Your eyes, ears, and teeth are connected to your body – Medicare/Medicaid at 56

Published in RINewsToday on August 2, 2021

Over 56 years ago, Congress became actively involved in the health insurance business with President Lyndon Johnson signing the Social Security Amendments establishing Medicare and Medicaid. The bipartisan legislation creating a national health insurance program. It was introduced in March 1965, and was passed by large majorities of Democratic and Republican lawmakers in the House and Senate chambers. 

At the signing ceremony that took place at the Truman Library in Independence, Missouri on July 30, 1965, Johnson handed the first Medicare cards, numbers one and two, to 81-year-old former President Harry S. Truman and his wife, Bess. Johnson proclaimed the former president to be “the real Daddy of Medicare.” Truman, the 33rd President, was considered to be the first president to vigorously call for national health insurance who ultimately saw his proposals stall on Capitol Hill, as the American Medical Association, the American Hospital Association and conservatives tagged it “socialized medicine.” 

Celebrating Medicare and Medicaid 

On July 30th of this year, top federal officials, Congressional Democrats, and aging advocates celebrated the 56th Anniversary of Medicare and Medicaid.

“For decades, Medicare and Medicaid have been a lifeline and a steady foundation for our seniors, children, women, families, people with disabilities, and at every stage in life,” says HHS Secretary Xavier Becerra, noting that about 140 million Americans have health insurance coverage through either Medicare (63 million) or Medicaid (74 million). An additional 4 million adults could benefit if the remaining 12 states expanded Medicaid through the Affordable Care Act.

“For 56 years, Medicare and Medicaid have made health coverage a reality for individuals and families when they have needed it,” adds Administrator Chiquita Brooks-LaSure, of the Centers for Medicare Services (CMS). “When President Lyndon Johnson called on Congress to spare the nation’s seniors of ‘the darkness of sickness without hope,’ nearly half of seniors were uninsured, most hospitals around the country were segregated, and health coverage was out of reach for many,” she noted. 

“Medicare and Medicaid were critical steps forward in the fight for civil rights that brought the peace of mind that health coverage provides to many, made health care access more equitable by requiring the integration of hospitals, and improved health outcomes across the country,” says LaSure.

With the health needs of those CMS programs recipients always evolving, LaSure calls for the expansion and strengthening of Medicare and Medicaid so they remain quality and reliable health programs. “Ensuring these programs also work to advance health equity nationwide is also a top priority for CMS. Access to health coverage is a right and no one should be left out, left behind or left on the sidelines,” she says.

House Speaker Nancy Pelosi also took time from her schedule to celebrate President Johnson’s landmark law creating Medicare and Medicaid. “Fifty-six years ago, our nation made a bedrock promise to our seniors and working families: that they deserve the dignity and security of quality, affordable health care. Today Medicare and Medicaid stand as pillars of health and justice, ensuring that millions of Americans receive the care they need, regardless of age or financial means,” says Pelosi.

“As we celebrate this anniversary, Democrats reaffirm this longstanding and unyielding belief: health care is a right, not a privilege. That is why we remain committed to defending Medicare and Medicaid against Republicans’ constant, callous attacks, as well as advancing legislation to bring down sky-high prescription drug prices, improve Medicare’s benefits for seniors and build on the success of the Affordable Care Act to lower health care costs for American’s families,” Pelosi adds.

As the nation celebrates Medicare and Medicaid’s 56th Anniversary, Max Richtman, president and CEO, of the Washington, DC-based National Committee to Preserve Social Security and Medicare, watches Congress’s continued debates about expanding Medicare benefits. “If you need to see a dentist, if you can’t see properly, if you can’t hear alarms, it’s not a luxury; it’s essential for the safety and health of older people,” he says.

Social Security Works Goes to Washington

On July 30, Social Security Works came to Capitol Hill to celebrate Medicare’s 56th anniversary by delivering more than 125,000 petitions to lawmakers urging them to lower the popular program’s eligibility age from age 65 to 60, allow Medicare to renegotiate lower prescription drug prices for everyone and to upgrade coverage to include vision, hearing and dental services.

“The 56th anniversary is as good as any other occasion to expand Medicare to cover more people, to do work that has not been done for generations,” says Dr.  Sanjeev Sriram, an adviser to the advocacy group Social Security Works, during the Capitol Hill rally. The Maryland primary care provider called these changes long overdue. 

“Now, as a doctor I can tell you: Your eyes, your ears, and your teeth are connected to your body,” said, Sriram during Friday’s rally on Capitol Hill to explain the importance Medicare covering vision, dental and hearing benefits. “I did not have to go to medical school to tell y’all this, but apparently I do have to tell Congress this.”

“We put Democrats in power to make changes, not excuses. It’s time to expand Medicare,” Sriram told senior advocates holding signs with the message, “Medicare for All” and “Medicare Expansion Now.”

Although Senate Democratic leadership agreed to expand Medicare in a recently $3.5 trillion budget reconciliation package, the measure does not lower the program’s eligibility from age 65 to age 60, says Sriram, noting that lowering the Medicare’s age requirement gives more than 23 million people health care coverage.

While critics say that the nation can’t afford to add vision, dental, hearing and vision benefits, a recently released poll says the Americans support this expansion of benefits. In June 2021, survey findings released by Data for Progress and Social Security Works proves just how popular these proposals are. A survey of 1,175 likely voters shows a full 83% of voters support expanding Medicare to cover hearing, vision and dental care, including 86% of those over the age of 45. That popularity even crosses party lines: 89% of Democrats, 82 of Independents, and 76% of Republicans are in favor.

Congress now has an opportunity to listen to constituents. And many think it’s time to expand Medicare’s benefits and lower the program’s eligibility age, for the benefit of America’s seniors.

“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.

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.