Congressional Panel Looks Over Medicare

Published in Woonsocket Call on March 20, 2016

Last Wednesday’s hearing of House Ways and Means Health Subcommittee signals the panel’s interest to bring Medicare, a federal health insurance program for people age 65 and over, into the 21st century to meet the needs of its current 55.3 million beneficiaries.

At the March 16 hearing, Chairman Pat Tiberi (R-OH), stated that “Today’s seniors [are] inundated with an array of confusing deductibles, coinsurance and copayments with no protection from high health care costs unless they enroll in a private plan. Despite major improvements and innovations in the health care sector that have transformed how care is delivered, traditional Medicare has barreled through the last 50 years on the same trajectory of increased costs and little innovation.”

In addition to the structural challenges facing the program, critical parts of Medicare are expected to run out of money by 2026. In other words, the benefits Americans were promised stand to disappear if policymakers don’t act soon, says Tiberi.

Putting the Spotlight on Medicare

Tiberi’s March 16 Health Panel hearing, entitled “Preserving and Strengthening Medicare,” held in room 1100 of the Longworth House Office Building, brought together three witnesses to discuss ways to sustain the nation’s Medicare program and to keep it from going bankrupt. From both sides of the aisle and expert witnesses all agreed that the federal government’s current approach to delivering high-quality health care is not working. As a result of an outdated Medicare program and harmful Obamacare policies, today’s seniors “must navigate a disjointed program, face rising health care costs, and have fewer healthcare choices,” says the GOP panel chairman.

“Of federal entitlements, Medicare presents the most difficult challenges,” says Heritage Foundation Senior Fellow Robert Moffit, warning that the Trust Fund “faces insolvency in 2026.”

At the hearing, Moffit gave his fix for revamping Medicare that have bipartisan support and promise to shore up the ailing entitlement program. He called for the Medicare program to be simplified by combining Parts A and B – including catastrophic coverage, an out-of-pocket cap, a single deductible, and uniform coinsurance in a single plan along with bringing reforms to Medigap coverage. Also, retargeting Medicare benefits to low-income enrollees can provide assistance to lower-income enrollees. Increasing Medicare’s eligibility age to 67 (the same eligibility age for Social Security) along with encouraging innovation and cultivating competition through Premium Support can put the brakes to rising program costs.

When it comes to simplifying Medicare and incorporating catastrophic coverage, Tiberi had called the need for reform a “no-brainer.” Moffitt overwhelmingly agreed, stating, “It is a no-brainer. It is absolutely a no-brainer … [seniors] do not have protection from the most important thing that health insurance should deliver, which is that ultimate protection.”

As Moffit explained, the lack of catastrophic coverage in Medicare not only puts financial strain on the beneficiary, but it also causes a significant increase in unnecessary health care spending.

Coming Up with a Commonsense Approach

In her testimony, Katherine Baicker, Harvard University Professor of Health Economic and serves on the Medicare Payment Advisory Commission, also called for commonsense solutions, specifically focused on the need for increased competition. She heighten the role that Medicare Advantage program plays in promoting innovation, as well as providing more seniors flexibility, choice, and quality at an affordable cost.

Baicker emphasized, “A thriving and competitive Medicare Advantage program can be a vital contributor to high quality beneficiary care in a sustainable health care system.”

When Baicker was asked which Obamacare provisions Congress should work to immediately repeal in an effort to protect Medicare Advantage, she replied, “I would like to see the cap on quality bonuses removed … and removing the double bonus for quality so that you’re appropriately rewarding plans for delivering the high-quality care that beneficiaries are seeking out.”

Finally, Stuart Guterman, senior scholar in residence at
AcademyHealth, told the panel that he believes the nation’s largest purchaser of health care can do more to ratchet up quality, enhance quality and coordinate care and control costs. “Because of Medicare’s unique position, it can be an important testing ground for cost and quality innovations. Policies have been put in place that encourage such development, including the expanding the power of the Secretary of Health and Human Services to put pilot programs on a ‘fast track’ and to work with private payers and providers to establish multi-payer initiatives.”

At the conclusion of the two hour hearing, like Baicker, Tiberi stressed the importance of bolstering support for Medicare Advantage, which serves approximately one-third of seniors today. Obamacare cut billions of dollars from Medicare Advantage and redirected those resources toward a one-size-fits-all, Washington-run entitlement, he says.

Tiberi also noted, “If we continue to berate a system that has been widely successful…I don’t think that’s a really good way to try to figure out how we bester serve patients, seniors, in a more cost-effective value-added, comprehensive way.”

Watching from the Sidelines

But, one aging group expressed strong concerns about the Health Panel’s look at Medicare. In his released statement, Max Richtman, President/CEO of the Washington, D.C.-based National Committee to Preserve Social Security Medicare (NCPSSM), viewed the Health Panel hearing as “an Orwellian political exercise in which politicians say preserve when they actually mean privatize, and strengthen when they mean slash.”

“Republicans in the House envision a future in which millions of seniors will lose their guaranteed Medicare benefits in favor of a privatized CouponCare system in which they receive a government coupon to try and buy private insurance. Millions of seniors in Medicaid will lose their benefits due to block-granting to states without providing the resources to pay for it. The repeal of the Affordable Care Act will leave tens of millions without insurance and strip benefits from seniors in Medicare,” says Richtman in NCPSSM’s statement.

Furthermore, “The Republican leadership has offered no plans to improve benefits in Medicare or make reforms to reign in the skyrocketing price of drugs and healthcare costs system wide. Instead, the GOP vision for seniors in Medicare is they must just do more with less. Stagnant wages are grinding away at the middle class’s ability to save for retirement. Many employers have significantly scaled back or eliminated the traditional retirement benefits offered to their employees. As a result, current and future retirees simply cannot afford proposals to cut benefits, raise the eligibility age or privatize the program,” says in the NCPSSM statement.

Finally, the aging advocate warns that the GOP majority on the House Ways and Means Health Subcommittee majority is moving to replace the nation’s traditional Medicare program in favor of a fully privatized system, and the GOP controlled House is in the process of producing a budget that would do just that.

A Democratic or Republican President? Which political party controls the House and Senate? When the dust settles these answered questions may result in a restructuring of the Medicare program, that may either be strengthened and expanded or put on the budgetary chopping block by the new incoming President or Congress. It’s a no brainer…Sitting on the political sideline will ultimately be detrimental to your pocketbook and coverage you receive for your health care.

Social Security Gets Attention at Debate

GOP Candidates Share Their Plans for Shoring Up System’s Solvency

Published in Woonsocket Call on March 12, 2016

Last Thursday, the four surviving G0P contenders for president at the CNN Republican debate at the Bank United Center on the campus of the University of Miami, focused on meaty policy issues and not theatrics. Previous debates were heated and sparks flew between candidates. But many political wonks consider this one to be subdued, may be even a little boring. Like the other 11 debates, on March 10 Ohio Governor John Kasich, Senator Ted Cruz of Texas, Businessman Donald Trump and Senator Marco Rubio of Florida, gave their two cents on scores of policy issues including, the right to bear arms, trade, jobs, illegal immigrants, education, national security, fighting ISIS, Iran’s nuclear deal and protecting Israel. But one political hot potato issue, Social Security, even got a little more air time during this debate.

With Florida having the highest percentage of retirees in the country, with nearly 3.1 million residents receiving a Social Security check, CNN Chief Political Correspondent Dana Bash, brought Social Security into the debate by asking the candidates how they would keep the nation’s retirement program afloat for future generations.

Bash called on Rubio to explain his position on rising the retirement age and reducing benefits for wealthy retirees. The Florida Senator said he would not cut Social Security checks, joking that “I’m against any changes to Social Security that are bad for my mother, a Social Security recipient.”

Younger Generations Take Brunt of GOP Fix for Social Security

Rubio warned that Social Security will ultimately go bankrupt taking the country down with it. So, here’s his fix. “So what it will require is people younger, like myself, people that are 30 years away from retirement, to accept that our Social Security is going to work differently than it did for my parents,” he noted.

The 44- year-old Florida Senator, called for increasing the retirement age of younger persons to age 68 ultimately to age 70, suggesting that Social Security checks should not “grow as fast as someone who made less money.”

“Medicare could very well become the option of using my Medicare benefit to buy a private plan that I like better. Medicare Advantage does that now,” said Rubio.
Explaining what he favors making changes to Social Security, Rubio noted that “in less than five years, only 17 percent of our budget will remain discretionary; 83 percent of the federal budget in less than five years will all be spent on Medicare, Medicaid, the interest on the debt.”

CNN moderator Bash called on Trump to explain why he did not want to raise the Social Security retirement age and his rationale for not wanting to cut benefits to wealthy retirees.

Trump responded by saying that his democratic opponents oppose cutting the retirement program, evening wanting to give recipients “even more.” The businessman, becoming more of a politician, clearly sees how the heated political issue, of making changes to Social Security, will bring votes to the Democrats. ”And that’s what we’re up against. And whether we like it or not, that is what we’re up against,” he says.

“I will do everything within my power not to touch Social Security [either making benefit cuts or rising the eligibility age”. Trump believes the solution is “to make this country rich again; to bring back our jobs; to get rid of deficits; to get rid of waste, fraud and abuse, which is rampant in this country.” He notes that catching improper retirement payments will also increase the solvency of the program.

Time Can Allow a Fix for Social Security Program

In response to those warning about the impending bankruptcy of the Social Security program if changes are not made, Trump says he would have a “a long-time to go,” possibly over 20 years, to increase the solvency of the program. It seems that he does believes that time will be on his side to fix Social Security, if he becomes president.

“The numbers don’t add up,” charges Rubio, to Trump’s assertion that reducing fraud and waste and in Social Security, the nation’s foreign aid programs and better purchasing policies. He chides both the Democrats and GOP for taking too long to “deal with” the solvency of Social Security.

With the spotlight on Cruz, the Texas Senator explained his advocacy for allowing younger workers to put some of their Social Security taxes into a 401 (k) accounts even with the

As president, Cruz pledges that he will not make any changes to Social Security that will impact anyone at or near retirement. “Every benefit will be protected to the letter,” he says, “But for younger workers, we need to change the rate of growth of benefits so it matches inflation instead of exceeding inflation.”

Finally, CNN moderator Bash, reminded Kasich of his position of cutting retirement payments. The Ohio Governor told a New Hampshire voter: “Get over cuts to Social Security benefits,” he says.

Kasich brought up his 1999 plan to save Social Security by allowing young people to have private retirement accounts. During a light hearted moment, Kasich quipped this memorable quote: “Now there are more 18-year-olds who believe they have a better chance of seeing a UFO than a Social Security check and we have a lot of seniors who are very nervous.”

Kasich’s plan to save Social Security is quite simple. “If you’ve had wealth throughout your lifetime, when the time comes to be on Social Security, you’ll still get it. It will just simply be less. And for those people who depend on that Social Security, they’ll get their full benefit. That’s the way it will work. And we don’t have to monkey around with the retirement age. And how do I know that? I’ve done all this before,” he told millions watching the two hour debate.

The writing is on the wall. 2016 GOP candidates for president, except Trump, look to make changes to Social Security to ratchet up the program’s solvency. Those calling for change say they won’t increase program eligibility, cut benefits or privatize the program, to impact aging baby boomers nearing retirement or for current Social Security recipients.

While differing on their political strategies, Democratic presidential contenders — former Secretary of State and New York Senator Hillary Clinton and Senator Bernie Sanders, — seek to strengthen and expand Social Security.

Generation’s X, Y and Z might will consider looking closely at Democratic and Republican presidential candidate positions on fixing Social Security. November’s winner might just tinker with your future retirement program or slash benefits, ultimately impacting how you will financially survive in your retirement years.

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.