Tag Archives for Medicaid

AARP report: States’ care for seniors “painfully inadquate”. Major gaps in RI

Published in RINewsToday on October 2, 2023

Last week, the Washington, DC-based AARP released its latest Long-Term Services and Supports (LTSS) Scorecard, calling care provided to seniors and persons with disabilities during the last three years after the COVID-19 pandemic “painfully inadequate.”  This nine-page report detailed state specific data, finds major gaps in providing care in every state, including Rhode Island, especially in these categories:  “Housing for Older Adults”, “Home Care Costs” and “Home Health Aide Supply”. 

The LTSS Scorecard, consisting of 50 indicators, focused on: affordability and access; choice of setting and provider; safety and quality; support for family caregivers; and community integration, using data from a variety of publicly available sources, such as the Centers for Medicare and Medicaid Services, American Community Survey, and Bureau of Labor Statistics.

Many benefits of accessing the data

According to AARP, this Scorecard can be a roadmap for improving the LTSS systems and the lives of those who rely on assistance.  Many others will benefit by reviewing this data, too. Federal, state, and local policy makers can identify priorities and ensure resources are allocated equitably. Aging advocates can glean public data and hold government officials accountable. Family caregivers can identify needed resources and become actively involved in policy discussions and advocacy. Seniors relying on long-term care programs and services can learn to inspire culture change and demand available tools. Finally, employers can improve workplace policies and practices to assist caregivers and healthcare groups so they can explore public-private partnerships and alliances. 

Like the findings reported in AARP’s LTSS Scorecard in 2020, Rhode Island ranked 12th in the country in 2023, but this year’s Scorecard reveals that the state has made some progress in improving care options for older Rhode Islanders, specifically the enrollment in the Program of All-Inclusive Care for the Elderly (PACE), as well as the availability of Adult Day Services.

“The pandemic reinforced the need to strengthen long-term care for countless loved ones across the country, including here in Rhode Island,” said AARP Rhode Island State Director Catherine Taylor in a Sept. 28th statement announcing the release of the 2023 LTSS Scorecard. 

“AARP’s Scorecard shows that there are many roads to meet the needs of all Rhode Islanders who deserve the very best care, including the 121,000 family caregivers in our state. The overwhelming majority — 87% — of Rhode Islanders age 45+ would prefer to receive care for themselves or loved ones at home with caregiver assistance. Yet, our low rankings in Housing for Older Adults (51st), Home Care Costs (43rd) and Home Health Aide Supply (41st) underscore how difficult it is for them to age the way they choose. It’s time to accelerate our efforts, for the sake of saving more lives,” she says.  

RI is dead last in housing

“In particular, Rhode Island’s dismal ranking for Housing for Older Adults – dead last – points to the urgent need to increase the supply of affordable, accessible housing. We can do that by passing legislation early in 2024 to strengthen homeowners’ ability to build an accessory dwelling unit (ADU) to allow them to age in place, support a family member, or house a caregiver,” Taylor said.

A national snapshot of the LTSS Scorecard’s 2023 Data

According to Scorecard, 12 states, including Rhode Island, have enacted paid family leave laws and 18 states have paid sick day laws, which can be used to assist caregivers. AARP’s latest Scorecard also reported that only 6 states provide a tax credit for family caregivers’ out-of-pocket expenses. Rhode Island does not provide a tax credit – nor is it among the 7 states that have statewide laws protecting caregivers from discrimination in the workplace that ensure they are not unfairly treated due to caregiving duties outside of work.

Meanwhile, it was reported that dozens of states experienced declines in the number of care choices that help support family caregivers. For instance, 16 states, including Rhode Island, had declines of 10% or more in access to home health aides since 2019. 

Regarding Home and Community-Based Services (HCBS), the LTSS Scorecard reported that 11 states, including Rhode Island, had state policies that improve presumptive eligibility for Medicaid HCBS at the time of data collection, making it possible for people to go home to receive care after being in the hospital – rather than having to be admitted to a nursing home while their eligibility for Medicaid payments is being determined.

The research indicated that many states also have large numbers of people with low care needs living in nursing homes, indicating a lack of HCBS access and services. More than 20% of nursing home residents in Rhode Island have low needs – compared to 9% nationally.

Data confirms Major Workforce Crisis in nursing facilities across US

As to nursing homes and institutional care, the AARP’s 2023 Scorecard confirmed that a  major workforce crisis exists in facilities across the country. Across all states, wages for direct care workers are lower than wages for comparable occupations, with shortfalls ranging from $1.56 to $5.03 per hour. In Rhode Island, wages are $1.79 lower than other entry level jobs.   

Nationally, more than 50% of nursing staff in nursing facilities leave their job within a year (53.9% turnover rate). However, in Rhode Island, the rate is slightly better than the average, at 49.3% – with Montana, Vermont, and New Mexico experiencing the highest averages in staffing turnover.  

Staffing disparities are also a significant challenge, say researchers, noting that residents of nursing facilities with high admissions of Black residents receive almost 200 fewer hours of care per year compared to residents of facilities with high admissions of white residents. 

According to the LTSS Scorecard, only 22% of nursing facility residents live in a facility with a 5-star rating in the US – with less than the national average, about 20.2%, of Rhode Island residents living in a 5-star facility. Gaps in workforce and equity result in persistent problems in care, say the researchers. One measure, pressure sores, can be life-threatening as they can lead to bone or joint infections, cancer, and sepsis. In this measure, 10% of facility residents nationwide experienced a pressure sore.

Finally, this year’s Scorecard announced that there is progress being made to create innovative and effective alternatives to traditional nursing facility models. Specifically, the researchers say that 10 states, including Rhode Island, made strides in nursing home innovations, such as by utilizing Green House® Nursing Home availability and policies, which includes small facilities, private rooms, and other best practices.

AARP’s 2023 LTSS Scorecard identified recommendations that can fix the nation’s delivery of long-term care programs and services to enable seniors to age in place in their communities. It called for increasing support to the nation’s 48 million family caregivers, “who are the backbone of the long-term care system, providing over $600 billion in unpaid care, such as with paid leave, tax credits, and other mechanisms to address health and financial needs.”

AARP Rhode Island continues to call on the Rhode Island General Assembly to support the state’s 121,000 family caregivers by advocating for enhancements to the state’s Temporary Caregivers Insurance program.

Recommendations on enhancing Long-Term Services and Supports

The Scorecard’s recommendations also called for investing in states’ Home and Community-based Care Infrastructure, by increasing support and training for home health aides and home visits, supporting the ability to access and use medical devices and equipment, and updating key Medicaid regulations and payment models.  

To tackle the workforce crisis, a recommendation suggests that it is crucial to support both nursing facility and in-home workforce by improving recruitment and training, increasing pay, and expanding the ability of trained nurses, aides, community health workers and other paraprofessionals to take on some aspects of care. States can choose to enact and enforce staffing and related care standards.

A recommendation also calls on States to expand the use of innovative, effective models for nursing homes can improve both quality of care and quality of life, such as with smaller facilities and private rooms and to address inequities by investing to close the staggering gaps in access to quality care and facilities and staffing shortages.

(Editor’s Note:  During the pandemic, then Governor Gina Raimondo allocated $5 million towards 2 changes in nursing homes – making all rooms private and providing non-shared, private bathrooms – for all residents – efforts to follow up on this effort have not resulted in what happened to that initiative according to the RI Department of Health).

Another recommendation urges states to create multisector plans for aging and building of coalitions and age-friendly health systems, to help seniors to age in place at home by having affordable and accessible housing and transportation, improved community design, and comprehensive emergency preparedness plans.

Researchers also suggested the advancing innovation in cities, counties, and states by supporting comprehensive state- and community-wide aging plans and piloting new approaches and programs, like Green House® Nursing Homes and presumptive eligibility, that can then be scaled.

Finally, Climate Change is increasing national disasters, and the LTSS Scorecard recommends that every state have a sound emergency preparedness plan to support nursing home residents, in particular, in times of crisis – including natural disaster.

“AARP’s LTSS Scorecard shows some progress and innovation, but there’s still a long way to go before we have systems that allow people to age well, and independently, for as long as possible and support the nation’s 48 million family caregivers. It’s also clear some emerging issues deserve more attention – from whether nursing homes are prepared to confront natural disasters, to whether they have plans in place to maintain and grow their workforces,” says Susan Reinhard, Senior Vice President, AARP Public Policy Institute.

The LTSS Scorecard is a charitable project made possible by a grant from AARP Foundation, with support from The SCAN Foundation, The Commonwealth Fund, and The John A. Hartford Foundation, and has been updated every three years since 2011.

To view the full Scorecard and state-by-state information visit https://ltsschoices.aarp.org/ 

To view the Scorecard for specifically Rhode Island, go to:  https://ltsschoices.aarp.org/scorecard-report/2023/states/rhode-island.

To view Previous Scorecards (2011, 2014, 2017 and 2020) go to https://ltsschoices.aarp.org/scorecard-report/report-archive/

Increased funding must be tied to nursing home mandated minimum staffing

Published in RINewToday on Sept 25, 2023

The Centers for Medicare and Medicaid Services (CMS) issued a proposed rule to establish comprehensive staffing requirements for nursing homes—including, for the first time, national minimum nurse staffing standards. The proposed rule seeks to would ratchet up the quality of care in the nation’s 18,700 skilled nursing facilities, delivering care to 1.2 million residents each day.

“Establishing minimum staffing standards for nursing homes will improve resident safety and promote high-quality care so residents and their families can have peace of mind,” said HHS Secretary Xavier Becerra in comments on Sept. 1, 2023. “When facilities are understaffed, residents suffer. They might be unable to use the bathroom, shower, maintain hygiene, change clothes, get out of bed, or have someone respond to their call for assistance. Comprehensive staffing reforms can improve working conditions, leading to higher wages and better retention for this dedicated workforce,” says Becerra.

The Nuts and Bolts of CMS’s proposed ruling

Under CMS’s proposal, nursing homes participating in Medicare and Medicaid would be required to meet specific nurse staffing levels that promote safe, high-quality care for residents. Nursing homes would need to provide residents with a minimum of 0.55 hours of care from a registered nurse per resident, per day, and 2.45 hours of care from a nurse’s aide per resident, per day, exceeding existing standards in nearly all states. CMS estimates approximately 75% of nursing homes would have to strengthen staffing in their facilities. As the long-term care sector continues to recover from the COVID-19 pandemic, the proposed standards take into consideration local realities in rural and underserved communities through staggered implementation and exemptions processes.

In addition, nursing homes would also be required to ensure a registered nurse is on site 24 hours a day, 7 days per week, and to complete robust facility assessments on staffing needs. Facilities would continue to be required to provide staffing that meets the needs of the individual residents they serve, which may require higher levels of staffing above the proposed minimum standards.  

CMS also proposed to require states to collect and report on compensation for workers as a percentage of Medicaid payments for those working in nursing homes and intermediate care facilities. These policies build on CMS’ recent proposals to support compensation for direct care workers in home and community based settings and to publish Medicaid data on average hourly pay rates for home care workers. This enhanced transparency will aid efforts to support and stabilize the long-term care workforce across settings strengthening access to high-quality long-term care both at home, in the community as well as in nursing homes and other facilities.

Attracting and supporting Nursing Home staff

Additionally, CMS announced a national campaign to support staffing in nursing homes. As part of the HHS Workforce Initiative, CMS will work with the Health Resources and Services Administration and other partners to make it easier for individuals to enter careers in nursing homes, investing over $75 million in financial incentives, such as scholarships and tuition reimbursement. This staffing campaign builds on other actions by HHS and the Department of Labor to build the nursing workforce.

More than 500,000 direct care workers provide care in nursing homes, assisting residents with daily tasks, such as bathing, dressing, mobility, and eating. This work, often performed primarily by women of color, is significantly undervalued. Direct care workers across long-term care settings earn low wages, rarely receive health and retirement benefits, and experience high injury rates. Improving working conditions and wages will lead to improvements in the recruitment and retention of direct care workers and enable nursing staff to provide safer care.  

CMS and the HHS Office of the Inspector General called for increased transparency and enhance enforcement of existing standards. This would result from increased audits of nursing homes’ staff, improving nursing  home inspections, oversight as to how nursing homes spend taxpayer dollars and cracking down on prescribing inappropriate antipsychotic drug prescribing practices.  The proposed rule would also undertake new efforts to improve resident safety during emergencies. 

Mandating more staffing during a severe labor shortage – pushback on an unfunded mandate

“It is unfathomable that the Biden administration is proceeding with this federal staffing mandate proposal. Especially when just days ago, we learned that CMS’ own study found that there is no single staffing level that would guarantee quality care, says Mark Parkinson, President and CEO of the American Health Care Association, a national nursing home trade group representing 14,000 nursing homes and other long-term care facilities across the nation taking care of five million residents each year.

“At the very same time, nursing homes are facing the worst labor shortage in our sector’s history, and seniors’ access to care is under threat. This unfunded mandate, which will cost billions of dollars each year, will worsen this growing crisis, warns Parkinson, noting that the proposed rule requires nursing homes to hire tens of thousands of nurses that are simply not there and then penalizes the facilities and threatens to displace hundreds of thousands of residents.

“Already, hundreds of nursing homes across the U.S. have closed because of a lack of workers,” states Parkinson. 

​John E. Gage, President, and CEO of the Rhode Island Health Care Association, with offices in Warwick, agrees with Parkinson’s assessment of the harm such proposals will trigger and its devastating impact on nursing homes and residents. “The federal staffing proposal is unfunded and is being implemented at a time when additional staff is simply not available,” he said.  

According to Gage, six Rhode Island-based facilities have closed since the beginning of the pandemic in March 2020. Three others are currently in receivership. Arbitrary federal staffing mandates will result in more closures, and residents will be displaced from their homes just as they were most recently when Charlesgate Nursing Center in Providence was forced to close because of skyrocketing costs, a scarcity of staff and chronically inadequate Medicaid funding. 

Unintended consequences of mandating minimum staffing

James Nyberg, president, and CEO of LeadingAge Rhode Island, with offices in East Providence, views see a staffing ratio mandate as a blunt enforcement instrument that does not consider the numerous challenges facing providers, including Medicaid underfunding, lack of workforce, and the diversity of resident needs. Moreover, the imposition of severe financial penalties on homes that are unable to meet a staffing ratio is counterproductive: fines siphon off scarce resources that providers need as they seek to address their workforce and resident care needs,” he says. 

“Our state’s experience illustrates the numerous challenges and unintended consequences of a staffing ratio mandate: the severity of fines, how compliance is measured and calculated, compliance costs, backlogs of people in hospitals waiting for skilled nursing care after admissions have been reduced due to a lack of staff and other access-related issues,” notes Nyberg, noting that even those homes that are currently able to comply with the staffing ratio are doing so at an unsustainable cost. 

While Kathleen Heren, executive director of the Alliance for Better Long-Term Care and the state’s Long-Term Care Ombudsman, supports HHS’s minimum staffing standard, the administration must adequately fund to train recruited workers and to pay a livable wage to retain them. “Rhode Island doesn’t have an issue with its nursing home inspection process as other states do, she says, noting that newly hired RI Department of Health surveyors are “doing a great job.” 

“RIDOH surveyors only cite facilities, when necessary,” says Heren, noting that administrators can challenge any cited deficiency if they view it as unfair, and she doesn’t see a problem in the use of antipsychotic medications in Rhode Island facilities “but acknowledges that there’s always room for improvement.”

Direct Caregivers, mainly women, undervalued despite significant work demands

“Almost 80 percent of nursing home care is paid for with government programs (Medicare and Medicaid), so it is hugely important that those dollars provide quality care,” says Maureen Maigret, chairperson of the aging in community subcommittee for the Long Term Care Coordinating Council.  She noted that studies show a clear relationship between staff levels and quality care but there is tremendous variation across the states in hours of direct care staff provided in nursing homes. 

“Rhode Island has required 24/7 RN staffing for many years and a 2021 state law requires minimum direct care staffing levels although implementation has been challenging due to the critical workforce shortage. Importantly, the proposed federal regulation would require states to report on compensation for workers as a percentage of Medicaid payments. For too long our direct care workers, mostly women, have been undervalued despite the significant demands of their work. It is time for them to receive a living wage and  shedding light on where our Medicaid dollars are going will help advocate for better wages helping to recruit and retain these essential workers,”  she says.

There will be a 60-day comment period for the notice of proposed rulemaking, and comments must be submitted to the Federal Register no later than November 6, 2023.  

For a copy of the federal register detailing CMS’s proposed rules on minimum staffing issued on Sept. 6, 2023, go to 

https://www.govinfo.gov/content/pkg/FR-2023-09-06/pdf/2023-18781.pd

For a copy of a CMS Fact Sheet on CMS’s proposed rules on minimum staffing, go to https://www.cms.gov/newsroom/fact-sheets/medicare-and-medicaid-programs-minimum-staffing-standards-long-term-care-facilities-and-medicaid

Social Security must be key issue in 2024 Presidential Election

Published in RINewsToday on July 17, 2023

Last Wednesday, 178 House Democrats, (90% of the House Democratic caucus) led by Rep. John Larson (D-Conn.) introduced  H.R. 4583, the “Social Security 2100 Act of 2023.” The 108-page bill would expand Social Security’s benefits, with no cuts, and keep the system fiscally strong for decades to come. Senator Richard Blumenthal (D-Connecticut) has introduced the companion measure in the upper Chamber.

In May, to drum up support, enthusiasm, and attention for H.R. 4583, Larson, House Ways and Means Social Security Subcommittee Ranking Member, was joined by House Democratic Leader Hakeem Jeffries (D-,New York), Ways and Means Committee Ranking Member Richard Neal (D- Massachusetts) and other House leaders to announce the upcoming introduction of Social Security 2100.

“10,000 Baby Boomers a day become eligible for Social Security, making the point of acting now even more urgent, says Larson. “I am proud to be joined again by a majority of my Democratic colleagues to introduce Social Security 2100, and again, ask my Republican colleagues, whose legislation we’ve included, to join us in helping uplift the 65 million Americans who rely on it. Including lifting 5 million Americans out of poverty, providing 23 million a tax cut, and making sure that Americans are able to get the essential benefits that allow them to pay rent, buy groceries, and fill their prescriptions,” he says.

“It’s important that the Social Security benefits that working Rhode Islanders have earned keep up with the cost of living, and that’s exactly what H.R.4583 – Social Security 2100 Act will accomplish. Unfortunately, extreme Republicans in the House are trying to cut Social Security instead of strengthening it. But I am determined to fight for Rhode Island’s seniors in Congress to ensure they receive the benefits they’ve earned,” says Congressman Seth Magaziner (D-R.I.), a sponsor of the legislative proposal. 

H.R. 4583: The Nuts and Bolts

On July 12, 2023, H.R. 4583 was introduced and referred to the House Ways and Means, Education and Labor, and Energy and Commerce Committees, being introduced in the lower chamber that day.

According to a legislative fact sheet, H.R. 4583, the legislative proposal would increase and expand essential benefits to Social Security beneficiaries. Larson’s legislation would:

•   Increase benefits 2% across the board for all Social Security beneficiaries for the first time in 52 years.  

• Improve the Cost-of-Living Adjustment (COLA), so it reflects the inflation actually experienced by seniors.

• Increase benefits to boost lower income seniors.

• Improve benefits for middle-income widows and widowers from two-income households.

• Restore student benefits up to age 26, for the dependent children of disabled, deceased, or retired workers.

• Increase access to benefits for children living with grandparents or other relatives.

• Repeal the Windfall Elimination Provision (WEP) and Government Pension Offset (GPO) that currently penalize many public servants.

• End the 5-month waiting period to receive disability benefits.

• Increases benefits by an additional 5% for the most elderly and those who have been receiving disability benefits the longest, those beneficiaries who have been receiving benefits for 15 years or more.

 • Provide caregiver credits to ensure that people (mostly women) are not penalized in retirement for taking time out of the workforce to care for children or other dependents.

• End the disability benefit cliff, replacing it with a gradual offset for earnings.

• Cut taxes for 23 million middle-income beneficiaries.

• Correct an unintended flaw in how Social Security benefits are wage-indexed, to prevent benefits from dropping (a “notch”) if the wage index decreases.

• Ensure that these benefits do not result in reduced Supplemental Security Income (SSI) payments or a loss of eligibility for Medicaid or CHIP.

• Combine the Old-Age and Survivors Insurance (OASI) and the Disability Insurance (DI) Trust Funds into one fund to ensure seamless benefit payments.

• Provide the Social Security Administration with resources to improve customer service.

Social Security 2100 Pays for These Benefits by:

• Ensuring millionaires and billionaires pay their fair share by applying FICA to earnings above $400,000.

H.R. 4583 would pay for strengthening the Social Security Trust Fund and pay for the enhanced benefits by having millionaires and billionaires pay their fair share by applying FICA to earnings above $400,000, with those extra earnings counted toward benefits at a reduced rate. The bill closes the loophole of avoiding FICA taxes and receiving a lower rate on investment income by adding an additional 12.4% net investment income tax (NIIT) only for taxpayers making over $400,000.

Social Security advocates call for passage

“By re-introducing his revised Social Security 2100 Act, Congressman John Larson once again defies the media narrative that ‘no one in Washington has the courage’ to address the program’s future,” says Max Richtman, President and CEO, of the Washington, DC-based National Committee to Preserve Social Security and Medicare, noting that the legislation extends the solvency of the Social Security trust fund for decades while also providing American seniors with an expansion of benefits.  Larson tackles the funding of the expansion of benefits by asking high earners to begin paying their fair share into the program, says Richtman. 

“At a time when House Republicans have proposed cutting benefits by raising the retirement age and other means — Congressman Larson offers a commonsense, fair, and forward-looking plan.

Not only is the Social Security 2100 Act wise policy, but it’s also overwhelmingly popular with voters across the political spectrum,” says Nancy Altman, President of Social Security Works and Chair of the Strengthen Social Security Coalition.

As the debate over Social Security heats up before the 2024 Presidential election, Altman charges that the nation’s media  refuses to “take Democratic plans to protect and expand Social Security seriously, and fails to call out Republicans for their unwillingness to state what they are for, not just what they are against.”

“Reporters are implicitly dismissing these bills because they cannot pass the House and Senate without Republican support. Instead of pressuring Congressional Republicans to introduce their own legislation, the mainstream media provides the Republicans with the cover they seek by claiming that both parties are avoiding action on Social Security” says Altman.

According to Altman, earlier this year President Joe Biden used the presidential bully pulpit at the State of the Union address to call out Republicans for their plans to cut Social Security and Medicare, forcing them to take these program cuts off the table during the debt ceiling negotiations. “If Biden champions a plan that expands benefits with no cuts, while requiring those earning over $400,000 to pay more, the mainstream media will be unable to ignore it,” predicts Altman. 

Congressional strategies regarding Social Security

On the same day that Larson introduced his legislation, Senator Sheldon Whitehouse (D-R.I.), Chairman of the Senate Budget Committee, held a hearing, “Protecting Social Security for All: Making the Wealthy Pay Their Fair Share,”  on his legislation, S. 1174, the Medicare and Social Security Fair Share Act.  A companion measure was introduced in the House by Congressman Brendan F. Boyle (D-Pennsylvania), Ranking Member of the House Budget Committee.

At the July 12th Senate Budget Committee hearing, Whitehouse explained that his legislation would bring enough revenue from the wealthiest to ensure that Social Security benefits will be paid and on time for the next 75 years and beyond.

“Right now, the cap on Social Security contributions means a tech exec making $1 million effectively stops paying into the program at the end of February, while a schoolteacher making far less contributes through every single paycheck all year,” says Whitehouse at the hearing. “That’s not fair, and my Medicare and Social Security Fair Share Act would fix that by requiring contributions to Social Security on wages above $400,000,” said the Rhode Island Senator.  

Whitehouse stressed the importance of Social Security to his Rhode Island constituents, by mentioning their comments and thoughts. 

 “I rely on my Social Security as my only source of income.  I would find it impossible to continue to live independently if Social Security were changed, reduced or eliminated.  Social Security benefits were a contract between the federal government and its citizens,” said Robert of Pawtucket.

Another Rhode Islander, Antonella of North Providence, said: “I would be very sad and depressed if there were any cuts to Social Security.  I just get by as it is.” And Laurel of Pawtucket said that without Social Security, she “would have to go back to work and probably have to work until I die.” 

Earlier this Congress, Senators Bernie Sanders (I-Vt.) and Elizabeth Warren (D-Mass.) introduced their own bill, S. 393, the Social Security Expansion Act (Whitehouse is an original cosponsor).   The Sanders-Warren bill would expand benefits by $ 2,400 each year while fully funding the program for the next three-quarters of a century and beyond.

As to the GOP position on Social Security, the House Republican Study Committee released a plan to cut Social Security by $718 billion over 10 years.  This plan, endorsed by three-fourths of the  House GOP Caucus), would also raise the retirement age to 69 (for everyone who is currently 59 and younger), which would effectively cut benefits by an estimated 13 percent every year and especially harm low-income workers.  It would also reduce benefits for future beneficiaries who earned a “higher salary” before retirement. Also, only “modest adjustments” to the Social Security program as it operates would be made but it doesn’t clarify the changes.

It is important to note that three fourths of the House GOP caucus endorse the RSC budget, making cuts to Social Security and Medicare.

According to SSW’s Altman, while Democratic proposals (Larson, Whitehouse and the Sanders- Warren proposals) to expand Social Security and Medicare are popular with Democratic, Republican and independent voters, Republican politicians have chosen to not co-sponsor any of these bills.

My final thoughts…

Polls show that Social Security and Medicare, two of the nation’s largest social safety net programs, are extremely popular. According to a poll released in March 2023 by the Associated Press and NORC Center for Public Affairs research, 79% of Americans are opposed to reducing the benefits that Social Security beneficiaries receive.  As to raising Social Security’s eligibility age from 67 to 70, 75% of American’s were against it.

Another poll released last March found that nearly 9 in 10 Americans say they oppose reducing spending on Social Security or Medicare, according to polling from Axios.  

The Congressional debate on financially shoring up Social Security and expanding benefits is of   extreme interest to 66 million older and disabled people (175,840 beneficiaries in Rhode Island), who rely on monthly payments from the program.  But the Social Security debate must include America’s younger generations, too. 

With 477 days left before the 2024 presidential elections, expanding Social Security and making the program fiscally sound and to ultimately be available to Gen Exers (1965 to 1979), Millennials (1980 to 1994), Gen Z (1995-2012) and Gen Alpha (2013 to 2025) must become a key election issue. Social Security beneficiaries and America’s younger generations must call on Congress to expand Social Security benefits and ensure its fiscal viability for every generation.  “Keep Your Hands Off Social Security” must be the powerful message they send to all presidential and congressional candidates before the upcoming 2024 presidential election.     

To review the text of Larson’s H.R. 4583, “Social Security 2100: A Sacred Trust Act,” go to https://larson.house.gov/sites/evo-subsites/larson.house.gov/files/evo-media-document/final-2023.07.11-text-of-social-security-2100-act.pdf.

To watch a video of Larson’s May press conference announcing the upcoming introduction of H.R. 4583, the Social Security 2100, go to https://www.youtube.com/watch?v=WO8QYRRQ-UQ.

Here is a copy of RSC’s FY 2024 Budget, Protecting America’s Economic Security https://hern.house.gov/uploadedfiles/202306141135_fy24_rsc_budget_print_final_c.pdf.