Tag Archives for Medicare

Obama’s Budget DOA, Thanks to GOP Gridlock

Published in the Woonsocket Call on February 14, 2016

With a GOP-controlled Congress President Obama’s final budget arrives “dead on arrival” on Capitol Hill.  The 182-page 2017 Fiscal Year budget, submitted on February 9, detailing $4.1 trillion in federal spending, which starts October 1, seems to be not worth the paper it’s written on.

Obama, a “lame duck” president in his last term, will not get his day in court.  Since the 1970s, a long-standing political tradition has brought the Office of Management and Budget Director and other senior administration officials, to present the president’s entire budget to Congress.  However, the Chairs of the House and Senate budget committees snubbed the Democratic President by issuing a joint statement saying, there will be no hearings before their panels this year. Sadly, political gridlock, fostered GOP Senate and House leadership, still seems to be alive and well on Capitol Hill.

Crafting the budget proposal now is in the hands of a very conservative Congress. But there a positives in Obama’s budget proposal, provisions that hopefully be placed in an enacted budget.

Obama’s budget proposal makes critical investments to fund domestic and national security priorities while adhering to the bipartisan budget agreement signed into law last fall.  It lifts sequestration in future years.  The budget proposal also attempts to drive down the federal deficit through smart savings from health care, immigration, and tax the wealthy and banks.

The Budget also seeks to tackle a multitude of domestic issues including confronting climate change, finding new clinical treatments for attacking cancer, advancing biomedical research, fighting infectious diseases, protecting the nation’s water supply and fostering clean energy initiatives, ratcheting up military readiness, revitalizing the American manufacturing sector, and funding job training and education initiatives.

Obama’s Final Budget and Seniors

But Obama’s 2017 Fiscal Year Budget has a number of budget provisions that directly impact older Americans, too.

According to  President and CEO Max Richtman, of the Washington, D.C.-based National Committee to Preserve Social Security and Medicare, like last year’s Obama recently released budget proposal proposes no changes in the way Social Security benefits are determined which is “good news for seniors.”

Richtman says that his aging organization worked tirelessly to make sure the FY 2017 budget did not include any Social Security proposals that would negatively impact benefits for current or future beneficiaries.  He notes, “The new budget proposes a substantial increase in the Social Security Administration’s (SSA) budget — $13.067 billion for SSA’s FY 2017 appropriation for administrative funding.  This is a $905 million, or 7.44 percent, increase over the FY 2016 enacted level.”

Finally, Obama’s newly released budget helps SSA to improve customer service for those applying for SSA and/or disability benefits by hiring additional front-line employees for its teleservice centers and local offices as well as additional staff to reduce the backlog of disability applications that have accumulated in SSA’s hearing offices, he says.

NCPSSM also applauded the President’s budget proposal for allowing Medicare to negotiate for lower prescription drug prices.

Richtman observed it has taken Congress a long time to acknowledge that the high cost of prescription drugs has hit older American’s hard in their wallets.  “Medicare spends billions providing Part D drug coverage each year while beneficiaries including seniors, the disabled and their families also face rising out-of-pocket costs and higher premiums, he says, noting that “All the while, drug makers continue to reap the profits of their price gouging.”

In his budget proposal Obama has again proposed lifting the ban preventing Medicare from negotiating prices with the drug companies, notes Richtman, warning that “Big Pharma has lobbied hard to keep the ban in place but seniors expect, this time, Congress will do the right thing and finally allow Medicare to negotiate for fair prices.”

Richtman says there are other budget provisions that benefit the nation’s seniors.  Specifically, the closing the Part D donut hole two years earlier, additional funding for in-home services, and reforms for overpayments going to private insurers in Medicare Advantage.

Meanwhile, the President’s budget was not all good news, adds Richtman, noting that “Once again, the budget proposes shifting even more healthcare costs to seniors by extending Medicare means-testing to the middle class and increasing out-of-pocket costs such as the home health care copayment and the Part B deductible.”

The President’s new funding request also targets vulnerable older Americans, by increasing funding from the 2016 Fiscal year Budget.  The President has increased last year’s budget by more than $10 million in discretionary resources for supportive services, also increasing the Congregate and Home-Delivered Nutrition Programs (like Meals on Wheels) by $14 million.  The Aging and Disability Resource Centers is also given a $2 million increase.

Other programs benefit from Obama’s budget proposal, too.  Elder Justice Initiative and Lifespan Respite Care Programs each would receive $2 increases from last year.  The Commodity Supplemental Food Program would get $14 million more.   The budget proposal also puts $10 million in for a new initiative to improve senior access to the Supplement Nutrition Assistance Program.  Section 202 Housing for the Elderly also gives a bump from last year in the tune of $72 million.

But the budget request slashes funding for programs that serve low-income seniors, specifically the Low-Income Home Energy Assistance Programs and the Community Development Block Grant takes huge fiscal hits.

Views from the Side Line 

             Obama’s budget proposal preserves programs for seniors, funding Social Security and Medicare, says Darrell M. West, Ph.D., Vice President and Director of Governance Studies at the Brookings Institution, “Not many Republicans are taking this budget very seriously as they plan to write their own budget. The GOP alternative likely is going to include changes to programs affecting senior citizens, he warns.

Rhode Island’s Congressional delegation weighs in on the looming heated partisan budget debate where law makers will be toeing the part line.

Congressman David Cicilline, notes that he is disappointed that the House Budget Committee will not ‎holding hearings on President Obama’s budget proposal. “We should be discussing ways to strengthen Social Security, preserve Medicare, and ensure retirement security for every American. Unfortunately, it’s clear that House Republicans don’t want to have this discussion,” he says.

U.S. Senator Sheldon Whitehouse weighed in on the brewing pre-election budget battle.  “I’m pleased to see that the President’s budget protects Social Security and Medicare from the cuts sought by many Republicans.  As the President has proposed, we should reduce the deficit by closing wasteful tax loopholes, not by compromising the programs essential to our seniors, and not after saving Rhode Island seniors $14.4 million in prescription costs thanks to the Affordable Care Act.”

Finally, U.S. Senator Jack Reed notes that the President’s budget proposal reflects a number of his ongoing efforts to support Rhode Island seniors.  “This budget blueprint proposes significant investments in the health and well-being of aging Americans, and I will work hard to champion these proposals as we work through the appropriations process this year, he says.

“I am particularly glad the President heeded my call to propose meaningful steps towards lowering the cost of prescription drugs, which is critical for middle class families,” adds the Senator.

Now the work begins as Congress starts to craft it’s 2017 Fiscal Year Budget.  Democratic Congressional lawmakers can glean and fight for provisions in Obama’s eighth and final budget that positively benefit older Americans. With Senator Reed, sitting on the Senate Appropriations Committee, the Rhode Island’s Senior Senator and the state’s Congressional Delegation will play a major role in shaping the nation’s future aging programs and services.

 

Kleyman Gives Post Mortem Report on 2015 WHCoA

Published in Woonsocket Call on January 17, 2016

In 1958, Rhode Island Congressman John E. Fogarty, a former bricklayer, introduced legislation calling for a White House Conference on Aging (WHCoA) to “promote the dignity, health and economic security of older Americans.” President Dwight D. Eisenhower signed the enacted legislation and the first conference was held in 1961, with subsequent conferences in 1971, 1981, 1995, 2005 and 2015.

Looking back, the 1961 WHCoA played a major role in the creation of Medicare and Medicaid, even the Older Americans Act. Ten years later, the conference’s recommendation’s for automatic cost-of-living adjustments for Social Security ultimately became law in 1975. The founding of the Senate Aging Committee came from recommendations at the 1971 WHCoA.

A Year Marked with Anniversaries

The one-day 2015 WHCoA (usually three days) was actually held at 1600 Pennsylvania Avenue, but with a much smaller assembly than in previous years at Washington hotels, such as in 1995, which had 2,221 delegates and 2005, where about 1,100 selected delegates gathered. But his time, new technologies allowed others to tune in. The White House could only accommodate a few hundred dignitaries.

Over 700 watch parties were held in every state and thousands of people tuned in on Monday, July 13, 2015, to watch the day-long proceedings by live webcast. Over 9,000 people participated, too, through social media on Twitter and Facebook.

But, Paul Kleyman, editor of the Generations Beat Online (GBONews.org), a E-Newsletter for age beat journalist, noted in the Jan. 17, 2016 issue, that this year’s aging conference had no delegate selection process like previous ones. “As we’ve noted previously, though, more than one expert expressed disappointment that the Obama Administration made little effort to muster bipartisan support among GOP congressional members who might well have wanted some representation on the issue going into the 2016 election season. Historically, governors and members of Congress got to pick local constituents in fields from retirement finance to health services with a prestigious delegate appointment to the conference,” says the seasoned journalist who served as a delegate at the 1995 WHCoA.

A Call for an Expansion of Social Security

The WHCoA’s scheduled date in 2015 fell in the year where advocates in aging celebrated the 50th anniversary of Medicare, Medicaid and the Older Americans Act as well as the 80th anniversary of Social Security. Kleyman notes that the newly released 34 page WHCoA report (with 49 pages of appendices) says, “The 2015 White House Conference on Aging (WHCOA) provided an opportunity to recognize the importance of these key programs as well as to look ahead to the next decade.”

President Obama was sent a letter with 74 Congressional cosigners reminding him that over half of today’s older workers are not expected to be able to have sufficient resources upon their retirement to maintain their current standard of living. Although they called for an expansion of Social Security, Kleyman says discussion was “barely audible” at the aging conference.

In addressing the WHCoA attendees, Obama called for “keeping Social Security strong, protecting its future solvency,” pledging to fight “privatization of the program. Kleyman observed that proposed new rules to help workers increase their retirement “stopped short of supporting stronger benefits that they need.”

It’s a Mixed Bag

But, Kleyman says that aging advocates consider the WHCoA’s recommendations a mixed bag. In his E-newsletter article, he references a Jan. 6, 2015 blog penned by Kevin Prindiville who serves as executive director of Justice in Aging. “The report details piecemeal public actions and private initiatives, but ignores the opportunity to lay out an ambitious policy proposal to address pressing systemic challenges,” he says.

Kleyman also zeros in on Prindiville’s observations as to why this year’s WHCoA was of the scaled down. He observed, “To those who followed the WHCOA closely, this was not a surprise. Congress’ failure to reauthorize the Older Americans Act, and the lack of appropriate funding for the conference, meant WHCOA organizers had to produce a conference without a budget. With little infrastructure and support, the White House did not propose any new big, bold ideas to prepare for a population that is literally booming.”

Kleyman says that attendees were pleased to see a recommendation calling for improving the quality and safety requirements in the nation’s 15,000 long-term care facilities and a proposal to allow low-income and frail home bound elders and people with disabilities to use food stamps for meals on wheels.

Meanwhile, attendees were told at this event that physicians would be paid starting in 2016 to counsel patients about their end-of-life care, adds Kleyman, noting that recommendations did not address the nation’s increasing diversity.  Yet, there was no discussion on hospice and palliative care, affordable senior housing issues, and little discussion of elder abuse, the need for adequate transportation and long-term care, he says.

See You in 2025

According to the Census Bureau, in 2050, the 65-and-older population will be 83.7 million, almost double of what it was in 2012. The 2015 WHCoA conference has taken place with a skyrocketing older population, referred to as the “Graying of America.” Can this year’s conference provide policy makers with a road map to shape the delivery of services for years to come? As Kleyman says, probably not. “So it goes, at least until 2025,” he says.

 

Conference on Aging Planned for Summer 2015

Published in Pawtucket Times, December 5, 2015

It seems that aging advocates will have many celebrations to attend throughout 2015. This year is the 50th anniversary of Medicare, Medicaid, and the Older Americans Act, as well as the 80th anniversary of Social Security. Last July, the White House announced the scheduling this summer of the White House Conference on Aging (WHCoA). This once-in-a-decade is an opportunity to recognize the importance of these key federal programs as well as to look ahead to the issues that will help shape the quality of life for older Americans for the next decade.

With Nora Super named as the Conference’s new Executive Director in July combined with its website up and running in October, planning for the event is gearing up.

A Look Back

The first White House Conference on Aging (WHCoA) was held in 1961, with following conferences in 1971, 1981, 1995, and 2005. Over the past 40 years, professionals in the aging network have viewed these decennial conferences to be catalysts for development of aging policy. The conferences generated ideas and ultimately political momentum to establish or make significant improvements to many of the nation’s domestic programs, including Medicare, Medicaid, the Older Americans Acts and even to Social Security.

The four-day 2005 WHCoA was geared to provide the nation’s73 million baby boomers plan for their decades in retirement. That year, Pre-WHOCoA Forums (listening, solutions and mini conferences) were held around the country, to develop proposed solutions to the challenges of aging and the Main Conference itself, ultimately resulted in 73 resolutions with 50 of them being presented to the president and Congress.

Ten years ago, Governors of all 50 States, Puerto Rico, the District of Columbia and the Territories, Members of the 109th Congress, the National Congress of American Indians and the Policy Committee, selected 1,200 bipartisan delegates. At press time, delegate selection details have not been announced. But, like previous Conferences, I expect that incoming Governor, Gina Raimondo, to have some slots to appoint. Stay tuned.

In the past, processes for the five conferences were created by federal statute with the form and structure directed by Congressional lawmakers through legislation authorizing the Older Americans Act. To date, a deeply divided Congress has not reauthorized this program, and the pending bill does not include a statutory requirement or framework for the 2015 conference.

WHCoA organizers say that without a Congressionally defined framework, the White House begins to plans, still strongly committed to hosting a White House Conference on Aging in 2015. The American public will be engaged and involved in developing the conference, they say, by utilizing technology, by using web tools and social media, can encourage the nation’s Baby Boomers and seniors to participate.
Super Takes the Reins

Nora Super, the executive director of the upcoming WHCoA, says on the event’s website, “the coming months will be a time for us to engage in a dialogue and build a shared vision on how to continue to maximize the contributions of Americans as we age, and how to advance priorities such as healthy aging, a secure retirement, accessing the services and supports older Americans need to remain in their communities, and protecting older Americans from financial exploitation, abuse, and neglect.”

Super, who has over 20 years working in the federal government, and a lobbyist for AARP and represented Kaiser Permanente’s eight regional Permanente Medical Groups, believes, “The White House Conference on Aging represents an important step in working to ensure that Americans throughout the lifespan have the opportunity to learn and develop skills, engage in productive work, make choices about their daily lives, and participate fully in community life.”

According to Super, “the Conference is designed to assist the public and private sectors to be responsive to the needs of a diverse aging population and to promote the dignity and independence of and expand opportunities for current and future generations of older persons and their families.”
Listening session, beginning last July that will continue up to and during the Conference, have produced some common themes, including: retirement security; healthy aging; long-term services and supports to help older adults remain in their communities; and preventing financial exploitation, abuse, and neglect of older adults.

A Call for Participation

Sign up to receive regular updates and emails to stay informed. You will learn more about the planned WHCoA listening sessions, regional forums, webinars and opportunities for public engagement. Provide your thoughts as to what’s most important to you and your ideas for actions that can help to improve the lives of older Americans.

Don’t sit on the sidelines. Bring your comments to the table, especially share personal stories and life experiences about your aging, either from the frame of reference as an older adult or caregiver. Give your thoughts about the different federal programs that have enhanced the quality of your life or those family members, friends, and neighbors around you.

Last October, the WHCoA website, http://www.WhiteHouseConferenceOnAging.gov, was launched as a way to engage the public about aging issues. It provides regular updates on Conference activities, more important it serves as a way to easily provide your comments and input.

This columnist, writing for McKnight’s LTC News, one of the oldest trade publications covering the long-term care sector, covered the 1995 WHCoA for the prestigious publication. As a journalist it was an exciting assignment, to report on a national Conference that brought together aging advocates, long-term care providers, academicians, and researchers. This synergy ultimately would create formal resolutions to be shared with President William Clinton and Congress as to how to direct the nation’s resources and federal programs to better serve older Americans.

Summer 2015 kicks off the WHCoA. Hopefully, Rhode Island Governor Gina Raimondo, the state’s Division of Elderly Affairs and RI AARP will be in the forefront to gather comments from Rhode Island’s Aging Baby Boomers and Seniors about aging issues and problems that impact them. Rhode Islanders must be at the table and have a voice at the nation’s most important aging conference.

Herb Weiss, LRI ’12, is a Pawtucket-based writer covering aging, health care and medical issues. He can be reached at hweissri@aol.com.