Obama’s Budget DOA, Thanks to GOP Gridlock

Published in the Woonsocket Call on February 14, 2016

With a GOP-controlled Congress President Obama’s final budget arrives “dead on arrival” on Capitol Hill.  The 182-page 2017 Fiscal Year budget, submitted on February 9, detailing $4.1 trillion in federal spending, which starts October 1, seems to be not worth the paper it’s written on.

Obama, a “lame duck” president in his last term, will not get his day in court.  Since the 1970s, a long-standing political tradition has brought the Office of Management and Budget Director and other senior administration officials, to present the president’s entire budget to Congress.  However, the Chairs of the House and Senate budget committees snubbed the Democratic President by issuing a joint statement saying, there will be no hearings before their panels this year. Sadly, political gridlock, fostered GOP Senate and House leadership, still seems to be alive and well on Capitol Hill.

Crafting the budget proposal now is in the hands of a very conservative Congress. But there a positives in Obama’s budget proposal, provisions that hopefully be placed in an enacted budget.

Obama’s budget proposal makes critical investments to fund domestic and national security priorities while adhering to the bipartisan budget agreement signed into law last fall.  It lifts sequestration in future years.  The budget proposal also attempts to drive down the federal deficit through smart savings from health care, immigration, and tax the wealthy and banks.

The Budget also seeks to tackle a multitude of domestic issues including confronting climate change, finding new clinical treatments for attacking cancer, advancing biomedical research, fighting infectious diseases, protecting the nation’s water supply and fostering clean energy initiatives, ratcheting up military readiness, revitalizing the American manufacturing sector, and funding job training and education initiatives.

Obama’s Final Budget and Seniors

But Obama’s 2017 Fiscal Year Budget has a number of budget provisions that directly impact older Americans, too.

According to  President and CEO Max Richtman, of the Washington, D.C.-based National Committee to Preserve Social Security and Medicare, like last year’s Obama recently released budget proposal proposes no changes in the way Social Security benefits are determined which is “good news for seniors.”

Richtman says that his aging organization worked tirelessly to make sure the FY 2017 budget did not include any Social Security proposals that would negatively impact benefits for current or future beneficiaries.  He notes, “The new budget proposes a substantial increase in the Social Security Administration’s (SSA) budget — $13.067 billion for SSA’s FY 2017 appropriation for administrative funding.  This is a $905 million, or 7.44 percent, increase over the FY 2016 enacted level.”

Finally, Obama’s newly released budget helps SSA to improve customer service for those applying for SSA and/or disability benefits by hiring additional front-line employees for its teleservice centers and local offices as well as additional staff to reduce the backlog of disability applications that have accumulated in SSA’s hearing offices, he says.

NCPSSM also applauded the President’s budget proposal for allowing Medicare to negotiate for lower prescription drug prices.

Richtman observed it has taken Congress a long time to acknowledge that the high cost of prescription drugs has hit older American’s hard in their wallets.  “Medicare spends billions providing Part D drug coverage each year while beneficiaries including seniors, the disabled and their families also face rising out-of-pocket costs and higher premiums, he says, noting that “All the while, drug makers continue to reap the profits of their price gouging.”

In his budget proposal Obama has again proposed lifting the ban preventing Medicare from negotiating prices with the drug companies, notes Richtman, warning that “Big Pharma has lobbied hard to keep the ban in place but seniors expect, this time, Congress will do the right thing and finally allow Medicare to negotiate for fair prices.”

Richtman says there are other budget provisions that benefit the nation’s seniors.  Specifically, the closing the Part D donut hole two years earlier, additional funding for in-home services, and reforms for overpayments going to private insurers in Medicare Advantage.

Meanwhile, the President’s budget was not all good news, adds Richtman, noting that “Once again, the budget proposes shifting even more healthcare costs to seniors by extending Medicare means-testing to the middle class and increasing out-of-pocket costs such as the home health care copayment and the Part B deductible.”

The President’s new funding request also targets vulnerable older Americans, by increasing funding from the 2016 Fiscal year Budget.  The President has increased last year’s budget by more than $10 million in discretionary resources for supportive services, also increasing the Congregate and Home-Delivered Nutrition Programs (like Meals on Wheels) by $14 million.  The Aging and Disability Resource Centers is also given a $2 million increase.

Other programs benefit from Obama’s budget proposal, too.  Elder Justice Initiative and Lifespan Respite Care Programs each would receive $2 increases from last year.  The Commodity Supplemental Food Program would get $14 million more.   The budget proposal also puts $10 million in for a new initiative to improve senior access to the Supplement Nutrition Assistance Program.  Section 202 Housing for the Elderly also gives a bump from last year in the tune of $72 million.

But the budget request slashes funding for programs that serve low-income seniors, specifically the Low-Income Home Energy Assistance Programs and the Community Development Block Grant takes huge fiscal hits.

Views from the Side Line 

             Obama’s budget proposal preserves programs for seniors, funding Social Security and Medicare, says Darrell M. West, Ph.D., Vice President and Director of Governance Studies at the Brookings Institution, “Not many Republicans are taking this budget very seriously as they plan to write their own budget. The GOP alternative likely is going to include changes to programs affecting senior citizens, he warns.

Rhode Island’s Congressional delegation weighs in on the looming heated partisan budget debate where law makers will be toeing the part line.

Congressman David Cicilline, notes that he is disappointed that the House Budget Committee will not ‎holding hearings on President Obama’s budget proposal. “We should be discussing ways to strengthen Social Security, preserve Medicare, and ensure retirement security for every American. Unfortunately, it’s clear that House Republicans don’t want to have this discussion,” he says.

U.S. Senator Sheldon Whitehouse weighed in on the brewing pre-election budget battle.  “I’m pleased to see that the President’s budget protects Social Security and Medicare from the cuts sought by many Republicans.  As the President has proposed, we should reduce the deficit by closing wasteful tax loopholes, not by compromising the programs essential to our seniors, and not after saving Rhode Island seniors $14.4 million in prescription costs thanks to the Affordable Care Act.”

Finally, U.S. Senator Jack Reed notes that the President’s budget proposal reflects a number of his ongoing efforts to support Rhode Island seniors.  “This budget blueprint proposes significant investments in the health and well-being of aging Americans, and I will work hard to champion these proposals as we work through the appropriations process this year, he says.

“I am particularly glad the President heeded my call to propose meaningful steps towards lowering the cost of prescription drugs, which is critical for middle class families,” adds the Senator.

Now the work begins as Congress starts to craft it’s 2017 Fiscal Year Budget.  Democratic Congressional lawmakers can glean and fight for provisions in Obama’s eighth and final budget that positively benefit older Americans. With Senator Reed, sitting on the Senate Appropriations Committee, the Rhode Island’s Senior Senator and the state’s Congressional Delegation will play a major role in shaping the nation’s future aging programs and services.

 

Social Security Recipients Thirsty for COLAs

Published in Pawtucket Times on October 19, 2015

With Christmas fast approaching, almost 65 million people who collect Social Security checks will get hit hard in their pocketbooks. On Thursday, the Social Security announced that there will be no cost of living adjustments (COLA) for 2016. It’s the third time this has happened in over 40 years. .

Unless Congress promptly acts to change the law to give COLAS, Medicare premiums will also be increasing dramatically for almost one-third of Social Security recipients. “The average American senior simply can’t afford a triple-digit increase for their Medicare coverage, says Max Richtman, President/CEO of the National Committee to Preserve Social Security and Medicare (NCPSSM) in a statement. The Washington, D.C.-based organization has lobbied Congress to pass legislation to address this urgent policy issue. “For millions of seniors, this large Medicare hike is devastating and a result of a well-intended “hold harmless” provision that left out too many Medicare beneficiaries,” he says.
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According to Richtman, “All of this was triggered by a zero COLA increase in Social Security for 2016, confirming yet again, that the current Social Security COLA formula isn’t accurately measuring seniors’ expenses. Seniors across this nation understand how important having an accurate measure of the increase in their real costs is to their day-to-day survival.”

House Democrats Rally for a COLA

Just one day before SSA’s announcement of no COLA next year, Congressman David N. Cicilline (D-RI), and 55 Democratic House members had sent a letter to the Social Security Administration (SSA) calling for the federal agency to find a way to provide a COLA for 2016. Not surprisingly Cicilline was not joined by House GOP lawmakers. Only Congressional action can revise this decision.

In the Ocean State, there are 153,349 beneficiaries who received $266,541,000 in total benefits in December 2014. In January 2015, beneficiaries received a 1.7% COLA, which averaged $29.55 per month, or $354.58 per year.

“Seniors, who are relying on Social Security for their retirement, have seen the costs of everything go up and deserve a COLA so they can have their basic needs met,” said Cicilline. “I hear from Rhode Islanders every day who are living on Social Security about their struggles with the rising costs of housing, food, and medicine. In fact, it seems everything is going up, except their Social Security check and this is dead wrong.”

SSA’s announcement on October 14 clearly shows that the current method of calculating COLA’s for Social Security beneficiaries negatively impacts the recipients, says Cicilline. The Democratic Congressman calls on Congress to quickly fix this problem now. The lawmaker has co-sponsored H.R. 1811, the Protecting and Preserving Social Security Act, to do just that.

Cicilline charges that the Social Security Administration has used the Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W) to determine whether the cost-of-living has increased. According to the Washington Post, the “biggest reason retirees aren’t getting a raise” is due to lower fuel prices, even though medical, housing, and food costs have increased.

It’s time to change the way COLAs are calculated, says Cicilline. Critics to the existing formula charge that fuel prices are less important in determining cost of living for the nation’s seniors – individuals ages 65 and older make up only 16% of all licensed drivers in the United States. To fix formula glitch, Cicilline has signed on as a co-sponsor of the CPI-E Act, which would replace CPI-W with the Consumer Price Index for the Elderly. CPI-E more accurately reflects cost of living for today’s older persons by weighting the cost of housing and medical care more compared to CPI-W. It also de-emphasizes fuel and transportation costs.

Blunting the Pain of Medicare Premium Hikes

Promptly responding to SSA’s double whammy of no COLA for 2016 and hikes in Medicare premiums, AARP, the nation’s largest aging advocacy organization in a letter called on Congress to “pass a fix.”

In her correspondence, Nancy LeaMond AARP’s EVP and Chief Advocacy and Engagement Officer, asks Congress to protect all Medicare beneficiaries from sharply increased out-of-pocket costs in light of the COLA announcement, requesting specifically that Congress “reduce. the impact of the sudden, sharp increases in the Part B premiums and deductible as soon as possible. Ideally, all Medicare beneficiaries should be held-harmless in the face of no Social Security COLA adjustment.”

LeaMond’s letter notes that 16.5 million Americans face sharp premium increases and that “all Medicare beneficiaries will see their Part B deductible increase 52 percent…from $147 to $223.” Additionally, AARP reiterates its opposition to the Chained Consumer Price Index (CPI), noting that “the Social Security COLA would be even more inaccurate and benefits would be even less adequate if recent proposals to adopt a Chained CPI had been enacted.

AARP has opposed all Administrative and Congressional attempts to enact a Chained CPI, and says it will continue to do so, says LeaMond, because the Chained CPI would further under reported inflation experienced by Social Security beneficiaries, and further erode their standard of living, cutting an estimated $127 billion in Social Security benefits from current and near retirees in the next ten years alone.”

With Capitol Hill polarized by political a House and Senate captured by ultra conservatives, Social Security beneficiaries will have to find ways to stay financially afloat until Congress can reduce the damaging impact of the Part B premium increases with no COLA increase to reduce the pain. Aging groups push for holding beneficiaries harmless to Medicare premium increases. With the election over a year off, law makers might just listen or face the wrath of older Americans who just exercises their right to vote at the polls.

Herb Weiss, LRI ’12 is a Pawtucket writer covering aging, health care and medical issues. He can be reached at hweissri@aol.com.

“Doc Fix” Law Brings Permanent Changes to Medicare Physician Payments

Published in Woonsocket Call on April 19, 2015

Congress put aside its fierce partisan bickering and came together to pass H.R. 2 – the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). This week President Obama took the opportunity to sign the legislation package into law.

The Congressional fix repeals and replaces the flawed Medicare physician reimbursement system known as the sustainable growth rate or Sustainable Growth Rate (SGR). For the past 13 years, physicians have faced the possibility of an arbitrary cut in their Medicare payments unless Congressional lawmakers passed a so-called “Doc.fix” Medicare bill. Since 2003, Congress has passed 17 short-term bills to block these cuts in Medicare doctors’ fees that were called for under the existing law.

On April 14, the U.S. Senate passed the MACRA by a whopping 92 to 8 (the House passing its version of the bill in late March by a large margin, 392-37). Two days later, at an outdoor signing ceremony in the Rose Garden, President Obama signed the legislation into law, with the House bill brokers, Speaker John Boehner (R-Ohio) and House Minority Leader Nancy Pelosi (D-Calif.) in attendance. .

A Permanent Fix Prevents Payment Cuts

Just hours before a cut in reimbursement that would take place this week, a rare bipartisan Congressional effort prevented a 21 percent cut in Medicare payments to occur. It’s a permanent fix. And the new law extends the Children’s Health Insurance Program, which has provided coverage to millions of American children.

At the signing, Obama called the passage “a milestone for physicians, and for the seniors and people with disabilities who rely on Medicare for their health care needs,” noting that it would also strengthen the nation’s health care delivery system for the long run.

Obama stated this new law “creates incentives to encourage physicians to participate in new, innovative payment models that could further reduce the growth in Medicare spending while preserving access to care.”

According to the Center for Medicare Advocacy (CMA), a national nonprofit, nonpartisan law group that provides education, advocacy and legal assistance to older people and people with disabilities, the estimated cost of the new law is roughly $214 billion over 10 years. CMA says roughly half (approximately $35 of the total $70 billion over 10 years) will come from Medicare beneficiaries through changes that will increase their out-of-pocket costs for health care.(through means testing of higher-income Medicare beneficiaries, increased Part B premiums, and added deductibles to Medigap plans purchased in the future.”

CMA adds that the nation’s pharmaceutical and insurance industries were not required to pay for any of this law, although doing so would have paid for a major portion of the SGR replacement.

On the Back of Medicare Beneficiaries

Aging advocacy groups, including the Center for Medicare Advocacy and AARP, failed in their attempts to improve the Senate bill Medicare beneficiaries, including a repeal of the annual therapy caps, raising eligibility standards for low-income programs and permanently extending outreach and education funding for critical programs aimed at low-income beneficiaries. The Senate bill passed without amendments.

While many gave thumbs up to the new law, Max Richtman, President and CEO of the Washington, DC –based National Committee to Preserve Medicare and Medicaid, sees big problems with MACRA. “The Senate ‘Doc Fix’ vote has traded one bad policy for another, shifting the costs of Congress’ failed Medicare payment formula for physicians to seniors who can least afford to foot that bill. Contrary to claims by supporters, on both sides of the aisle, this ‘doc fix’ will hit millions of seniors who aren’t ‘wealthy’ by any stretch of the imagination. Seniors at all income levels who are already paying steep premiums for Medigap plans to help control their health care costs will now be hit with even higher costs. Forty-six percent of all Medigap policy holders have incomes of $30,000 or less.”

Richtman added, “Medicare beneficiaries will also be forced to contribute nearly $60 billion in premiums over the next decade thanks to passage of this so-called ‘fix.’

It’s no surprise that conservatives applaud this legislation as ‘the first real entitlement reform in two decades’ because it fulfills their political goal of shifting costs to seniors, cutting benefits and expanding means-testing to push Medicare further and further away from being the earned benefit seniors have long valued and depended on.”.

“Trading a bad deal for doctors for a bad deal for seniors is not a legislative victory and it is a surprising move from so many in Congress who have previously vowed to protect Medicare from harmful benefit cuts and seniors from cost-shifting,” says Richtman. .

AARP CEO Jo Ann Jenkins also expressed strong disappointment in the Senate not passing an amendment that would have removed Medicare’s arbitrary cap on physical therapy, speech language pathology, and occupational services. “Many Medicare patients, particularly stroke victims and people with Parkinson’s and Multiple Sclerosis would have benefited,” says Jenkins. With a majority of the Senate agreeing with this amendment, Jenkins says that AARP will continue to lobby to remove the arbitrary coverage cap.

But, Jenkins sees the positives. “Passage of MACRA moves Medicare in the right direction toward better quality health care and greater transparency for patients. These changes will benefit Medicare beneficiaries, as well as physicians and other providers, hospitals, and the overall health care system,” she says.
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Through the enactment of MACRA Congress put aside its political differences that made a permanent fix to a flawed law. If you can do it once, let’s see our lawmaker do this again, to provide improved programs and services to our nation’s older population.

Herb Weiss, LRI ’12 is a Pawtucket-based writer covering aging, health care and medical issues. He can be reached at hweissri@aol.com.