Tag Archives for Medicaid

The legislative wish list of Rhode Island’s groups on aging

Published in RINewsToday on April 15, 2024

The Rhode Island General Assembly’s 2024 session kicked off on Jan. 2, 2024, scheduled to adjourn on June 30, 2024.  According to LegiScan, over the last three months 2,164 bills have been thrown into the legislative hopper.

“The state budget will likely be voted upon by the House Finance Committee in late May or early June.  Then a week later it is considered by the full House of Representatives, followed by votes by the Senate Finance Committee and the full Senate, and the final step would be consideration by the Governor. That process is usually completed  by mid-June to late June because the new fiscal year begins on July 1.” says Larry Berman, who has served as House Communication Director for 22 legislative sessions.“

According to Berman, the Senate and House both focus on their priorities within their own chambers first, and once those bills pass, then discussions take place between the leadership teams of both chambers to finalize bills for passage in both chambers before sending them to the Governor.  That time period will be May, and well into June. 

Legislative Wish List

Aging advocates are pushing for their legislative agenda’s to be included in the House budget.  They also are carefully monitoring the status of bills that have been introduced, specifically those that will have an impact on programs and services delivered to older Rhode Islanders.

Maureen Maigret, Policy Advisor, of Senior Agenda Coalition of RI (SACRI) puts the passage of H 7333 and S 2399 on ita priority legislative list to assist financially struggling seniors and persons with disabilities on Medicare. “As many older adults are struggling financially, SACRI is prioritizing H7333 (by Rep. Karen Alzate) and S2399 (by Senator Sandra Cano) to expand the Medicare Savings Program eligibility up to $28,000. These bills would put more money in the pockets of lower-income persons not on Medicaid by covering the Medicare Part B premiums that amount to $2,100 a year and also help them with prescription drug costs,” she says.

To provide financial help to our many unpaid caregivers we also support S2375 (by Rep. Linda L. Ujifusa) and H7490 (by Rep. Susan Donovan) to create a state tax credit up to $1,000 for half the costs incurred to care for an older family member needing supports and S2121 (by Sen. Valarie J. Lawson) and H 7171 (by (by Rep. Joshua J Giraldo) to increase the Temporary Caregiver Insurance program from six to 12 weeks.

According to Maigret, there are a number of bills addressing housing issues that SACRI also supports including those to promote ADU development, funding for affordable senior housing and incorporating accessibility features into new housing.

H. 7062, sponsored by Rep. June S. Speakman has passed the House. This bill would boost hosing production by helping Rhode Islanders to develop  ADUs has been identified by as a high priority this year for House Speaker K. Joseph Shekarchi (D-Dist. 13, Warwick).

“In looking at the Governor’s State FY2025 budget we are advocating to add about $660,000 to the Office of Healthy Aging budget to increase funding to local communities to support local senior centers/programs to reach a level of $10 per each person age 65 and older in the city or town,” notes Maigret. SACRI calls for increased funding to implement the recommended increases for social and human services providers beyond the one-third level proposed by the Governor to help address the long wait list for accessing homecare services and provide more livable homecare staff wages. This is critical as the average private cost of home health aide services in RI is $36/hour, she notes.

“ As our industry continues to fight off the existential threats of inadequate funding and staffing shortages, our Association is staying laser focused on our homes receiving sufficient and sustainable financial reimbursements and supporting all initiatives to improve staff availability. Without substantive help from the General Assembly, we will continue to lose more homes and our ability to care for our most fragile RI citizens,” states John E. Gage, MBA, NHA, president and CEO of the Rhode Island Health Care Association. 

At AARP Rhode Island’s 2024 Legislative reception, State Director Catherine Taylor called for passage of H 7127 to provide an optional, voluntary Roth-IRA plan to the 172,000 Rhode Island employees who do not have access to a convenient, low-cost voluntary retirement savings plan through their employer.

The Secure Choice program, endorsed by Gov. Dan McKee and AARP Rhode Island, would be administered by the office of the General Treasurer, would see retirement savings accumulated in individual accounts for the exclusive benefit of the participants or their beneficiaries.  

The legislation has been referred to the House Finance Committee. A similar measure (S 2045) has been introduced in the upper chamber by Sen. Meghan E. Kallman.

According to Taylor, Secure Choice has been enacted in 18 states to date. In Connecticut, the program led to over 25,0000 workers saving over $19 million dollars in the first year of operation. These savings would not have been realized without Secure Choice.

Taylor also noted that Rhode Island is one of only 8 states that tax hard-earned Social Security benefits. “Our state tax on Social Security undermines the purpose of Social Security, which was designed to lift older adults out of poverty – not to fund state government,” she says.

AARP Rhode Island supports the efforts of Sen. Elaine Morgan (S 84) to completely eliminate the state tax on Social Security income and Sen. Walter Felag (S 246) to increase the thresholds to $ 110,000 for single, and $ 140,000 got joint filers, says Taylor.

“We would like to see the passage of S. 2556 [by Senators Lou Dipalma, Bridget Valverde, John Burke, and Pam Lauria] and H. 7493, sponsored by Rep. Scott Slater and Rep. Grace Diaz, that would establish a 20% add-on to the Medicaid per diem rate for nursing homes that have single-occupancy rooms and bathrooms,” says James Nyberg, executive director of LeadingAge RI.

According to Nyberg, there is a growing body of research that shows the benefits of single rooms on residents’ physical ad mental health and well-being, which was clearly exposed by the COVID-19 pandemic.  “There is also the simple fact that it promotes human dignity. Older Rhode Islanders should not have to share a bathroom and shower with strangers during a frail time of life,” he says.

“As for the budget, we want to ensure that the nursing home funding included in the Governor’s budget is maintained, and the Office of the Health Insurance Commissioner recommended rate increases be expedited, if possible, as well,” says Nyberg.

Just a Few More to Watch

Here is a sampling of other bills, of interest to aging advocates, thrown into the legislative hopper this legislative session:

Sen. Linda L. Ujifusa and Rep. Megan Cotter are sponsoring a bill (H 7208, S 2063) to provide relief to some of the state’s most vulnerable households by raising the eligibility limit and the maximum credit for the “circuit breaker” tax credit, which benefits low-income seniors and individuals with disabilities. The bills have been referred to their chamber’s Finance Committee.

The circuit breaker credit program provides an income tax credit to low-income Rhode Island homeowners and renters who are over 65 or disabled, equal to the amount that their property tax exceeds a certain percent of their income. That percent ranges from 3 to 6 percent, based on household income. In the case of renters, a figure representing 20 percent of their annual rent is used in the place of property tax in the calculation.   

The Senate approved S 2082, sponsored by Sen. Melissa A. Murray, to limit insured patients’ co-pays for supplies and equipment used to treat diabetes to $25 for a 30-day supply.

The legislation would apply to private insurers, health maintenance organizations, nonprofit hospital service or medical service corporations and the state employee health insurance plans that cover such supplies. Under the bill, beginning Jan. 1 (or, for state employees, the next time the health plan contract is purchased or renewed by the state), co-pays for insulin administration and glucose monitoring supplies shall be capped at $25 for a 30-day supply, or per item when an item is intended to be used for longer than 30 days.

During this legislative session, S 0089 and H 5417 were introduced by Senator Meghan Kallman and Rep. Evan P. Shanley and take their savings with them when they change jobs. The legislative proposals have been referred to the House Finance and Senate Committees for consideration.

For more details about legislation being considered by the Rhode Island General Assembly, go to https://legiscan.com/RI/legislation/2024.

___

Medicare Savings Program bill will be a win for low income seniors, and Rhode Island

Published in RINewsToday on March 25, 2024

A few weeks ago, advocates for seniors gathered on Smith Hill, attending a Senate Committee on Health & Human Services hearing to push for passage of S. 2399.  The legislation would expand income eligibility for the Medicare Savings Program (MSP), helping many lower income seniors and disabled residents pay their $175/month Medicare Part B premium and covering co-pays and deductibles for those with very low-income.

Thousands of low-income seniors and persons with disabilities on Medicare, but not eligible to participate in the state’s Medicaid program, struggle to pay their Medicare Part B premiums and co-pay costs for services and prescription drugs causing many to forgo needed health care as they cannot afford to pay the co-payments.

S. 2399, introduced by Pawtucket Sen. Sandra Cano (D-Dist. 8, Pawtucket), would expand eligibility for the Medicare Savings Program (MSP) by increasing the income limit to 186% of the federal poverty line and eliminating the strict asset limit.  It also increases from 100% to 138% of the federal poverty line a part of the program that covers deductibles and co-payment.

S. 2399 was heard on March 12, 2024 and held for further study.  At press time, H. 7333, introduced by Pawtucket Rep. Karen Alzate (D-Dist. 60, Pawtucket, Central Falls), has been referred to the House Finance Committee for consideration. No hearing date has been scheduled.

“With health care costs rising at an alarming rate, it is imperative that we make sure that no one goes without the care they need due to unaffordability.  This bill adapts to the significant changes in our society and economy while also ensuring that our most vulnerable senior and disabled residents are able to access the care and medicine that is essential to their daily lives,” said Cano, who champions S. 2399 and in previous legislative sessions introduced legislation to expand the MSP.

“Too many of our low-income seniors and disabled residents are falling through the cracks and foregoing crucial health care services due to rising co-pays and out of pocket costs.  This is unacceptable, but thankfully, we can do something about it.  By passing this legislation, thousands or more Rhode Islanders will be able to receive the care that they desperately need while also keeping more money in their pockets that’s needed for daily living expenses,” said Alzate, who sponsored the House companion measure.

“We understand this is very important legislation. We had a very informative, thorough hearing on this bill, and I look forward to reviewing all the information we collected.” says Senate Health and Human Services Committee Chairman Joshua Miller (D-Dist. 28, Cranston, Providence).

The Policy Problem and its Solution  

Currently, the income limit of $20,331 leaves thousands of older Rhode Islanders and disabled low-income persons on Medicare with significant gaps in coverage and hefty out of pocket costs.

If the MSP income limit is increased to $28,012, as required by the legislation, an estimated 17,000 persons would be newly eligible to have their Medicare Part B covered by being enrolled in MSP. Anyone enrolled in the MSP receives automatic enrollment in Part D “Extra Help,” a federal program which significantly lowers out-of-pocket Medicare prescription costs at no cost to the State. The federal government establishes the minimum income and asset thresholds for the MSP, and states are permitted to increase these limits and many have done so. 

Advocates of Cano’s MSP legislative proposal say it also particularly helps Rhode Island’s older woman and minorities. “Since women and people of color and persons with disabilities are disproportionately represented in low-income populations, increasing access to the MSP promotes equity,” finds an advocacy partnership’s analysis of the legislative proposals. “Poverty rates among older adult Hispanic women are two and one-half times that of older Hispanic men and persons age 18 and over with disabilities are twice as likely to live below 150% of the poverty level, said the analysis.

The advocacy partnership’s analysis also noted that significant numbers of older adults and those with disabilities enrolled in Medicare face financial challenges meeting basic needs. The number of older adults living below or near poverty has increased, housing costs have climbed dramatically, food cost have increased and many more rely on food pantries.

Covering the $175/month Medicare Part B premium for 17,000+ Rhode Islanders (at no cost to the State) and additionally covering co-pays and deductibles for thousands of very low-income adults and persons with disabilities on Medicare will give them much needed financial relief.  And enrollment in the Extra Help program to reduce drug-related costs provides significant additional financial assistance and improves access to critical medication.

Testimony At the Senate Committee Hearing

Nine organizations either testified at this hearing or submitted written testimony to urge passage of S. 2399.  AARP Rhode Island did not testify at the hearing but signed up in support in the committee room.  There was no opposition to Cano’s legislative proposal.

“I first became aware of the need to expand the income eligibility for MSP quite a few years ago when an older man in my neighborhood contacted me to tell me he lost out on the program because he was just a few dollars over the income limit. As a result, the Senior Agenda Coalition of RI (SACRI) has advocated for several years to increase the income cap,” says Maureen Maigret, SACRI’s policy Advisor.

It’s a win-win for both older Rhode Islanders  and for the Rhode Island General Assembly, says Maigret. “S. 2399 would help Medicare beneficiaries to access care along with putting money back in their pockets to pay for food, rent and their basic needs.  By increasing the Medicaid income to $28,012, the federal  government will pay the full cost of the newly eligible Medicare beneficiaries,” she told the lawmakers.  

Strongly supporting S2399, Karen Malcolm, of Protect Our Healthcare Coalition, noted that the legislative proposal is modeled on the MSP changes enacted in New York last year and approved by the Centers for Medicare and Medicaid Services. “Rhode Island should take advantage of the opportunity to expand access to affordable coverage for seniors and people with disabilities and bring new [federal] revenue to our state.”

H. Phillip West, Jr. lobbyist for the Village Common of Rhode Island, states MSP already makes an enormous difference for many beneficiaries. But, “Rhode Island’s low threshold for eligibility and low allowable assets leaves thousands of our needy neighbors out. The good news is that Senator Cano’s legislation address these defects,” he said.

In submitted written testimony, Heather Smith, MD, president of the Rhode Island Medical Society stated “From our perspective as physicians, we witness firsthand the adverse effects of financial barriers on patient health outcomes. Too often, individuals are forced to forgo or ration medications, delay necessary treatments, or skip preventative care due to concerns of affordability. These delays can exacerbate health conditions, lead to complications, and ultimately result in higher healthcare costs down the road.”

Alex Moore, political director of SEIU 1199NE, stressed the many benefits of passing S. 2399, specifically enhancing access to care, providing needed financial  relief, leveraging federal funds, and strengthening the health care workforce. By supporting the legislative proposal, “we demonstrate our commitment to health and well-being of our state’s most vulnerable populations,” he stated in written testimony.

Even with the strong support of the aging community, the state’s Office of Healthy Aging has not yet taken an official position on S. 2399.  “As with any other bills at this stage of the session, we are reviewing the impact of H 7333 and S 2399 on Rhode Islanders. We will continue to follow these bills as they make their way through the legislative process,” says  Director Maria Cimini.

Samuel Salganik, JD, executive director of RIPIN, which offered testimony in support for S.2399, said, “This is one of the best investments available right now for our state government.  At a cost of just over $5 million, the State can draw down more than $40 million in federal support to assist low-income seniors in Rhode Island,” says Salganik. “It’s a great deal for the state. I think that’s a deal that most of us would happily take,” adds Salganik.

Gov. Dan McKee’s recently released FY 2024 Budget does not include funding for to expand the state’s MSP.  Now the ball is in House Speaker Joseph Shekarchi’s (D-Dist. 23, Warwick) court as his chamber collaborates with the Senate to hammer out budget resolution to be approved by the Rhode Island General Assembly to be sent for the Governor’s signature. Hopefully, Shekarchi will see the expansion of the state’s MPM as a win-win for lower-income and disabled persons on Medicare and the state.  As supporters of  S 2399 and H 7333 say, “it’s a no brainer.”

The Advocacy Partners for MSP Expansion was established to push for the passage of S 2399 and H 7333 during this legislative session. They are: the Senior Agenda Coalition of Rhode Island, Rhode Island Organizing Project, RIPIN, the Economic Progress Institute, the Protect Our Healthcare Coalition and the Ocean State Center for Independent Living.

To access the bills under consideration: http://webserver.rilegislature.gov/BillText/BillText24/SenateText24/S2399.pdf – http://webserver.rilegislature.gov/BillText/BillText24/HouseText24/H7333.pdf

Expanding the income eligibility for the Medicare Savings Program (MSP) is one of the legislative priorities of the Senior Agenda Coalition of Rhode Island. These policy issues will be discussed at its upcoming  Legislative Leaders Forum scheduled on Wednesday, March 27, 2024, from 10:00 a.m. to 11:00 a.m., at the Crowne Plaza Hotel, 601 Greenwich Ave,, Warwick, RI. 

The Senior Agenda Coalition of RI’s Annual Legislative Leaders Forum is this week:

Congressman Magaziner takes baton on bringing back House Aging Committee

Published in RINewsToday on March 4, 2024

Over 30 years ago, the US House Democratic leadership’s belt-tightening efforts to save $1.5 million resulted in the termination of the House Permanent Select Committee on Aging. Congressman Seth Magaziner (RI-2) has picked up the baton from former Congressman David Cicilline who sought to bring back the House Aging Committee during the 114th-117th Congresses.

At press time, Magaziner’s H. Res. 1029, introduced Feb. 23, 2024, has been referred to the House Committee on Rules for mark-up, and if passed, will be considered by the full House.

“Older Americans deserve a seat at the table, particularly when it comes to important issues such as protecting Social Security and Medicare,” said Magaziner in a statement announcing his legislative efforts to pass H. Res. 1029. “I am proud to introduce legislation to re-establish a House Permanent Select Committee on Aging, which will advocate for America’s aging population and ensure seniors’ voices are heard when it comes to federal policymaking,” he says.

Every day 12,000 Americans turn 60. By 2030, nearly 75 million people in the U.S. — or 20% of the country — will be age 65 or older. As our country’s aging population grows, the need for support and services provided under programs like Social Security, SSI, Medicare, Medicaid and the Older Americans Act increases.

“Ensuring that seniors can thrive in our communities should always be a priority for the House of Representatives,” said Congressman Gabe Amo (RI-1)  one of 15 original cosponsors of H. Res. 1029, who initially called for bringing back the House Aging Committee during his campaign to win former Cicillini’s vacant seat.

“That is why it is essential that there is a dedicated committee for lawmakers to focus on the issues that impact seniors’ quality of life. From preserving and expanding Social Security and Medicare to reducing the cost of prescription drugs to keeping seniors in safe and stable housing, there are so many issues to address under the leadership of a Special Committee on Aging. Seniors in Rhode Island and across the country deserve nothing less,” says Amo.

The House can readily create an ad hoc (temporary) select committee by approving a simple resolution that contains language establishing the committee—giving a purpose, defining membership, and detailing other aspects, says EveryCRSReport. Salaries and expenses of standing committees, special and select, are authorized through the Legislative Branch Appropriations bill.

Putting a spotlight on aging issues

H. Res. 1029 simply amends the Rules of the House to establishes a Permanent House Select Committee on Aging, noting that this panel shall not have legislative jurisdiction, but it’s authorized to conduct a continuing comprehensive study and review of the aging issues, such as income maintenance, poverty, housing, health (including medical research), welfare, employment, education, recreation, and long-term care.

The 213-word resolution would have authorized the House Aging Committee to study the use of all practicable means and methods of encouraging the development of public and private programs and policies which will assist seniors in taking a full part in national life and which will encourage the utilization of the knowledge, skills, special aptitudes, and abilities of seniors to contribute to a better quality of life for all Americans.

Finally, the House Resolution would also allow the House Aging Committee to develop policies that would encourage the coordination of both governmental and private programs designed to deal with problems of aging and to review any recommendations made by the President or by the White House Conference on aging in relation to programs or policies affecting seniors.’

Aging organizations, advocates call for passage of H. Res. 1029

According to Max Richtman, President and CEO of the Washington D.C.-based National Committee to Preserve Social Security and Medicare (NCPSSM), jurisdiction over many programs affecting seniors is shared by multiple standing committees, which can make it difficult for them to fully explore solutions that do not fit squarely into a single committee’s expertise. Such issues include a variety of intergenerational concerns that merit attention, such as the growing demands on family caregivers and our intractable retirement security crisis. “An inter-disciplinary approach to these issues can best be advanced by a Select Committee with broad jurisdiction,” he says. 

“Re-establishing a Select Committee on Aging in the House would also complement the strong bipartisan work of its counterpart in the Senate,” says Richtman. “In recent years, the Senate Special Committee on Aging has effectively promoted member understanding on a range of issues,” he says, noting that these issues include concerns of grandparents raising grandchildren, elder abuse and fraud, the effects of the COVID-19 pandemic on older Americans and their families, the importance of financial literacy in planning for retirement, and the costs associated with isolation and loneliness. 

“Historically, the House Select Committee on Aging served as a unique venue that allowed open, bipartisan debate from various ideological and philosophical perspectives to promote consensus that, in turn, helped facilitate the critical work of the standing committees. We believe that issues affecting seniors would be best advanced by the re-establishment of such a Committee in the House,” adds Richtman. 

NCPSSM will endorse H. Res. 1029 and plans to promote it to House lawmakers. If the Democrats take control of the House next November, the organization will approach the Democratic House Speaker when he is crafting rules to operate and request that the rules include reestablishing the HSCoA. 

Nancy Altman, President of the Washington, DC-based Social Security Works, strongly supports Magaziner’ efforts to bring back the HSCoA. “Social Security is a critical issue for older Americans. “There’s so much misinformation out there about Social Security, and as a result many people aren’t confident they’ll get the benefits they’ve earned. More accurate information coming from Congress would help,” she says.

According to Altman, the Social Security Subcommittee of the House Ways and Means Committee does incredibly important work, but Ways and Means has such a broad jurisdiction that Social Security and other aging related issues don’t always get the attention they deserve. “A House Aging Committee could shine an important spotlight, informing the public, the media, and fellow members,” she notes.

Altman offers suggestions to the Rhode Island Congressman to increase the chances for passage of H. Res. 1029. “If he doesn’t already have Republican co-sponsors, he should try to get some since they’re more likely to convince Speaker Mike Johnson to create the committee,” she says. 

In addition to working for passage of H. Res. 1029, this Congress, Altman recommends that Magaziner start working now to line up Democrats to push for the reestablishing the House Select Committee on Aging at the beginning of the next Congress, where there is likely to be Democratic control. 

Robert S. Weiner, now President, Robert Weiner Associates News, was House Aging Committee Chief of Staff under Chairman Claude Pepper, from 1976 to 1980, when the Florida lawmaker headed the HSCoA, as a force to be reckoned with in his advocacy of America’s seniors.

“I saw first-hand the power of that committee when we met with Presideent Jimmy Carter and he endorsed the HSCoA’s efforts to abolish mandatory retirement,” says Weiner, noting that the bill passed 359-2 in the House and 89-10 in the Senate, and signed into law by the President.

According to Weiner, the Carter Center recently invited him to pen an article this fall, for their “last print edition of the “Carter-Mondale Newsletter,” entitled “Carter, Pepper Strike Blow Against Age Discrimination.”

“We also held high-powered hearings on nursing home abuses, cancer insurance fraud, the need for expanded home health care (which ultimately became law), elder abuse, and pensions,” adds Weiner. As to Social Security, the Pepper-O’Neill-Reagan deal guaranteed the solvency of Social Security through 2034.

As to legislative strategy, Weiner suggests that Magaziner get 100 plus sponsors – Democrats and Republicans – by bringing a copy of the resolution to the House floor and getting cosponsoring significantly efficiently and quickly by first-hand recruiting action. He might even ask to address the House for a one-minute speech about the importance of passing H. Res. 1029.

“Both parties are nuts if they don’t help seniors by having a dedicated House Select Committee on Aging,” asserts Weiner.

“This is a significant opportunity for the Congress to take a comprehensive view as to how we as a country wish to better support the aging of America.  Older adults suffered the most during the COVID pandemic — more than 90% of the deaths were individuals over 60.  Many older adults are still suffering from loneliness and social isolation.  Such a bipartisan effort led by Congressmen Magaziner and Amo would be historic,” stated Vincent Marzullo, who served 31 years as a career federal civil rights and social justice administrator at the National Service Agency, and a well-known aging advocate.  He serves on Magaziner’s he RI-02 Seniors Advisory Committee.

The clock is ticking. With the upcoming presidential elections taking place in about 246 days, Magaziner must quickly work to get House Republicans cosponsors to get House Speaker Mike Johnson to allow a vote in the House Rules Committee. Without support of his caucus, he is likely to say no.

Magaziner must convince Congressmen Brian Fitzpatrick (R-PA) and Josh Gottheimer (D-NJ), co-chairs of the “Problem Solvers Caucus,” consisting of essentially an equal number of 63 Republican and Democratic lawmakers, to push for passage of H. Res. 1029.  This may be the only way to pass a resolution to reestablish HSCoA in a Republican-controlled House.