Tag Archives for Medicare

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.

 

New Budget Deal Protects Seniors’ Pocketbooks

Published in Woonsocket Call on November 1, 2015

Just days after a Republican-controlled House passed legislation with a vote of 266-167 to prevent the U.S. government from going into default on its debt obligations on Nov. 3, also averting a potential federal government shutdown next month, on Friday, Oct.30, the Republican-led upper chamber followed suit.  Just after 3:00 a.m., the Senate voted 64-35 to approve a two-year bipartisan budget plan sending the bill to President Obama for his signature.

Before Friday’s Senate vote, on Thursday afternoon GOP Presidential contender Sen. Rand Paul (R-Ky.)’s 20 minute filibuster fizzled, with Senate leadership moving forward for the budget bills consideration.  The measure had strong support for passage.  Retiring House GOP Speaker John Boehner with Congressional leaders from both political parties and President Barack Obama pulled together, putting aside differences, to craft the bill.

.           Before the companion legislation was taken up by the House and Senate, in a statement AARP CEO Jo Ann Jenkins, representing 38 million baby boomers and seniors, called on Congressional leaders and their members to support the bipartisan agreement, one that financially protect older Americans.   Jenkins detailed a number of provisions within the 144 page bill that would “reduce skyrocketing Medicare Part B premiums and alleviate the challenges faced by the Social Security Disability Insurance (SSDI) Trust Fund.”

Rhode Island Lawmakers Give Thumbs Up

U.S. Senator Jack Reed (D-RI), called the bipartisan budget agreement “a credible compromise,” noting that “It is only a two-year patch, but it puts us on a much better path forward.   Reed, who sits on the powerful Appropriations Committee, called on the House and Senate Appropriations committees to “quickly reach consensus and produce a detailed omnibus spending package by the Dec. 11 deadline.”

“This budget deal will provide much-need relief from harmful sequester cuts and give the nation a measure of certainly we have lacked amid the patchwork of stop-gap spending bills in recent years,” added U.S. Senator Sheldon Whitehouse (D-RI).

Whitehouse noted the bipartisan budget deal provides “much-needed relief from harmful sequester cuts and gives the nation a measure of certainty it has “lacked amid the patchwork of stop-gap spending bills passed in recent years.”

With 37,000 Rhode Islander’s relying on the SSDI program it was easy for Representative David Cicilline (D-RI) to support the bipartisan compromise budget plan because it “prevents a 20 percent cut to SSDI benefits and extends the solvency of this critical program an additional seven years, as well as protecting thousands of Rhode Island seniors from an increase in their Medicare premiums.”

“We need to do more to protect Social Security benefits for seniors, ensure cost-of-living adjustments are calculated in a way that accounts for their needs, and lift the cap on payroll taxes so millionaires and billionaires pay their fair share,” said Rhode Island’s Democratic Congressman.

On the side line, aging advocates were also closely watching the action in both chambers, too.  “We are glad that the Budget passed by Congress this week lets people who rely on Medicare breathe a bit easier – knowing their premiums and deducible will not skyrocket next year,” said Judith Stein, founder and executive director of the Center for Medicare Advocacy. “However, we still have concerns about the way in which the Part B cost-sharing resolution is paid for, and concerns about the expenses underlying the original Part B increases.”

“The Center continues to urge law-makers to join Congressman Courtney (CT-2) in asking Secretary Burwell to investigate and fix the underlying reasons for the huge increase in Part B costs,” said Stein. “Much of the increase seems to come from parallel increases in billing inpatient hospital care to Part B – which was never meant to pay for such care – through the use of so-called ‘outpatient’ Observation Status.”

Older Americans Protected by Enacted Budget Plan

The Bipartisan Budget Act of 2015 would raise the nation’s debt ceiling through March 2017, allowing the government to borrow to pay its debt. During these two years it allow Congressional lawmakers to lift budget caps for defense and domestic programs by $80 billion.

The passed budget plan derails a 52 percent Medicare Part B premium increase to 30 percent of beneficiaries, which would have hit millions of seniors in their wallets next year. Similarly, the deductible was projected to increase for these individuals to $223 next year.  But thanks to the budget agreement passed this week, the deductible will instead have a more modest increase from the current amount of $147 to approximately $167.

A general fund loan to the Medicare trust fund lessens the premium and deducible increases. Beneficiaries will repay this loan by a $3 per month premium surcharge over a five-year period.

According to the enacted budget plan, next year, only the 30 percent of the beneficiaries hit by the premium increase would pay this $3 premium surcharge.  In 2017 and beyond, all Medicare beneficiaries not subject to the hold harmless provision in a given year would pay a $3 monthly surcharge theoretically until the general fund loan is repaid..

The federal Centers for Medicare and Medicaid Services is expected to announce final premiums for 2016 by the beginning of November.

Keeping SSDI Afloat

The enacted budget plan also prevents a 20 percent cut in Social Security Disability Insurance (SSDI) benefits that would have occurred in late 2016 impacting 11 million recipients nationwide.  The enacted law now ensures at least 7 years of certainty that SSDI will pay full benefits.  Now, the passed budget measure “reallocates” a small percentage of the Social Security payroll tax to the SSDI program.  This has occurred 11 times.  But, GOP lawmakers have blocked recent efforts to transfer funds as a bargaining chip to force Congress and the Obama Administration to make cuts to Social Security benefits.

The new law would also tightens up the SSDI review process by requiring a physician or psychologist to review applications before a decision is made.  It ensures that application reviews are uniform nationally.  Finally, it requires the Social Security Administration to reject medical evidence presented in a disability application that was provided by “unlicensed” or “unsanctioned” physicians.

It also attacks Social Security fraud and abuse by providing additional funding to contact case reviews ensuring the applicants are entitled to the benefits, improves the fraud-fighting capacity of the SSA’s Office of Inspector General and increases penalties for those physicians, lawyers, translators who perpetuate fraud.

Finally, the bipartisan budget agreement closes loopholes in the current SSA law that allows higher-income recipients to exploit the rules for applying for benefits, with the goal of receiving large pension checks than Congress intended, and which most retirees are able to receive.

The savings made in the Social Security and SSDI programs remain in the Social Security trust funds and can only be used to pay for future benefits.

With Representative Paul D. Ryan now becoming the 62nd speaker of the House, the nation waits to see if the Wisconsin lawmaker has the special political skills to rein in the ultra-conservative wing of his party.  With only 374 days before the upcoming 2016  presidential and congressional elections America’s federal lawmakers must begin to work together to craft laws that will enhance the quality of life of the nation’s retirees.  Compromise is not a dirty word to those residing outside the Washington, DC beltway.  Gridlock is.