Tag Archives for Medicare

A Sacred Trust – moves to strengthen Social Security

Published on November 8, 2021 in RINewsToday

Almost two weeks ago, House Ways and Means Social Security Subcommittee Chairperson John B. Larson (D-Conn.) threw H.R. 5723, the Social Security 2100: A Sacred Trust, into the legislative hopper. During its unveiling in the historic committee room of the House Ways and Means Social Security subcommittee, the same room where Social Security and Medicare legislation was crafted in the 1930s and 1960, the Connecticut Congressman’s proposal comes on the heels of the Social Security Administration’s 2021 estimate that the trust funds that support the program will be depleted in just 13 years, averting an estimated 20 percent cut in benefits by 2034.

The Sacred Trust Act is the successor to Larson’s original Social Security 2100 Act, which he first introduced in 2014.The House Ways and Means Committee is planning to hold a hearing on the bill in Nov. followed by a markup.

At press time, 194 House Democratic Members are cosponsoring the 100-page House Democratic proposal with no Republican lawmakers crossing the aisle. Almost 40 advocacy groups are endorsing the House Democratic proposal.

At the Oct. 26 news conference unveiling Larson’s legislative proposal, the Connecticut congressman noted that Congress expanded Social Security during the past 50 years and it has been 38 years since lawmakers have taken any comprehensive action to strengthen the program.“ With 10,000 Baby Boomers a day becoming eligible, and with millennials needing Social Security more than any generation, the time for Congress to act is now,” he said.

Taking a Close look at H.R. 5723

According to the legislative fact sheet released at the news conference, H.R. 5723 gives a benefit bump for current and new Social Security beneficiaries. It provides an increase for all beneficiaries (receiving retirement, disability or dependent benefits) equivalent to an average of 2% of benefits to make up for inadequate Cost-of-Living Adjustments (COLA) since 1983.

Larson’s Social Security proposal also protects Social Security beneficiaries against inflation. It improves the annual COLA formula by adopting a Consumer Price Index for the Elderly (CPI-E), to better reflect the costs incurred by seniors who spend a greater portion of their income on health care and other necessities. Although the 2022 COLA 5.9%, the largest in years, the average for the past 10 years is roughly 1.5% and in 3 of the past 12 years, beneficiaries received no COLA at all.

It protects low-income works that provides a new minimum benefit stet at 25% above the poverty line and would be tied to wage levels to ensure that minimum benefits doe not fall behind. Currently, 5 million seniors live in poverty.

The Sacred Trust Act also contains other provisions that seniors and their advocates have sought for years, including:

  • Improving Social Security benefits for widows and widowers in two income households so they are  not penalized for having two incomes.
  • Ending five-month waiting period to receive disability benefits so those with ALS or other severe disabilities no longer have to wait.
  • Providing caregiver credits for Social Security wages to ensure that caregivers are not penalized in retirement for taking timeout of the workforce to care for children and other dependents.
  • Extending Social Security benefits for students to age 26 and for part-time students.
  • Increasing access to Social Security dependents for children who live with grandparents or other relatives.
  • Requiring Social Security Administration (SSA) to mail annual statements to all workers detailing the FICA contributions they make and projects of their benefits in the future. 
  • Preventing unwarranted closures of SSA offices to improve customer serve
  • Improving access to legal representation for people seeking long-term disability benefits.

H.R. 5723 would pay for strengthening the Social Security Trust Fund by having millionaires and billionaires pay the same rate as everyone else.Currently, payroll taxes are not collected on an individual wages over $142,800.The legislative proposal would apply payroll taxes to wages above $400,00.This provision would only impact the top 0.04% of wage earners.

Larson’s proposal would also extend the solvency of Social Security by making a significant contribution to the programs solvency, making up more than half of the shortfall in the Social Security Trust Funds.

Finally, H.R. 5723 would combine the Old-Age and Survivors Insurance with Disability Insurance into one Social Security Trust Fund, to ensure all benefits will be paid.

It’s Now Time to Fix Social Security 

Larson’s Social Security proposal would “take historic steps to expand Social Security — delivering for retirees, people with disabilities, and their families the first real boost in benefits in 50 years.  The Sacred Trust Act also would bring new revenue into Social Security amid projections that the trust fund will run dry in 2034 if Congress doesn’t take action,” says Max Richtman, President and CEO of the Washington, DC-based National Committee to Preserve Social Security and Medicare.

“To those who claim that no one in Washington has the courage to address Social Security’s challenges, or that the only solution is to cut benefits for future generations, Congressman Larson’s bill is a stunning refutation,” states Richtman, noting that he understands that beneficiaries need an increase in monthly checks to meet skyrocketing living expenses. “He knows that the fairest way to strengthen Social Security’s finances is for the wealthy to begin paying their fair share of payroll contributions.  For years, seniors and their advocates have demanded these improvements,” adds Richtman.   

“There is good news for everyone in this bill, which is only fitting, since Social Security touches almost every American’s life.  Beneficiaries have waited long enough for these vital improvements.  Congressman Larson now has nearly 200 cosponsorsin the House.  After seven long years, seniors and their advocates can finally see the finish line, says Richtman.  

With the Democrats controlling the White House, seniors have a good chance of seeing the expansion and strengthening of Social Security.  The proposal has many of President Biden’s promises made during his campaign.  But, like Larson’s previous Social Security Bill, the latest version has no Republican cosigners.

Over the years, poll after poll has shown that the American public strongly supports Social Security, across party and demographic lines.  Larson’s legislative proposal has the support in the House, but will it pass in the upper chamber with Senate Democrats holding a slim majority?  Will voter support influence Republican lawmakers to work across the aisle with Democrats to hammer out an acceptable bipartisan  proposal, as the 2022 mid-term elections get closer?  We’ll just have to wait and see.

Fixing rising pharmaceutical drug costs once and for all

Published in RI News Today on September 27, 2021

Just days ago, WBUR.org, Boston’s NPR News Station, featuring NPR News and Programs, aired a 45.37 minute program, “Steps to Fix America’s Broken Prescription Drug System,”  clearly illustrating the need to fix America’s ailing prescription drug program.  While Americans are traveling to Mexico in search of affordable prescription drugs, referred to as “Pharmaceutical Tourism,” the NPR program added a new twist. Now some state insurance companies are sending their beneficiaries to Mexico to purchase cheaper their pharmaceuticals manufactured in the United States at a lower price, on their tab.  

For instance, let’s take a look at Ann Lovell, of  Salt Lake City, Utah. The NPR Program, aired on Sept. 24, 2021, introduced us to the hearing-impaired former teacher who worked at an early-intervention program for deaf students that’s part of the Utah Schools for the Deaf and Blind, who traveled from Utah to Mexico five times to purchase Enbrel, to treat rheumatoid arthritis, with travel costs and a $500 cash incentive paid by her insurer, the Public Employees Health Program (PEHP). 

Lovell’s Utah physician writes her a prescription, and each tie she travels to Mexico she sees a physician at the Tijuana-based hospital as well.  She updates the physician on her medical condition, gets her prescription, and takes it to the pharmacist, who gives her the medication. 

NPR’s program noted that the Utah initiative was created under a 2018 state law, “Right to Buy,” by Republican Congressman Norm Thurston.  PEHP offers it only for people who use a drug on a list of about a dozen medications were the state can see significant savings.  Of the 150,000 state and local public employees covered by the insurer, fewer than 400 are eligible to participate.

Responding to a tweet promoting the offer, Levell quickly enrolled for as they say an offer she could not refuse.  She and a companion would travel on an all-expenses paid trip from Utah to Tijuana, Mexico to pick buy her pharmaceuticals at a steep discount paid for by the state of Utah’s public insurer to slash the high cost of prescription drugs. PEHP would only have to pay half of the cost of Embrel versus if Levell got it in the United States, saving tens of thousands of dollars. The annual U.S. list price for the drug, Enbrel, is over $62,000 per patient. 

It was one long, exhausting travel day.  At 5:00 a.m., Lovell and her friend flew from Salt Lake City to San Diego.  There, an escort picked them up and took them across the boarder to a Tijuana hospital, where she got a refill on her prescription.  After that, they were shuttled back to the airport and arrived back home by midnight. 

Lovell said she initially began paying $50 a month for her pharmaceutical, increasing to $450 in co-pays.  It would have increased up to $2,500 if she hadn’t started traveling to Mexico.  Without the program, she would not be able to afford the medicine she needed

With the COVID-19 pandemic closing the borders, PEHP’s “Pharmaceutical Tourism” initiative came to an end with the borders closing.   Lovell’s insurer came up with a new option of getting Enbrel at lower cost.  That’s when Lovell was told about the drug manufacturer’s coo-pay program where she would only have to pay five dollars a month.  

Calls for Medicare Negotiating the Cost of Pharmaceuticals 

Although traveling to Mexico or Canada to purchase more affordable pharmaceuticals is a temporary fix, the Washington, DC-based AARP calls for a permanent solution.  The national AARP advocacy group has launched a $4 million ad buy calling Medicare to step in to lowering the spiraling costs of pharmaceuticals.  

The Washington, DC-AARP noted that a recent AARP survey of voters found that 80% agreed or strongly agreed that drug prices could be lowered without harming innovation of new medicines. Strong majorities of voters, regardless of political affiliation, want Congress to act on the issue this year, with 70% saying it is very important. The survey also found that 87% of voters support allowing Medicare to negotiate prescription drug prices. 

AARP’s full-scale ad campaign blitz, including a $4 million ad buy, pushing back on false claims from the pharmaceutical industry that reforms would limit Americans’ access to medicines. AARP has called for fair drug prices for years and is urging Congress to pass legislation that would allow Medicare to negotiate drug prices, put a cap on out-of-pocket costs that older adults pay for their prescription drugs and impose penalties on drug companies that raise prices faster than the rate of inflation.

AARP’s new national ad campaign points out that Americans’ tax dollars subsidize new drug development even as Big Pharma charges Americans dramatically higher drug prices. The ad goes on to urge Congress to “stop the Big Pharma scam. Let Medicare negotiate drug prices.” Beginning tomorrow, it will air nationally on MSNBC and CNN; and in the DC metro area on the Sunday political shows and local radio stations, as well as on digital platforms including the New York Times, Washington Post, CNN, and Politico. In addition to paid advertising, AARP members began taking part in grassroots action beginning September 20. A social media campaign calling for older adults to #ShowYourReceipts has led thousands to share their monthly medication costs with AARP, with their monthly “bills” now running over $11 million.

“Americans are fed up with paying the highest prices in the world for prescription drugs,” said Nancy LeaMond, AARP Executive Vice President and Chief Advocacy & Engagement Officer in a Sept. 17, 2021 statement announcing this advertising campaign. “Our 38 million members are watching and they are counting on their members of Congress to do what’s right and vote to let Medicare negotiate for lower drug prices.”

Now, Congress Must Act…

Congress is currently debating measures to rein in the cost of prescription drugs, and the House Ways & Means Committee advanced legislation this week that includes many of AARP’s priorities on fair drug prices.

Nursing facilities gear up for October vaccination deadline

Published in RI News Today on September 20, 2021

Over a month ago, the U.S. Centers for Disease Control and Prevention (Centers for Disease Control and Prevention) issued a Health Alert Network (HAN) Health Advisory to public health practitioners and clinicians about the urgent need to increase COVID-19 vaccination coverage across the United States to prevent surges in new infections that could increase COVID-19 related morbidity and mortality, overwhelm health care capacity, and widen existing COVID-19-related health disparities.

According to the July 27 Health Advisory, there is growing medical evidence that the Delta variant is at least twice as contagious as the original SARS-CoV-2 virus. It is reported that most cases of COVID-19 hospitalizations and death are in unvaccinated people; however, there are breakthrough infections in vaccinated people because of the surge of infections among the unvaccinated. This is a particular concern in nursing homes, where vaccinated residents are infected by unvaccinated staff.

The Biden Administration announced plans in August to require COVID-19 vaccinations for nursing home staff as a condition for those facilities to continue receiving federal Medicare and Medicaid funding. Rhode Island Governor Daniel J. McKee, along with other states’ leadership, took similar steps to protect nursing home residents by requiring all healthcare staff to be vaccinated and the new federal mandate will ensure consistent and equitable standards throughout the country. At a COVID-19 update held at the state capitol in early August, McKee called for the new vaccine mandate (as a term of employment) to take effect.

COVID Cases Rise in Rhode Island Nursing  Homes

Coronavirus continues to increase in nursing homes, warns AARP Rhode Island in a statement issued on September 17. According to the latest data from AARP’s Nursing Home COVID-19 Dashboard, in the four weeks ending August 22, resident cases increasing from 0.05 to 0.34 per 100 residents and staff cases increasing from 0.11 to 0.88 per 100 residents since the mid-July report.

Nationally, cases are concentrated among the unvaccinated, and those residents were three times as likely to contract COVID-19 last month compared to residents who are fully vaccinated.

The last eight months have shown vaccines to be the most effective tool in preventing COVID-19 related deaths, says AARP Rhode Island’s statement. There were modest increases in vaccination rates during this four-week period, with 92% of Rhode Island Nursing Home residents and 76% of staff fully vaccinated as of August 22.

“This month’s dashboard underscores why all staff and residents in long-term care facilities must be vaccinated as quickly as possible,” said AARP Rhode Island State Director, Catherine Taylor. “For unvaccinated nursing home residents, their risk of an infection is back up to the levels we saw a year ago. Too many people in Rhode Island who lived and worked in nursing facilities have died from COVID-19, and no one wants to see that tragedy repeated,” said Taylor.

The AARP Nursing Home COVID-19 Dashboard also found over a 300% increase in RI nursing homes reporting an urgent need for PPE in the period ending August 22, with almost 10% of facilities in Rhode Island reporting they did not have sufficient PPE.

Nursing Facilities Struggling to Maintain Adequate Staffing

While the Rhode Island Health Care Association supports Governor McKee’s decision to mandate COVID-19 vaccinations across the health care continuum, says John E. Gage, President and CEO of the Rhode Island Health Care Association, representing 64 of the 77 nursing facilities in the Ocean State, nursing homes are struggling to maintain their staffing levels to meet the state’s direct care requirements, but many are struggling to maintain that level, he says, noting that next month’s deadline requiring nursing facility staff will further strain the already “precarious staffing crisis in the state’s nursing facilities”.

Gage noted that the state’s Department of Health has surveyed facilities this week regarding the number of staff that will be unable to enter facilities in two weeks because they are unvaccinated. “It is reported that nursing facilities will lose 7% of their workforce – 706 staff of 10,137 in the workforce across all disciplines,” says Gage, noting that 495 out of the 706 are clinical staff members.

According to Gage, “Rhode Island nursing facilities are ranked the fourth best state for resident vaccinations and fifth best state for staff vaccination rates in the country. He notes, when taking a look at the Centers for Medicare and Medicaid Services data released last week, in Rhode Island 92.65% of residents are fully vaccinated compared to 84.1% nationwide. As to staff, 78.99% of Rhode Island’s nursing facility staff are fully vaccinated compared to 63.7% nationwide.

Gage says, “The vaccine mandate will further add to the challenge of staff retention and recruitment. We are facing the implementation of a minimum staffing mandate to take effect 1/1/22. There’s not adequate staff available to hire, and the legislature did not provide for adequate funding to achieve the upcoming mandate”. 

Finally, Gage notes that while visitation is currently open at Rhode Island nursing facilities there are many factors that make it difficult to stop the spread of COVID-19 from staff to residents. “Our staff are members of each and every community in Rhode Island  They interact with others outside of work who may or may not be vaccinated, and many have children under the age of 12 who are not eligible for vaccination. To further complicate matters, there are breakthrough cases among those who are fully vaccinated, especially now with the prevalence of the Delta variant,” says Gage.

“Rhode Island facilities will continue to take all steps necessary to mitigate the risks of COVID-19 infections,” says Gage, noting that vaccinations are the key to eradicating this pandemic, together with the proper use of personal protective equipment.  

The AARP Nursing Home COVID-19 Dashboard analyzes federally reported data in four-week periods going back to June 1, 2020. Using this data, the AARP Public Policy Institute, in collaboration with the Scripps Gerontology Center at Miami University in Ohio, created the dashboard to provide snapshots of the virus’ infiltration into nursing homes and impact on nursing home residents and staff, with the goal of identifying specific areas of concern at the national and state levels in a timely manner.

The full Nursing Home COVID-19 Dashboard is available  www.AARP.org/nursinghomedashboard, and an AARP story about this month’s data is available here. For more information on how COVID is impacting nursing homes and AARP’s advocacy on this issue, visit www.aarp.org/nursinghomes.