Tag Archives for Medicare

Government Shutdown Hurts Seniors, Too

Published in Pawtucket Times on January 21, 2019

At press time, the federal government has been partially shut down for over 29 days because of Democrats and Republicans being at odds over President Trump’s ask for $5.7 billion to be included in continuing spending resolutions for the Oct. 1 start of the new federal fiscal year. Trump calls for billions of dollars to build a border wall along the 234 miles of the nation’s southern border.

The partial shutdown began on Dec. 22 because Congress had not passed legislation, signed by the President, to fund nine federal departments, so these departments do not have funding to operate. The department’s include Agriculture (USDA), Commerce, Justice, Homeland Security, Housing and Urban Development (HUD), Interior, State, Transportation and Treasury.

During the partial government shutdown, Trump has so refused to retreat from his request for funding to build a wall. With strong Democratic opposition the political standoff has made this partial shutdown the longest one of its kind in the nation’s history. There have been 21 shutdowns since 1976.

Local media has widely reported that this shutdown has left 800,000 federal workers furloughed without pay, as well as those working in several federal agencies. But half of these employees are still working, being recalled but without being pay. But Trump has signed legislation this week to pay these employees retroactively once a funding bill is enacted.

What About Aging Programs and Services?

According to AARP’s Senior Writer Dena Bunis in a Jan. 18th web article, “Essential Services Stay in Place Despite Massive Federal Employee Furloughs,” the government shutdown does not impact major domestic programs, like Medicare, Medicaid and Social Security but other programs and services for seniors are affected.
Medicare, Medicaid and Social Security will continue operating and not be disrupted by the shutdown because these programs are funded by an advance appropriations and Social Security [ an earned benefit] is separately funded, says Bunis.

Bunis adds, even with the shutdown aging veterans will still have access to VA hospitals, medical centers and clinics because the Department of Veterans Affairs is funded.

Retirees will find many of the nation’s 400 national parks open but having limited services. Park rangers are furloughed and volunteers are stepping up to help where needed, says Bunis, noting that with employees not reporting for work, bathrooms and other facilities remain unattended with trash piling up and vandalism reports are increasing.

Although flights are not affected and air traffic controllers remain working, Transportation Security Administration’s airport security screeners are calling in sick in large numbers, increasing waiting times, notes Bunis. She says that Federal Aviation Administration has brought back thousands of safety inspectors and engineers to keep the planes in the air flying safely.

Seniors receiving SNAP (formerly called food stamps) from the USDA can expect getting their February benefits, says Bunis, but Meals on Wheels and the Commodity Supplemental Food Program food-box deliveries will be available through March.

Bunis notes that the U.S. Food and Drug Administration has brought back nearly 150 furloughed employees without pay “to resume safety inspections on certain drugs, medical devices and high-risk foods, such as cheese, fruits and vegetables, and infant formula.”

The current government shutdown has closed the Equal Employment Opportunity Commission (EEOC). Those workers age 40 and over who file age discrimination claims may experience difficulties in applying and getting these claims processed, says Bunis.

USDA loans for low- and moderate-income Americans who live in rural areas have stopped because of the shutdown, says Bunis. “The Federal Housing Administration is not issuing the needed paperwork for reverse mortgages to get approved. More than 1,000 contracts between HUD and landlords who provide rental assistance to low-income tenants have expired, and hundreds more will expire in February,” she notes.

Meanwhile, USDA has recalled 2,500 Farm Service Agency employees to temporarily assist agricultural producers with existing farm loan payments to ensure they get the tax documents necessary to file their returns, says Bunis.

It’s tax season…Bunis says that although the Internal Revenue Service is affected by the shutdown because it is part of the Treasury Department, over 46,000 furloughed employees have been called back to work to process income-tax returns and refunds. Filing season officially begins on Jan. 28.

Casey Calls on Trump to Reopen Government

Last week, U.S. Senator Bob Casey (D-PA), Ranking Member of the U.S. Senate Special Committee on Aging, urged Trump to end the partial shutdown charging that the federal government’s closing jeopardizes the transportation, housing, and nutrition needs of older Americans and people with disabilities.

“I am particularly concerned about the adverse impact of the shutdown on seniors, people with disabilities and their families,” stated in Jan 15 correspondence to the President. Food assistance programs administered through the UDSA, rental assistance payments from HUD, transportation services through the Department of Transportation (DOT), and frauds and scams investigations and enforcement by the Federal Trade Commission (FTC) and Federal Communications Commission (FCC) are all negatively impacted during the shutdown, said Casey.

“Elected and appointed officials in Washington have a sacred responsibility of ensuring seniors can age with dignity and people with disabilities can live independently. I request you direct the USDA, HUD, DOT, FTC and FCC to provide additional information to Congress on the steps they will take to mitigate the harmful impact this shutdown will have on seniors and people with disabilities. And, I urge you to reopen the government so that the health and financial security of our aging loved ones are no longer put in jeopardy,” Casey adds.

For a copy of Casey’s correspondence, go to http://www.aging.senate.gov/press-releases/casey-to-trump-the-shutdown-hurts-seniors_.

Midterm Elections are Here: Your Vote Sends a Message to Congress

Published in the Woonsocket Call on November 11, 2018

The mid-term elections are here and Americans have an opportunity, if they choose to vote, to send a strong message to Capitol Hill about what policy issues are important to them. All 435 Congressional seats are on the ballot including 35-Senate seats. The outcome of these political races will ultimately impact older Americans. Will Congressional lawmakers work to ensure the solvency of Social Security and Medicare, or protect those with pre-existing conditions? Or will they put political differences aside to craft legislation that will put the brakes to spiraling prescription drug costs.

Last month, AARP released, a 52-page report, “2018 Mid-Term Election Voter Issue Survey,” that found that the majority of those surveyed say the following issues will help them make their voting decisions in days: lowering health care costs (79 percent), strengthening and reforming Social Security (75 percent) and Medicare, (70 percent) and putting the brakes to skyrocketing prescription drug costs (74 percent).

AARP’s survey data were collected by Alan Newman Research (ANR) between July 7 and July 18, 2018. ANR conducted a total of 802 telephone interviews of registered likely voters age 50 and older. All data were weighted by education, race/ethnicity, age, gender, and census division according to Current Population Survey statistics provided by AARP.

What Issues Are Important to Older Voters?

Let’s take a closer look at AARP’s July telephone survey findings…

The top issue for the Democratic survey respondents was health care costs, Social Security, drug costs and Medicare while Republicans identified national security as their issue.

People become eligible for health insurance through Medicare when they turn age 65. Democrats responding to the AARP survey (77 percent) were more likely to support giving those age 50 to 64, the option to buy health insurance through Medicare than the responding Republicans (57 percent).

Vermont Senator Bernie Sanders and other lawmakers have proposed a national health plan in which all Americans would get their insurance from a single
government plan (called Medicare-for-All). The researchers noted that Democratic respondents gave the thumbs up (75 percent) to supporting this legislative policy while only 34 percent of the Republican respondents supported the health care policy.

The AARP survey also found that 66 percent of the respondents supported allowing Medicare to negotiate lower prescription drug costs to increase the solvency of the program.

Last year, Congress passed legislation that required pharmaceutical companies to contribute more to contribute more to close the Medicare Part D coverage gap to reduce the high out-of-pocket cost of drug costs. The pharmaceutical lobby is working to reverse this requirement. The AARP survey found that 78 percent of the age 50 and over respondents support the existing requirement to contribute more to close the Medicare Part D coverage gap.

Federal law prohibits insurance companies from charging those with pre-existing conditions more for health coverage. While some want to repeal this law because they believe the person should pay more, others say that paying a higher premium is unfair. The AARP survey found that 84 percent of the women and Democrats surveyed were more likely to say that the higher costs of health care is unfair for those with preexisting conditions.

Current federal law allows insurance companies to charge up to three times more for health insurance for those over age 50. Some Congressional lawmakers propose increasing this charge up to five times more for health insurance. Eighty three percent of the older survey respondents oppose this, calling any changes unfair.

Over half of the age 50 older survey respondents have caregiving experiences. Two in five of these respondents believe they will become caregivers. The survey found that 75 percent of the respondent’s support employer requirements for family caregiving. The requirements include: ensuring that employees can not be fired for taking time off for caregiving; allowing the use of existing sick leave for caregiving activities; allowing a limited amount of unpaid and paid leave for use by caregivers.

Eighty seven percent of the AARP survey respondents believe Congress should pass laws to protect caregivers from being fired for taking time off to care for a loved one. Most of these respondents (88 percent) also believe that stronger laws are needed to protect older workers from age discrimination.

Currently, there is discussion on Capitol Hill about the need for a rule that requires professional financial advisors, when giving advice to their older clients about their retirement savings accounts, to give advice that is in the best interest of these individuals. The AARP survey found that 69 percent of the survey respondents agree to this rule.

Phone App Informs Older Voters on Aging Issues

The Washington, DC-based AARP today launches “Raise Your Voice,” the nation’s first comprehensive advocacy and voting app for smart speakers (works on Amazon Alexa and Google Home) . The voice-enabled experience is designed to help older voters to use smart speakers to become educated on a wide range of aging issues — including Social Security, Medicare, prescription drugs, Medicaid and caregiving.

“This groundbreaking skill empowers voters at a time when people are looking for trustworthy, accessible sources of information,” said John Hishta, AARP Senior Vice President of Campaigns, in a statement announcing the Oct. 11 release of the phone app.

To invoke the app, the user simply says their smart speaker’s wake command, followed by “Open Raise Your Voice.” With days before the upcoming midterm elections, the user can direct “Raise Your Voice” to look up polling information and send it directly to the user’s cell phone. Similarly, the user can command the app to provide information on AARP issues.

“Traditional voter education is laudable and important work, but it’s a leap forward to develop technology that better supports voters as they seek out the location of their polling place, information on key issues, and the ability to contact their elected officials,” said Sami Hassanyeh, AARP Senior Vice President of Digital Strategy and Membership. “

The app is available at http://www.aarp.org/raiseyourvoice.

Send a Message to Congress

Robert Roach, Jr., President of the Washington, DC-based Alliance for Retired Americans, calls on older voters to “Know your rights before heading to the polls.” Your state’s Secretary of State’s website can provide details about voter identification requirements and other laws. If you are encountering problems with voting or suspect voter rights at your polling site, seek out an elected official to discuss, suggests Roach. Also, call the voting rights hotline at 1-866-OUR-VOTE (687-8683).

“Bring a snack, a book and even a chair if you think there may be a line. Don’t go home until your vote has been counted,” says Roach. “An unfortunate election result could lead to health insurers charging people aged 50-64 five times more than younger consumers for the same coverage. A good result could lead to an expansion of your earned Social Security benefits,” he says.

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

Published in Woonsocket Call on October 28, 2018

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

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

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

Bringing Down Medicare’s Skyrocketing Drug Costs

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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