Social Security must be key issue in 2024 Presidential Election

Published in RINewsToday on July 17, 2023

Last Wednesday, 178 House Democrats, (90% of the House Democratic caucus) led by Rep. John Larson (D-Conn.) introduced  H.R. 4583, the “Social Security 2100 Act of 2023.” The 108-page bill would expand Social Security’s benefits, with no cuts, and keep the system fiscally strong for decades to come. Senator Richard Blumenthal (D-Connecticut) has introduced the companion measure in the upper Chamber.

In May, to drum up support, enthusiasm, and attention for H.R. 4583, Larson, House Ways and Means Social Security Subcommittee Ranking Member, was joined by House Democratic Leader Hakeem Jeffries (D-,New York), Ways and Means Committee Ranking Member Richard Neal (D- Massachusetts) and other House leaders to announce the upcoming introduction of Social Security 2100.

“10,000 Baby Boomers a day become eligible for Social Security, making the point of acting now even more urgent, says Larson. “I am proud to be joined again by a majority of my Democratic colleagues to introduce Social Security 2100, and again, ask my Republican colleagues, whose legislation we’ve included, to join us in helping uplift the 65 million Americans who rely on it. Including lifting 5 million Americans out of poverty, providing 23 million a tax cut, and making sure that Americans are able to get the essential benefits that allow them to pay rent, buy groceries, and fill their prescriptions,” he says.

“It’s important that the Social Security benefits that working Rhode Islanders have earned keep up with the cost of living, and that’s exactly what H.R.4583 – Social Security 2100 Act will accomplish. Unfortunately, extreme Republicans in the House are trying to cut Social Security instead of strengthening it. But I am determined to fight for Rhode Island’s seniors in Congress to ensure they receive the benefits they’ve earned,” says Congressman Seth Magaziner (D-R.I.), a sponsor of the legislative proposal. 

H.R. 4583: The Nuts and Bolts

On July 12, 2023, H.R. 4583 was introduced and referred to the House Ways and Means, Education and Labor, and Energy and Commerce Committees, being introduced in the lower chamber that day.

According to a legislative fact sheet, H.R. 4583, the legislative proposal would increase and expand essential benefits to Social Security beneficiaries. Larson’s legislation would:

•   Increase benefits 2% across the board for all Social Security beneficiaries for the first time in 52 years.  

• Improve the Cost-of-Living Adjustment (COLA), so it reflects the inflation actually experienced by seniors.

• Increase benefits to boost lower income seniors.

• Improve benefits for middle-income widows and widowers from two-income households.

• Restore student benefits up to age 26, for the dependent children of disabled, deceased, or retired workers.

• Increase access to benefits for children living with grandparents or other relatives.

• Repeal the Windfall Elimination Provision (WEP) and Government Pension Offset (GPO) that currently penalize many public servants.

• End the 5-month waiting period to receive disability benefits.

• Increases benefits by an additional 5% for the most elderly and those who have been receiving disability benefits the longest, those beneficiaries who have been receiving benefits for 15 years or more.

 • Provide caregiver credits to ensure that people (mostly women) are not penalized in retirement for taking time out of the workforce to care for children or other dependents.

• End the disability benefit cliff, replacing it with a gradual offset for earnings.

• Cut taxes for 23 million middle-income beneficiaries.

• Correct an unintended flaw in how Social Security benefits are wage-indexed, to prevent benefits from dropping (a “notch”) if the wage index decreases.

• Ensure that these benefits do not result in reduced Supplemental Security Income (SSI) payments or a loss of eligibility for Medicaid or CHIP.

• Combine the Old-Age and Survivors Insurance (OASI) and the Disability Insurance (DI) Trust Funds into one fund to ensure seamless benefit payments.

• Provide the Social Security Administration with resources to improve customer service.

Social Security 2100 Pays for These Benefits by:

• Ensuring millionaires and billionaires pay their fair share by applying FICA to earnings above $400,000.

H.R. 4583 would pay for strengthening the Social Security Trust Fund and pay for the enhanced benefits by having millionaires and billionaires pay their fair share by applying FICA to earnings above $400,000, with those extra earnings counted toward benefits at a reduced rate. The bill closes the loophole of avoiding FICA taxes and receiving a lower rate on investment income by adding an additional 12.4% net investment income tax (NIIT) only for taxpayers making over $400,000.

Social Security advocates call for passage

“By re-introducing his revised Social Security 2100 Act, Congressman John Larson once again defies the media narrative that ‘no one in Washington has the courage’ to address the program’s future,” says Max Richtman, President and CEO, of the Washington, DC-based National Committee to Preserve Social Security and Medicare, noting that the legislation extends the solvency of the Social Security trust fund for decades while also providing American seniors with an expansion of benefits.  Larson tackles the funding of the expansion of benefits by asking high earners to begin paying their fair share into the program, says Richtman. 

“At a time when House Republicans have proposed cutting benefits by raising the retirement age and other means — Congressman Larson offers a commonsense, fair, and forward-looking plan.

Not only is the Social Security 2100 Act wise policy, but it’s also overwhelmingly popular with voters across the political spectrum,” says Nancy Altman, President of Social Security Works and Chair of the Strengthen Social Security Coalition.

As the debate over Social Security heats up before the 2024 Presidential election, Altman charges that the nation’s media  refuses to “take Democratic plans to protect and expand Social Security seriously, and fails to call out Republicans for their unwillingness to state what they are for, not just what they are against.”

“Reporters are implicitly dismissing these bills because they cannot pass the House and Senate without Republican support. Instead of pressuring Congressional Republicans to introduce their own legislation, the mainstream media provides the Republicans with the cover they seek by claiming that both parties are avoiding action on Social Security” says Altman.

According to Altman, earlier this year President Joe Biden used the presidential bully pulpit at the State of the Union address to call out Republicans for their plans to cut Social Security and Medicare, forcing them to take these program cuts off the table during the debt ceiling negotiations. “If Biden champions a plan that expands benefits with no cuts, while requiring those earning over $400,000 to pay more, the mainstream media will be unable to ignore it,” predicts Altman. 

Congressional strategies regarding Social Security

On the same day that Larson introduced his legislation, Senator Sheldon Whitehouse (D-R.I.), Chairman of the Senate Budget Committee, held a hearing, “Protecting Social Security for All: Making the Wealthy Pay Their Fair Share,”  on his legislation, S. 1174, the Medicare and Social Security Fair Share Act.  A companion measure was introduced in the House by Congressman Brendan F. Boyle (D-Pennsylvania), Ranking Member of the House Budget Committee.

At the July 12th Senate Budget Committee hearing, Whitehouse explained that his legislation would bring enough revenue from the wealthiest to ensure that Social Security benefits will be paid and on time for the next 75 years and beyond.

“Right now, the cap on Social Security contributions means a tech exec making $1 million effectively stops paying into the program at the end of February, while a schoolteacher making far less contributes through every single paycheck all year,” says Whitehouse at the hearing. “That’s not fair, and my Medicare and Social Security Fair Share Act would fix that by requiring contributions to Social Security on wages above $400,000,” said the Rhode Island Senator.  

Whitehouse stressed the importance of Social Security to his Rhode Island constituents, by mentioning their comments and thoughts. 

 “I rely on my Social Security as my only source of income.  I would find it impossible to continue to live independently if Social Security were changed, reduced or eliminated.  Social Security benefits were a contract between the federal government and its citizens,” said Robert of Pawtucket.

Another Rhode Islander, Antonella of North Providence, said: “I would be very sad and depressed if there were any cuts to Social Security.  I just get by as it is.” And Laurel of Pawtucket said that without Social Security, she “would have to go back to work and probably have to work until I die.” 

Earlier this Congress, Senators Bernie Sanders (I-Vt.) and Elizabeth Warren (D-Mass.) introduced their own bill, S. 393, the Social Security Expansion Act (Whitehouse is an original cosponsor).   The Sanders-Warren bill would expand benefits by $ 2,400 each year while fully funding the program for the next three-quarters of a century and beyond.

As to the GOP position on Social Security, the House Republican Study Committee released a plan to cut Social Security by $718 billion over 10 years.  This plan, endorsed by three-fourths of the  House GOP Caucus), would also raise the retirement age to 69 (for everyone who is currently 59 and younger), which would effectively cut benefits by an estimated 13 percent every year and especially harm low-income workers.  It would also reduce benefits for future beneficiaries who earned a “higher salary” before retirement. Also, only “modest adjustments” to the Social Security program as it operates would be made but it doesn’t clarify the changes.

It is important to note that three fourths of the House GOP caucus endorse the RSC budget, making cuts to Social Security and Medicare.

According to SSW’s Altman, while Democratic proposals (Larson, Whitehouse and the Sanders- Warren proposals) to expand Social Security and Medicare are popular with Democratic, Republican and independent voters, Republican politicians have chosen to not co-sponsor any of these bills.

My final thoughts…

Polls show that Social Security and Medicare, two of the nation’s largest social safety net programs, are extremely popular. According to a poll released in March 2023 by the Associated Press and NORC Center for Public Affairs research, 79% of Americans are opposed to reducing the benefits that Social Security beneficiaries receive.  As to raising Social Security’s eligibility age from 67 to 70, 75% of American’s were against it.

Another poll released last March found that nearly 9 in 10 Americans say they oppose reducing spending on Social Security or Medicare, according to polling from Axios.  

The Congressional debate on financially shoring up Social Security and expanding benefits is of   extreme interest to 66 million older and disabled people (175,840 beneficiaries in Rhode Island), who rely on monthly payments from the program.  But the Social Security debate must include America’s younger generations, too. 

With 477 days left before the 2024 presidential elections, expanding Social Security and making the program fiscally sound and to ultimately be available to Gen Exers (1965 to 1979), Millennials (1980 to 1994), Gen Z (1995-2012) and Gen Alpha (2013 to 2025) must become a key election issue. Social Security beneficiaries and America’s younger generations must call on Congress to expand Social Security benefits and ensure its fiscal viability for every generation.  “Keep Your Hands Off Social Security” must be the powerful message they send to all presidential and congressional candidates before the upcoming 2024 presidential election.     

To review the text of Larson’s H.R. 4583, “Social Security 2100: A Sacred Trust Act,” go to https://larson.house.gov/sites/evo-subsites/larson.house.gov/files/evo-media-document/final-2023.07.11-text-of-social-security-2100-act.pdf.

To watch a video of Larson’s May press conference announcing the upcoming introduction of H.R. 4583, the Social Security 2100, go to https://www.youtube.com/watch?v=WO8QYRRQ-UQ.

Here is a copy of RSC’s FY 2024 Budget, Protecting America’s Economic Security https://hern.house.gov/uploadedfiles/202306141135_fy24_rsc_budget_print_final_c.pdf.

Nursing home workforce crisis deepens with minimum staffing standards

Published in RINewsToday on February 13, 2023

“The long-term care industry is enduring the worst workforce crisis in its history, in Rhode Island, and across the country. Although providers are committed to recruiting and retaining staff to provide quality care for residents, despite our best efforts, many nursing homes have fallen short of the staffing ratio set by the RI Department of Health,” notes James Nyberg, Executive Director of the East Providence-based Leading Age Rhode Island (LARI), representing nonprofit providers of aging services.

“We are extremely  concerned about the impending fines that will be imposed on nursing homes here in Rhode Island as a result of our state’s existing nursing home minimum staffing ratio statute,” said Nyberg. Because of staffing ratio mandates, “the industry would have faced fines of over $11 million, in just one sample quarter (April – June 2022), since over 70% of nursing homes are not in compliance,” he said.  

“While April-June was a sample, the fines go into effect for July-September and we will receive a similar notice in just a few weeks, with only 10 days to pay the fine,” says Nyberg, stressing that these fines will only increase going forward if nursing homes are unable to meet the minimum staffing ratio.

Nyberg calls on the Rhode Island General Assembly to rescue Rhode Island’s nursing homes and provide relief from these penalties by delaying them and exploring an alternative approach to support the efforts of nursing homes to meet the ratio.  He warns that the current fine-based approach is excessive and counterproductive and will lead to reduced access to care and threaten the survival of the state’s nursing homes.

Nyberg points out that the current workforce shortages are already preventing nursing homes from filling open positions, limiting new admissions, and forcing organization closures (five nursing homes have already closed since the COVID pandemic began).  These challenges are also resulting in backlogs at hospitals, which are unable to discharge patients due to reduced capacity in nursing homes.  

“We are working with numerous stakeholders on various initiatives to develop a pipeline of workers, but the simple fact is that it will take time.  In addition, as you know, the industry has faced years of underfunding from Medicaid, which pays for the majority of nursing home care.  This has made recruiting and retaining workers more difficult than ever,” says Nyberg. 

John Gage, President of the Rhode Island Health Care Association (RIHCA) agrees with Nyberg’s assessment of the nursing home workforce.  “Nursing homes across the nation are facing an historic labor shortage as the direct result of chronic Medicaid underfunding and the devastating impact of the Covid-19 pandemic on the workforce, he says, noting that the state’s nursing home workforce is down 20% since the start of the pandemic, with 2,000 workers lost from Jan. 2020 to June 2022.  Nationwide, the nursing home workforce is down 210,000 workers.

According to Gage, Rhode Island’s staffing mandate, while well-intentioned, will siphon tens of millions of dollars from resident care. In the first year of full implementation of the state’s minimum staffing mandate, RIHCA estimates that facilities will be fined upwards of $60 million. “These fines will imperil care, not bolster it,” he warns.  

Without legislative action, Rhode Island nursing homes will be fined an estimated $11 million on or about February 28, 2023, because of their inability to attract workers to meet the mandate from July 1, 2022, through September 30, 2022, Gage charges. “There are simply not enough available workers to fill the open staff positions, and resources are scarce.  Nursing homes will be devastated by these fines.  Facilities will reduce admissions, backing up hospital referrals and clogging hospital beds.  More nursing facilities will close – five have already closed since the beginning of the pandemic,” he predicts.  

Gage asks, “Who will care for Rhode Island’s frailest elders?” To recreate a minimum staffing mandate in nursing homes on the federal level would be a huge mistake, especially given the historic workforce crisis here in Rhode Island and nationwide,” he says.  

Gage’s comments echo concerns expressed by another group of US Senators in Jan. 20 correspondence (https://www.tester.senate.gov/wp-content/uploads/1-20-23-Nursing-Home-Staffing-Mandate-Letter-FINAL.pdf) sent to CMS by Senators John Bourasso, Jon Tester, and eleven other US Senators.  They caution the agency that a one-size fits all mandate would undermine access to care for patients, and they encouraged CMS to work with Congress on tailored solutions that address the workforce challenges facing nursing facilities.

At the federal level

Just days ago, U.S. Senators Bob Casey (D-PA), Chairman of the Senate Committee on Aging, and Ron Wyden (D-OR), Chairman of the Senate Finance Committee, called on the Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure to encourage the federal agency to establish minimum staffing standards in nursing homes to ensure high-quality care for nursing home residents. In Feb. 10 correspondence, Casey and Wyden, along with Senators Sherrod Brown (D-OH), Kirsten Gillibrand (D-NY), Richard Blumenthal (D-CT), Cory Booker (D-NJ), and Elizabeth Warren (D-MA) urged CMS to advance the agency’s ongoing study to determine adequate staffing requirements in nursing homes.

“We appreciate the work that CMS has undertaken to promote safety and quality in nursing homes and applaud the Biden-Harris Administration’s commitment to protecting our nation’s seniors,” said the senators in Feb. 10 correspondence, urging CMS to “bring this work to completion.” 

“In our view, that means continuing the agency’s ongoing study to determine the level of staffing that is necessary to ensure safe and high-quality care for nursing home residents, developing an evidence-based and actionable proposal for mandatory minimum staffing levels, and a robust and transparent process—including direct stakeholder engagement— that will allow for further discussion and fine-tuning of requirements before the proposal is finalized,” wrote the senators.

The senators noted that studies have shown a correlation between inadequate staffing levels and lower quality of care. More recent studies have demonstrated that higher nurse staffing ratios mitigated the effect of COVID-19 outbreaks in nursing homes and resulted in fewer deaths. A recent Department of Health and Human Services Office of Inspector General report examining the high level of COVID-19 infections in nursing homes also pointed to the need for the establishment of minimum staffing requirements.  

In the correspondence, the senators cite the Social Security Act, which requires skilled nursing facilities to “provide 24-hour licensed nursing service which is sufficient to meet nursing needs of its residents,” including the services of a registered nurse at least 8 consecutive hours per day, 7 days a week. The letter commends CMS for working to update this vague standard that has led to substantial variation in staffing levels and quality of patient care across facilities.

“Achieving the shared goal of ensuring quality care in nursing homes nationwide is a complex undertaking, says LeadingAge’s Ruth Katz, senior vice president, policy. LeadingAge is an association of nonprofit providers of aging services, including nursing homes.

“As our Get Real on Ratios proposal highlights, a number of conditions must be met in advance of any mandate implementation,” suggests Katz. “The senators correspondence to CMS is a promising development; it covers many of the same points as our Get Real on Ratios proposal – a recognition of the critical need for adequate reimbursement; that one size does not fit all, and that workforce shortages will need to be addressed with additional support. Without addressing these, staffing mandates are impossible. We look forward to continuing our discussions with Congressional leaders on this critical issue so that older adults and families can access much-needed care and services,” she says.

“The Senior Agenda Coalition of RI fully supports the need to develop national staffing standards to ensure quality care is provided to nursing home residents across our nation. It is important to note that Rhode Island has been a leader in this area. For many years our state has required 24/7 RN coverage in nursing homes and in 2021 the legislature passed the Nursing Home Staffing and Quality Care Act that includes staffing standards,” says Maureen Maigret, Policy Advisor to Senior Agenda Coalition of RI. “Now we must work to address workforce shortage issues and ensure that adequate government resources are provided especially through Medicaid payments so the standards can be met, and our critical direct care workers receive competitive living wages in order to keep them working in long term care,” she adds.

As the House Leadership hammers out the FY 2024 budget, it is crucial that adequate Medicaid funding is allocated to allow nursing homes to attract the necessary staff to meet the state’s minimum nursing standards that it codified into law. We must address this policy problem now rather than just kick the can down the road.

AARP launches campaign to support Family Caregivers

Published in RINewsToday on July 5, 2021

With caregiving costs skyrocketing, and with caregivers now estimated to be spending $7,242 annually out-of-pocket, AARP launches a national campaign to push for passage of the Credit for Caring Act.

The Washington, DC-based aging advocacy group has endorsed the bipartisan legislative proposal that would provide up to a $5,000 nonrefundable federal tax credit for eligible working family caregivers. The caregiver bill was introduced on May 18th  in the Senate by Senators Joni Ernst (R-IA), Michael Bennet (D-CO), Shelley Moore Capito (R-WV), and Elizabeth Warren (D-MA) and in the House by Representative Linda Sánchez (D-CA).

According to the National Alliance for Caregiving and AARP’s Caregiving in the U.S. 2020 study, there are an estimated 48 million Americans who provide care to either an adult or child with special needs at some time in the past 12 months. The study showed an increase of about 8 million caregivers from 2015 to 2020, indicating a significant growth in the nation’s caregivers’ population.

A 2019 AARP Public Policy Institute report noted that family caregivers in the United States provide $470 billion in uncompensated care.

Calling for Congressional Action to Assist Caregivers

AARP’s national campaign, urging passage of the Credit for Caring Act and more support for family caregivers, involves significant grassroots advocacy, including at least 60 tele-town halls, a major digital and video advertising initiative, and social media outreach through AARP’s national and state offices. Already, more than 100,000 contacts have been made with Members. In addition, more than 110 organizations, including 36 military and veterans service and support organizations, have joined AARP in asking Congress to pass the act. 

“This research reflects the incredible strain and sacrifices our 48 million family caregivers face every day. They are the backbone of our long-term care system, yet their backs are breaking from a lack of support,” said Nancy A. LeaMond, AARP Executive vice president and Chief Advocacy Officer in a June 29th statement announcing the kick-off of its new national grassroots campaign and also the release of its newest caregiver study, “AARP’s Caregiving Out- of-Pocket Costs Study.”

Adds AARP Rhode Island State Director Catherine Taylor: “This research reflects the incredible strain and sacrifices the 136,000 family caregivers in Rhode Island face every day. They are the backbone of our long-term care system, yet their backs are breaking,” 

“AARP research shows family caregivers contribute 114 million hours each year in their vital roles, “Taylor noted.

“We hear from so many caregivers from across the state who struggle financially,” Taylor added. “It is heartbreaking to know that cost, along with stress, fatigue and other factors take their toll over time. The need for support is more than evident.”

The Cost of Caregiving

Last month, AARP released its caregiver study, putting a spotlight on the out-of-pocket costs of caregiving, taking a close look at the financial strains on family caregivers and financial sacrifices (uncompensated care) they make in providing assistance to their loved ones. The study is a five year follow up to the landmark 2016 out-of- pocket caregiving study.

According to newly released study, nearly 8 in 10 of those caring for an adult family member (78%) are facing regular out-of-pocket costs, with the highest burden falling on younger caregivers and those who are Hispanic/Latino or African American. AARP researchers tracked what caregivers pay for using their own money and found average annual spending totaled $7,242 and, on average, 26% of the caregiver’s income. Housing expenses like rent or mortgage payments, home modifications, and assisted living made up more than half of caregivers’ spending, followed by medical expenses at 17%.

Out-of-pocket spending is much greater for some groups of caregivers, either in total dollars spent or as a percentage of average household income.

The researchers say that working caregivers who reported two work-related strains from caregiving, such as taking time off or working more hours, spend $10,525 each year on average – twice as much as caregivers who report one or no work-related strains.

AARP’s caregiver study also examined how caregiving financially impact between different generations of caregivers. Gen X caregivers spent the most money at $8,502. However, Gen Z and Millennial caregivers reported the greatest financial strain (spending on average $7,462 per year), spending a larger share of their household income. These caregivers have less time in the workforce to build financial security.

The AARP study found that Hispanic/Latino and African American caregivers also reported greater financial strain than White or Asian American caregivers. Hispanic/Latino caregivers spent on average, 47% of their household income on caregiving, and expenses for African American caregivers totaled, on average, 34% of income.

Researchers also found that caregivers caring for someone with Alzheimer’s disease/dementia or mental health issues tend to spend more ($8,978 per year and $8,384 per year, respectively) than those caring for someone without those conditions.

Work-related or personal strain as a result of caregiving can impact the caregiver’s long term financial security, too, say the researchers.  Nearly 47% of caregivers have experienced at least one setback as a result of being a caregiver. These setbacks include dipping into personal savings, cutting back on their own spending, and reducing how much they save for their retirement years.

More than 53% have experienced at least one work-related impact as the result of caregiving. Taking time off (both paid or unpaid) and working different hours are ways that caregiving impacts work. 

In addition to direct out-of-pocket spending, caregivers are also experiencing indirect financial setbacks. Nearly half of family caregivers (47%) experienced at least one financial setback such as having to cut back on their own health care spending, dip into their personal savings or reduce how much they save for their retirement.

Send your letters to Congress urging passage of the bipartisan Credit for Caring Act.  With an aging society and the number of caregivers increasing, a $5,000 nonrefundable federal tax credit for eligible working family caregivers might just help to pay the mounting costs of caregiving expenses. 

For more details about AARP’s caregiver study, go to:  https://www.aarp.org/content/dam/aarp/research/surveys_statistics/ltc/2021/family-caregivers-cost-survey-2021.doi.10.26419-2Fres.00473.001.pdf.

More resources for family caregivers, including a free financial workbook, are available at aarp.org/caregiving.