Tag Archives for Medicare

Countdown to 2024 elections heating up about what to do about Social Security

Published in RINewsToday on November 27, 2023

The political clock is ticking. It’s 340 days before the upcoming presidential elections and control of Congress and the White House are up for grabs.  As education, abortion, foreign policy, immigration, crime are emerging as upcoming campaign issues, fixing Social Security and Medicare are also on the voter’s radar screens, too.  

As the Democrats call for expanding and shoring up the existing Social Security Program (by introducing H.R. 4583, Social Security 2100 Act and S. 393, Social Security Expansion Act and other legislative proposals), Republicans are calling for changes in the program including looking at raising the eligibility age for full-time retirement, possible means-testing, and adjusting benefits for higher income earners.

The Nov. 9th Republican debate was not reassuring for younger taxpayers who are counting on collecting the Social Security benefits they earn with every paycheck, says Max Richtman, President and CEO, National Committee to Preserve Social Security & Medicare. Two of the GOP presidential hopefuls promised, in effect, to cut Social Security for future beneficiaries,” he said. 

However, former President Donald J. Trump, who didn’t participate in this debate, has warned the other candidates not to make cuts in Social Security and Medicare benefits. While he opposes raising payroll taxes to ensure the fiscal solvency of these programs, he doesn’t provide specific proposals as how to do this. 

Presidential GOP candidates call for fixes to an unsustainable Social Security system 

According to Richtman, Nikki Haley claimed that Social Security is going “bankrupt,” and she would raise the retirement age for workers who are now in their 20s, and also means-test benefits. Chris Christie also said he would raise the retirement age and eliminate benefits for higher earners, essentially converting Social Security into a safety net program, instead of an earned benefit. 

“Governor Christie and Ambassador Haley fail to recognize that future generations of retirees will rely on their Social Security benefits even more than today’s seniors do — and that means testing would cut deep into the heart of the American middle class,” says Richtman.  “Ron DeSantis — to his credit — promised not to cut Social Security, but demonstrated a fundamental misunderstanding of the program’s finances by perpetuating the myth that the government is ‘stealing’ from the trust fund,” he added.

On Oct. 25, the newly sworn in Republican House Speaker, Mike Johnson (R-LA) sent a message to his caucus calling for Social Security and Medicare reforms to be made by a debt commission to tackle changes being targeted for these programs. Richtman warns that this approach is “designed to give Congress political cover for cutting Americans’ earned benefits.”  In response, the Biden Administration described such a commission as a “death panel” for Social Security.

Over six years ago, Congressman Johnson (now newly elected House Speaker) called for cuts to Social Security. According to Independent News Network, Meidas Touch Network, in a 2018 speech before the American Enterprise Institute, as incoming chair of the Republican Study Committee, he called for cuts in Social Security, Medicare and Medicaid.  He viewed these programs as “essential threats” to the American way of life, even suggesting that the government might cease to exist if they continued to be fully funded the way they are now. 

Slashing SSA benefits through a Debt Reform Commission

“That is why these commissions have been rightly described as ‘death panels’ for Social Security and Medicare. It is unfortunate and disappointing that one of the Speaker’s first priorities is creating a mechanism intended to slash programs that American workers pay for in every paycheck, fully expecting the benefits to be there when they need them,” says Richtman, charging that the House Speaker “clearly wishes to break this compact with the American people.”

“Congress should address Social Security in the sunlight, through regular order, as it always has,” said Nancy Altman, President of Social Security Works, and former top assistant to Alan Greenspan on the 1983 commission. “The only reason to create a fast-track, closed door commission is to overthrow the will of the American people by cutting their hard-earned benefits. Anyone who supports this commission is supporting benefit cuts.”

In a Nov. 13 correspondence to Congress, Jo Ann C. Jenkins of the Washington, DC-based AARP, also opposes the creation of s debt commission.  She strongly disputes the GOP’s claim that Social Security is a driver of the annual deficits or national debt, stressing that the program is self-financed.

According to Jenkins, 90% of the retirement program is financed through payroll contributions from workers and their employers.  Around 4% of its funding comes from federal income taxes on some Social Security benefits and 5.4% comes from interest earned on U.S. Treasury bonds held by the Social Security Trust Funds.

“Any argument that claims that Social Security is a driver of the national debt – simply because it receives interest from the U.S. Treasury bonds- is disingenuous,” says Jenkins, noting that U.S. Treasury bonds are of the world’s safest investments.

Alex Lawson, Executive Director of the Washington, DC-based Social Security Works, agrees with Richtman’s assessment of House Speaker Johnson’s ongoing approach to Social Security and Medicare. “The Louisiana Congressman recently joined the vast majority of his caucus to vote for a commission designed to fast-track cuts to Social Security and Medicare behind closed doors”, notes Lawson. 

“As Chair of the Republican Study Committee from 2019-2021, Johnson released budgets that included $2 trillion in cuts to Medicare and $750 billion in cuts to Social Security,” says Lawson. This includes raising the retirement age, decimating middle class benefits, making annual cost-of-living increases smaller and ultimately moving towards privation of Social Security and Medicare,” he notes.  

With Johnson pushing for the creation of a debt commission, over 100 organizations have become co-signers on Nov. 8 correspondence to Congress opposing the legislative proposal.   

Aging groups begin to mobilize

While the Social Security Trust Fund Report, released in April 2023, warned that Social Security funds will become depleted in 2033, making the program totally insolvent in 2034 when beneficiaries could only receive about 80 percent of their scheduled benefits, the cosigners say the program’s projected short falls are “manageable by size and still a decade away, are fully understood.” 

“In this Congress alone, several legislative proposals that do just that have been introduced with numerous cosponsors. The only reason to make changes to Social Security via a closed-door commission is to cut already modest earned benefits — something the American people overwhelmingly oppose  — while avoiding political accountability, say the co-signers. 

“Congress already has a process to confront the federal debt. That process is known as reconciliation. Revealingly, Social Security cuts are excluded from the reconciliation procedure, because, as previously stated, the program is totally self-funded, cannot pay benefits or associated costs without the revenue to cover the costs, has no borrowing authority, and, therefore, does not add a penny to the deficit. Consequently, if a debt commission with jurisdiction over Social Security were to be formed, its purpose would be clear: to cut its modest benefits, while avoiding political accountability,” warn the cosponsors.

But the shortfall is real

In an article in Money magazine, the writer notes, “Taxpayer funds cover the bulk of Social Security payments, but if the program’s reserves run dry, beneficiaries would face immediate 20% cuts to their checks come 2034. Any decrease to Social Security payments would likely be extremely unpopular, considering they’re a major source of retirement income for tens of millions of people.” According to a new report from the ​​American Academy of Actuaries, the longer the issue is put off, the harder it will be to address the looming shortfall.

The Third Rail of national politics 

According to AARP research, “85% of older Americans, regardless of party, strongly oppose targeting Social Security and Medicare to reduce federal budget deficits. Specifically, the survey found that 88 percent of Republicans, 79 percent of Independents, and 87 percent of Democrats strongly oppose cutting Social Security. Similarly, 86 percent of Republicans, 80 percent of independents, and 88 percent of Democrats said they strongly oppose cutting Medicare.”

Washington insiders consider Social Security to be the “third rail of a nation’s politics”, a metaphor coming from the high-voltage third rail in some electric railway systems. Stepping on it usually results in electrocution and the use of the term in the political arena refers to “political death”.

Next November, can the GOP politically survive stepping on the third rail by targeting the nation’s most popular social welfare programs (Social Security and Medicare) for adjustments to reduce the federal budget deficit? When the dust settles after November, 2024 elections, we’ll see if younger voters, who have the most to economically lose, view Social Security and Medicare as a key issue influencing their vote and “untouchable.”

We’ll see. 

Federal Court denies attempt to stop Medicare drug negotiation program

Published in RINewsToday on November 6, 2023

Over two months ago, as supporters of President Biden’s Inflation Reduction Act (IRA) celebrated the one-year anniversary of the passage of the historic legislation, the U.S. Chamber of Commerce, Pharmaceutical Research and Manufacturers of America (PhRMA), along with drugmakers filed multiple lawsuits to block the IRA’s drug price negotiation provisions.  The drug price negotiation program, created by IRA, allows Medicare to use its bargaining power to negotiate the prices of ten prescription drugs for the first time.

The multiple-filed legal suits came weeks before Sept. 1 when the for Centers Medicare & Medicaid Services (CMS) was scheduled to publish a list of the first 10 drugs that would be subjected to negotiations.  These lawsuits argued that the federal price negotiation program was unconstitutional because it violated the First and Fifth Amendments of the U.S. Constitution, as well as the separation of powers clause, by giving the U.S. Department of Health and Human Services (HHS) discretion over a maximum fair price for any given drug selected for negotiation.  These lawsuits also charge that CMS price controls would force drug makers to pull back on developing new drugs, jeopardizing medical breakthroughs for individuals with life-threatening and chronic illnesses. 

Among the nine lawsuits scheduled to go to trial, one was a motion filed on July 12, 2023 by the Chamber and several of its affiliates in Ohio. This motion requested the court to issue a preliminary injunction to halt the Medicare drug negotiation program from implementation. The ruling came before the Oct. 1, 2023 deadline requiring drugmakers whose pharmaceuticals were selected for negotiations to either sign agreements to participate or to face stiff penalties.  

The U.S. Department of Justice opposed the Chamber’s motion, filing a motion to dismiss its case.  On Sept. 15, 2023, the court held oral arguments giving the  Chamber and the DOJ an opportunity to present their legal arguments in greater detail.  

Overcoming a Major Legal Hurdle 

On Friday, September 29, 2023, U.S. District Judge Michael J. Newman for Southern District of Ohio, denied the Chambers request to block implementation of the newly established Medicare drug price negotiation program before the drug price negotiation talks began.  The ruling called on the Chamber to file an amended complaint by Oct. 13, 2023. DOJ would then have until Oct. 27, 2023 to renew its motion to dismiss.

According to Spencer Kimball of CNBC, legal experts say the pharmaceutical industry hopes to see conflicting rules from lawsuits filed in other federal appellate courts to bring this issue to the Supreme Court for final resolution. 

The Willimantic, Connecticut-based Center for Medicare Advocacy (CMA), a nonprofit group pushing for comprehensive Medicare coverage, health equity and quality of health care for seniors and people with disabilities, is encouraged by Judge Newman’s ruling, which assessed the drug manufacturer’s claims “to be weak in the face of clearly established laws.”

According to CMA, the 28-page court order found that the Chamber and other plaintiffs had demonstrated neither likelihood of success on the merits, nor irreparable harm, which are required for a preliminary injunction.  CMS noted that this case cited “clear” law that “participation in Medicare, no matter how vital it may be to a business model, is a completely voluntary choice.” The court also found that the price established by negotiations cannot be considered ‘confiscatory,’ as the Chamber charges or “a violation of due process, because drug manufacturers can opt out of Medicare entirely.”

Newman’s ruling noted that drugmakers are not compelled to sell drugs at the prices established by the Medicare program and that any economic harm, when the negotiated drug prices take effect in 2026, was too speculative to warrant immediate relief, reported CMS.  However, the court did deny the government’s motion to dismiss the lawsuit entirely, saying that more information on whether the plaintiffs have standing to sue would be beneficial and therefore the judge is allowing for limited discovery to clarify issues related to legal standing, after which the government may renew its motion to dismiss, noted the Medicare advocacy group.

With this ruling, Medicare may move forward with its implementation of its drug negotiation program as this case and others continue to proceed. 

Giving their two cents…

At press time, the Chamber did not respond to a request for comment about the court’s ruling.  But health care and aging advocacy groups issued statements expressing their thoughts about the impact of Newman’s ruling. 

“This is the first major blow to Big Pharma in its legal battles to block the drug price negotiation provisions under the Inflation Reduction Act, says Peter Maybarduk, Public Citizen’s director of the Access to Medicines program.

“The Chamber’s lawsuit lacks merit; the court made the right decision not to grant the injunction, which would have caused needless patient suffering and treatment rationing, notes Maybarduk, calling on drugmakers “to drop their lawsuits and drop their prices.”

“Now, drug companies should agree to participate in the negotiation program in good faith. The program is an important first step in ending the exorbitant prices charged to Medicare enrollees,” adds Maybarduk.

Frederick Isasi, Executive Director of Families USA, happily noted that the Medicare drug negotiation program continues, calling the ruling “a big win for seniors and their ability to purchase life-saving medications. The ability to afford medication is a matter of life and death for millions of older adults. That’s why we are fighting this David and Goliath battle – people deserve to pay a fair price for their drugs and Medicare price negotiation is a critical piece of this puzzle. And let’s not forget each drug subject to fair price negotiation is an old drug that millions of people need and doesn’t have competition,” he notes.

“It never ceases to amaze us that – on one hand – Big Pharma can cry poverty by saying that drug negotiations will hurt their bottom line, while recent earnings reports show they are raking in money hand over fist.  We are glad Judge Michael J. Newman, a Trump appointee in Ohio’s Southern District, saw through this hypocrisy by affirming the Biden administration’s power to begin negotiating the prices of 10 medications with drugmakers,” says Dan Adcock, Director of Government Relations and Policy, of the Washington, DC-based National Committee to Preserve Social Security and Medicare. (NCPSSM).

According to NCPSSM, Drug makers made a whopping $493 billion in revenue from ten drugs that are now subject to price negotiations between CMS and the manufacturer, which have accounted for more than $170 billion in gross Medicare spending, according to a report from the nonprofit, Protect Our Care.

“The court’s decision to allow Medicare drug price negotiations to move forward is welcome news, says William Alvarado Rivera, Senior Vice President for Litigation at AARP Foundation. “Pausing Medicare negotiations would have risked billions of dollars in savings for taxpayers – and countless lives. It is unconscionable that Americans face such high prescription drug costs that many people skip taking medication altogether or must ration it,” he said.

“We’re prepared to fight for as long as necessary to ensure big drug companies can’t charge excessive prices at the expense of patients’ health, says Rivera, noting that the new Medicare negotiation law would bring financial and medical relief to millions of older Americans and their families, and put drugs that treat life-threatening and chronic conditions, from cancer to heart disease, within their reach. Rivera says, “It must not be derailed.” 

Congress has put the breaks to the spiraling costs of pharmaceuticals by giving Medicare the authority to negotiate the price of popular drugs with drug makers.  America’s seniors will continue to suffer financial  hardships and many might even lose their lives by not choosing not to take their costly medications if courts rule in favor of drug companies.  Time will tell.   

U.S. Judge Michael J. Newman ruling denying the U.S. Chamber of Commerce’s request for a preliminary injunction, go to https://www.bloomberglaw.com/public/desktop/document/DaytonAreaChamberofCommerceetalvBecerraetalDocketNo323cv00156SDOh/5?doc_id=X3U600KOGG69QHQBPEU24OS1JMO

A listing of drugmaker revenues of the first ten negotiated drugs, go to https://www.protectourcare.org/by-the-numbers-the-ten-costly-drugs-that-are-now-eligible-to-have-lower-prices-negotiated-by-medicare/

Senate bipartisan proposal boon to nation’s family caregivers

Published on October 30, 2023

Many family caregivers will tell you that coping with the stress of providing care to loved ones, is made more difficult when they are forced to navigate the confusing federal bureaucracy to identify key financial and health care programs for support. Last week, S 3109, the Alleviating Barriers for Caregivers (ABC) Act, was thrown into the legislative hopper to make it easier for more than 48 million family caregivers to obtain this information. The Senate caregiver proposal was referred to the Senate Finance Committee and no House companion measure has been introduced at press time. 

On Oct. 24, the bipartisan Senate proposal was introduced by Senators Edward Markey (D-MA) and Shelley Moore Capito (R-WV) and is co-sponsored by Senators Kyrsten Sinema, (I-AZ), Susan Collins (R-ME), Bob Casey (D-PA), and Thom Tillis (R-NC). The proposal would require the Administrator of the Centers for Medicare & Medicaid Services and the Commissioner of Social Security to review and simplify the processes, procedures, forms, and communications for family caregivers to assist individuals in establishing eligibility for, enrolling in, and maintaining and utilizing coverage and benefits under the Medicare, Medicaid, CHIP, and Social Security programs respectively, and for other purposes. The agencies must conduct a review and seek input from family caregivers prior to taking actions that would improve their experiences coordinating care for their loved ones.

Currently, more than 48 million family caregivers in the U.S. help take care of loved ones. According to AARP and the National Alliance for Caregiving in the U.S. report, caregivers provide support ranging from selecting the best providers; coordinating multiple health and long-term care providers; navigating the care system; advocating with providers, community services, and government agencies; and managing medications, complex medical tasks, meals, finances, and more.

According to AARP, most caregivers say additional information and support for managing these needs is essential. One in four family caregivers (25%) report they want help figuring out forms, paperwork, and eligibility for services and 26% say that it is difficult to coordinate care across various providers and services. While most (61%) work full- or part-time, and some also care for children, family caregivers spend almost 24 hours a week caring for a loved one on average, says the Washington, DC-based advocacy group.

Personal caregiving experiences leads to calls for caregiver assistance 

Being family caregivers, both Senators Markey and Capito, primary sponsors of S 3109, like many caregivers, encountered red tape when they attempted to find needed federal caregiving programs and services to care for their parents.

“When my mother suffered from Alzheimer’s, my father was her caregiver in our home in Malden,” remembers Senator Markey. “Caregivers serve on the frontlines of our nation’s health care system by giving our families and friends the care and support they need to remain in their homes and communities with their loved ones. However, our aging and disabled community members can’t get the care they need if their caregivers – the backbone of their treatment – are struggling to navigate complex, burdensome, and stressful processes each and every day while also still managing day-to-day family and professional responsibilities. 

“As a caregiver for my parents during their struggle with Alzheimer’s disease, I know personally the level of responsibility put on family caregivers and the burdens, which can be created by federal process and procedure,” said Senator Capito. “Caregivers in West Virginia and across our country put family first and balance multiple priorities at once, which is why we must do all we can to alleviate roadblocks that could delay and even prohibit them from receiving the support they need,” she said. 

Calls for upper Chamber to pass caregiver proposal

At press time, 32 national aging and health care strongly support passage of S 3109.

“Family caregivers are the backbone of our nation’s long-term care system, and they are overwhelmed with their responsibilities and time spent managing their loved one’s care,” said Executive Vice President and Chief Advocacy and Engagement Officer Nancy LeaMond. “The Alleviating Barriers for Caregivers Act could help save family caregivers valuable time and reduce their stress by making it easier to navigate resources, eligibility, benefits, and health systems when providing care, she says.  

“Our concern is that these federal caregiver programs are so complicated, they become virtually inaccessible, discouraging family and friends from providing caregiving services. The ABC Act is the first step to holding CMS and SSA accountable for eliminating these barriers to caregiving so people with intellectual and developmental disabilities can live their lives in the community,” said Robin Troutman, Deputy Director at National Association of Councils on Developmental Disabilities.

“The Rosalynn Carter Institute for Caregivers (RCI) supports the Alleviating Barriers for Caregivers Act. Far too often family caregivers are faced with burdensome administrative obstacles in accessing the resources and supports to which they’re due. As system fragmentation is a significant component of caregiver strain, we commend this important first step to better streamline, simplify, and coordinate access across federal programs, said Dr. Jennifer Olsen, CEO of the Rosalynn Carter Institute for Caregivers.

“Being a caregiver to someone living with Alzheimer’s is already an incredibly difficult and emotionally draining job. When you layer on top of it the daunting task of navigating our country’s complex healthcare coverage system, it can become downright overwhelming for even the smartest person. This bill is an important step toward making it easier for caregivers to fully advocate on behalf of their loved ones to ensure they have access to the diagnostic, pharmaceutical, and treatment services they need, said George Vradenburg, Chair and Co-founder of UsAgainstAlzheimer’s.

Congress must come together to support caregivers

Family caregivers across the national  provide 36 billion hours of unpaid care, valued at an estimated $600 billion annually. In the Ocean State, 121,000 family caregivers provide 113 million hours of unpaid care valued to be 2.1 billion. These caregivers need assistance from Congress to access resources to provide care to their loved ones. 

There is 372 days left until the 2024 president elections. AARP research tells us that a majority of voters, 78%, are either a current, past, or future family caregiver. Over 70% of voters across the political spectrum say they would be more likely to support a candidate who backed proposals to support family caregivers, such as a tax credit, paid family leave, and more support and respite services.

Hopefully, more Senators will see the value of S. 3109 and quickly become cosigners. It’s time the newly elected House Speaker Mike Johnson (R-LA) and his caucus put the need of their caregiver constituents first, over their political priorities, and support passage of a House companion measure. The House Problem Solvers Caucus can be instrumental in pushing for the introduction and passage. Time will tell.

For more information about caregiving, go to www.aarp.org/caregiving.

For a copy of the 2022 National Strategy to Support Family Caregivers, go to https://acl.gov/sites/default/files/RAISE_SGRG/NatlStrategyToSupportFamilyCaregivers.pdf