Jenkins: Working Senior’s Priming the Nation’s Economic Engine

Published in the Woonsocket Call on December 22, 2019

In recent years, Senate Majority Leader Mich McConnell of Kentucky, Sen. Marco Rubio of Florida and even former House Speaker Paul Ryan of Wisconsin, have warned that the growing number of seniors is fast becoming an economic drag to the nation’s economic growth, citing the spiraling costs of Social Security and Medicare. As the 2020 presidential election looms, GOP candidates are calling for reining in the skyrocketing federal budget deficit by slashing these popular domestic programs.

In 2015, President Donald Trump declared that he would not touch Social Security and Medicare. But now some GOP insiders are saying he may cut these programs during his second term, if he wins.

But after you read the newly released AARP report, The Longevity Economy Outlook, you may just want to consider these comments about seniors being a drain on the economy as false and misleading claims, just “fake news.”

AARP’s Longevity Economy Outlook report pulls from national data detailing how much people age 50 and older spend, earn working and pay in taxes.

Just days ago, AARP CEO Jo Ann Jenkins penned a blog article on the Washington, DC-based aging group’s website highlighting the findings of this major report. AARP’s top senior executive strongly disputes the myth that people age 50 and over are an economic drain on society. Rather the report’s findings indicate that older workers, who are getting a monthly Social Security check and receiving Medicare benefits, are priming the nation’s economic engine, she says.

“As the number of people over 50 grows, this cohort group is transforming America’s economic markets and sparking fresh ideas, and the demand for new products and services across our economy,” says Jenkins.

Jenkins notes that when older workers delay their retirement they continue to impact the economy by earning a paycheck, purchasing goods and services, and generating tax revenues for local, state and federal government.

“The economic activity of people 50-plus supports 88.6 million jobs in the U.S. generates $5.7 trillion in wages and salaries, and accounts for $2.1 trillion in combined taxes,” says Jenkins.

AARP’s economic impact study, released on Dec. 19, reports that people age 50 and older contribute a whopping $8.3 trillion to the U.S. economy, putting this age group just behind the U.S. (20.5 trillion) and China (13.4 trillion) when measured by gross domestic product. They also create an additional $745 billion in value through being unpaid family caregivers (see my commentary in the November 17/18 issues of the Woonsocket Call and Pawtucket Times).

Jenkins says, AARP ’s major report also projects the economic impact of older works to continue in the coming decades, tripling to more than $28 trillion by 2050 as younger generations (millennials and Generation Z) turn age 50 in 2031 and 2047, respectively.

With the graying of the nation’s population (predicted to be 157 million by 2050), the AARP report predicts that older persons will have more collective spending power, too, says Jenkins. “Fifty-six cents of every dollar spent in the United States in 2018 came from someone 50 or older,” she says, adding that by 2050 this amount is expected to jump to 61 cents of every dollar.

For over six years, AARP has been tracking the economic impact of older adults on the nation’s economy, Jenkins’ penned in her recently published blog article. It’s growing steadily over these years, she says.

“When AARP began researching the economic power of people 50 and older in 2013, we found that they generated $7.1 trillion in economic activity,” says Jenkins, noting that three years later it had grown to 7.5 trillion. “The 2019 report reflects an 11 percent growth in economic impact, a 6 percent growth in jobs created and a 12 percent growth in wages and salaries over the most recent three-year period,” adds Jenkins.

Older Rhode Islanders and the State’s Economy

By virtue of Rhode Island being one of the oldest states per capita in the country we have long been aware of the contribution and buying power older people contribute to the state’s economy,” said AARP Rhode Island State Director Kathleen Connell. “When you add in those 50-64 it becomes a big and powerful percentage of the population,” she says.

Over the years, Connell has observed more engagement with AARP in the younger end of the demographic spectrum because people in their 50s have justifiable concerns about their future. They wonder: “Will they outspend their savings? Will Social Security change in ways that will reduce their benefits? Will out-of-pocket prescription drug expenses sink the savings they hope to put away for retirement?,” she says.

“Waiting for retirement to think about these issues could well be too late,” warns Connell. “This is creating greater interest in government and politics and magnifies the importance of their vote,” she adds.

“At the same time, as older Rhode Islanders remain the workforce longer, they are keep paying taxes – a sizable plus for the state’s economy,” observes Connell. “With their extensive experience, many continue to be movers and shakers, innovators and professionals lending guidance that helps fuel economic growth,” she states.

Connell adds: “Outside the workplace, they are connected in new ways via technology and social media. The great thing is that across the range of 50 and older workers it can be said that more people are sharing the workplace adding to our cultural development and participating in civic engagement more than ever before.”

Wake Up Call to Businesses, Congress

AARP’s report should be a “wake-up call” to businesses and federal and state policymakers to rethink their attitudes, warns Jenkins in the concluding of her blog article. She calls on business leaders to “build strategies for marketing their products and services to older Americans and to embrace a multi-generational workforce.” Jenkins also urges Congress and state law makers to develop policies to support the growing number of uncompensated caregivers.

Herb Weiss, LRI’12, is a Pawtucket writer covering aging, health care and medical issues. To purchase “Taking Charge: Collected Stories on Aging Boldly,” a collection of 79 of his weekly commentaries, go to herbweiss.com.

Democratic House Passes Landmark Legislation to Drive Down Spiraling Prescription Drug Costs

Published in the Woonsocket Call on December 16, 2019

Just days ago, the Democratic House leadership successfully pushed for passage of landmark legislation, the Elijah E. Cummings Lower Drug Costs Now Act (H.R. 3), that would give Medicare the power to negotiate directly with drug companies to bring down pharmaceutical prices and make those savings available to seniors.

House Democrats passed Speaker Nancy Pelosi’s sweeping legislation on Dec. 12 to lower the cost of prescription drugs on a largely party-line vote. The bill, which passed 230 to 192 with unanimous Democratic support and the backing of two Republicans, Reps Brian Fitzpatrick (R-Penn) and Jamie Herrera Beutler (R-Wash), is considered “dead on arrival” in the Senate. The White House has indicated President Trump would veto H.R. 3 it if it came to his desk.

The House Republicans fought to block passage of H.R. 3 by releasing their own legislative proposal, H.R. 19, to lower drug costs. The bill, consisting of bipartisan legislative provisions to lower drug costs that had already been adopted, would have achieved lower drug prices without imposing government price controls that House Republicans believed would decrease research and development spending for new drug cures.

Although House Republican Whip Steve Scalise called on the Democratic leadership to bring H.R. 19, with 135 sponsors and no Democrats, to the House Floor, the GOP proposal did not receive a vote on its own. It was offered by Rep. Greg Walden (R-Ore.) as an amendment to H.R. 3 and failed by a vote of 201 to 223, getting eight Democrat votes.

The Nuts and Bolts

H.R. 3 would put the brakes of spiraling drug cost by giving power to the Secretary of the Department of Health and Human Services to negotiate directly with drug companies to force real price reductions while also ensuring that seniors never lose access to the medicines they need. The legislation also expands access to the lower, negotiated drug prices to persons with private insurance, not just Medicare beneficiaries.

The 320-page House bill also prevents pharmaceutical companies from price gouging patients by capping the maximum price for a negotiated drug at the average price people in countries similar to the U.S. pay. It would create a brand new, $2,000 out-of-pocket limit on prescription drug costs for Medicare beneficiaries and even delivers vision, dental, and hearing benefits to Medicare beneficiaries for the first time.

H.R. 3 also increases the number of low-income seniors eligible for assistance with their drug costs and cost sharing for hospital and doctor visits. By extending guaranteed issue protections to disabled beneficiaries and to individuals who want to switch from Medicare Advantage to traditional Medicare, the legislation improves access to private supplemental coverage that helps fill in Medicare’s gaps for beneficiaries in traditional Medicare.

“The U.S. House of Representatives resoundingly defied Big Pharma today by-passing historic legislation to lower prescription drug prices for America’s seniors and their families. The Lower Drug Costs Now Act (H.R. 3) accomplishes what we and other advocates have long demanded — that Medicare be empowered to negotiate prices with pharmaceutical companies, which the CBO says will save more than $450 billion in drug costs. It also caps Medicare beneficiaries’ out-of-pocket prescription drug costs at $2,000 per year, says Max Richtman, president and CEO of the National Committee to Preserve Social Security and Medicare, in a statement.

The Pros and Cons of H.R. 3

Richtman says that it is time for the Senate Chamber to act. Drug pricing legislation that passed by the Senate Finance Committee has not been brought up for a vote on the Senate floor. “We insist that the Senate follow the House’s lead and act now to lift the burden of crushing prescription drug prices. Seniors who have been rationing pills or foregoing other necessities in order to afford crucial medications have waited long enough,” he says.

In a statement released following House passage of H.R. 3, AARP Executive Vice President and Chief Advocacy and Engagement Officer Nancy LeaMond, called the legislation” a bold step toward lowering prescription drug prices and high out-of-pocket costs for millions of older Americans.”
“High drug prices disproportionately hurt older Americans, particularly Medicare Part D enrollees, who take between four and five prescription medications each month and have an average annual income of just over $26,000 a year. The average annual price of a specialty drug used on a chronic basis is now $79,000. Medications cannot work if they are unaffordable, says LeaMond.

Adds AARP Rhode Island State Director Kathleen Connell, “Drug companies are price-gouging older Americans and taxpayers– who pay the highest drug costs in the world,” noting that “AARP is proud to support H.R. 3, which would allow Medicare to negotiate drug prices and cap out-of-pocket costs for Part D enrollees. The bill also enhances Medicare by improving access and adding needed dental, hearing, and vision coverage.”

Opposing the passage of H.R. 3, the White House says in a statement, “Heavy-handed government intervention may reduce drug prices in the short term, but these savings are not worth the long-term cost of American patients losing access to new lifesaving treatments.” Noting that lowering the price of prescription drugs is major concern for seniors, the White Houses warned that H.R. 3 is the wrong approach to address this issue, “especially when bipartisan legislative alternatives that encourage innovation while lowering prescription drug

During a briefing with reporters over two months ago, President and CEO Stephen Ubl, of the Pharmaceutical Research and Manufacturers of America (PhRMA), warned the passage of H.R.3 would trigger “nuclear winter” for biotech innovation. Fiercely opposing passage, PhRMA has called on the Senate to “stop H.R. 3 in its tracks.”

Putting the Brakes on Rising Drug Costs in Rhode Island

“We all know someone who has been forced to ration the medication they need to live so that they can afford to keep a roof over their family’s heads or put food on the table. In America, in 2019, this should never be the case,” said Congressman David N. Cicilline (D-RI), who voted to pass the measure. “Pharmaceutical companies have abused American patients and taxpayers to increase their profits hand over fist without recourse for too long. The Lower Drug Costs Now Act will put an end to the price gouging by big pharma that sees American patients and taxpayers paying more for their prescription drugs than people in other countries, says the Rhode Island Congressman representing the state’s first congressional district.

In his 2016 campaign, President Donald J. Trump supported the government to negotiate drug prices. Cicilline calls on the president to honor this promise and urges Republican Senate Majority Leader Mitch McConnell to bring a companion measure to the Senate floor for consideration. At press time more than 300 House passed bills are stuck in the Senate (about 275 are bipartisan).

According to Cicilline, the out-of-pocket savings to Rhode Islanders will be substantial. “This year alone, more than 1,000 women in the state will be diagnosed with breast cancer, 550 people will be told they have prostate cancer, and 190 folks will be diagnosed with leukemia. H.R. 3 will lower the average costs of many popular medications for these and other cancer treatments. The cost of Ibrance for treating breast cancer will be reduced by as much as 65 percent. Zytiga, a common prescription for people with prostate cancer, will be reduced by as much as 66 percent. And the cost of Tasigna, which is commonly prescribed to people with leukemia, will go down by as much as 71 percent,” says Cicilline, who serves as the Democratic Policy and Communication Committee Chair.

Earlier this year, the Rhode Island Congressman released information detailing how much more Rhode Islanders with diabetes pay for their insulin than people in other countries. Currently, 8.6 percent of Rhode Islanders, just over 83,000 people, have diabetes. They pay from $1,200 to $20,000 per year for the most commonly used insulin medications. Under the newly passed H.R. 3, the average total cost of NovoLOG Flexpen, a common insulin medicine, would decrease by as much as 76 percent. Under H.R. 3, Rhode Islanders could spend 3.5 times less on insulin, and some of the commonly used insulins could cost as little as $400 per year.

According to Cicilline, seniors in his Congressional District will see Medicare improvements if H.R. 3 becomes law. At this time, Medicare does not provide coverage for: oral exams for 71 percent of beneficiaries, eye exams for 66 percent of beneficiaries, hearing exams for 66 percent of beneficiaries, dental exams for 75 percent of beneficiaries, eye glasses for 75 percent of beneficiaries, and hearing aids for 86 percent beneficiaries.

Under H.R. 3’s Medicare expansion, 93 percent of beneficiaries (98,800 people) stand to gain from adding a dental benefit, 75 percent of beneficiaries stand to gain from adding a vision benefit, and 97 percent (102,700 people) of beneficiaries stand to gain from adding a hearing benefit.

On December 6, Senate Finance Committee Chairman Chuck Grassley (R-Iowa) and Ranking Member Ron Wyden (D-Ore.) released an updated version of their bipartisan Prescription Drug Pricing Reduction Act of 201. Will McConnell, who controls its legislative fate, allow it to be considered on the Senate floor? Can a conference committee iron out the different between a Senate bill and H.R. 3, that can be pass both chambers and be signed by the president?

The legislative clock is ticking. It’s 324 days until the upcoming 2020 presidential election and the voters are demanding Congress to put aside philosophical policy differences and come up with a compromise that will truly put the brakes on rising drug costs. We’ll see.

Herb Weiss, LRI’12, is a Pawtucket writer covering aging, health care and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.

House Committee Moves to Rein in Skyrocketing Prescription Drug Costs

Published in the Woonsocket Call on December 1, 2019

On Nov. 18, House Antitrust Subcommittee Chair David N. Cicilline (D-RI) and Judiciary Committee Chairman Jerrold Nadler (D-RI) introduced The Affordable Prescriptions for Patients Through Promoting Competition Act of 2019 (H.R. 5133) to put the brakes on skyrocketing prescription drug costs. The bill attacked increasing costs by prohibiting pharmaceutical companies from engaging in anticompetitive “product hopping.”

Two days later, the Committee unanimously passed the bipartisan bill to drive down the rising costs of prescription drugs. Now H.R. 5133 goes to the House floor for a vote.

“Big pharmaceutical companies have done everything they can to increase their profits regardless of who it affects. Their CEOs make millions in bonuses ever year while hardworking folks are forced to ration their medicine just so they can put food on the table for their kids,” said Cicilline, in a released statement announcing the introduction of the bill.

Since becoming Chair of the House Antitrust Subcommittee, Cicilline has sought to take on the anticompetitive behavior in the health care and pharmaceutical sectors. “This is wrong, and it needs to stop. This bill, along with the suite of legislation to lower health care costs the House has passed already this year, will put an end to anticompetitive behavior that is driving prices up while pushing the middle class further and further down,” says Cicilline in pushing for the bill’s passage.

“This bill builds on the Committee’s strong record of bipartisan legislation to confront one of the leading drivers of high prescription drug costs—efforts by drug companies to keep generic drugs off the market so that they can preserve their monopoly profits,” adds Chairman Nadler when H.R. 5133 was thrown into the legislative hopper. “The outrageous behavior of product hopping puts profits before patients and thwarts the competition that is essential to lowering prescription drug prices,” he charges. Nadler says that H.R. 5133 would “encourage drug companies to focus on delivering meaningful innovation for sick patients rather than delivering profits to their bottom line.”

Fixing the Problem

According to Cicilline and Nadler, pharmaceutical companies use a wide array of tactics when their patent on a drug is near expiration to switch patients to another version of the drug that they have the exclusive right to sell. Called “product hopping,” this anticompetitive practice extends the manufacturer’s ability to charge monopoly prices by blocking the patient’s ability to switch to a cheaper, generic alternative. Product hopping benefits the manufacturer’s bottom line at the expense of patients who are stuck paying higher prices often for many years at a time, they say.

The two Congressmen say that there is another roadblock to lowering prescription drug costs. Although antitrust agencies have made an effort to curb product hopping, the Federal Trade Commission (FTC) still faces a number of hurdles under existing law when trying to hold companies accountable for this anticompetitive conduct. The Affordable Prescriptions for Patients Through Promoting Competition Act of 2019 strengthens the FTC’s ability to bring and win cases against pharmaceutical companies that engage in all forms of product hopping.

A similar version of H.R. 5133 was considered in the Senate and it would save taxpayers an estimated $500 million according to the nonpartisan Congressional Budget Office.

A week earlier, before H.R. 5133 was passed by the and Judiciary Committee, a new report was released by AARP Public Policy Institute (PPI), giving data to Congress to enact legislation to lowering prescription drug costs. The report findings indicate that brand-name drug prices rose more than twice as fast as inflation in 2018.

According to the AARP PPI report, retail prices for 267 brand-name drugs commonly used by older adults surged by an average of 5.8 percent in 2018, more than twice the general inflation rate of 2.4 percent. The annual average cost of therapy for one brand-name drug ballooned to more than $7,200 in 2018, up from nearly $1,900 in 2006.

“There seems to be no end to these relentless brand-name drug price increases,” said Debra Whitman, Executive Vice President and Chief Public Policy Officer at AARP, in a Nov. 13 statement announcing the release of the report. “To put this into perspective: If gasoline prices had grown at the same rate as these widely-used brand-name drugs over the past 12 years, gas would cost $8.34 per gallon at the pump today. Imagine how outraged Americans would be if they were forced to pay those kinds of prices,” says Whitman.

Brand-name drug price increases have consistently and substantially exceeded the general inflation rate of other consumer goods for over a decade, notes the AARP PPI data.

If brand-name drug retail price changes had been limited to the general inflation rate between 2006 and 2018, the average annual cost of therapy for one brand-name drug would be a whopping $5,000 lower today ($2,178 vs. $7,202). The report’s findings note that the average senior takes 4 to 5 medications each month, and the current cost of therapy translates into an annual cost of more than $32,000, almost 25 percent higher than the median annual income of $26,200 for a Medicare beneficiary.

“While some people will undoubtedly see a slower rate of price increases as a sign of improvement, the reality is that there is absolutely nothing to stop drug companies from reverting back to double-digit percentage price increases every year,” said Leigh Purvis, Director of Health Services Research, AARP Public Policy Institute, and co-author of the report. “Americans will remain at the mercy of drug manufacturers’ pricing behavior until Congress takes major legislative action,” adds Purvis.

With over 340 days before the upcoming 2020 Presidential and Congressional elections, Senate Democrats say that more than 250 House-passed bills are “buried in Senate Majority Leader Mitch McConnell’s (R-Ky) legislative graveyard.” The Senate’s top Republican}, referred to as the “Grim Reaper,” has blocked consideration on these bills (including prescription drug pricing bills) effectively killing them. As the election day gets closer this number is expected to increase.

President Trump and Republican lawmakers are loudly chanting that the Democrats are “getting nothing done in Congress.” This is just fake “political” news. Major reforms that would prop up Social Security, Medicare, and lower Prescription Drug prices get the legislative kibosh in the GOP-controlled Senate. It is now time to put these bills to an up or down vote in the upper chamber. The voters will send a message to Congress next November if they agree with the results. It’s time for McConnell to put down his reaper

For details, of AARP report, go to http://www.aarp.org/rxpricewatch.

Herb Weiss, LRI’12, is a Pawtucket writer covering aging, health care and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.

Seniors Can Expect Small Increase in Their 2020 Social Security COLA

Published in the Woonsocket Call on Oct. 27, 2019

The Social Security Administration (SSA) announces Oct. 10 that Social Security and Supplemental Security Income (SSI) benefits for nearly 69 million Americans will increase 1.6 percent in 2020 (Some recipients receive both Social Security and SSI benefits).

Social Security and SSI recipients will be notified about their new benefit amount by mail in early December. This COLA notice can also be viewed online through their my Social Security account. People may create or access their my Social Security account online at http://www.socialsecurity.gov/myaccount.

According to SSA, the 1.6 percent COLA increase will begin with benefits payable to more than 63 million Social Security beneficiaries in January 2020. Increased payments to more than 8 million SSI beneficiaries will begin December 31, 2019. The Social Security Act ties the annual COLA to the increase in the Consumer Price Index as calculated by the Department of Labor’s Bureau of Labor Statistics.

The maximum amount of earnings subject to the Social Security tax (taxable maximum) will increase from $132,900 to $137,700, says SSA.

The earnings limit for workers who are younger than “full” retirement age (age 66 for people born in 1943 through 1954) will increase to $18,240. SSA will deduct $1 from benefits for each $2 earned over $18,240.

The earnings limit for people turning age 66 in 2020 will increase to $48,600. SSA will deduct $1 from benefits for each $3 earned over $48,600 until the month the worker turns age 66.)

There is no limit on earnings for workers who are “full” retirement age or older for the entire year.

COLA Not Keeping Up with Rising Cost of Living

Over the years, Social Security’s COLA has not provided financial protection against rising costs, charge aging advocacy groups.

Social Security checks in 2019 are as much as 18 percent lower due to the impact of extremely low COLAs over the past 10 years, says an analysis recently released by the Arlington, Virginia-based The Senior Citizens League (TSCL). TSCL’s Social Security policy analyst, Mary Johnson authored this analysis.

Johnson’s analysis noted that from 2000 to 2010, COLAs routinely averaged 3 percent
annually. People who have been receiving Social Security checks since 2019, have only seen a COLA higher than 2,8 percent one time (in 2012), she said, noting that Social Security benefits have lost 33 percent of buying power since 2000.

Johnson’s findings reported that in 2010, 2011, and 2016 there was no COLA payable at all and, in 2017, the COLA was just 0.03 percent. However, in 2018, the COLA was 2 percent, but rising Part B premiums consumed the entire increase for roughly half of all beneficiaries.

Calls for Strengthening the COLA

According to the National Committee to Preserve Social Security and Medicare (NCPSSM), the upcoming COLA change will give a whopping $24 per month increase for the average beneficiary. With Medicare Part B premiums expected to rise around $8 next year, the net cost-of-living adjustment for most seniors will be only $16 per month. The new COLA brings the average monthly retirement benefit up to $1,503 — it’s just a $288 yearly raise for seniors living on fixed incomes.

NCPSSM notes that roughly half of America’s seniors rely on Social Security for at least 50 percent of their income, and 1 in 4 depending on the program for at least 90 percent of their income, the 2020 COLA increase does not go very far in helping these recipients pay their bills. A $16 per month probably won’t cover typical expenses, such as the cost of a single prescription copay, a month’s medical supplies, or transportation to a doctor’s appointment, adds the Washington, DC- advocacy group whose goal is to protect Social Security and Medicare.

“It’s ironic that as billionaires and big corporations continue to profit from the $1.5 trillion in Trump/GOP tax cuts, America’s seniors are to get by with a meager $24 monthly raise,” says Max Richtman in a statement after SSA announced the 2020 COLA increase. NCPSSM’s President and CEO. “The negligible 2020 COLA illustrates why seniors need a more accurate formula for calculating the impact of inflation on their Social Security benefits. For years, we have urged the government to adopt the CPI-E (Consumer Price Index for the Elderly), which reflects the spending priorities of seniors, including health care, as opposed to the current formula based on younger urban wage earners’ expenses,” says Richtman.

If the CPI-E were adopted, beneficiaries would see a 6 percent overall increase in benefits over 20 years compared to the current formula used, which yielded a zero cost-of-living adjustment three times during the past decade — and a mere 0.3 percent in 2017, says Richtman, noting that health care costs have increased about 6 percent in 2019 alone.

“The prices of the most commonly prescribed drugs for seniors on Medicare rose ten times the rate of inflation from 2013-2018. The cost of senior living facilities is growing at 3 percent annually – which adds up quickly over time,” adds Richtman.

Adds Webster Phillips, NCPSSM’s Senior Legislative Representative, “COLAs are out of sync with seniors’ actual expenses. Retirees have been living on very tight cost-of-living adjustments for a number of years now, which forces them to make hard decisions about their monthly budgets.”

In a statement, AARP chief executive officer Jo Ann Jenkins said, “Social Security’s annual COLA amount typically does not keep pace with all the increases in living expenses that most seniors face, including the costs of housing, food, transportation and, especially, health care and prescription drugs. AARP’s recent Rx Price Watch report found that retail drug prices increased by twice the rate of inflation during 2017, and have exceeded the inflation rate for at least 12 consecutive years,” she says.

“AARP will continue our advocacy for bipartisan solutions to help ensure the long-term solvency of the Social Security program, as well as adequate benefits for recipients. We will also continue to fight for lower health care and prescription drug costs, which are eating up a growing share of Social Security benefits,” adds Jenkins.

TSCL’s Mary Johnson says that her group calls on Congress to require a minimum COLA of no less than 3 percent every year, even in years when inflation falls below that amount. “Strengthening the COLA,” she says, “would help slow the drain of retirement savings and help keep older Americans out of poverty.”

For information about Social Security benefits and claiming strategies, those approaching retirement age may visit AARP’s Social Security Resource Center, at https://www.aarp.org/retirement/social-security/.

Report on Falls, Injuries Released

PUblished in Woonsocket Call on October 20, 2019

Last Wednesday morning in Dirksen Senate Office Building 562, the U.S. Special Committee on Aging held a hearing to put a spotlight on the economic consequences on falls and to explore ways to prevent and reduce falls and related injuries. At the one hour and 55-minute hearing, titled “Falls Prevention: National, State, and Local Level Solutions to Better Support Seniors,” its annual report, Falls Prevention: Solutions to Better Support Seniors, was released.

According to the Senate Aging Committee, falls are the leading cause of both fatal and nonfatal injuries among older adults that incur $50 billion annually in total medical costs. That number is expected to double to $100 billion by 2030, and the majority of these costs are borne by Medicare and Medicaid.

“Falls are the leading cause of fatal and non-fatal injuries for older Americans, often leading to a downward spiral with serious consequences. In addition to the physical and emotional trauma of falls, the financial toll is staggering,” said Sen. Susan Collins (R-Maine), who chairs the Senate Aging Committee. “Now is the time, and now is our opportunity, to take action to prevent falls. Our bipartisan report includes key recommendations to take steps to reduce the risk of falls,” the Maine Senator noted in an Oct. 16 statement.

Pushing for Positive Change in Releasing Fall Report

“We must dispel our loved ones of the stigma associated with falling so that they can get the help they need to age in place – where they want to be – in their homes and communities,” said Sen. Robert P. Casey, Jr. (D-Pa.). “I am hopeful that our work over the past year will propel the research community to do more, get more dollars invested into supporting home modifications and encourage more older adults to be active,” said the Special Committee’s Ranking Member.

At the hearing, the Committee unveiled a comprehensive report that provides evidence-based recommendations on ways to reduce the risk of falling. The Committee received input from multiple federal agencies, including the Centers for Disease Control and Prevention, Centers for Medicare and Medicaid Services, and the Food and Drug Administration. In addition, approximately 200 respondents representing falls prevention advocates, hospitals, community organizations, home health agencies, and others shared their expertise on this issue.

The 34-page Aging Committee’s report made recommendations as how to raise awareness about falls-related risks, prevention and recovery at the national, state and local levels. It suggested ways of improving screening and referrals for those at risk of falling so that individuals receive the preventive care necessary to avoid a fall or recover after one. It noted ways of targeting modifiable risk factors, including increasing the availability of resources for home safety evaluations and modifications, so that older adults can remain in their homes and communities. Finally, it called for reducing polypharmacy so that health care providers and patients are aware of any potential side effects that could contribute to a fall.

Increasing Medicare Funding for Bone Density Testing

In an opening statement, Collins noted that falls are often times attributed to uneven sidewalks or icy stairs, medications, medical reasons or muscle strength. But one key cause of falling is osteoporosis, which can be especially dangerous for people who are completely unaware that they suffer from low bone density, she says.

According to Collins, although Medicare covers bone density testing, reimbursement rates have been slashed by 70 percent since 2006, resulting in 2.3 million fewer women being tested. “As a result, it is estimated that more than 40,000 additional hip fractures occur each year, which results in nearly 10,000 additional deaths,” she said, noting legislation, Increasing Access to Osteoporosis Testing Beneficiaries Act that she has introduced with Sen. Ben Cardin,” to reverse these harmful reimbursement cuts.

Casey stated, “I am particularly interested in sharing this report with the relevant agencies and learning how the recommendations will be implemented. Not just put in a report. Implemented,” adds Casey.

Peggy Haynes, MPA, Senior Director, of Portland-based Healthy Aging, MaineHealth that offers A Matter of Balance, an evidence-based falls prevention program, came to the Senate hearing to share details about its impact. “The health care community has a critical role to play in fall prevention – beginning with screening for falls, assessing fall risk factors, reviewing medications and referring to both medical and community-based fall prevention interventions. Our health system is focused on preventing falls in every care setting,” says Haynes.

“The need for a range of community-based options led MaineHealth to be a founding member of the Evidence Based Leadership Collaborative, promoting the increased delivery of multiple evidence-based programs that improve the health and well-being of diverse populations,” adds Haynes.

Haynes noted that older participants attend eight two-hour sessions to help them reduce their fear of falling, assisting them to set realistic goals for increasing their activity and changing their home environment to reduce fall risk factors. A Matter of Balance is offered in 46 states reaching nearly 100,000 seniors.

Virginia Demby, an 84-year-old visually-impaired retired nurse who is an advocate for Community and Older Adults, in Chester, Pennsylvania, came to the Senate hearing to support the importance of fall prevention programs. Despite living with low vision, Demby remains physically active by participating in exercises classes for older adults at the Center for the Blind and Visually Impaired in Chester. She is an advocate for older adults and now helps the local senior center wellness manager recruit more seniors to take falls prevention classes and find new places to offer the classes.

Kathleen A. Cameron, MPH, Senior Director, Center for Healthy Aging, of the Arlington, Virginia-based National Council on Aging, discussed the work of the National Falls Prevention Resource Center, which helps to support evidence-based falls prevention programs across the nation and highlighted policy solutions to reduce falls risk.

Finally, Elizabeth Thompson, chief executive officer, Arlington, Virginia-based National Osteoporosis Foundation, testified that bone loss and osteoporosis are fundamental underlying contributors to the worst consequences of falls among older Americans: broken and fractured bones. Osteoporotic fractures are responsible for more hospitalizations than heart attacks, strokes and breast cancer combined, she noted.

For details of the Senate Aging Committee report, go to http://www.aging.senate.gov/imo/media/doc/SCA_Falls_Report_2019.pdf.

Senators Seek to Identify Subpar Nursing Homes

Published in the Woonsocket Call on July 14, 2019

Last month, U.S. Senators Bob Casey (D-PA) and Pat Toomey (R-PA) succeeded in prodding the Centers for Medicare and Medicaid Services (CMS) to publicly release the April listing of underperforming nursing homes across the nation that require closer regulatory scrutiny but are not receiving any. Before CMS released the listing of candidates to the Special Focus Facility (SFF) program, the federal agency, charged with overseeing the care and quality in nursing homes, had not publicly identified these troubled facilities.

Less than 6 percent (88 facilities) out of more than 15,700 nursing homes nationwide are participants of the SFF program. CMS publicly identifies these facilities to the public. But an additional 2.5 percent (or approximately 400 facilities) qualify as candidates for the program because of having a “persistent record of poor care” but are not selected because of limited resources at CMS, according to a 26-page report, “Families’ and Resident’s Right to Know: Uncovering poor care in America’s Nursing Homes,” released in June 2019 by Pennsylvania’s two U. S. senators.

Nursing homes that are part of the SFF program have 12 to 18 months to correct any deficiencies and have two clean CMS surveys. If a facility fails to meet that target, it is are subject to increased regulatory enforcement, including being dropped from the Medicare and Medicaid programs.

Calls for Transparency

On March 4, 2019, Casey and Toomey wrote to CMS requesting information on its oversight of nursing homes in the SFF program. In that letter, the Senators requested the federal agency to provide the names of the 400 SFF candidates, calling for details about programs operations, scope and overall effectiveness. On May 3, 2019, CMS provided a written response and two weeks later, on May 14, the Senators received the listing of SFF candidates for April 2019. The names of these SFF candidates were not made public until Cassy and Toomey forced the issue by releasing this information in their report on June 5.

In CMS administrator Seema Verna’s May 14 letter to the two senators, Rhode Island-based participants and candidates in the SFF program were identified. They are: Charlesgate Nursing Center (SFF Candidate); Hebert Nursing Home (SFF Candidate); Oak Hill & Rehabilitation Center (SFF); St. Elizabeth Manor East Bay (SFF Candidate); and Tockwotton on the Waterfront (SFF Candidate).

In responding to the senators, Verma said that regardless of whether a nursing home is part of the SFF program, “any facility that performs poorly on surveys and continues to jeopardize residents’ health and safety will be subject to CMS enforcement,” which includes civil money penalties, denial of payment for new admissions or termination from the Medicare and Medicaid programs. Verma also stressed that in addition to her agency’s regulatory oversight, its Nursing Home Compare website has been improved to include “new, more reliable sources for obtaining staffing and resident census data, as well as including more claims-based quality measures.”

“Regardless of participation in the SFF program, any facility that performs poorly on surveys and continues to jeopardize residents’ health and safety will be subject to CMS enforcement remedies, such as civil money penalties, denial of payment f-or new admissions, or termination,” adds Verma.

Casey and Toomey believe that the list of SFF candidates is information that must be publicly available to individuals and families seeking nursing care for their loved ones. For that reason, the Senators have released the April 2019 list of SFF candidates and are continuing to work with CMS to make future lists public.

Through the release of the SFF candidate list and the Senate report, which details preliminary findings from surveys and public information about these candidate facilities, the Senators aim to provide Americans and their families with the transparency and information needed to choose a nursing home that would provide quality care to a loved one.

CMS Inquiry Identifies Issues

Casey and Toomey’s CMS inquiry into the SFF program put the spotlight on several issues. It became apparent to the two senators that a nursing home’s participation in the SFF program was not easily understandable to the public or would-be residents and their families. It became clear that CMS’s Nursing Home Compare, the agency’s online website, was not consistently updated to reflect any changes in the SFF program. “For example, in March 2019, the small icon used to indicate that a facility is an SFF participant was not on the webpage of five of the 17 newly-added SFF participants,” noted the Senate report. Most important, CMS’ website did not identify SFF candidates.

According to the released Senate report, only CMS and the state regulatory agency in which the nursing home is located and the facility itself, had knowledge of who is an SFF candidate. While CMS requires every nursing home to notify residents and its community of its regulatory SFF participant designation, these requirements do not apply to SFF candidates.

Aside from CMS recently updating its Nursing Home Compare webpage to more clearly indicate which nursing homes are SFF participants, it lacks details about the SFF program. There is no information explaining the reason for a facility’s participation in the program, the length of time it has been in the program or whether it has fixed the care issue. Most important, CMS does not include information on facilities that routinely cycle in and out of the SFF program, says the Senate report.

“There are few decisions more serious or life-altering than that of choosing a nursing home. I am pleased that CMS has taken the work that I have done with Senator Toomey seriously and is heeding our call to release the list of nursing facilities that are nominated to the Special Focus Facility program,” said Casey. “Our bipartisan work will ensure that families have all the information at their fingertips when choosing a nursing home. Now we must work in a bipartisan fashion to ensure the SFF program is working properly and that CMS has the funding it needs to improve underperforming nursing homes nationwide,” he says.

Adds, Toomey, “Ensuring that families have all the information they need about a nursing home will improve the quality of care at facilities across the country.”

Trump Spending Priorities Would Fray Social Safety Net Programs

Published in the Woonsocket Call on March 16, 2019

Last Monday, President Donald Trump released his proposed FY 2020 budget request to Congress. Lawmakers, who rejected many of these budgetary spending requests in the president’s previous two submitted budgets proposals, consider his latest to be “dead-on-arrival.”

But, Trump’s $4.7 trillion fiscal blueprint, outlined in the 150-page “Budget for a Better America,” gives us a clear picture of his spending priorities and policies he seeks to implement through executive orders and regulator changes.

Trump’s FY 2020 spending plan proposes funding increases for combating the opioid epidemic, improving veteran’s health care, fixing the nation’s crumbling infrastructure ($200 billion increase), even giving the Pentagon a 5 percent increase in spending exceeding what the military asked for. White House senior advisor Ivanka Trump successfully pushed for the FY 2020 budget to include $750 million to establish a paid parental leave program and a $1 billion one-time fund to provide childcare to under served populations.

Trump’s budget proposal makes a commitment of $291 million to eliminate the spread of HIV within a decade, it slashes the National Institutes of Health’s funding by 12 percent, and the budget for the Centers of Disease Control and Prevention by about 10 percent.

Trump does not back away from his controversial stance of building a wall, putting in an additional $8.6 trillion for the construction of a U.S. Mexico border barrier. Congress had earlier opposed his demand for $5.7 billion for the construction project.

Trump Budget Proposal Puts Senior’s Earned Benefits at Risk

In 2016, Presidential candidate Trump had pledged not to cut Medicare, Medicaid or Social Security, but he does in his submitted FY 2020 budget proposal.

Trump calls for a 5 percent cut in non-defense federal agencies, including a whopping $ 1.5 trillion in Medicaid over 10 years. The budget plan instead allocates $1.2 trillion to create “market-based health care grants,” (a.k.a block grants) for states that would start in 2021. This gives states the power to set their own rules for this program.

Medicaid expansion under the Affordable Care Act (ACA) would be eliminated by Trump’s FY 2020 budget proposal by ending ACA’s protections for people with pre-existing conditions and causing millions of people to join the ranks of the uninsured. About 15 million more Americans have joined Medicaid since the ACA expansion was enacted.

Trump’s budget proposal also cuts Medicare by $845 billion over the next decade by cutting payments to hospitals and physicians, rooting out fraud and abuse, and by lowering prescription drug costs.

Meanwhile, the Social Security Disability Insurance program takes a huge budgetary cut of $25 billion and the Social Security Administration’s (SSA) operating budget is slashed by 1 percent, at a time when the agency is working hard to ratchet up its customer service provide to SSA beneficiaries.

Trump’s budget proposal would cut $220 billion from the Supplemental Nutrition Assistance Program (SNAP), popularly referred to as the food stamp program. The program currently serves 39 million people. Under this budget, beneficiaries would be required to be employed for 20 hours a week to be eligible for assistance and replacing the EBT-debit card used to purchase groceries with the delivery of a “Harvest Box” filled with non-perishable foods like cereal and pasta, canned goods and surplus dairy products.

Housing and Urban Development’s 202 housing program for seniors and people with disabilities takes a $36 million hit, says long-time aging advocate Bill Benson, principal of Washington, D.C.-based Health Benefits ABC, in the March 15th issue of Aging Policy and Public Health News.

According to Benson, several Older Americans Act programs including the Family Caregiver Support program would be cut in Trump’s budget proposal. The Long-Term Care Ombudsman Program would be cut by $1 million. Elder Justice Programs would also be cut under the President’s budget including a $2 million cut to the Elder Justice Initiative at Administration for Community Living.

” Cruelest of all [budgetary cuts] is the proposed out-right elimination of the Social Services Block Grant (SSBG) which is the only source of sustained federal funding to states for Adult Protective Services (APS),” says Benson. Some 37 states use SSBGs to support their APS programs. SSBG is also used by states for a number of other services benefiting older adults including home-delivered meals and case management.

Shortchanging Seniors

Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare (NCPSSM) warns that Trump’s budget proposal shortchanges seniors. “In combination with 2017’s tax cuts for the wealthy and the administration’s failure to allow Medicare to negotiate with Big Pharma, the Trump budget shows that his administration is not plugged into the realities of being elderly in America,” he says.

Richtman says that Trump’s budget plan also proposes to eliminate federal grants that help pay for programs under the Older Americans Act, such as Meals on Wheels and home heating assistance for the elderly poor.”

According to Richtman, the 116th Congress gives seniors hope with introduced legislation that would boost Social Security benefits and expand Medicare coverage to include dental, hearing and vision services, changes that an overwhelming majority of Americans support. He calls on Congress to “quickly reject this callous budget proposal — and take decisive action to enhance the well-being of older Americans.

Robert Greenstein, president of the Center on Budget and Policy Priorities, sees Trump’s newly released budget proposal as very troubling, too. “It sharply cuts funding in the part of the budget that invests in future economic growth through education and training, scientific research, infrastructure, and the like,” he says.

“It reverses progress in making affordable health care available to people who don’t have employer coverage or can’t afford private coverage. It cuts basic assistance substantially for families, children, and elderly and disabled people who are in need and struggle to get by. And, it doubles down on policies that take away health care, food, and housing when adults aren’t able to meet a work requirement,” says Greenstein.
“Despite bemoaning deficits, it calls for making the costly 2017 tax cuts — which largely benefit those who already have high incomes and wealth — permanent,” he adds.

Richtman believes that Trump’s 2020 spending proposal serves as a warning of what the administration would do if it were not for the firewall known as the Democratic-led House of Representatives. “These draconian ideas – though rejected by voters in the 2018 mid-terms – remain in the conservative political bloodstream, requiring continued advocacy on the part of seniors and their champions in Congress,” he says.

The release of Trump’s FY 2020 budget program begins the Democratic party’s efforts to retake the White House and Senate in the 2020 presidential election, just over 598 days away. By making major cuts in Social Security and Medicare and turning Medicaid into a state block grant program, Trump is giving Democratic challengers in the 2020 presidential election fodder to create politically-charged themes for ads to turn senior voters against him for seeking cuts in these popular domestic programs.

Herb Weiss, LRI’12, is a Pawtucket writer covering aging, healthcare, and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.