Tag Archives for Medicaid

House Bill to Expand, Strengthen Social Security

Published in Woosocket Call on February 3, 2019

With the 116th Congress kicking off on January 3, 2019 and the Democrats seizing control of the House, it did not take long for a bill to emerge that would strengthen and expand the nation’s Social Security program. Seven years ago, when U.S. Congressman John Larson (D-CT) first introduced the Social Security 2100 Act during the 113th Congress, the GOP controlled Congress blocked a fair hearing and vote. Now, with a Democratic majority in the House Larson’s Social Security proposal will finally get a thorough review as Democrats take control of the House Ways and Means, Energy and Commerce, and Education and Labor. These committees have oversight of Social Security.

Larson chose to throw the bill into legislative hopper on the 137th anniversary of President Franklin D. Roosevelt’s birth, who signed Social Security into law in 1935.

On January 30, 2019, Larson, recently appointed to chair of the House Ways and Means subcommittee on Social Security, introduced H.R.860, the Social Security Act 2100 Act, with over 202 House Democrats cosponsors (including Rhode Island Representatives David N. Cicilline and James R. Langevin), to ensure the retirement security of working Americans for another century.

Passage of the Social Security 2100 Act only requires a simple majority vote of 218 lawmakers. With 235 Democratic lawmakers sitting in this chamber, it is expected to pass. But, with the Senate-controlled by Republican Majority Leader Mitch McConnell of Kentucky and his GOP caucus, it will be difficult for Senators Chris Van Hollen (D-MD) and Richard Blumenthal (D-CT) to see their companion measure make it to the Senate floor for a vote.

H.R. 860’s eight provisions expand benefits for 62 million Social Security beneficiaries. It would provide an across-the-board benefit increase for current and new beneficiaries that is the equivalent of 2 percent of the average benefit. It also calls for an improved cost-of-living adjustment (COLA), through adopting a CPI-E formula, that takes into account the true costs (include health care expenses) incurred by seniors and a stronger minimum benefit set at 25 percent above the poverty line, tied to their wage levels to ensure that the minimum benefit does not fall behind. Finally, the bill would ensure that any increase in benefits from the bill do not result in a reduction in SSI benefits or loss of eligibility for Medicaid or Children’s Health Insurance Program. Finally, 12 million Social Security recipients will receive a tax cut through the eliminating the tax on their benefits.

Increasing the Financial Solvency of Social Security

According to an independent analysis of the Social Security’s Office of the Chief Actuary, H.R. 860 proposal would also strengthen and protect the Trust Funds by 75 years.

H.R. 860 would have wealthy individuals pay the same rate as everyone else. Presently, payroll taxes are not collected on wages over $132,900.
Larson’s legislation would apply the payroll tax to wages of $400,000, affecting the top 0.4% of wage earners. The bill gradually phases in an increase in the pay roll contribution rate beginning in 2020, of 50 cents per week, so that by 2043 workers and employers would pay 7.4 percent instead of 6.2 percent. Finally, the bill’s provisions would combine the Old-Age and Survivors, called Social Security, and the Disability Insurance trust funds into one Social Security Trust Fund, to ensure that all benefits will be paid.

“Social Security is a promise that after a lifetime of hard work, you should be able to retire with dignity and economic security. It’s critical that Congress preserve and strengthen this promise for years to come,” said Cicilline, who serves as Chair of the Democratic Policy and Communications Committee, representing Rhode Island’s 1st congressional district.

Larson, recently appointed chair of the House Ways and Means Subcommittee on Social Security, noted, “With 10,000 baby boomers becoming eligible for Social Security every day, the time to act is now. The Social Security 2100 Act will provide economic security not just for today’s seniors but for future generations too,” said Larson, as the bill was thrown into the legislative hopper.”

There have not been any significant adjustments to Social Security since 1983, when Tip O’Neill was Speaker and Ronald Reagan was President, said Larson. “It’s time for Congress and the President to come together again, just like Speaker O’Neill and President Reagan did to make this a reality, he said.

“For years, fiscal hawks have told us that the only way to ‘save’ Social Security is to cut benefits for future retirees. Congressman Larson’s bill is a resounding rebuke to those claims. The Social Security Act 2100 keeps the program financially sound for most of this century while boosting benefits for millions of beneficiaries,” said Max Richtman, president and CEO of the National Committee to Preserve Social Security and Medicare.

Richtman says, “Congressman Larson has promised that, for the first time, this legislation will receive thorough consideration in the U.S. House, including hearings with testimony from experts and the public. We applaud him for his vision, persistence, and advocacy on behalf of America’s current and future retirees in moving this bill forward.”

Today, more than 222,000 Rhode Islanders receive Social Security benefits today. It is the most important retirement income for 4 out of 5 seniors and provides financial protections to disabled workers and families who have lost a breadwinner.

For decades, GOP lawmakers pushed its Social Security reforms by privatization, raising the retirement eligibility age and imposing stingier COLA formulas. But, national poll after poll, across party lines and age groups, revealed the public’s strong support for the nation’s retirement program.

Washington Insiders expect Larson’s Social Security bill to pass the House. While GOP Senate leadership keeps the companion measure at arms-length, the upcoming 2020 elections may well grease the legislative wheels for passage. Over 20 Republican Senate, whose seats are at serious risk, may well vote for passage with Democratic Senators.
Stay tuned…

Funding for Seniors in Raimondo’s FY 2020 Budget Blueprint

Published in the Woonsocket Call on January 27, 2019

By Herb Weiss

Almost two weeks ago, Democratic Governor Gina Raimondo formerly unveiled her $9.9 billion budget proposal to the Rhode Island General Assembly. The House and Senate Finance Committees then begin the task of holding hearings on budget plan, getting feedback from the administration and the public. Once the revised estimates of tax revenue and social-services spending is available in May, negotiations seriously begin between Raimondo, the House Speaker and Senate President to craft the House’s budget proposal. Lawmakers will hammer out and pass a final state budget for the fiscal year that begins July 1.

Local media coverage of Raimondo’s ambitious spending initiatives zeroed in on her call for expanding free tuition to Rhode Island College and adding some public pre-kindergarten, increasing minimum wage from $ 10.50 to $ 11.10 per hour, allowing mobile sports betting and legalizing recreational marijuana.

But, Raimondo’s budget proposal gives state lawmakers a road map for what programs and services are needed for a state with a graying population.

According to Meghan Connelly, DEA’s Spokesperson, a nearly 60 percent increase in the State’s population of residents aged 65 and older from the years 2016 to 2040 highlights the need for continued investments in programs servicing Rhode Island’s older adults and their family caregivers.

Connelly says Raimondo’s budget proposal, released on January 17, elevates Elderly Affairs from a division under the Department of Human Services to an Office within the Executive Office of Health and Human Services. The governor shifts financing for the office and 31.0 FTE positions to EOHHS to accomplish this recommended action.

“The projected increase in the state’s senior population – from 174,000 in 2016 to 265,000 by 2040 – coupled with the proven impact of community-based supports and services, highlights the need for continuing to invest in helping our seniors remain home, connected to their families and networks. Support of aging-related health-promotion initiatives are essential to maintain a high quality of life for Rhode Island seniors while minimizing aging-related healthcare costs,” says Connelly

“We are focused on making it easier for older adults to live independent, fulfilling lives for as long as possible,” said Michelle Szylin, Acting Director of the Division of Elderly Affairs. “The Co-Pay expansion [in the governor’s proposed budget] enables additional older adults to age-in-place, remaining safely in their homes and engaging in their communities.”

The Co-Pay expansion enables additional older adults to age-in-place, remaining safely in their homes and engaging in their communities. The governor’s proposal to expand the state’s Co-Pay program [by $ 550,000] will allow more seniors to reside in their communities, staying connected to their family and network of friends and neighbors.

Providing access to the Co-Pay program to individuals earning up to 250% of the Federal Poverty Level will allow more seniors to age-in-place with a better quality of life and delay nursing home admission. The DEA Co-Pay program was established in 1986 as an option for elders who would otherwise be ineligible for subsidized home and community care assistance because they did not qualify for the Rhode Island Medical Assistance program.

Recognizing the importance of the state’s Elderly Transportation Program to keep older Rhode Islander’s independent, Raimondo’s budget proposal calls for additional funding of $1.8 million from general funds to support the State’s elderly transportation program. This program provides non-emergency transportation benefits to Rhode Islanders age 60 and over who do not have access to any means of transportation. The program provides transportation to and from medical appointments, adult day care, meal sites, dialysis/cancer treatment and the Insight Program.

Raimondo’s proposed budget also increases Health Facilities regulation staffing to increase the number of inspections to state-licensed health care facilities. The governor recommends a $327,383 increase in restricted receipt funds for 3.0 FTE positions. These positions will bolster existing staffing to increase the number of inspections to state-licensed healthcare facilities.

The Governor’s proposed FY 2020 budget also through the Rhode Island Public Transit Authority continues to subsidize the transit of elderly and disabled Rhode Islanders through the Rhode Island Public Transit Authority.

Raimondo’s proposed budget also continues the support for the Independent Provider model P model with almost $200,000 in general revenue funds budgeted (about $770,000 all funds) to cover implementation costs. The goal of this model is to increase workforce capacity and create a new option for delivery of direct support services for both seniors and people with developmental disabilities.

Finally, the governor’s FY 2020 budget also allocates funding to an array of programs and services for seniors. Here’s a sampling: $800,000 to support the state’s senior centers through a grant process (the amount was doubled last year); $ 530,000 to support Meals on Wheels; $ 85,000 to implement security measures in elderly housing complexes; $ 169,000 for the long-term care ombudsman through the Alliance for Better Long Term Care, which advocates on behalf of residents of nursing homes, assisted living residences and certain other facilities, as well as recipients of home care services; and $ 500,000 funds the state’s Home Modifications program at Governor’s Commission on Disabilities.

Nursing Facility Provides Take a Hit

Raimondo’s proposed budget plan seeks to freeze the state’s Medicaid payment rates to hospitals, slashing funding by an estimated $15 million overall for the year, and to limit the rate increase for nursing homes to 1%, costing them nursing home providers about $4 million.
“We are beginning the budget process with a 1 percent increase in the COLA (Cost of Living Adjustment), says Scott Fraser, President and CEO of Rhode Island Health Care Association (RIHCA), warning that “this is not enough.”

“Since 2012, nursing facility costs have risen 21.6 percent while Medicaid payment rates have only gone up by 9.6 percent, adds Fraser, noting that by statute, rates are supposed to be adjusted annually for inflation. “We will be advocating for additional funding for nursing facilities throughout the remainder of the budget process,” he warns.

Jim Nyberg, Director LeadingAge RI, an organization representing not-for-profit providers of aging services, joins with RIHCA in calling on Rhode Island lawmakers to restore the full inflation adjustment. “Ongoing increases in minimum wage (up 42 percent since 2012) make it harder for publicly funded providers to compete for skilled workers,” says Nyberg, noting that most of his nonprofit nursing homes have 60 percent to 70 percent of their residents on Medicaid. “A rate increase is needed help nursing homes recruit and retain the direct care workers that are so critical to providing quality care,” he says.

“Since 2016, our nursing homes and consumers have been severely disrupted by UHIP, financially and operationally. The ongoing problems with Medicaid application approvals and payments has resulted in significant increases in staff workload just to maintain operations, let alone the impact on cash flow and financial stability, adds Nybrg.

Nyberg’s group is also advocating to expand the CoPay program for individuals under the age of 65 with dementia. “This has been proposed in the past but not included in this budget. We think that such an expansion will help this at-risk population for whom no publicly-funded programs and services currently exist,” he says.

Lawmakers, AARP Rhode Island Gives Comments

AARP Rhode Island is encouraged to see that the Governor placed an increase in the State Budget for the Department of Elderly Affairs home healthcare Co-Pay program,” said AARP Rhode Island Advocacy Director John DiTomasso. “By increasing the income eligibility from 200% of the poverty level to 250%, more older Rhode Islanders will be able to obtain home care services at reduced hourly rates,” he added. “This will help large numbers of people to extend the time they can age in place in their home and in their community rather than in more costly state-paid long-term care facilities,” says DiTomasso.

Senate President Dominick J. Ruggerio says, “Upon a first look at the budget, I am very pleased that some of the Senate’s top priorities are incorporated. The Governor had to close a significant deficit, and difficult choices had to be made. However, the budget is a statement of priorities, and initiatives like the no-fare bus pass program for low-income seniors and disabled Rhode Islanders are a priority for us in the Senate. I am very pleased to see this program funded in the budget, along with many other services for seniors, and I look forward to deeper analysis of all aspects of the budget in the months ahead.”

AddsD House Speaker Nicholas Mattiello, “The House Finance Committee will soon begin holding public hearings and reviewing every aspect of the Governor’s budget proposal. We will make certain that the level of care and services to older adults will be maintained and hopefully enhanced. We are facing significant budget challenges this year, but we will always keep the needs of our seniors at the forefront of the discussions.”

Older Rhode Islanders and aging groups must continue to push the House to at a minimal maintain the governor’s senior agenda. Hopefully, as Mattiello said, senior programs and services can be enhanced.

For a Senate Fiscal Analysis of Raimondo’s FY 2020 budget, go to http://www.rilegislature.gov/sfiscal/Budget%20Analyses/FY2020%20SFO%20Governor’s%20Budget%20-%20First%20Look.pdf.

Government Shutdown Hurts Seniors, Too

Published in Pawtucket Times on January 21, 2019

At press time, the federal government has been partially shut down for over 29 days because of Democrats and Republicans being at odds over President Trump’s ask for $5.7 billion to be included in continuing spending resolutions for the Oct. 1 start of the new federal fiscal year. Trump calls for billions of dollars to build a border wall along the 234 miles of the nation’s southern border.

The partial shutdown began on Dec. 22 because Congress had not passed legislation, signed by the President, to fund nine federal departments, so these departments do not have funding to operate. The department’s include Agriculture (USDA), Commerce, Justice, Homeland Security, Housing and Urban Development (HUD), Interior, State, Transportation and Treasury.

During the partial government shutdown, Trump has so refused to retreat from his request for funding to build a wall. With strong Democratic opposition the political standoff has made this partial shutdown the longest one of its kind in the nation’s history. There have been 21 shutdowns since 1976.

Local media has widely reported that this shutdown has left 800,000 federal workers furloughed without pay, as well as those working in several federal agencies. But half of these employees are still working, being recalled but without being pay. But Trump has signed legislation this week to pay these employees retroactively once a funding bill is enacted.

What About Aging Programs and Services?

According to AARP’s Senior Writer Dena Bunis in a Jan. 18th web article, “Essential Services Stay in Place Despite Massive Federal Employee Furloughs,” the government shutdown does not impact major domestic programs, like Medicare, Medicaid and Social Security but other programs and services for seniors are affected.
Medicare, Medicaid and Social Security will continue operating and not be disrupted by the shutdown because these programs are funded by an advance appropriations and Social Security [ an earned benefit] is separately funded, says Bunis.

Bunis adds, even with the shutdown aging veterans will still have access to VA hospitals, medical centers and clinics because the Department of Veterans Affairs is funded.

Retirees will find many of the nation’s 400 national parks open but having limited services. Park rangers are furloughed and volunteers are stepping up to help where needed, says Bunis, noting that with employees not reporting for work, bathrooms and other facilities remain unattended with trash piling up and vandalism reports are increasing.

Although flights are not affected and air traffic controllers remain working, Transportation Security Administration’s airport security screeners are calling in sick in large numbers, increasing waiting times, notes Bunis. She says that Federal Aviation Administration has brought back thousands of safety inspectors and engineers to keep the planes in the air flying safely.

Seniors receiving SNAP (formerly called food stamps) from the USDA can expect getting their February benefits, says Bunis, but Meals on Wheels and the Commodity Supplemental Food Program food-box deliveries will be available through March.

Bunis notes that the U.S. Food and Drug Administration has brought back nearly 150 furloughed employees without pay “to resume safety inspections on certain drugs, medical devices and high-risk foods, such as cheese, fruits and vegetables, and infant formula.”

The current government shutdown has closed the Equal Employment Opportunity Commission (EEOC). Those workers age 40 and over who file age discrimination claims may experience difficulties in applying and getting these claims processed, says Bunis.

USDA loans for low- and moderate-income Americans who live in rural areas have stopped because of the shutdown, says Bunis. “The Federal Housing Administration is not issuing the needed paperwork for reverse mortgages to get approved. More than 1,000 contracts between HUD and landlords who provide rental assistance to low-income tenants have expired, and hundreds more will expire in February,” she notes.

Meanwhile, USDA has recalled 2,500 Farm Service Agency employees to temporarily assist agricultural producers with existing farm loan payments to ensure they get the tax documents necessary to file their returns, says Bunis.

It’s tax season…Bunis says that although the Internal Revenue Service is affected by the shutdown because it is part of the Treasury Department, over 46,000 furloughed employees have been called back to work to process income-tax returns and refunds. Filing season officially begins on Jan. 28.

Casey Calls on Trump to Reopen Government

Last week, U.S. Senator Bob Casey (D-PA), Ranking Member of the U.S. Senate Special Committee on Aging, urged Trump to end the partial shutdown charging that the federal government’s closing jeopardizes the transportation, housing, and nutrition needs of older Americans and people with disabilities.

“I am particularly concerned about the adverse impact of the shutdown on seniors, people with disabilities and their families,” stated in Jan 15 correspondence to the President. Food assistance programs administered through the UDSA, rental assistance payments from HUD, transportation services through the Department of Transportation (DOT), and frauds and scams investigations and enforcement by the Federal Trade Commission (FTC) and Federal Communications Commission (FCC) are all negatively impacted during the shutdown, said Casey.

“Elected and appointed officials in Washington have a sacred responsibility of ensuring seniors can age with dignity and people with disabilities can live independently. I request you direct the USDA, HUD, DOT, FTC and FCC to provide additional information to Congress on the steps they will take to mitigate the harmful impact this shutdown will have on seniors and people with disabilities. And, I urge you to reopen the government so that the health and financial security of our aging loved ones are no longer put in jeopardy,” Casey adds.

For a copy of Casey’s correspondence, go to http://www.aging.senate.gov/press-releases/casey-to-trump-the-shutdown-hurts-seniors_.