Published in RINewsToday on March 25, 2024
A few weeks ago, advocates for seniors gathered on Smith Hill, attending a Senate Committee on Health & Human Services hearing to push for passage of S. 2399. The legislation would expand income eligibility for the Medicare Savings Program (MSP), helping many lower income seniors and disabled residents pay their $175/month Medicare Part B premium and covering co-pays and deductibles for those with very low-income.
Thousands of low-income seniors and persons with disabilities on Medicare, but not eligible to participate in the state’s Medicaid program, struggle to pay their Medicare Part B premiums and co-pay costs for services and prescription drugs causing many to forgo needed health care as they cannot afford to pay the co-payments.
S. 2399, introduced by Pawtucket Sen. Sandra Cano (D-Dist. 8, Pawtucket), would expand eligibility for the Medicare Savings Program (MSP) by increasing the income limit to 186% of the federal poverty line and eliminating the strict asset limit. It also increases from 100% to 138% of the federal poverty line a part of the program that covers deductibles and co-payment.
S. 2399 was heard on March 12, 2024 and held for further study. At press time, H. 7333, introduced by Pawtucket Rep. Karen Alzate (D-Dist. 60, Pawtucket, Central Falls), has been referred to the House Finance Committee for consideration. No hearing date has been scheduled.
“With health care costs rising at an alarming rate, it is imperative that we make sure that no one goes without the care they need due to unaffordability. This bill adapts to the significant changes in our society and economy while also ensuring that our most vulnerable senior and disabled residents are able to access the care and medicine that is essential to their daily lives,” said Cano, who champions S. 2399 and in previous legislative sessions introduced legislation to expand the MSP.
“Too many of our low-income seniors and disabled residents are falling through the cracks and foregoing crucial health care services due to rising co-pays and out of pocket costs. This is unacceptable, but thankfully, we can do something about it. By passing this legislation, thousands or more Rhode Islanders will be able to receive the care that they desperately need while also keeping more money in their pockets that’s needed for daily living expenses,” said Alzate, who sponsored the House companion measure.
“We understand this is very important legislation. We had a very informative, thorough hearing on this bill, and I look forward to reviewing all the information we collected.” says Senate Health and Human Services Committee Chairman Joshua Miller (D-Dist. 28, Cranston, Providence).
The Policy Problem and its Solution
Currently, the income limit of $20,331 leaves thousands of older Rhode Islanders and disabled low-income persons on Medicare with significant gaps in coverage and hefty out of pocket costs.
If the MSP income limit is increased to $28,012, as required by the legislation, an estimated 17,000 persons would be newly eligible to have their Medicare Part B covered by being enrolled in MSP. Anyone enrolled in the MSP receives automatic enrollment in Part D “Extra Help,” a federal program which significantly lowers out-of-pocket Medicare prescription costs at no cost to the State. The federal government establishes the minimum income and asset thresholds for the MSP, and states are permitted to increase these limits and many have done so.
Advocates of Cano’s MSP legislative proposal say it also particularly helps Rhode Island’s older woman and minorities. “Since women and people of color and persons with disabilities are disproportionately represented in low-income populations, increasing access to the MSP promotes equity,” finds an advocacy partnership’s analysis of the legislative proposals. “Poverty rates among older adult Hispanic women are two and one-half times that of older Hispanic men and persons age 18 and over with disabilities are twice as likely to live below 150% of the poverty level, said the analysis.
The advocacy partnership’s analysis also noted that significant numbers of older adults and those with disabilities enrolled in Medicare face financial challenges meeting basic needs. The number of older adults living below or near poverty has increased, housing costs have climbed dramatically, food cost have increased and many more rely on food pantries.
Covering the $175/month Medicare Part B premium for 17,000+ Rhode Islanders (at no cost to the State) and additionally covering co-pays and deductibles for thousands of very low-income adults and persons with disabilities on Medicare will give them much needed financial relief. And enrollment in the Extra Help program to reduce drug-related costs provides significant additional financial assistance and improves access to critical medication.
Testimony At the Senate Committee Hearing
Nine organizations either testified at this hearing or submitted written testimony to urge passage of S. 2399. AARP Rhode Island did not testify at the hearing but signed up in support in the committee room. There was no opposition to Cano’s legislative proposal.
“I first became aware of the need to expand the income eligibility for MSP quite a few years ago when an older man in my neighborhood contacted me to tell me he lost out on the program because he was just a few dollars over the income limit. As a result, the Senior Agenda Coalition of RI (SACRI) has advocated for several years to increase the income cap,” says Maureen Maigret, SACRI’s policy Advisor.
It’s a win-win for both older Rhode Islanders and for the Rhode Island General Assembly, says Maigret. “S. 2399 would help Medicare beneficiaries to access care along with putting money back in their pockets to pay for food, rent and their basic needs. By increasing the Medicaid income to $28,012, the federal government will pay the full cost of the newly eligible Medicare beneficiaries,” she told the lawmakers.
Strongly supporting S2399, Karen Malcolm, of Protect Our Healthcare Coalition, noted that the legislative proposal is modeled on the MSP changes enacted in New York last year and approved by the Centers for Medicare and Medicaid Services. “Rhode Island should take advantage of the opportunity to expand access to affordable coverage for seniors and people with disabilities and bring new [federal] revenue to our state.”
H. Phillip West, Jr. lobbyist for the Village Common of Rhode Island, states MSP already makes an enormous difference for many beneficiaries. But, “Rhode Island’s low threshold for eligibility and low allowable assets leaves thousands of our needy neighbors out. The good news is that Senator Cano’s legislation address these defects,” he said.
In submitted written testimony, Heather Smith, MD, president of the Rhode Island Medical Society stated “From our perspective as physicians, we witness firsthand the adverse effects of financial barriers on patient health outcomes. Too often, individuals are forced to forgo or ration medications, delay necessary treatments, or skip preventative care due to concerns of affordability. These delays can exacerbate health conditions, lead to complications, and ultimately result in higher healthcare costs down the road.”
Alex Moore, political director of SEIU 1199NE, stressed the many benefits of passing S. 2399, specifically enhancing access to care, providing needed financial relief, leveraging federal funds, and strengthening the health care workforce. By supporting the legislative proposal, “we demonstrate our commitment to health and well-being of our state’s most vulnerable populations,” he stated in written testimony.
Even with the strong support of the aging community, the state’s Office of Healthy Aging has not yet taken an official position on S. 2399. “As with any other bills at this stage of the session, we are reviewing the impact of H 7333 and S 2399 on Rhode Islanders. We will continue to follow these bills as they make their way through the legislative process,” says Director Maria Cimini.
Samuel Salganik, JD, executive director of RIPIN, which offered testimony in support for S.2399, said, “This is one of the best investments available right now for our state government. At a cost of just over $5 million, the State can draw down more than $40 million in federal support to assist low-income seniors in Rhode Island,” says Salganik. “It’s a great deal for the state. I think that’s a deal that most of us would happily take,” adds Salganik.
Gov. Dan McKee’s recently released FY 2024 Budget does not include funding for to expand the state’s MSP. Now the ball is in House Speaker Joseph Shekarchi’s (D-Dist. 23, Warwick) court as his chamber collaborates with the Senate to hammer out budget resolution to be approved by the Rhode Island General Assembly to be sent for the Governor’s signature. Hopefully, Shekarchi will see the expansion of the state’s MPM as a win-win for lower-income and disabled persons on Medicare and the state. As supporters of S 2399 and H 7333 say, “it’s a no brainer.”
The Advocacy Partners for MSP Expansion was established to push for the passage of S 2399 and H 7333 during this legislative session. They are: the Senior Agenda Coalition of Rhode Island, Rhode Island Organizing Project, RIPIN, the Economic Progress Institute, the Protect Our Healthcare Coalition and the Ocean State Center for Independent Living.
To access the bills under consideration: http://webserver.rilegislature.gov/BillText/BillText24/SenateText24/S2399.pdf – http://webserver.rilegislature.gov/BillText/BillText24/HouseText24/H7333.pdf
Expanding the income eligibility for the Medicare Savings Program (MSP) is one of the legislative priorities of the Senior Agenda Coalition of Rhode Island. These policy issues will be discussed at its upcoming Legislative Leaders Forum scheduled on Wednesday, March 27, 2024, from 10:00 a.m. to 11:00 a.m., at the Crowne Plaza Hotel, 601 Greenwich Ave,, Warwick, RI.
The Senior Agenda Coalition of RI’s Annual Legislative Leaders Forum is this week:
Tag Archives for Medicare
Congressman Magaziner takes baton on bringing back House Aging Committee
Published in RINewsToday on March 4, 2024
Over 30 years ago, the US House Democratic leadership’s belt-tightening efforts to save $1.5 million resulted in the termination of the House Permanent Select Committee on Aging. Congressman Seth Magaziner (RI-2) has picked up the baton from former Congressman David Cicilline who sought to bring back the House Aging Committee during the 114th-117th Congresses.
At press time, Magaziner’s H. Res. 1029, introduced Feb. 23, 2024, has been referred to the House Committee on Rules for mark-up, and if passed, will be considered by the full House.
“Older Americans deserve a seat at the table, particularly when it comes to important issues such as protecting Social Security and Medicare,” said Magaziner in a statement announcing his legislative efforts to pass H. Res. 1029. “I am proud to introduce legislation to re-establish a House Permanent Select Committee on Aging, which will advocate for America’s aging population and ensure seniors’ voices are heard when it comes to federal policymaking,” he says.
Every day 12,000 Americans turn 60. By 2030, nearly 75 million people in the U.S. — or 20% of the country — will be age 65 or older. As our country’s aging population grows, the need for support and services provided under programs like Social Security, SSI, Medicare, Medicaid and the Older Americans Act increases.
“Ensuring that seniors can thrive in our communities should always be a priority for the House of Representatives,” said Congressman Gabe Amo (RI-1) one of 15 original cosponsors of H. Res. 1029, who initially called for bringing back the House Aging Committee during his campaign to win former Cicillini’s vacant seat.
“That is why it is essential that there is a dedicated committee for lawmakers to focus on the issues that impact seniors’ quality of life. From preserving and expanding Social Security and Medicare to reducing the cost of prescription drugs to keeping seniors in safe and stable housing, there are so many issues to address under the leadership of a Special Committee on Aging. Seniors in Rhode Island and across the country deserve nothing less,” says Amo.
The House can readily create an ad hoc (temporary) select committee by approving a simple resolution that contains language establishing the committee—giving a purpose, defining membership, and detailing other aspects, says EveryCRSReport. Salaries and expenses of standing committees, special and select, are authorized through the Legislative Branch Appropriations bill.
Putting a spotlight on aging issues
H. Res. 1029 simply amends the Rules of the House to establishes a Permanent House Select Committee on Aging, noting that this panel shall not have legislative jurisdiction, but it’s authorized to conduct a continuing comprehensive study and review of the aging issues, such as income maintenance, poverty, housing, health (including medical research), welfare, employment, education, recreation, and long-term care.
The 213-word resolution would have authorized the House Aging Committee to study the use of all practicable means and methods of encouraging the development of public and private programs and policies which will assist seniors in taking a full part in national life and which will encourage the utilization of the knowledge, skills, special aptitudes, and abilities of seniors to contribute to a better quality of life for all Americans.
Finally, the House Resolution would also allow the House Aging Committee to develop policies that would encourage the coordination of both governmental and private programs designed to deal with problems of aging and to review any recommendations made by the President or by the White House Conference on aging in relation to programs or policies affecting seniors.’
Aging organizations, advocates call for passage of H. Res. 1029
According to Max Richtman, President and CEO of the Washington D.C.-based National Committee to Preserve Social Security and Medicare (NCPSSM), jurisdiction over many programs affecting seniors is shared by multiple standing committees, which can make it difficult for them to fully explore solutions that do not fit squarely into a single committee’s expertise. Such issues include a variety of intergenerational concerns that merit attention, such as the growing demands on family caregivers and our intractable retirement security crisis. “An inter-disciplinary approach to these issues can best be advanced by a Select Committee with broad jurisdiction,” he says.
“Re-establishing a Select Committee on Aging in the House would also complement the strong bipartisan work of its counterpart in the Senate,” says Richtman. “In recent years, the Senate Special Committee on Aging has effectively promoted member understanding on a range of issues,” he says, noting that these issues include concerns of grandparents raising grandchildren, elder abuse and fraud, the effects of the COVID-19 pandemic on older Americans and their families, the importance of financial literacy in planning for retirement, and the costs associated with isolation and loneliness.
“Historically, the House Select Committee on Aging served as a unique venue that allowed open, bipartisan debate from various ideological and philosophical perspectives to promote consensus that, in turn, helped facilitate the critical work of the standing committees. We believe that issues affecting seniors would be best advanced by the re-establishment of such a Committee in the House,” adds Richtman.
NCPSSM will endorse H. Res. 1029 and plans to promote it to House lawmakers. If the Democrats take control of the House next November, the organization will approach the Democratic House Speaker when he is crafting rules to operate and request that the rules include reestablishing the HSCoA.
Nancy Altman, President of the Washington, DC-based Social Security Works, strongly supports Magaziner’ efforts to bring back the HSCoA. “Social Security is a critical issue for older Americans. “There’s so much misinformation out there about Social Security, and as a result many people aren’t confident they’ll get the benefits they’ve earned. More accurate information coming from Congress would help,” she says.
According to Altman, the Social Security Subcommittee of the House Ways and Means Committee does incredibly important work, but Ways and Means has such a broad jurisdiction that Social Security and other aging related issues don’t always get the attention they deserve. “A House Aging Committee could shine an important spotlight, informing the public, the media, and fellow members,” she notes.
Altman offers suggestions to the Rhode Island Congressman to increase the chances for passage of H. Res. 1029. “If he doesn’t already have Republican co-sponsors, he should try to get some since they’re more likely to convince Speaker Mike Johnson to create the committee,” she says.
In addition to working for passage of H. Res. 1029, this Congress, Altman recommends that Magaziner start working now to line up Democrats to push for the reestablishing the House Select Committee on Aging at the beginning of the next Congress, where there is likely to be Democratic control.
Robert S. Weiner, now President, Robert Weiner Associates News, was House Aging Committee Chief of Staff under Chairman Claude Pepper, from 1976 to 1980, when the Florida lawmaker headed the HSCoA, as a force to be reckoned with in his advocacy of America’s seniors.
“I saw first-hand the power of that committee when we met with Presideent Jimmy Carter and he endorsed the HSCoA’s efforts to abolish mandatory retirement,” says Weiner, noting that the bill passed 359-2 in the House and 89-10 in the Senate, and signed into law by the President.
According to Weiner, the Carter Center recently invited him to pen an article this fall, for their “last print edition of the “Carter-Mondale Newsletter,” entitled “Carter, Pepper Strike Blow Against Age Discrimination.”
“We also held high-powered hearings on nursing home abuses, cancer insurance fraud, the need for expanded home health care (which ultimately became law), elder abuse, and pensions,” adds Weiner. As to Social Security, the Pepper-O’Neill-Reagan deal guaranteed the solvency of Social Security through 2034.
As to legislative strategy, Weiner suggests that Magaziner get 100 plus sponsors – Democrats and Republicans – by bringing a copy of the resolution to the House floor and getting cosponsoring significantly efficiently and quickly by first-hand recruiting action. He might even ask to address the House for a one-minute speech about the importance of passing H. Res. 1029.
“Both parties are nuts if they don’t help seniors by having a dedicated House Select Committee on Aging,” asserts Weiner.
“This is a significant opportunity for the Congress to take a comprehensive view as to how we as a country wish to better support the aging of America. Older adults suffered the most during the COVID pandemic — more than 90% of the deaths were individuals over 60. Many older adults are still suffering from loneliness and social isolation. Such a bipartisan effort led by Congressmen Magaziner and Amo would be historic,” stated Vincent Marzullo, who served 31 years as a career federal civil rights and social justice administrator at the National Service Agency, and a well-known aging advocate. He serves on Magaziner’s he RI-02 Seniors Advisory Committee.
The clock is ticking. With the upcoming presidential elections taking place in about 246 days, Magaziner must quickly work to get House Republicans cosponsors to get House Speaker Mike Johnson to allow a vote in the House Rules Committee. Without support of his caucus, he is likely to say no.
Magaziner must convince Congressmen Brian Fitzpatrick (R-PA) and Josh Gottheimer (D-NJ), co-chairs of the “Problem Solvers Caucus,” consisting of essentially an equal number of 63 Republican and Democratic lawmakers, to push for passage of H. Res. 1029. This may be the only way to pass a resolution to reestablish HSCoA in a Republican-controlled House.
Unique Partnership Creates Pilot Senior Fellows Program
Published in RINewsToday on December 11, 2023
Buoyed by the success of a pilot Senior Fellows Program, Leadership Rhode Island (LRI) and Age-Friendly Rhode Island (AFRI) are hoping to find the funding to offer another session in the summer of 2024.
The initial effort “to lift the voices, knowledge and vision of Rhode Islanders, age 62 and ver” prepared 25 Senior Fellows to advocate for improvements that address age-elated challenges. The initial eight-week program was tuition-free.
The first crop of Senior Fellows, residents of 13 different cities and towns in Rhode Island, ranged in age from 62 to 83. Nearly half were retired.
The idea to develop a senior advocates program came from Marianne Raimondo, a graduate of LRI’s Core Program, who made the connection between Leadership Rhode Island and James Burke Connell. Connell is the executive director of Age-Friendly Rhode Island, an initiative at Rhode Island College that represents a coalition of public and private agencies, organizations and individuals committed to healthy aging.
Empowering Seniors to Become Advocates
Connell proposed the pilot program because, he says, empowering seniors to become advocates, activists and champions of age-friendly thinking and practices “will result in a Rhode Island where older adults thrive and live their best lives.” He was inspired by similar programs in Maine and New Hampshire.
Connell pitched the idea to Michelle Carr, LRI’s executive director, who could easily see the benefits of the proposed joint venture. One such positive: Nearly a fourth of LRI’s 3000 alumni are 62 years or older, many of whom are prime candidates for the program.
More importantly, Carr adds, LRI and Age-Friendly RI are both propelled by the belief that citizens of all ages who are actively engaged in their communities can make lasting impacts.
Age-Friendly RI raised the funds for the pilot program, and relied on LRI’s “talented team” to handle recruiting, participant selection, curriculum planning, and guiding participants in the development of individual community commitments, Connell says.
Gilda Hernandez, a 65-year-old research librarian at Providence College, participated with two goals in mind. As the medical advocate for her 88-year-old parents, Hernandez wanted to become an educated caregiver, one who knows how to navigate state agencies to get appropriate services for them. She also wanted to develop advocacy skills so she can address the societal problem of ageism, especially in the education sector.
The program was “what I expected. . . and more,” says Hernandez, who gave a thumbs up to the “exceptional programming and top-notch presenters.”
Most session days were divided into two parts, with half focused on knowledge-building around relevant issues, such as housing, food insecurity, transportation needs, and health care.
The other half focused on skill-building, such as writing persuasively, public speaking and network building, to enable the Fellows to develop and eventually execute their own Civic Commitments.
Pitching Personal Civic Commitments at State House
The Fellows took turns describing their Civic Commitments during their final session, held at the State House. The presentations, which included several “poignant and pin-drop moments,” were well received by the audience, which included representatives from the state’s Office of Equity and Engagement, and from the AARP, House of Hope, Meals on Wheels Rhode Island, and the United Way.
Senior Fellow Ron Caniglia, 77, from Warwick, applauds the advocacy program for emphasizing the importance of “living in place,” rather than “aging in place.” In fact, his Civic Commitment — to urge the expansion of Medicare benefits to adequately cover hearing, vision and dental care — would enable more older adults “to live life to the fullest.”
A retired contractor, Caniglia’s arguments for the expansion of these benefits are passionate and personal. Hearing loss, if not addressed, can contribute to the breakdown of family and everyday social relationships, he says. This could lead to unhealthy isolation.
Teresa DeFlitch, LRI’s director of leadership development, says she has high hopes that Rhode Island’s first 25 Senior Fellows will have a positive impact on senior citizens throughout the Ocean State. They are expected to begin their advocacy work within six months of leaving the program.
We hope, she says, that the Fellows have expanded their knowledge, network, and confidence when it comes to making a difference.
It is also hoped, she adds, that each participant feels more connected to a supportive and joyful community, including their fellow Fellows, and the LRI and Age-Friendly networks.
“We are eager to run the program again and incorporate feedback from this year’s cohort. Working with Age-Friendly Rhode Island has been wonderful and we are learning a great deal from the cohort members about what’s affecting them as older adults in the state. It’s been an inspiring and energizing experience,” DeFlitch says.
Herb Weiss 