2020 Census Data Impacts Federal Funding Allocated to Aging Programs and Services

Published in the Woonsocket Call on January 19, 2020

By April 1, every home across the nation will receive an invitation from the U.S. Census Bureau, a nonpartisan government agency, to participate in the 2020 Census. Once this invitation arrives, it’s important for you to immediately answer the short questionnaire by either going on-line, phone, or by mail. When you respond to the census, you’ll tell the Census Bureau where you live as of April 1, 2020.

The U.S. Constitution: Article 1, Section 2, mandates that the country conduct a count of its population once every 10 years. The 2020 Census will mark the 24th time that the country has counted its population since 1790

The population statistics generated by the upcoming 2020 Census will be used to distribute over $700 billion annually in federal funds back to tribal, state and local governments. The collected census data also determines the number of seats each state has in the U.S. House of Representatives, provides insight to governments, business and community planning groups for planning purposes, and finally defines congressional and state legislative districts, school districts and voting precincts

2020 Census Statistics and the Graying of America

According to a blog story published on Dec. 10, 2019, by American Counts (AC) Staff, the upcoming 2020 Census will provide the federal government with the latest count of the baby boom generation, now estimated at about 73 million. The boomer generation born after World War II, from 1946 to 1964, will turn 74 next year. When the 2010 census was taken, the oldest had not even turned 65.

Baby Boomers are also projected to outnumber children under age 18 for the first time in U.S. history by 2034, according to Census Bureau projections. With an increasing need for caregiver and health services and less family caregiver support, the boomers will be forced to depend on federally-funded support services, their allocation depending on policy decisions based on census data.

“Data from the 2020 Census will show the impact of the baby boomers on America’s population age structure,” said Wan He, who has for over 21 years overseen the Aging Research Programs for the Population Division of the U.S. Census Bureau.

AC’s blog article, part of a Census Bureau series detailing the important community benefits that come from responding to the 2020 Census questionnaire, stresses that exact count of American’s age 65 and over is important for tribal, local, state and federal lawmakers to determine how they will spend billions of dollars annually in federal funds on critical aging programs and services for the next 10 years.

While everyone uses roads, hospitals and emergency services some state and federal programs specifically target older Americans – the 2020 Census statistics will be used to distribute funding to senior centers, adult day care facilities, nutrition programs including meals on wheels, and the Supplemental Nutrition Assistance Program, job-training programs, elder abuse programs, Medicare Part B health insurance and Medicaid, the health insurance program for low-income people including those age 65 and older.

“The census is really important to us in the aging community,” said John Haaga, of the National Institute on Aging in Washington, D.C. in the AC’s blog article. “It’s our only way to figure out how things are different across the country, what areas are aging faster, where elderly disabled people live, or where older people are concentrated, like Appalachia or West Virginia, because young people are leaving for the cities,” says Haag, noting that “Older people are remaining behind there.”

Haaga noted, “Other states, such as Florida, have large older populations because people are moving there to retire.”

“You can start to look at specifics like how many older people are living alone who are more than 10 miles from an adult day care centers,” says Haaga. “You can answer questions of access and how to improve it,” he adds, noting that census statistics helps lawmakers or business people decide where to open health clinics or senior citizen centers, among other services.

Calls for Action: Fill Out that Census Questionnaire

AARP has three main goals, according to State Director Kathleen Connell. “First,” she said, “to ensure a fair and accurate census count by educating our​ members and older adults about the census outreach efforts. Second, to provide tips and resources to encourage safe participation while protecting themselves from bad actors and census related fraud during this time. And third, to help people age 50 and over gain employment as census enumerators.”

“AARP has long been involved in informing people about the census, including the fact that the headcount is labor intensive – to the tune of 400,000 temporary staff. In the past, retired adults have made up a good portion of those who work in the decennial count of Americans, often as enumerators who go door-to-door in neighborhoods. In many communities, the Bureau will be looking for bilingual applicants.”

To be sure, Connell adds, the loss of a Congressional seat would have an impact on Medicare funding and other services that support Rhode Island’s age 50 and over population. “If a subset of people doesn’t participate in the census, the area in which they live will be represented as having fewer residents than it actually does; the costs to states and communities could be large, consequential and long-lasting. A census that is as complete and accurate as it can be – and doesn’t undercount the number of residents in a given area – is a vital resource for everyone,” she said.

Connell sits on the RI Complete Count committee and the AARP State Office is using its email list and social media in a series of reminders and encouragement to participate in the census. AARP also is reaching out to members who might consider becoming census workers.

Adds Jennifer Baier, AARP Senior Advisor, Census lead: “Many federally funded programs rely on census data to distribute billions of dollars to states and localities across the country. According to the George Washington Institute of Public Policy, Rhode Island receives about $3.8 billion per year based on Census data. That includes funds for schools, roads and hospitals and also programs that aid older Americans, such as Medical Assistance Program (Medicaid) Medicare Part B, Special Programs for the Aging, Meals on Wheels, Heart Disease Prevention Programs and more.”

“The 2020 Census is just nine questions long, and takes about 10 minutes to fill out – those ten minutes impact millions of dollars of federal funding in every state and communities across the country,” says Baier.

Ahead of Midterms, Trump Unveils His Proposal to Slash Prescription Drug Costs

Published in Woonsocket Call on October 28, 2018

With mid-term elections looming, President Trump moves to block Democrats tying the high cost of prescription drugs to an unresponsive Republican-controlled Congress and to GOP efforts to undo health care protections for people with preexisting medical conditions, one of the most popular provisions of the Affordable Care Act, referred to as Obamacare.

According to recent Roll Call poll, health care is a top issue for Democratic and Independent voters in key battle ground states while the GOP tout’s immigration and the economy and jobs as its priority.

Last Thursday, afternoon, at the Department of Health and Human Services (HHS) with Secretary Alex Aza, FDA Commissioner Scott Gottlieb and CMS Administrator Seem Verman standing by President Trump, he announced major changes as to how Medicare pays for prescription drug to bring down costs by making prescribed medications more affordable to seniors, making pricing of U.S. drugs fairer relative to costs paid by other countries.

Bringing Down Medicare’s Skyrocketing Drug Costs

“We’re taking aim at the global freeloading that forces American consumers to subsidize lower prices in foreign countries through higher prices in our country,” said Trump at the Oct. 25 press conference in his 14-minute speech. He noted that the costs for the same pharmaceutical drug in some countries are 20 percent less than those purchased in the United States even though it was made by the same manufacturing company.

“At long last, the drug companies and foreign countries will be held accountable for how they rigged the system against American consumers,” says Trump.

Trump rattled off specific examples of how Medicare pays higher prices for the same pharmaceutical drugs that are cheaper in other developed countries. For instance, one eye medication that prevents blindness would annually cost about $187 million rather than $1 billion dollars if Medicare paid the same prices other countries pay, he said.

Another example, a highly used and very effective cancer drug is nearly seven times as expensive for Medicare as it is for other countries, said Trump, noting that “this happens because the government pays whatever price the drug companies set without any negotiation whatsoever.”

Under Trump’s unveiled proposal, a new Medicare model, the International Pricing Index (IPI), is created to bring down Medicare drug costs to ensure seniors get a “more fair deal on the discounts drug companies voluntarily give to other countries.”

Currently, Medicare sets payments for physician-administered drugs at the average sales price in the U.S. market—plus a price-based add-on fee. Trump’s proposal would allow Medicare to set the payment of these drugs at a Target Price, based on the discounts drug companies give other countries. With the model fully implemented, it is estimated that total payment for these drugs would drop by 30 percent.

Under the IPI model, described in an Advance Notice of Proposed Rulemaking, Medicare’s payments for select physician-administered drugs would shift to a level more closely aligned with prices in other countries. Overall savings for American taxpayers and patients is projected to total $17.2 billion, with out-of-pocket savings potentially totaling $3.4 billion over five years.

Medicare beneficiaries not covered by the IPI model could also see their drug costs lowered, because the average price used to calculate traditional Medicare reimbursement will drop.

Trump’s drug pricing proposal still needs to be refined and put though a federal rule-making process and its impact may not be seen for years.

Is Trump’s Efforts to Lower Drug Costs Just Election Year Posturing?

“It’s hard to take the Trump administration and Republicans seriously about reducing health care costs for seniors two weeks before the election when they have repeatedly advocated for and implemented policies that strip away protections for people with pre-existing conditions and lead to increased health care costs for millions of Americans,” says U.S. Senate Minority Leader Chuck E. Schumer in a statement.

“Once again, the President’s plan doesn’t go far enough to bring down the costs of prescription drugs. Democrats have proposed letting the HHS Secretary negotiate the prices of all drugs covered under Medicare, as well as new tools to ensure transparency and accountability when companies try to raise their prices. Without these critical steps, the President’s plan is just more words with little substance,” says Rhode Island Congressman David N. Cicilline.

Pharmaceutical Research and Manufacturers of America (PhRMA) president and CEO Stephen J. Ubl, opposes Trump’s proposal to lower Medicare’s drug costs, warning that it would “jeopardize access to medicines for seniors and patients with disabilities living with devastating conditions such as cancer, rheumatoid arthritis and other autoimmune diseases.” Trump’s proposal severely alters the Medicare Part B program by reducing physician reimbursement and inserting middlemen between patients and their physicians,” charges Ubl.

Adds, Frederick Isasi, executive director of Families USA, in his statement: “The data is clear. The way we currently pay providers and pharmaceutical companies for drugs administered in doctors’ offices and hospitals creates perverse financial incentives for providers to select extraordinarily expensive drugs that may not be best for their patients. “

“Medicare Part B is the perfect example of misaligned incentives, and the proposed rule, if implemented, could pilot significant new ways to pay for drugs that align incentives so that patients get the highest value care, they have the best outcomes possible, and costs come down, says Isasi.

Like many, Isasi hopes that Trump’s proposal of using the power of the federal government to reduce Medicare drug costs is “not just election year posturing” but truly reflects a policy shift to using federal negotiating power to get unstainable prescription drug prices under control.

Next year, after the dust settles after the mid-term elections, Congress must work together to hammer out a comprehensive legislative strategy to lower pharmaceutical drug costs and to provide health care to all Americans. Listen to the polls.

New Budget Deal Protects Seniors’ Pocketbooks

Published in Woonsocket Call on November 1, 2015

Just days after a Republican-controlled House passed legislation with a vote of 266-167 to prevent the U.S. government from going into default on its debt obligations on Nov. 3, also averting a potential federal government shutdown next month, on Friday, Oct.30, the Republican-led upper chamber followed suit.  Just after 3:00 a.m., the Senate voted 64-35 to approve a two-year bipartisan budget plan sending the bill to President Obama for his signature.

Before Friday’s Senate vote, on Thursday afternoon GOP Presidential contender Sen. Rand Paul (R-Ky.)’s 20 minute filibuster fizzled, with Senate leadership moving forward for the budget bills consideration.  The measure had strong support for passage.  Retiring House GOP Speaker John Boehner with Congressional leaders from both political parties and President Barack Obama pulled together, putting aside differences, to craft the bill.

.           Before the companion legislation was taken up by the House and Senate, in a statement AARP CEO Jo Ann Jenkins, representing 38 million baby boomers and seniors, called on Congressional leaders and their members to support the bipartisan agreement, one that financially protect older Americans.   Jenkins detailed a number of provisions within the 144 page bill that would “reduce skyrocketing Medicare Part B premiums and alleviate the challenges faced by the Social Security Disability Insurance (SSDI) Trust Fund.”

Rhode Island Lawmakers Give Thumbs Up

U.S. Senator Jack Reed (D-RI), called the bipartisan budget agreement “a credible compromise,” noting that “It is only a two-year patch, but it puts us on a much better path forward.   Reed, who sits on the powerful Appropriations Committee, called on the House and Senate Appropriations committees to “quickly reach consensus and produce a detailed omnibus spending package by the Dec. 11 deadline.”

“This budget deal will provide much-need relief from harmful sequester cuts and give the nation a measure of certainly we have lacked amid the patchwork of stop-gap spending bills in recent years,” added U.S. Senator Sheldon Whitehouse (D-RI).

Whitehouse noted the bipartisan budget deal provides “much-needed relief from harmful sequester cuts and gives the nation a measure of certainty it has “lacked amid the patchwork of stop-gap spending bills passed in recent years.”

With 37,000 Rhode Islander’s relying on the SSDI program it was easy for Representative David Cicilline (D-RI) to support the bipartisan compromise budget plan because it “prevents a 20 percent cut to SSDI benefits and extends the solvency of this critical program an additional seven years, as well as protecting thousands of Rhode Island seniors from an increase in their Medicare premiums.”

“We need to do more to protect Social Security benefits for seniors, ensure cost-of-living adjustments are calculated in a way that accounts for their needs, and lift the cap on payroll taxes so millionaires and billionaires pay their fair share,” said Rhode Island’s Democratic Congressman.

On the side line, aging advocates were also closely watching the action in both chambers, too.  “We are glad that the Budget passed by Congress this week lets people who rely on Medicare breathe a bit easier – knowing their premiums and deducible will not skyrocket next year,” said Judith Stein, founder and executive director of the Center for Medicare Advocacy. “However, we still have concerns about the way in which the Part B cost-sharing resolution is paid for, and concerns about the expenses underlying the original Part B increases.”

“The Center continues to urge law-makers to join Congressman Courtney (CT-2) in asking Secretary Burwell to investigate and fix the underlying reasons for the huge increase in Part B costs,” said Stein. “Much of the increase seems to come from parallel increases in billing inpatient hospital care to Part B – which was never meant to pay for such care – through the use of so-called ‘outpatient’ Observation Status.”

Older Americans Protected by Enacted Budget Plan

The Bipartisan Budget Act of 2015 would raise the nation’s debt ceiling through March 2017, allowing the government to borrow to pay its debt. During these two years it allow Congressional lawmakers to lift budget caps for defense and domestic programs by $80 billion.

The passed budget plan derails a 52 percent Medicare Part B premium increase to 30 percent of beneficiaries, which would have hit millions of seniors in their wallets next year. Similarly, the deductible was projected to increase for these individuals to $223 next year.  But thanks to the budget agreement passed this week, the deductible will instead have a more modest increase from the current amount of $147 to approximately $167.

A general fund loan to the Medicare trust fund lessens the premium and deducible increases. Beneficiaries will repay this loan by a $3 per month premium surcharge over a five-year period.

According to the enacted budget plan, next year, only the 30 percent of the beneficiaries hit by the premium increase would pay this $3 premium surcharge.  In 2017 and beyond, all Medicare beneficiaries not subject to the hold harmless provision in a given year would pay a $3 monthly surcharge theoretically until the general fund loan is repaid..

The federal Centers for Medicare and Medicaid Services is expected to announce final premiums for 2016 by the beginning of November.

Keeping SSDI Afloat

The enacted budget plan also prevents a 20 percent cut in Social Security Disability Insurance (SSDI) benefits that would have occurred in late 2016 impacting 11 million recipients nationwide.  The enacted law now ensures at least 7 years of certainty that SSDI will pay full benefits.  Now, the passed budget measure “reallocates” a small percentage of the Social Security payroll tax to the SSDI program.  This has occurred 11 times.  But, GOP lawmakers have blocked recent efforts to transfer funds as a bargaining chip to force Congress and the Obama Administration to make cuts to Social Security benefits.

The new law would also tightens up the SSDI review process by requiring a physician or psychologist to review applications before a decision is made.  It ensures that application reviews are uniform nationally.  Finally, it requires the Social Security Administration to reject medical evidence presented in a disability application that was provided by “unlicensed” or “unsanctioned” physicians.

It also attacks Social Security fraud and abuse by providing additional funding to contact case reviews ensuring the applicants are entitled to the benefits, improves the fraud-fighting capacity of the SSA’s Office of Inspector General and increases penalties for those physicians, lawyers, translators who perpetuate fraud.

Finally, the bipartisan budget agreement closes loopholes in the current SSA law that allows higher-income recipients to exploit the rules for applying for benefits, with the goal of receiving large pension checks than Congress intended, and which most retirees are able to receive.

The savings made in the Social Security and SSDI programs remain in the Social Security trust funds and can only be used to pay for future benefits.

With Representative Paul D. Ryan now becoming the 62nd speaker of the House, the nation waits to see if the Wisconsin lawmaker has the special political skills to rein in the ultra-conservative wing of his party.  With only 374 days before the upcoming 2016  presidential and congressional elections America’s federal lawmakers must begin to work together to craft laws that will enhance the quality of life of the nation’s retirees.  Compromise is not a dirty word to those residing outside the Washington, DC beltway.  Gridlock is.