Tag Archives for Medicaid

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.

Tracking legislation of interest to seniors as RI General Assembly wraps up – Herb Weiss

Published in RINewsToday on June 28, 2021

 In the waning days of the 2021 legislative session, RI House lawmakers approved a $13.1 billion state budget for the 2022 fiscal year (by a party-line vote of 64 Democrats to 10 Republicans) that boosts key supports for vulnerable Rhode Islanders — particularly affordable housing and social services— without imposing any broad-based tax increases.

The budget plan also fully funds K-12 education, boosts support for higher education, restores funding to Eleanor Slater Hospital and funds a first-of-its-kind statewide program for police body cameras.  

Additionally, the budget codifies the state’s existing Livable Home Grant Program to provide subsidies (up to 50%) for certain disability and accessibility home modifications, which will enable older people to remain in their homes. The budget includes $500,000 for the Livable Home Grant Program.

At press time, the state budget moves to the Senate for consideration. Once passed by the upper Chamber and signed into law by Gov. Dan McKee, the budget covers the new fiscal year, beginning July 1.

In the Waning Days…

According to Larry Berman, the House’s Communication Director, 1,470 bills were introduced in the House and 978 in the Senate. According to the RI General Assembly’s bill tracker, less than 30 are identified as directly related to seniors.

Here is a sampling of these bills:

The Nursing Home Staffing and Quality Care Act, sponsored by Senate Majority Whip Maryellen Goodwin (D- District 1, Providence) and Rep. Scott A. Slater (D-District 10, Providence), sets minimum staffing levels for Rhode Island nursing homes and was signed into law by Gov. McKee, two days after General Assembly passage. The legislation (S 0002A, H 5012Aaa) will establish a minimum standard of 3.58 hours of resident care per day, initially, and 3.81 hours of resident care per day beginning January 1, 2023. The bill also provides funding to raise wages for direct care staff to help recruit and retain a stable and qualified workforce.

With final votes in both chambers, the General Assembly approved The Elder Adult Financial Act sponsored by Sen. Cynthia A. Coyne (D-District 32, Barrington, Bristol and East Providence) and Rep. Joseph J. Solomon, Jr. (D-District 22, Warwick). The legislation requires financial institutions to report suspected financial exploitation of seniors to the Office of Healthy Aging and authorizing them to temporarily hold transactions they suspect as such. The legislation will be sent to the governor for signature. The legislation (S 0264A, H 5642A) would require financial institutions to train employees to recognize indicators of elderly financial exploitation, and on their obligation to properly report it and place a hold on suspicious transactions. The legislation was the result of recommendations made by the Special Task Force to Study Elderly Abuse and Financial Exploitation, a group led by Sen. Coyne that met in 2018 and 2019 to explore the facets of elder abuse and make policy recommendations to address them.

Rep. Gregg Amore (D-District 65, East Providence) and Sen. Valarie J. Lawson’s (D-District 14, East Providence) legislation, The Uniform Control Substance Act, would exclude chronic intractable pain from the definition of “acute pain management” for the purposes of prescribing opioid medication has been signed into law by Gov. McKee. The legislation (H 5247A, S 0384A) calls for new guidelines for treatment of chronic intractable pain based upon the consideration of the individualized needs of patients suffering from it. The legislation acknowledges that every patient and their needs are different, especially those suffering from chronic pain. Chronic intractable pain is defined as pain that is excruciating constant, incurable, and of such severity that it dominates virtually every constant, moment. It also produces mental and physical debilitation and may produce a desire to suicide for the sole purpose of stopping the pain.

The House passed legislation sponsored by Rep. June S. Speakman (D-District 68, Warren, Bristol) to allow visitation for nursing home residents by a designated family member or caregiver during a state of emergency. Under the Rights of Nursing Home Patients legislation, an essential caregiver would be an individual—whether a family member or friend of a resident of a nursing home or long-term care facility – who is designated to provide physical or emotional support to the resident during a declaration of disaster emergency. The legislation (H 5543aa) would require the Department of Health to create rules and regulations providing for the designation of essential caregivers to provide in-person physical or emotional support to a resident of a nursing home or long-term care facility during the period of 15 days after a declaration of disaster emergency and until 60 days after the termination of the declaration. The bill would require DOH to develop rules and regulations on designating an essential caregiver and the criteria to qualify. Those rules would include health and safety regulations as well as requirements allowing an essential caregiver to have regular and sustained in-person visitation and physical access to a resident of the nursing home or long-term care facility. The bill now goes to the Senate, which on June 1st passed companion legislation (S 0006A) sponsored by introduced by Sen. Frank S. Lombardi (D-District 26, Cranston).

As part of its ongoing efforts of addressing the cost of prescription drugs, the RI Senate passed legislation that requires pharmaceutical companies to disclose drug pricing information and legislation would prohibit an annual or lifetime dollar limit on drug benefits. The first legislative proposal (S 0494A), which was introduced by Senate President Dominick J. Ruggerio (D-District 4, North Providence, Providence) would require the pharmaceutical manufacturers disclose to the Office of the Health Insurance Commissioner the wholesale acquisition costs of drugs if this cost is at least $100 for a 30-day supply. It would also require the disclosure of pharmacy benefit management information to include rebates, price protection payments and other payments that are saved by the pharmacy, health plan issuer or enrollees at the point of the drug. The second one, (S 0381A), which was introduced by Senate Majority Leader Michael J. McCaffrey (D-District 29, Warwick), would require that health plans that provide prescription drug coverage not include an annual or lifetime dollar limit on drug benefits. It would also cap out-of-pocket expenses that some consumers would be required to pay for prescription drugs.  The measures now move to the House for consideration.

The Senate also approved legislation sponsored by Sen. Melissa A. Murray (D-District 27, Woonsocket, North Smithfield) limiting insured patients’ copays for insulin used to treat diabetes to $40 for a 30-day supply. The legislation (S 0170A), which is part of the Senate’s prescription drug affordability legislative package, would apply to all insurance plans that cover insulin. Under the legislation, insurers would be required to cap the total amount that any covered person is required to pay for covered insulin at $40 for a 30-day supply, regardless of the amount or type of insulin prescribed. It also forbids that coverage from being submit to any deductible. The bill does allow insurers to charge less if they choose. The cost of insulin has risen sharply over the years, and the cost is much higher in the United States than in other countries.  Millions of Americans depend on insulin for the management of diabetes. The legislation goes to the lower chamber, where House Speaker Pro Tempore Brian Patrick Kennedy (D-District. 38, Hopkinton, Westerly) is sponsoring a companion bill (H 5196A).

Finally, the passed legislation sponsored by Sen. Valarie J. Larson (D-District 14, East Providence) would increase temporary caregiver benefits for Rhode Islanders. The bill (S 0688) increases temporary caregiver benefits to six weeks in a benefit year starting Jan. 1, 2022, and would increase temporary caregiver benefits to eight weeks in a benefit year beginning Jan. 1, 2023.Rhode Island was the third state in the nation to pass a paid family leave programs when it enacted the Temporary Caregiver Insurance program in 2013.  It provides up to four weeks of partial (about 60%) wage replacement for workers who need to take time from their jobs to care for a serious ill family member or to bond with a newborn, adopted or foster child.  The worker’s job and seniority are protected while the worker is on leave.An amended companion measure (H 6090A), sponsored by House Majority Whip Katherine S. Kazarian (D-District 63, East Providence) passes the House and now heads to the Senate for consideration.

Deputy House Republican Minority Leader, George Nardone (R-Dist. 28, Coventry, Rep. Michael Chippendale (R-Dist. 40, Coventry, Foster, and Glocester and Rep. Raymond A. Hull (R-District 6, Providence) submitted H 5547 to ensure proper, safe, and personal contact with loved ones in congregate care facilities.  The legislation addresses the COVID-19 mandates that denied access to individuals in hospitals, group homes, nursing homes, assisted living facilities and Veterans homes. The purpose of this legislation is to entitle all residents of healthcare facilities and group homes the opportunity to designate a support person for regular, in-person visits. The policy is designed to balance disease transmission protocols with the benefits of having a loved one present during a lockdown. The House Health & Human Services Committee recommended the legislation be held for further study.

Senate Minority Whip Jessica de la Cruz (R-Dist. 23, Burrillville, Glocester, North Smithfield, introduced S 644 to provide medical assistance coverage for medical services provided qualifying eligible recipients for community-based care. The Senate Health & Human Services Committee has also recommended the legislation be held for further study.

Thoughts from the Sidelines at AARP

AARP Rhode Island says they “…are thrilled that the Livable Home Modification Grant Program, which provides matching funds for needed construction to ensure that Rhode Islanders with disabilities can remain safely and comfortably at home, was included in the FY22 budget,” said AARP Rhode Island State Director Catherine Taylor. “That was the highlight of the budget for us. Codifying this program has been a major priority.

“Another important win was enactment of the Elder Adult Financial Exploitation Prevention Act. This law is an important new tool to fight for the one-in-five older Rhode Islanders who is a victim of financial exploitation, with an average loss of $120,000. AARP-RI wrote to Governor McKee urging him to sign this critical legislation and they are delighted that he has done so.  This will be a game-changer in the effort to protect the life savings of older Rhode Islanders.

“Now we have our eye on the number of prescription drug bills that we’ve been working hard on, and we’re hopeful they will see passage before the end of the session. At this time, there are four Senate-approved Rx bills that need action in the House, and we are eagerly awaiting House passage of Rep. Brian Patrick Kennedy’s insulin cap bill.

The Legislative session is expected to end by the end of next week. Stay tuned to see what legislative proposals ultimately make it to the Governor’s desk for signature.

UPDATE:

‘According to Maureen Maigret, Vice Chair of Rhode Island’s Long-Term Care Coordinating Council, a former state representative and Director of Rhode Island’s Elderly Affairs, one of the biggest wins for older adults in the budget — the expansion of the Office of Healthy Aging @Home Cost Share program to increase income eligibility from 200% of the federal poverty level to 250% and to include persons under age 65 with Alzheimer’s/dementia. “Over $2Mil in all funds was added to the budget to do this. It was promoted by legislation sponsored by Sen. Walter Felag and Rep. Joseph Solomon. An estimated 500 persons will get subsidized home care and/or adult day services with this expansion. It was a priority of the Aging in Community Subcommittee for several years,” she says. 

Maigret also notes that the budget also includes Medicaid rate increases for a number of home and community care providers designed to increase access to these options for persons needing care. “These include assisted living, adult day services, shared living and home care. Importantly, with the cost of so many basic services such as rent and food increasing it raises the amount of money a person on home care can keep to pay for living expenses before they must pay a share of the cost of the services,”

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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.