Tag Archives for Medicare

Trump’s Big Bill, Big Promises – But a Bust for Seniors

Pubished in Blackstone Valley Call & Times on July 8, 2025

After 48 relentless days of political maneuvering—marked by cajoling, backroom bargaining, strategic threats, and last-minute incentives to win over stubborn holdouts—President Donald Trump finally got his wish: Congress passed his prized “One Big Beautiful Bill” (H.R. 1), which he triumphantly signed into law on July 4, 2025.

On May 22, 2025, the House narrowly approved the sweeping 900-page bill by a vote of 215–214–1. Every House Democrat opposed the measure. Two Republicans, Reps. Thomas Massie (R-KY) and Warren Davidson (R-OH), joined the opposition, while Freedom Caucus Chair Andy Harris (R-MD) voted “present.” Two GOP lawmakers did not vote.

What’s In the Bill: Tax Breaks Up, Safety Nets Down

The legislation extends the 2017 individual tax cuts and adds new deductions for tips, overtime pay, auto loan interest, and “Trump Accounts” for children. It raises the SALT deduction cap to $40,000 for five years, increases the child tax credit, imposes a remittance levy, and taxes college endowment income.

On the spending side, H.R. 1 raises the debt ceiling by $5 trillion, slashes over $1 trillion from Medicaid and Medicare, expands work requirements for  Supplemental Nutrition Assistance Program (SNAP) recipients, and allocates $150 billion each to defense and border enforcement—boosting ICE funding to over $100 billion by 2029.

Senate Republicans spent more than five weeks reviewing the House bill’s provisions to comply with the Byrd Rule, walking a tightrope between deficit hawks and moderates. After a marathon “vote-a-rama” that saw 46 amendment votes (only six of which passed), the Senate approved the bill 51–50 on July 1, with Vice President J.D. Vance casting the tie-breaking vote.

The reconciliation process allowed the Senate to pass the bill with a simple majority rather than the standard 60-vote threshold. When the bill returned to the House Speaker Mike Johnson and President Trump personally lobbied holdouts, linking support to other legislative priorities and negotiating procedural rules. Early on July 3, the House adopted the Senate version in a 218–214 vote, with only Reps. Brian Fitzpatrick (R-PA) and Thomas Massie (R-KY) voting with Democrats. The bill was sent to the White House and signed into law the following day.

Despite Republican praise, public reaction to Trump’s “One Big Beautiful Bill” has been largely negative. A KFF Health Tracking Poll found that 64% of Americans view H.R. 1 unfavorably, compared to 35% in support.

President Trump and GOP leaders hailed the bill as a historic conservative win that fulfills “America First” promises—cutting taxes, slashing regulations, boosting border security, promoting energy independence, and reducing federal spending. “This is a major victory for hardworking families,” said Rhode Island GOP Chair Joe Powers in a statement, praising the bill for delivering middle-class tax relief and real border control.

But Congressman Gabe Amo (D-RI), representing Rhode Island’s 1st Congressional District, sees it differently and warns of the devastating consequences to aging programs and services.

“Trump’s big, ugly bill” shows that Republican lawmakers, following Trump’s marching orders, voted for “the largest theft in American history to further enrich the richest among us,” he says.

“Simply put, because of this horrific legislation, Americans will be poorer, sicker, hungrier, and further away from economic opportunity,” says the Rhode Island Congressman.

Deep Cuts and Dire Warnings from Aging Advocates

SACRI Policy Advisor Maureen Maigret emphasized the need for swift action in Rhode Island, stating, “It is crucial for the Secretary of the Executive Office of Health and Human Services to promptly convene the advisory group outlined in Section 8 of the state’s FY 2026 budget bill.”

“For years, SACRI has worked to ensure a balanced system of long-term services—supporting quality nursing home care, expanding access to affordable home and community-based services, and collaborating with the Office of Healthy Aging and other aging advocacy groups to promote healthy aging,” says Maigret.

SACRI, a statewide coalition advocating for older Rhode Islanders, has partnered with other organizations to make significant strides in these areas, according to Executive Director Carol Anne Costa. “We cannot allow this progress to be reversed, especially as older adults are the fastest-growing segment of the state’s population,” Costa says.

“We have sent a letter to Secretary Charest requesting that SACRI be included in the advisory group established by Article 8 of the state’s FY 2026 budget bill.”

Now accounting for nearly 20 percent of the total population, the number of Americans age 65 and older is steadily increasing.

“Make no mistake: this harmful, cold-hearted bill will wreak havoc on our country’s fragile aging services infrastructure—at a time when demand for the Medicare and Medicaid-supported services it delivers is growing,” warns Katie Smith Sloan, president and CEO of LeadingAge.

“This legislation deals a significant blow to a core element of our country’s social safety net: Medicaid,” adds Sloan, emphasizing that the consequences “will not be pretty.”

She further warns, “Due to the level of deficit this bill will create, Medicare payments to providers may be reduced by 4% for the next ten years.”

According to Sloan, the bandaids included in H.R. 1—such as freezing (but not reducing) nursing home provider taxes and creating a rural health transformation fund, both touted as protections for older adults and aging services providers—will soon prove ill-equipped to prevent the bill’s damage. As states begin to grapple with budget shortfalls caused by reduced federal Medicaid contributions, the suffering, she says, will begin.

Max Richtman, President & CEO of the National Committee to Preserve Social Security and Medicare, warned that 16 million Americans may lose health coverage, and millions more could lose access to food assistance. He stressed the bill’s devastating effects on the 7.2 million seniors dually enrolled in Medicare and Medicaid and the 6.5 million older adults who rely on SNAP benefits.

“These beneficiaries are some of the most vulnerable members of our society — and Republicans have put them at risk in order to pay for another tax cut mainly for the rich,” he says.

AARP: Safety Nets Shredded, Protections Undermined

Although AARP expressed strong opposition to many provisions in the reconciliation bill, the organization did support several key measures. These included increased investment in affordable housing through the Low-Income Housing Tax Credit, raising the additional senior standard deduction to $6,000, and expanding the Section 45S tax credit for paid family and medical leave.

Executive Vice President Nancy LeaMond criticized the bill’s cuts to Medicaid, ACA Marketplace coverage, and food assistance, calling them particularly harmful to older adults, rural residents, and family caregivers. She emphasized that over 17 million Americans aged 50 and older rely on Medicaid to remain in their homes and manage chronic health conditions.

“This is a moment to strengthen—not weaken—the supports that help people stay in their homes, access needed health care, and live with dignity and independence,” said LeaMond, representing nearly 38 million members nationwide.

She stressed that AARP remained strongly opposed to Senate provisions that would slash Medicaid, Marketplace coverage, and food assistance, making it harder for older adults to get by.

“More than 17 million Americans age 50 and older rely on Medicaid as a critical safety net to stay in their homes, manage chronic conditions, and afford long-term care,” says LeaMond. “By limiting how states fund their Medicaid programs, the new law threatens health care access—particularly for people in rural and underserved areas and through safety-net providers,” she adds.

LeaMond also expressed concern over delayed implementation of nursing home staffing standards, which are estimated to save 13,000 lives annually, and provisions allowing drug companies to continue charging high prices for certain orphan drugs—even while selling the same medicines overseas at far lower costs.

AARP opposes H.R. 1’s new burdens that could cost people their health care or food assistance when they are unable to work due to age discrimination, caregiving responsibilities, or chronic illness. “This will only make it harder for many older adults to access needed health care and to put food on the table,” she says.

She also warns that the new SNAP cost-sharing formula could shift billions in expenses to state budgets, forcing states to restrict eligibility, reduce benefits, or withdraw from the program entirely.

Finally, AARP strongly opposed the bill’s 10-year moratorium on state and local regulation of artificial intelligence (AI), arguing that it undermines consumer protections in employment, housing, and health care—leaving older adults more vulnerable to harm from biased or untested AI systems.

For additional information on H.R. 1’s impact on senior programs and service, visit: aarp.org/advocacy/fight-senate-cuts-medicaid-snap
aarp.org/advocacy/support-budget-bill-tax-proposals

With the Latest SSA Trustee Report Released, Congress Must Act Now to Fix Social Security

Published in Blackstone Valley Call & Times on June 24, 2025

Just before Medicare celebrates its 60th anniversary this July and Social Security marks its 90th birthday in August, the Social Security Board of Trustees recently released its annual report on the financial status of the Social Security Trust Funds.

According to this year’s estimate, by 2033, projected revenues will only cover 77% of scheduled benefits—unless Congress takes action to address the program’s looming shortfall. Combining the Old-Age and Survivors Insurance (OASI) and Disability Insurance (DI) trust funds would extend coverage for another year, ensuring 81% of scheduled benefits through 2034, instead of 2035, as previously estimated.

The trustees also reported that Medicare’s Hospital Insurance Trust Fund (Medicare Part A, which covers certain healthcare services) will be able to pay full benefits until 2033, a year earlier than the previous estimate of 2024. At that point, the fund is expected to cover 89% of benefits.

For 2024, the Social Security Administration (SSA) paid $1.47 trillion in benefits to about 68 million beneficiaries, while its administrative costs were just $7.4 billion—representing a very low 0.5% of total expenditures. However, the projected 75-year actuarial deficit is 3.82% of taxable payroll, higher than the 3.50% projected in last year’s report.

Frank Bisignano, Commissioner of Social Security, stressed that ensuring the financial stability of the trust funds remains a top priority for the Trump Administration. “We must work together—Congress, SSA, and others—to eliminate waste, fraud, and abuse to protect and strengthen the trust funds for millions of Americans who rely on it for secure retirement or disability benefits,” he stated.

In responding to the released Trustee’s report, House Ways and Means Social Security Subcommittee Ranking Member John B. Larson (D-CT) criticized the current administration’s approach, calling the Trustees’ Report a wake-up call to enhance Social Security for the first time in more than 50 years. Larson also pushed back against misleading claims from President Trump and Elon Musk about waste and abuse within the system. “Seniors, veterans, and disabled workers rely on these earned benefits, and they’re counting on Congress to do its job,” Larson said. “While Republicans push for privatization, Democrats have a plan to protect and expand Social Security.”

Larson’s Social Security 2100 Act, introduced in the last Congress with 189 cosponsors, aims to strengthen Social Security by expanding benefits and increasing payroll taxes to ensure the program’s long-term solvency.

Media Headlines on Social Security’s “Insolvency” Create Unnecessary Fear

Some media outlets, including The Washington Post, have raised alarms with bold headlines warning that Social Security could become “insolvent by 2033” or even “bankrupt.” In a statement, Bob Weiner, former Chief of Staff to the U.S. House Committee on Aging, rejects these claims, noting that the SSA currently holds a $2.7 trillion surplus. According to Weiner, the Trustees’ warning that the program may cover only 81% of benefits by 2034 is being misinterpreted as insolvency or bankruptcy. “That’s neither bankruptcy nor insolvency. Congress can fix this, perhaps by raising the income cap on Social Security taxes,” Weiner explains.

Weiner points out that, in 2026, the income cap for paying Social Security taxes is set to be $181,800. He also emphasizes that Social Security has faced repeated budget cuts to fund tax breaks for the wealthy. “We must protect Social Security as a priority,” Weiner says. “As Speaker Emerita Pelosi often reminds us, ‘First, do no harm.’”

Aging Groups Give Their Thoughts About Fixing Social Security

In statements, Social Security advocacy groups have also weighed in on and give   comments on the latest Social Security and Medicare Trustee reports.  

Nancy Altman, President of Social Security Works, argues that the program is fully affordable and costs only about 6% of the GDP at the end of the 21st century. She believes Congress will act to avert the projected shortfall, as it always has in the past. The key question to ask, Altman says, is whether lawmakers will choose to bring in more money through higher taxes or reduce benefits.

Altman strongly opposes cutting benefits, charges that politicians who don’t support increasing Social Security revenue are, by default, advocating for cuts. She highlights the impact of income inequality, which has cost Social Security over $1.4 trillion since 1983. “If the wealthy paid their fair share into the program, we could easily protect and expand Social Security’s modest benefits,” she notes.

While Americans are divided on many issues, Altman points out that there is broad consensus in support of Social Security. “The real crisis facing Social Security is not a future shortfall, but the ongoing sabotage it’s experiencing now,” she says. Altman specifically references the role of Elon Musk’s DOGE, which has pushed out thousands of Social Security staff members, including nearly half of its senior executives, resulting in an irreplaceable loss of institutional knowledge.

Despite these challenges, Altman notes that Social Security is run efficiently, with administrative costs well under a penny for every dollar spent. A major increase or decrease in administrative spending would have minimal impact on the program’s finances.

Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare, says this year’s comments on the Trustees’ report, mirrors those he made last year – It’s time to rebuild reserves in the Social Security Trust Fund. However, he warns against harmful proposals such as raising the retirement age or means-testing benefits, both of which would cut benefits for millions of Americans.

“Raising the retirement age to 69 or 70 would significantly reduce lifetime benefits. These ideas have been part of Republican proposals to address the projected shortfall,” Richtman explains.

Richard Fiesta, Executive Director of the Alliance for Retired Americans, urges aging advocacy groups not to remain complacent. “Republicans in Congress are eager to cut the benefits Americans have worked a lifetime to earn,” he warns. “We cannot allow Social Security to be privatized or dismantled.”

Fiesta also calls for stronger Medicare reform, urging Congress to curb the high cost of prescription drugs and hold Medicare Advantage insurance corporations accountable for rising costs that don’t benefit patients.

A Final Note…

Social Security is an essential lifeline for millions of Americans, and its future is now at a crossroads. Can a partisan Congress work together to find a political viable fix?

While the media reports Social Security’s impending insolvency and bankruptcy, there is no doubt that Congress must act soon to ensure the program’s long-term sustainability. Whether through increasing revenue or reforming benefits, the decision on how to strengthen Social Security will shape the future of retirement and disability benefits for generations to come. It’s time for Congress to act.

View the 2025 Trustees Report at www.socialsecurity.gov/OACT/TR/2025/.

New Detailed Aging Report Will Help Officials, Policymakers

Published in RINewsToday on May 17,2025


By Herb Weiss

In an era of tightening budgets and shrinking federal and state resources for aging programs, legislators, service providers, and advocates now have access to vital data that can help identify and address the unmet needs of older adults in their communities.

Just over a week ago, the Gerontology Institute at the University of Massachusetts Boston released the latest Healthy Aging Data Reports (HADR), funded by the Point32Health Foundation. These reports offer a comprehensive, neighborhood-level view of aging in America—insights often unavailable from other sources.

Rhode Island’s updated report, released on May 1, 2025, follows previous editions published in 2016 and 2020. This year’s release also includes updates for Connecticut, Massachusetts, and New Hampshire, and introduces a first-time report for Maine. The HADR team is now expanding its reach to additional regions, including parts of the Deep South (such as Mississippi) and the West (including Wyoming).

“This is what’s magical about our report: we provide data at very local levels,” says Dr. Elizabeth Dugan, principal investigator and associate professor of gerontology at UMass Boston. “That empowers local advocates, helps policymakers make smarter investments, and allows philanthropists to assess the impact of their contributions,” she says.

The Rhode Island report features 41 community profiles—covering each city and town, along with two neighborhoods in Providence. Drawing on data from the U.S. Census Bureau, Medicare Summary Beneficiary Files, the CDC’s Behavioral Risk Factor Surveillance System, and state health departments, the report highlights disparities that may be hidden in broader state- or county-level statistics.

“What’s powerful about this approach is that we can observe health outcomes that vary dramatically even within a 10-minute walk in the same city,” adds Dugan.

Spotlight on Rhode Island

Several key findings emerged from the 2025 Rhode Island report:

  • Health: Rhode Island ranks highest in New England for rates of high cholesterol, diabetes, hypertension, ischemic heart disease and peripheral hearth disease, stroke, multiple chronic conditions (four or more), and anxiety disorders.
  • Gender Disparities: Women experience anxiety and depression at rates 15% higher than men and are also more likely to suffer from Alzheimer’s disease, schizophrenia, and PTSD.
  • Housing: Roughly 39% of older renters spend more than 35% of their income on housing. Additionally, 46% of Rhode Islanders aged 65 and older report annual incomes under $50,000.

“The Rhode Island Healthy Aging Data Reports are invaluable,” says Maureen Maigret, Policy Advisor for the Senior Agenda Coalition of Rhode Island and a member of several state aging commissions. “They provide essential data down to the ZIP code level, which is useful for legislative testimony, policy recommendations, program planning, and grant writing.”

With Rhode Island’s older adult population rising from 16.5% in 2020 to 18% in 2025, this data is more critical than ever. “The report shows how age and racial diversity vary widely across communities,” Maigret says, noting that in some smaller towns, older adults now make up over 30% of the population.

Maigret notes that availability of localized data helps municipalities develop comprehensive plans and adopt age-friendly strategies. Interactive maps within the report allow comparisons with state averages, making it easier to target resources where they are most needed.

The report also reveals demographic shifts, including a rise in the Hispanic older adult population—from 4.9% in 2020 to 5.9% in 2025. “There are significant racial and ethnic disparities in health outcomes,” says Maigret. “Black and Hispanic older adults are more likely to be dually eligible for Medicare and Medicaid and to be enrolled in Medicare managed care,” she says.

As lawmakers navigate complex budget negotiations and potential changes to federal programs such as the Administration for Community Living, Medicaid, and the CDC, Maigret stresses the importance of leveraging this data in decision-making.

“Despite the growth in our older population and increasing reports of elder abuse, neglect, and substandard nursing home care, the Office of Healthy Aging’s budget has remained relatively flat,” she warns. “With half of its funding coming from the federal government, proposed cuts could seriously undermine vital programs such as the Long-Term Care Ombudsman,” she adds.

The report also shines a light on mental health, showing high rates of depression and anxiety—especially among older women. Maigret believes this supports increased investment in the 988 mental health crisis line and other behavioral health services.

Another notable trend is the continued shift toward Medicare managed care, now covering more than half of Rhode Islanders aged 65 and older. While rates of arthritis and depression have increased, the report also notes a decline in nursing home stays, inpatient admissions, emergency room visits, and several chronic conditions such as diabetes, COPD, hypertension, and heart disease.

Since the 2020 report, communities have taken meaningful steps to support aging in place. “The Village Common of RI has built age-friendly communities that enable older adults to live independently with the care and resources needed to promote health and well-being,” says Maigret. “There are now 11 local villages across 14 communities, supported by trained volunteers who help members stay connected and independent.”

Data Driving Policy and Innovation

Marie E. Cimini, MSW, Director of the Rhode Island Office of Healthy Aging, says the HADR report has broad implications. “As a state agency, we must lead with policies that prioritize inclusion, access, and dignity throughout the aging journey.”

“The report reinforces our commitment to advancing the goals outlined in the RI 2030 Plan, especially around expanding in-home care, supporting workforce development, and strengthening behavioral health services,” Cimini continues. “But it also challenges us to go further—to integrate aging into every aspect of public life and ensure that the voices of older adults inform policy at every level.”

For Meghan Grady, Executive Director of Meals on Wheels of Rhode Island (MOWRI), one of the most important takeaways is the persistence of health disparities, particularly in managing chronic conditions. Grady supports legislation introduced by Sen. Victoria Gu (D-Dist. 38) and Rep. Justine Caldwell (D-Dist. 30) to integrate medically tailored meals into healthcare delivery. “This report validates our advocacy,” she says. “Food is a fundamental part of care, especially for aging populations facing health disparities.”

The HADR report is also proving instrumental for nonprofit organizations. “We use the data in community presentations, grant proposals, and to guide our work in promoting health equity,” says Debra Burton, Executive Director of RI Elder Info. “With so much uncertainty around policy and funding for programs that impact older adults and caregivers, this data helps us identify where changes will have the greatest impact,” she says.

James Connell, Executive Director of Age-Friendly RI, agrees. “The Healthy Aging Data Report is extraordinarily helpful for nonprofits across sectors. I used it to support funding for a home-share program that pairs older homeowners with individuals facing housing insecurity—a creative approach to our state’s housing crisis,” he says.

“The ’25 Healthy Aging Report provides vital indicators of older adult well-being that are essential for policymaking, intentional planning, and program development,” says Connell. “The data highlight serious concerns about the mental and emotional health of our community, with one in three Rhode Islanders experiencing anxiety and/or depression.” Connell also emphasizes the report’s finding that women are disproportionately affected, calling it “a clear call to action for improved screening and more accessible treatment options.”

Greg Shell, Chair of the Point32Health Foundation Board of Directors, emphasizes the value of data in shaping policy. “When we use data to guide our work, we can change policies and practices, engage communities, and highlight what truly matters,” he says. “These reports are essential tools in making New England a better place to grow up and grow old.”

The research team behind the Healthy Aging Data Reports includes: Principal Investigator Elizabeth Dugan, PhD, along with Nina Silverstein, PhD; Qian Song, PhD; Taylor Jansen, PhD; Jay Lee, PhD; Yan-Jhu Su, PhD; Han Lin, PhD; Shan Qu, MS; Tiffany Tang, BS; Jeannine Johnson, PhD; Amanda Cox, MS; and Mengshi Liu.

To access the 2025 Rhode Island Healthy Aging Data Report, visit https://healthyagingdatareports.org/ri/rhode-island-healthy-aging-data-report.