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.

Trump’s Budget Proposal Comes ‘Dead on Arrival’ to Aging Groups

Published in Woonsocket Call on February 18, 2018

Last Monday, President Donald Trump released his 2019 budget proposal, “An American Budget,” providing guidance to Congress on how to spend hundreds of billions of dollars in new federal spending plan authorized by the Bipartisan Budget Act recently passed into law. Trump’s federal spending wish list clearly shows that many programs and services for older Americans will take a huge hit if any of these proposals are picked up by the Republican-controlled Congress.

The Washington, DC-based National Committee to Preserve Social Security and Medicare (NCPSSM) expresses concern that Trump’s budget proposal contains many of the same harmful proposals that the Administration and Republican-controlled Congress has pushed before, including $1.4 trillion in Medicaid cuts, $490 billion in Medicare cuts, and repeal of the Affordable Care Act.

Social Security on the Chopping Block

According to the NCPSSM’s analysis released this month, the President’s budget blue print calls for deep cuts to Social Security Disability Insurance, breaking his campaign promise not to touch Social Security.

Trump proposes to slash up to $64 billion from Social Security Disability Insurance (SSDI) benefits through eight demonstrations “ostensibly” geared toward helping disability beneficiaries to stay at work or return to work, says NCPSSM, noting that these Social Security Administration’s (SSA) demonstration projects, established in 1980, had only “a modest effect on beneficiaries’ workforce participation.”

NCPSSM’s analysis warns that the President’s proposed budget also calls for other benefit cuts for disabled seniors, including limiting the retroactivity of applications for disability benefits from 12 months to six months. It would also deny unemployment compensation payments to SSDI beneficiaries who work but get laid off. Social Security Income recipients that live together, even with families, would see their benefits reduced, too.

The Trump Administration also proposes $12.393 billion for SSA’s FY 2019 appropriation for administrative funding, says NCPSSM, warning that this $89 million funding cut will result in longer waits for decisions on initial disability claims and time to speak to a representative from SSA’s 800 number. “With 10,000 baby boomers reaching age 65 every day, SSA needs substantial yearly increases just to keep pace with increased workloads, says NCPSSM.

President Trump’s budget plan only funds production and mailing of only 15 million Social Security statements. “This proposal is part of SSA’s overall plan to limit sending statements only to individuals who are 60 or older rather than sending them to all workers every five years,” says the aging advocacy group, urging the Administration “to send these important financial planning documents to all workers, as is required in section 1143 of the Social Security Act.”

Medicare Takes a Blow

President Trump’s draconian budget calls for over $500 billion in cuts to Medicare, many of these savings coming from cuts to Medicare providers and suppliers. This is another campaign promise broken.

NCCPSSM warns that President Trump’s 2019 budget proposal also includes policy changes to the prescription drug benefit that would impact Medicare’s spending and beneficiary costs. It would create an out-of-pocket maximum for Part D. Medicare t beneficiaries with very high drug costs would no longer have cost sharing responsibility once they hit the catastrophic threshold. This would add $7.4 billion in costs over 10 years.

Trump’s budget proposal would also change the way the threshold for moving out of the coverage gap or “donut hole”” is calculated that would make it more costly to seniors to move through it. “Taken together with an out-of-pocket cap, it will mean savings for some seniors with very high drug costs, but costs will climb for a larger number of seniors. This saves $47.0 billion over 10 years,” reports NCPSSM.

Finally, Trump’s 2019 budget proposal saves $210 million over 10 years by eliminating the cost-sharing on generic drugs for low-income beneficiaries.

Hurting Medicaid Recipients

In FY 2015, federal and state governments spent about $158 billion or 30 percent of Medicaid spending on long-term services and supports (LTSS). The federal and state partnership pays for about half of all LTSS for older adults and people with disabilities.

The President’s 2019 budget proposal slashes the program’s funding by changing the structure of the program into either a per capita cap or Medicaid block grant, with a goal of giving states more flexibility of managing their programs. Through 2028, the president’s budget would cut $1.4 trillion from the Medicaid program through repealing the Affordable Care Act, restructuring the program.

NCPSSM expresses concern that if states lose money under per capita caps or block grants, state law makers would have to make up the funding themselves if federal funds do not keep up with their Medicaid population’s needs. This can happen by either by cutting benefits and/or limiting eligibility, requiring family members to pick up more nursing home costs, or scaling back nursing home regulations that ensure quality, service and safety protections.

And That’s Not All

NCPSSM’s analysis says that Trump’s budget proposal also calls for the elimination of the Older Americans Act Title V Senior Community Service Employment Program (SCSEP). The program, funded $ 400 million in FY 2017. provides job training to nearly 70,000 low-income older adults each year.

Community Services Block Grants ($715 million), the Community Development Block Grant ($3 billion) and the Social Services Block Grant ($1.7 billion) programs are also targeted to be eliminated. Some Meals on Wheels programs rely on funding from these federal programs, in addition to OAA funding, to deliver nutritious meals to at-risk seniors.

Trump’s 2019 Budget proposal would also eliminate funding for the Low-Income Home Energy Assistance Program (LIHEAP) This program received $3.39 billion in FY 2017. “Of the 6.8 million households that receive assistance with heating and cooling costs through LIHEAP each year, 2.26 million or one-third are age 60 or older,” says NCPSSM.

Trump’s budget plan also eliminates funding for Senior Corps programs including the Retired and Senior Volunteer Program, Foster Grandparents and Senior Companions. Current Senior Corps funding at the FY 2017 level is $202.1 million. “These programs enable seniors to remain active and engaged in their communities, serving neighbors across the lifespan, and benefitting their own health in the process. In 2016, 245,000 Senior Corps volunteers provided 74.6 million hours of service,” says NCPSSM. .

Finally, research into cancer, Alzheimer’s Parkinson’s and other diseases affecting older persons will be negatively impacted with $ 46 million in funding cuts to National Institute on Aging at the National Institutes of Health.

Aging advocacy groups view Trump’s second budget “flawed,” jam-packed with “damaging policies” for Congress to enact with an aging population. It’s “Dead on Arrival.” If Trump and GOP lawmakers choose not to listen to their older constituents, the results of the upcoming mid-term elections might just get their attention.

Aging Groups Fear that Deficit May Lead to Attacks on Entitlement Programs

Published in Woonsocket Call on January 21, 2018

In early December, the GOP-controlled Senate passed by a partisan vote of 51 to 49 its sweeping tax rewrite, sending the $1.5 trillion tax package, detailed in a 492 page bill, to the Conference Committee to iron out the differences between the Senate and House bills. The House’s Tax Cuts and Jobs Act (H.R. 1), was passed by a 227-to-205 vote on November 16, 2017. Congress ultimately passed the Conference Committee’s revised tax bill, sending it to President Trump’s desk for signature. While the new tax law has a few positive provisions for seniors, aging groups predict a frontal assault by the GOP-controlled Congress and White House in 2018 to make cuts on Medicare, Medicaid, and Social Security to balance to ballooning federal deficit.

Just days before President Trump signed into law on December 22, 2017, the Tax Cuts and Jobs Act (P.L. 115-97), considered to be the biggest tax reform overhaul in over 30 years, AARP’s Chief Executive Officer, Jo Ann C. Jenkins, sent a letter to Congress raising the Washington, DC-based aging groups concerns with the law’s significant shortcomings as well as highlighting its impact “on the nation’s ability to fund critical priorities.”

Putting Medicare on the Chopping Block

In December 19 correspondence, Jenkins noted that AARP opposed the tax bill because of its negative impact on older adults. She expressed concern that there would be increased calls for greater spending cuts in Medicare, Medicaid and other domestic programs serving older Americans, with the tax legislation increasing the nation’s deficit by $1.5 trillion over the next ten years (with an unknown amount beyond 2027).

“Indeed, the non-partisan Congressional Budget Office (CBO) has confirmed that unless Congress takes action, the reconciliation legislation will result in automatic federal funding cuts of $136 billion in fiscal year 2018, $25 billion of which must come from Medicare,” said Jenkins. With the tax legislation’s repeal of Obamacare’s individual mandate, health care premiums would increase by 10 percent (with 64-year olds paying an average increase of $1,490) and there would be 13 million fewer Americans with health coverage, says Jenkins, citing a CBO’s analysis of the tax legislation.

However, AARP did appreciate that the Tax Cuts and Jobs Act retained the medical expense , deduction and restored the 7.5 percent income threshold for all tax filers for two years, said Jenkins, noting that “almost three-quarters of tax filers who claimed the medical expense deduction are age 50 or older and live with a chronic condition or illness, and seventy percent of filers who claimed this deduction have income below $75,000.”

Finally, Jenkins also said that the Tax Cuts and Jobs Act retained the additional standard deduction for those age 65 and older, as well as rejected proposals to make significant changes to the tax treatment of retirement contributions, which would have negatively affected the ability many tax filers to save for their retirement.

Targeting Social Security, Medicare, and Medicaid

Like Jenkins, the Washington, DC-based National Committee to Preserve Social Security and Medicare also sees Medicare, Medicaid and Social Security becoming more vulnerable to benefit cuts due to the huge $1.5 trillion increase in the public debt resulting from the enactment of the GOP’s tax law.

According to the NCPSSM’s Government Relations and Policy staff in a January 2018 policy brief, key supporters of the Tax Cuts and Jobs Act made it very clear that Medicare, Medicare and Social Security, would be targeted to balance the federal budget immediately after its approval. “For example, Senator Marco Rubio (R-FL) said that the tax bill is just the first step before “…instituting structural changes to Social Security and Medicare…” benefits to reduce the federal deficit. Similarly, House Speaker Paul Ryan (R-WI) said that “we’re going to have to get back next year [2018] at entitlement reform, which is how you tackle the debt and the deficit.” In other words, the majority leadership will seek cuts to Medicare, Medicaid and Social Security benefits as the next step to pay for the deficits this tax bill will create,’ NCPSSM’s policy brief.

In 2018, NCPSSM anticipates that the GOP-controlled Congress will seriously look at privatizing Medicare, raising the Medicare eligibility age, increasing beneficiary out-of-pocket costs, expand means testing of Medicare premiums, and block granting Medicaid, as a way to reducing the huge federal debt.

NCPSSM says that under the GOP’s Medicare privatization plan, when people become eligible for Medicare benefits they would not enroll in the current traditional Medicare program, which provides guaranteed benefits, but would receive a voucher to purchase private health insurance or traditional Medicare through a Medicare Exchange. The voucher’s amount would be determined annually when private health insurance plans and traditional Medicare participate in a competitive bidding process.

Medicare costs could also be cut by gradually increasing the eligibility age of Medicare to correspond with Social Security’s retirement age which is increasing from 65 to 67. Although this GOP strategy would initially save money, it would increase “system-wide health spending for everyone else,” warns NCPSSM.

NCPSSM says that “savings from redesigning the Medicare benefit [to reduce the federal deficit] by combining the Part A and Part B deductibles and making changes to supplemental insurance (Medigap) policies, would likely increase costs for people with Medigap policies.”

In 2018, the GOP Congress also might even consider expanding means-testing of Medicare premiums to reduce the federal deficit, says NCPSSM. “Expand income-related premiums under Medicare Parts B and D until 25 percent of beneficiaries are subject to these premiums [would reduce costs]. A Kaiser Family Foundation study found that this proposal would affect individuals with incomes equivalent to $45,600 for an individual and $91,300 for a couple in 2013,” says NCPSSM’s policy brief.

Medicaid provides funding for health care to low-income seniors, people with disabilities, children and some families. “We anticipate [GOP] proposals will be made that would end the current joint federal/state financing partnership and replace it with per capita caps (or a block grant, at state option) giving states less money than they would receive under current law,” says NCPSSM’s policy brief, noting that repealing the Medicaid expansion under Obama’s Affordable Care Act would prevent low-income adults from accessing health care services.

Concerns Over Fast-Track Reforming Social Security

Finally, NCPSSM’s policy brief warns that GOP lawmakers might push for a “fast-track” procedure that would lead to cutting social security benefits. This proposal would require the President to submit a plan to be considered in Congress under “expedited procedures” to reform Social Security if the Social Security Trustees determine the Trust Funds do not meet a 75-year actuarial balance. NCPSSM views this proposal “as a way that to circumvent public scrutiny of proposals to reduce Social Security programs.”

NCCPSSM also anticipates a GOP proposal to eliminate concurrent receipt of unemployment insurance and Social Security Disability Insurance (SSDI) for beneficiaries who work, get laid off and as a result qualifies for Unemployment Insurance.

Last month, the GOP-controlled Congress and White House enacted the largest tax reform bill. AARP, NCPSSM and other aging advocacy groups warn that Social Security, Medicare and Medicaid will be targeted by the GOP lawmakers to balance the tax reform law’s $1.5 billion costs. Older voters must now become politically active in protecting and strengthening these programs for both current beneficiaries and future generations” With the looming 2018 mid-term elections, may be Congress might just listen.