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GOP House Budget Fray’s Nation’s Safety Net

Published in the Woonsocket Call on June 24, 2018

Just six months ago, the Republican-controlled House passed their massive $1.5 trillion tax cuts for the nation’s largest corporations and to the wealthiest 1 percent. The day of reckoning has now come as the GOP spells out how it will rein in the nation’s spiraling deficit through its recently released FY 2019 budget resolution. On Tuesday, the House Budget Committee unveiled its 85-page budget resolution, making trillions in spending cuts to Medicare and Medicaid, he nation’s two largest entitlement programs, health care, and programs benefiting veterans, students and working families. ‘

The budget titled, “A Brighter American Future,” calls for $8.1 trillion of deficit reduction while including reconciliation instructions for 11 House authorizing committees to enact at least $302 billion over nine years. Consistent with levels signed into law in February 2018, this budget sets topline discretionary spending at $1.24 trillion ($647 billion for defense spending and $597 billion for non-defense discretionary spending).

The budget blueprint cleared the House Budget Committee by a partisan vote of 21-13, with a vote, with a Democratic and Republican lawmaker absent from the vote. Political insiders Fortunately, Capitol Hill-watchers say the 2019 House GOP Budget proposal is unlikely to make it before the full House or pass this year. But, it sends a message out to voters about the Republican’s legislative priorities to rein in a skyrocketing deficits and debt by slashing entitlement and popular domestic programs.

Putting the Wealthy and Powerful Ahead

When unveiling the House GOP’s budget, Chairman Steve Womack of Arkansas, notes that it addresses “unsustainable mandatory spending, continues economic growth, encourages better government and greater accountability, and empowers state and local governments.”

During a CNBC interview on June 22, 2018, Womack said, “We have done our job and it is a reflection of what we believe is the stark reality of the fiscal condition of our country right, unstable deficits year over year and $21 trillion in debt that is going to continue to grow over time. We just felt like it was time to sound the alarm and do something about and this and this particular budget resolution does it.”
Democratic Policy and Communications Committee Co-Chair David N. Cicilline counters Womack’s rosy assessment of the House GOP budget. ““If a budget is a statement of your values, then this budget shows Republicans are putting the wealthy and powerful ahead of working people. Just a few months after passing a massive tax cut for billionaires and corporate special interests, Republicans are proposing to repeal the Affordable Care Act; cut funding for road repairs and other infrastructure projects; cripple Medicare and Social Security; make deep cuts to Pell grants; and repeal Dodd-Frank so the big banks can do whatever they want once again. In fact, this budget is so terrible, it’s hard to imagine Republicans will ever bring it to the floor,” says the Rhode Island lawmaker.

“But despite an extraordinary past and a booming economy thanks to tax reform, there are real fiscal challenges casting a shadow of doubt on the nation’s future, including $21 trillion of debt that is rapidly on the rise. We must overcome the challenges,” says Womack.

Womack says that his budget plan “offers a balanced and responsible plan to not only address the challenges but give rise to the nation’s prosperity.”

Medicare and Medicaid on Budgetary Chopping Block

Numerous federal programs affecting old Americans would be put on the budgetary chopping block, which includes another call for full repeal of the Affordable Care Act (ACA), leaving 23 million Americans without health coverage. $5.4 trillion of cuts would come from mandatory or automatic spending programs such as Medicare and Medicaid. The plan calls for raising the Medicare eligibility age to 67, as well as combining Medicare Parts A and B, and allowing for privatization of the entitlement program. The projected cuts for Medicare alone add up to $537 billion.

The GOP’s efforts to privatize Medicare runs counter to what Americans want, preserving the program in its current form. The Kaiser Family Foundation released poll results in 2015, celebrating Medicare’s 50th Anniversary, the respondents by a margin of more than two to one, do not want to see their traditional Medicare privatized.

As to Medicaid, a joint federal and state program that helps with medical costs for some people with limited income and resources, the GOP budget plan limits per capita payments and allows states to turn it into a block grant. It also introduces stricter work requirements for beneficiaries and shifting to a capped system linked to medical inflation rates, these changes cutting about $1.5 trillion. Additionally, Womack’s budget would no longer allow people on Social Security disability to receive unemployment insurance at the same time, slashing $4 billion for the FY 2019 budget.

Outside of mandatory spending programs, the budget would cut trillions from “welfare,” federal retirement programs and veterans programs, while overhauling rules for medical liability lawsuits.

“This budget proposal is a direct attack on the quality of life of America’s seniors,” said Robert Roach, Jr., President of the Alliance of Retired Americans. “We must hold our elected officials accountable for their actions. We predicted cuts to our hard-earned benefits after the GOP passed their unfunded tax cuts for billionaires and corporations. Unfortunately, that reality is now staring us in the face,” he says.

Adds Max Richtman, president and CEO of the National Committee to Preserve Social Security and Medicare, “Speaker Ryan is obviously making good on his promise to come after safety net programs to pay for the reckless Trump/GOP tax reform. In so doing, he and his party are sending a clear message: older, poorer, and disabled Americans are not as important as the billionaires and big corporations who are the main beneficiaries of a tax scheme that is blowing up our nation’s debt.”

Before the House Budget Committee vote, Joyce A. Rogers, AARP’s Senior Vice President Government Affairs, urged that Medicare not be cut. She called for good changes such as “reducing prescription drugs costs, enhancing payment and delivery reforms, and addressing the widespread fraud, waste, and abuse in the program.”

According to Rogers, “The typical senior, with an annual income of approximately $26,000 and already spending one out of every six dollars on health care, counts on Social Security for the majority of their income, and on Medicare for access to affordable health coverage.”

Finally, Rogers notes that the Supplemental Nutrition Assistance Program (SNAP) plays vital role in providing nutritional assistance to millions of eligible, low-income individuals and families, many seniors. “In 2016, 8.7 million (over 40 percent of) SNAP households had at least one adult age 50 or older. Proposals to block grant the program, or expand work requirements, will make SNAP less responsive and accessible in times of need,” she says.

Educate Yourself About the Issues

With the upcoming Rhode Island primary on September 12, and midterm elections just 135 days, AARP Rhode Island State Director Kathleen Connell urges all registered Rhode Island voters to review candidates’ positions on the issues and go to the polls and cast your ballot. “The 2018 midterms will be among the most historic elections in a generation,” she said.

Nationwide, the balance of power in both houses of Congress, as well as in many state legislatures and governorships, could shift because of the results in the fall’s general elections, says Connell.

While the most common way to vote is for registered voters to go to their local polling place on Election Day, Connell said that many family caregivers and others who may have difficulty voting on that day may be eager to take advantage of other methods of casting a ballot.

“With all that unpaid family caregivers have on their plates each day, it can often be hard for them to get to the polls on Election Day,” said Connell. “If a caregivers’ loved one is voting, it can be even harder, especially if their loved one has mobility issues. When available, alternative methods of casting a ballot (a mail ballot) are essential to allowing our state’s family caregivers and others to participate in this important election.” To learn more about mail ballots, visit https://vote.sos.ri.gov/

To mobilize it’s 35 million members, AARP has launched “Be the Difference. Vote,” a campaign designed to maximize the political influence of over age 50 voters. The initiative seeks to get the largest possible turnout of older voters to the polls during the ongoing primaries and in the November general election. It will also put front and center issues like Medicare security and family caregiving, along with other topics of particular interest to older voters.

To learn more about “Be the Difference. Vote,” check out aarp.org/vote to see how to get involved and state informed.

Bipartisan Fix Needed to Ensure Solvency of Social Security, Medicare

Published in the Woonsocket Call on June 10, 2018

On June 5, 2018, the Social Security and Medicare trustees released their annual report to Congress providing a snapshot of the long-term financial security of Medicare and Social Security, two of the nation’s two large entitlement programs. It was not good news for lawmakers. Nor for the 67 million people who receive retirement, or disability benefits from Social Security and for 58.4 million on Medicare.

The 2018 Social Security Trustee’s Report to Congress, prepared by nonpolitical actuaries and economists, warned that the combined asset reserves of the Old-Age and Survivors Insurance and Disability Insurance (OASDI) Trust Funds are projected to become depleted in 2034, the same as projected in last year’s Annual Report, with 79 percent of benefits payable at that time.

According to the Annual Report’s findings, the OASI Trust Fund is projected to become depleted in late 2034, as compared to last year’s estimate of early 2035, with 77 percent of benefits payable at that time. The DI Trust Fund will become depleted in 2032, extended from last year’s estimate of 2028, with 96 percent of benefits still payable.’

As to Medicare, the Medicare trustee’s report predicted that the Medicare hospital program will not be able to pay full benefits in 2026. The Trustees, for a second year in a row, issued a Medicare funding warning due to general revenue funding expected to exceed 45 percent of total Medicare outlays within 7 years, triggering a requirement for the President to submit to Congress in 2019 legislation to address warning to be considered on an expedited basis.

Released Report Triggers Discussion on Social Security, Medicare, Solvency

Media across the country reported the Social Security and Medicare trustees warning about long-term financial issues facing Social Security and Medicare. Just read the New York Time’s headline: “Medicare’s Trust Fund is Set to Run Out in 8 Years. Social Security.” Here’s CNN’s take: “Social Security Must Reduce Benefits in 2034 if Reforms Aren’t Made.” Or take a look at the New York Daily News’s attention-grabbing headline, “Social Security and Medicare Head Toward the Skids.”

With the release of the 2018 Annual Report, the powerful House Ways and Means Committee Chairman Kevin Brady (R-TX), called for ensuring the financial solvency of Social Security and Medicare. “The time is now to come together in a bipartisan manner to address these real challenges, he said.

Health Subcommittee Chairman Peter Roskam (R-IL) also gave his two cents. “The Medicare Trustees paint an even bleaker picture than last year, pointing to the need for commonsense reforms to ensure this critical safety net program continues to deliver health care to our nation’s seniors and individuals with disabilities,” said Roskam. “The solutions are not elusive as was demonstrated in part earlier this year when Congress acted on key Medicare reforms contained in the Bipartisan Budget Act of 2018 to improve access and quality in the Medicare program, but more work remains to be done. This warning from the Trustees is a sobering marker of the work ahead to ensure this program is around for our children and grandchildren,” he said.
Looking at the Glass Half-Full, not Half-Empty

Even with the bleak findings, the National Committee to Preserve Social Security and Medicare and other aging advocacy groups have their take.

Max Richtman, president and CEO of the National Committee to Preserve Social Security and Medicare (NCPSSM), notes the released Annual Report confirms that the Social Security’s trust fund is “still very much intact, with $2.89 trillion in assets – or $44 billion more than last year.”

There is still time for Social Security fixes, says Richtman. “The Trustees have confirmed that Congress has ample time (16 years) to enact modest and manageable changes to Social Security to address the fiscal shortfall. Most Americans agree that raising the payroll wage cap is the easiest and most effective way to strengthen Social Security’s finances, negating the need for harmful benefit cuts like means testing or raising the retirement age,” he said.

According to NCPSSM, since 2013 there has been a growing number of aging groups [along with Democratic lawmakers] calling to lift the wage cap and increase Social Security benefits. The Washington, DC-based NCPSSM’s Boost Social Security Now campaign endorses legislation in Congress introduced by Senator Bernie Sanders (I-VT), Rep. John Larson (D-CT) and others, which keeps the Social Security Trust Fund solvent well into this century, while boosting benefits and cost-of-living adjustments (COLAs).

On Medicare, the Trustees report shows that the Part A Trust Fund will be able to pay full benefits until 2026, at which point payroll taxes are estimated to be sufficient to cover 91% of benefits – if nothing is done to bolster the system’s finances, says Richtman, noting that NCPSSM supports several measures to keep Medicare financially sound, including a genuine push to allow the program to negotiate drug prices with pharmaceutical companies.

NCPSSM calls for restoring rebates the pharmaceutical companies formerly paid the federal government for drugs prescribed to “dual-eligibles” (those who qualify for both Medicare and Medicaid), in addition to innovation in the delivery of care and in the way, care is paid for – to keep Medicare fiscally sound for future beneficiaries.

AARP CEO Jo Ann Jenkins urges Congress to work “in a bipartisan manner to strengthen these vital social insurance programs to ensure they can meet their benefit promises for current and future generations.” She agrees with Richtman about the need to rein in rising Medicare pharmaceutical costs. “In particular, we need to take further steps to lower the cost of health care, especially the ever-rising price of prescription drugs. No good reason exists for Americans to continue paying the highest brand name drug prices in the world. High-priced drugs hurt Americans of all ages, and seniors, who on average take 4.5 medications a month, are particularly vulnerable,” she said.

Nancy Altman, President of Social Security Works and the Chair of the Strengthen Social Security Coalition, calls for strengthening and expanding Social Security not cutting it.

The Social Security program is “fully affordable,” says Altman, noting that “poll after poll shows that the American people overwhelmingly support expanding the program’s benefits.” Politicians are listening, too, she said.

“Social Security is a solution to our looming retirement income crisis, the increasing economic squeeze on middle-class families, and the perilous and growing income and wealth inequality. In light of these challenges and Social Security’s important role in addressing them, the right question is not how we can afford to expand Social Security, but, rather, how can we afford not to expand it,” says Altman.

It’s Time for a Bipartisan Fix

As the mid-term election approaches, it’s time for the Republican congressional leaders to work with their Democratic colleagues to craft bipartisan legislation to make permanent long-term fixes to Social Security and Medicare to ensure these program’s fiscal solvency for future generations.

It is projected roughly 10,000 Baby Boomers will turn 65 today, and about 10,000 more will cross that threshold every day for the next 19 years. By the time the last of this generation approaches retirement age in 2029, 18 percent of the U.S. will be at least that age, reports the Pew Research Center.

With the graying of American, the hand writing is on the wall. With the release of this year’s report by the Social Security and Medicare trustees, Congress must decisively act now to ensure that Social Security and Medicare are strengthened, expanded and benefits not cut. As Chairman Brady, of the House Ways and Means Committee, says, it is now time to address these real challenges. Hopefully, his House colleagues and lawmakers in the upper chamber will agree.

2050 and the Caregiver Dilemma

Published in the Woonsocket Call on April 22, 2018

The year 2030 marks an important demographic turning point in U.S. history according to the U.S. Census Bureau’s 2017 National Population Projections, released last month. By 2030, older people are projected to outnumber children. In the next twenty years, when these aging baby boomers enter their 80s, who will provide informal caregiving to them.

Almost three years earlier, in a July 2015 report, “Valuing the Invaluable: 2015 Update Undeniable Progress, but Big Gaps Remain,” the AARP Public Policy Institute warned that fewer family members will be around to assist older people with caregiving needs.

According to AARP’s 25-page report, coauthored by Susan C. Reinhard, Lynn Friss Feinberg, Rita Choula, and Ari Houser, the ratio of potential family caregivers to the growing number of older people has already begun a steep decline. In 2010, there were 7.2 potential family caregivers for every person age 80 and older. By 2030, that ratio will fall sharply to 4 to 1, and is projected to drop further to 3 to 1 in 2050.

Family caregivers assisting relatives or close friends afflicted with chronic, disabling, or serious illness, to carry out daily activities (such as bathing or dressing, preparing meals, administering medications, driving to doctor visits, and paying bills), are key to keeping these individuals in their homes and out of costly nursing facilities. What is the impact on care of aging baby boomers when family caregivers no longer provide assistance in daily activities?

“In 2013, about 40 million family caregivers in the United States provided an estimated 37 billion hours of care to an adult with limitations in daily activities. The estimated economic value of their unpaid contributions was approximately $470 billion in 2013, up from an estimated $450 billion in 2009,” notes AARP’s caregiver report. What will be the impact on the nation’s health care system without family caregivers providing informal care?

The Census Bureau’s 2017 National Population Projections, again puts the spot light on the decreasing caregiver ratio over the next decades identified by the AARP Policy Institute, one that must be planned for and addressed by Congress, federal and state policy makers.

Who Will Take Care of Aging Baby Boomers?

With the expansion in the size of the older population, 1 in every 5 United States residents will be retirement age. Who will provide informal caregiving in our nation with a larger adult population and less children to serve as caregivers?

“The aging of baby boomers means that within just a couple decades, older people are projected to outnumber children for the first time in U.S. history,” said Jonathan Vespa, a demographer with the U.S. Census Bureau. “By 2035, there will be 78.0 million people 65 years and older compared to 76.4 million under the age of 18.”

The 2030s are projected to be a transformative decade for the U.S. population, says the 2017 statistical projections – the population is expected to grow at a slower pace, age considerably and become more racially and ethnically diverse. The nation’s median age is expected to grow from age 38 today to age 43 by 2060.

The Census Bureau also observed that that as the population ages, the ratio of older adults to working-age adults, also known as the old-age dependency ratio, is projected to rise. By 2020, there will be about three-and-a-half working-age adults for every retirement-age person. By 2060, that ratio will fall to just two-and-a-half working-age adults for every retirement-age person.

Real Challenges Face Congress as the Nation Ages

Jean Accius, Ph.D., AARP Policy Institute’s Vice President, Independent Living, Long-Term Services and Supports, says, “The recent Census report highlights the sense of urgency to develop innovative solutions that will support our growing older adult population at a time when there will likely be fewer family caregivers available to help. The challenges that face us are real, but they are not insurmountable. In fact, this is an opportunity if we begin now to lay the foundation for a better system of family support for the future. The enactment of the RAISE (Recognize, Assist, Include, Support and Engage) Family Caregivers Act, which would create a strategy for supporting family caregivers, is a great path forward.”

Max Richtman, President and CEO of the Washington, DC-based National Committee to Preserve Social Security and Medicare, gives his take on the Census Bureau’s 2017 statistical projections, too.

“Despite how cataclysmic this may sound, the rising number of older people due to the aging of baby boomers is no surprise and has been predicted for many years. This is why the Social Security system was changed in 1983 to prepare for this eventuality. Under current law, full benefits will continue to be paid through 2034 and we are confident that Congress will make the necessary changes, such as raising the wage cap, to ensure that full benefits continue to be made well into the future,” says Richtman.

Richtman calls informal caregiving “a critical part of a care plan” that enhances an older person’s well-being. “While there currently are programs such as the Medicaid Waiver that will pay family members who provide caregiving support more can be done to incentivize caregiving so that loss of personal income and Social Security work credits are not barriers to enlisting the help of younger individuals to provide informal support services,” he says.

Adds Richtman, the Medicare and Medicaid benefits which reimburse for the home-based services and skilled nursing care “will be unduly strained ”as the diagnosed cases of Alzheimer’s disease skyrockets with the growing boomer population. He calls on Congress to “immediately provide adequate research funding to the National Institutes of Health to accelerate finding a cure in order to save these programs and lower the burdens on family caregivers and the healthcare system. “

Finally, AARP Rhode Island State Director Kathleen Connell, says “Our aging population represents challenges on many, many fronts, including healthcare, housing, Social Security, Medicare and, of course, caregiving. It would be nice to think everything would take care of itself if there were more younger people than older people. But that misses the point entirely. The needs of older Americans are a challenge to all Americans, if for no other reason than most of us end up with multiple late in life needs. And too many reach that point without savings to cover those needs.”

“It’s worth noting, by the way, that many of the solutions will come from people 50 and older — many of whom will work longer in their lives to improve the lives of older Americans. We need to stop looking through the lens of ‘old people’ being the problem and instead encourage and empower older Americans to take greater control over their lives as they help others,” says Connell.

“Congress needs to focus on common sense solutions to assure families that Social Security and Medicare are protected. The healthcare industry needs to face the medical challenges. And at the state and local level, we must focus on home and community-based health services,” adds Connell.

For details about the Census Bureau’s 2017 statistical projections, co to http://www.census.gov/newsroom/press-releases/2018/cb18-41-population-projections.html.

For more information about AARP’s July 2015 caregiver report, go to http://www.aarp.org/content/dam/aarp/ppi/2015/valuing-the-invaluable-2015-update-new.pdf.

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