by 17 percent after inflation, with its staffing falling a commensurate 16 percent – marking the lowest level in 25 years. These cuts happened even as the number of Social Security beneficiaries grew by 12 million, or 22 percent. Being forced to serve millions more people with fewer staff and resources has caused tremendous strain at SSA, and beneficiaries are suffering the consequences,” says Romig.

On March 9th, Biden released a FY 2024 budget calling for increased appropriations to SSA. According to the Office of Management and Budget (OMB), the president’s budget provides an increase of $1.4 billion (a 10% increase) over the FY 2023 budget to cover salaries, benefits and rent increases. It would also improve customer service at field offices, state disability determination services, and teleservice centers.   

Each year, SSA processes more than 6 million retirement, survivors, and Medicare claims, and more than 2 million disability and SSI claims, says OMB, charged with producing the president’s budget. Biden’s budget increase boosts staffing levels from FY 2023, allowing the agency to process about a half a million more disability cases in FY 2024 that were completed in FY 2022, significantly reducing wait times for those decisions.

GOP debt limit bill drastically cuts SSA’s operating budget

Just last week, by a razor thin margin, House Speaker Kevin McCarthy (R-CA)’s Limit, Save, Grow Act of 2023 (H.R. 2811) passed by a partisan vote of 217-215. Four Republicans voted “no”. While this legislation to lift the nation’s debt limit allows the U.S. Treasury to pay the nation’s bills, it has no chance for passage in the Democratic-controlled Senate. However, it will force the president’s team to the negotiation table with Republican House and Senate leadership, hoping it will push compromise on future spending limits.

Failure to increase the debt limit would have catastrophic consequences for the U.S. and global economies, as well as for all Americans, who rely on the federal budget to provide public services. (from Social Security and Medicare to food safety inspection, air traffic control, school nutrition, and environmental. 

After the House vote, Alex Lawson, SSW’s Executive Director of Social Security, charged that 217 House Republicans just voted to cut Social Security. “Nearly every Republican in the U.S. House just voted to slash the already inadequate funding of the Social Security Administration (SSA). If this bill becomes law, it will force SSA to close field offices, reduce hours, and lay off thousands of workers. This will make it far harder for Americans to claim the benefits they’ve earned,” warned Lawson. “Cuts to SSA are cuts to Social Security, and we will hold every single one of these members accountable,” he says.

Max Richtman, President and CEO of the Washington, DC-based National Committee to Preserve Social Security and Medicare (NCPSSM) agrees with SSW’s assessment. One day before the vote, he wrote House members to urge them to pass “clean’ debt limit legislation.

“If the spending cuts and other [GOP] legislative changes that are incorporated in this legislation were ever to become law, the negative impact would be felt by virtually every American family in every Congressional District in the country,” wrote Richtman.

According to Richtman, the GOP’s proposed debt limit legislation includes among its provisions a roll-back of ALL discretionary federal spending to Fiscal Year 2022 levels in FY 2024, with growth limited to one prevent annually for the next decade. “This is not a minor trimming of spending that has been portrayed by some, but a dramatic slashing that will have devastating impacts on the Americans who rely on the affected programs for their health and well-being,” says the nationally recognized Social Security advocate. 

Reluctance to cut Defense and Veteran Health funding would have at least a 23 percent reduction to all other programs for FY 2024, charges Richtman, this resulting in funding cuts to SSA’s customer service budget.

“Cutting funding by six percent would significantly affect SSA’s ability to serve the public and undermine the Agency’s core-mission – producing longer wait times for benefits and to reach SSA representatives, as well as reduced access to in-person programs, noted Richtman, stressing that face-to-face access with SSA’s employees is critical to those who are elderly and disabled.

SSA calculates that for every $100 million in additional funding cut the federal agency would be forced to lay off an additional 1,000 employees, this equivalent to closing 40 field offices, says Richtman.

Since 1960, Congress has acted 78 separate times to permanently raise, temporarily extend, or revise the definition of the debt limit – 49 times under Republican presidents and 29 times under Democratic presidents, says the U.S. Treasury.  Like in the past, this Congress must follow to raise the nation’s debt limit, and is expected to do so.

Ultimately, it is crucial for Biden and McCarthy’s negotiations to hammer out a “clean” debt limits bill that will not cut SSA’s operational funding further which could send the agency’s customer service efforts into a tailspin. It is time for Congress to fix SSA’s operational funding issues once and for all to improve customer service provided to 65 million beneficiaries. 

For a copy of SSA’s 2023 Operating Plan go to https://www.ssa.gov/budget/assets/materials/2023/2023OP.pdf.

For a summary of H.R. 2811, Limit, Save, Grow Act of 2023, go to 

https://www.govtrack.us/congress/bills/118/hr2811/summary

For a copy of President Biden’s FY 2024 Budget, go to:  https://www.whitehouse.gov/omb/briefing-room/2023/03/09/fact-sheet-the-presidents-budget-for-fiscal-year-2024.

Kennedy Must Lead Fight Against Medicare HMO Rate Hikes

Published in The Pawtucket Times on November 19, 2001

Across the nation, seniors who have enrolled in Medicare HMOs are getting hit hard in the pocketbook.  Premiums and copays for hospital care, nursing services and prescription drugs are skyrocketing. Complaining about inadequate federal funding offered to provide health care services to seniors, a growing number of Medicare HMOs are opting out of the program, leaving their senior enrollees high and dry.

In Rhode Island, seniors are also seeing this alarming trend. Last year, United Healthcare discontinued its Medicare Plus Choice program, first in Newport County, then in Bristol County.  Now Blue Cross Blue Shield of Rhode Island (BCBS) informs its seniors that higher premiums and copays come next year for two of their three BlueCHiP for Medicare plans. The increases include prescription drugs, inpatient care, skilled nursing services, and more. The added out-of-pocket costs impacts about 41,000 seniors across the state.

However, Rep. Patrick Kennedy (D-RI) is not buying BlueCHiP’s request for a rate increases.

In a strongly worded letter Tom Scully, the administrator of the Centers for Medicare and Medicaid Services, the agency charged with overseeing the Medicare program, the Rhode Island congressman strongly protested the rate hikes.

He called on the federal official to investigate whether the current market for Medicare HMOs in Rhode Island has created a situation where the types of increases charged by BCBS are more likely to occur and be approved.

Furthermore, he requested a review to determine if the increases are actuarially sound.

Scott Fraser, BCBS spokesperson, acknowledges that the premium increases of the two BlueCHiP plans were the result of higher medical costs passed onto the BlueCHiP plans by hospital and other medical providers. “It’s medical inflation,” he quips, adding that even higher medication costs charged by drug companies has resulted in an increase in drug copays.

Even with next year’s increases, the BlueCHiP plans will not increase the premiums for the most commonly used services, specifically physician visits, laboratory tests and X-ray services, Fraser adds. “These co-pays have been the same for the last three years.”

CMS has reviewed BCBS’s application for the changes in rates and benefits over the summer, says Fraser, adding that the rate increase was given a thumbs up by the Feds.

Are BCBS’s rate increase actually sound thus justifiable?

CMS spokesperson Peter Ashkenaz told All About Seniors “the fact that the request has been approved by CMS speaks for itself. If the costs seem to be higher than what would be paid for in fee-service Medicare, we would have questioned them.”

Ed Zesk, president of Aging 2000, a non-profit consumer advocacy group. Believes that Rep. Kennedy has asked the right questions in his letter to CMS, specifically, “Are these premium and deductible increases justifiable?”

“Consumers just don’t have access to that type of information, Zesk said.

With Medicare reform now on the back burner as the nation gears up to fight terrorism, Rep. Kennedy must use his position on the House Appropriations Committee and Subcommittee on Labor, Health and Human Services and Education, to address the rising out-of-pocket healthcare costs for Medicare HMO enrollees. As the Congressional elections approach, seniors will want to see concrete congressional action leading to meaningful Medicare reforms.

Kennedy Must Lead Fight Against Medicare HMO rate Hikes

Published in the Pawtucket Times on November 19, 2001

Across the nation, seniors who enrolled in Medicare HMOs are getting hit hard in the pocket book. Premiums and co-pays for hospital care, nursing services and prescription drugs are skyrocketing. Complaining about the inadequate federal funding offered to provide health care services to seniors, a growing number of Medicare HMOs are opting out of the program, leaving their senior enrollees high and dry.

In Rhode Island, seniors are also seeing this alarming trend. Last year, United Healthcare discontinued its Medicare Plus Choice program, first in Newport County, then in Bristol County. Now Blue Cross and Blue Shield of Rhode Island BCBSRI) informs its seniors that higher premiums and copays come net year for two of their three BlueCHiP for Medicare plans. The increases include prescription drugs, inpatient care, skilled nursing services and more.  The added out-of-project costs impact about 41,000 seniors across the state.

However, Rep. Patrick Kennedy (D-RI) is not buying  BlueCHiPs request for rate increases.

In a strongly worded letter to Tom Scully, the administrator of the Centers for Medicare and Medicaid Services (CMS), the agency charged with overseeing the Medicare program, the Rhode Island congressman strongly protested the rate hikes.

He called on the federal official to investigate whether the current market for Medicare HMOs in Rhode Island has created a situation where the types of increases charged by BCBSRI are more likely to occur and be approved.

Furthermore, he requested a review to determine if the increases are actuarially sound.

Scott Fraser, BCBSRI spokesperson, acknowledges that the premium increases of the two BlueCHiP plans were the result of higher medical costs passed onto the BlueCHiP plans by hospitals and other medical providers. “It’s medical inflation,” he quips, adding that even higher medication costs charged by drug companies has resulted in an increase in drug copays.

Even with next year’s increases, the BlueCHiP plans will not increase the premiums for the most commonly used services, specifically physician visits, laboratory tests and X-ray services, Fraser adds.  “These co-pays have been the same for the last three years,” he says.

CMS has reviewed BCBS’s application for the changes in rates and benefits over the summer, says Fraser, adding that the rate increases were given a thumbs up by the feds.

Are BCBSRI’s rate increases actually sound, thus justifiable?

CMS spokesperson Peter Ashkenaz told All About Seniors “the fact that the request has been approved by CMS speaks for itself. If the costs seem to be higher than what would be  paid for in fee-for-service Medicare, we would have questioned them.”

Ed Zesk, president of Aging 2000, a non-profit consumer advocacy group, believes that Rep. Kennedy has asked the right questions in his letter to CMS, specifically, “Are these premium and deductible increases justifiable.”

“Consumers just don’t have access to that type of information,” Zesk said.

With Medicare reforms now on the back burner as the nation gears up to fight terrorism, Rep. Kennedy must use his position on the House Appropriations Committee and the Subcommittee on Labor, Health and Human Services and Education to address the rising out-of-pocket health care costs for Medicare HMO enrollees.  As the Congressional elections approach, seniors will want to see concrete congressional action, leading to meaningful Medicare reform.