Medicare Takes a Blow Under GOP’s Major Tax Plan Fix

Published in the Woonsocket Call on December 10, 2017

In early December, the GOP-controlled Senate passed by a partisan vote of 51 to 49 its sweeping tax rewrite (with Republican Senator Bob Corker of Tennessee siding with the Democrats and opposing the measure), sending the $1.4 trillion tax package, detailed in a 492 page bill, to the Conference Committee to iron out the differences between the Senate and House bill, Tax Cuts and Jobs Act (H.R. 1), that was passed by a 227-to-205 vote on November 16, 2017.

While Democrats are technically part of the conference committee, Republicans are yet again hashing out the details behind closed doors on a purely partisan basis. Democrats charge that the GOP lawmakers on the conference committee will look to rubber-stamp whatever their leadership comes up with and do not expect to see any changes to the legislation for the better.

The cores of the House and Senate bills are already very similar: tax cuts for the wealthiest and corporations paid for by middle-class Americans. Republicans are rushing to get legislation to President Donald Trump’s desk for his signature before Christmas. While Trump looks forward to the first major legislative accomplishment of his presidency (once signed into law) as a Christmas gift to the nation, those opposing the massive changes to the nation’s US tax code view it as a stocking stuffed with coal.

Congressional insiders expect to see a finalized tax bill in the coming days, and votes in the House mid-next week at the earliest.

Medicare Takes a Blow

U.S. Senator Sheldon Whitehouse, sitting on the Senate Special Committee on Aging, sees the writing on the wall with the passage of the GOP tax bill. “The Republican tax plan would run up huge deficits, trigger immediate cuts to Medicare, and threaten Social Security and Medicaid down the line,” says the Rhode Island Senator.

Adds, Max Richtman, president and CEO of the National Committee to Preserve Social Security and Medicare (NCPSSM), this forces the “the poor, middle class, and elderly to pick up the tab for trillions of dollars in tax breaks that the super-rich and profitable corporations do not need..” If enacted, the GOP tax fix triggers an automatic $25 billion cut to Medicare,” he warns, noting that “it blows a $1 trillion hole in the deficit, inviting deep cuts to Social Security, Medicare, and Medicaid.”

Richtman says, “adding insult to injury” both the GOP Senate and House tax bills repeal the Obamacare mandate, which will raise ACA premiums for older adults (age 50-64) by an average of $1,500 in 2019. He notes that the Senate tax bill uses the “Chained CPI” inflation index for calculating deductions and tax brackets, this “setting a dangerous precedent that could spill over into cost-of-living adjustments for Social Security.”

In her December 7 correspondence to Congressional leadership, AARP Chief Executive Officer Jo Ann Jenkins, representing millions of members who whose health care depends on Medicare, urged lawmakers to work together in a bipartisan fashion to enact tax code legislation that would meet the needs of the older population and arrive at a tax code that is “more equitable and efficient, promotes growth, and produces sufficient revenue to pay for critical national programs, including Medicare and Medicaid.”

Jenkins urged Congress to prevent $25 billion in automatic cuts to Medicare in 2018 that would result from the enactment of H.R. 1 and its $1.5 trillion deficit increase (according to the Congressional Budget Office) since it “would have an immediate and lasting impact, including fewer providers participating in Medicare and reduced access to care for Medicare beneficiaries.”

“The sudden cut to Medicare provider funding in 2018 would have an immediate and lasting impact, including fewer providers participating in Medicare and reduced access to care for Medicare beneficiaries,” said Jenkins, who warned that health care providers may choose to stop accepting Medicare patients at a time when the Medicare population is growing by 10,000 new beneficiaries each day.

Jenkins also expressed her concern that Medicare Advantage plans and Part D prescription drug plans may charge higher premiums or cost-sharing in future years to make up for the cuts now.

The Devil is in the Details

On the AARP website, Gary Strauss, an AARP staff writer and editor, posted an article on December 6, 2017, “Your 2018 Taxes? Congress Now Deciding,” that identifies specific GOP tax bill provisions that hit older tax payers in their wallets.

According to Strauss, an AARP Public Policy Institute analysis also found that more than one million taxpayers 65 and older would pay higher taxes in 2019, and more than 5 million would see their taxes increase by 2027. More than 5 million seniors would not receive a tax break at all in 2019, and 5.6 million would not see their taxes decrease by 2027.

The House and Senate tax bills also have differing views on the medical expense deduction, used by nearly 75 percent of filers age 50 and older, says Strauss. The Senate plan allows taxpayers to deduct medical expenses exceeding 7.5 percent of their income rather than a current 10 percent — for the next two years. The House tax plan eliminates this deduction. Some 70 percent of filers who use the deduction have incomes below $75,000.

Strauss says that the House bill eliminates the extra standard deduction for those age 65 and up, while the Senate bill retains it. For 2017, that’s $1,250 for individuals, $1,550 for heads of households or $2,500 for couples who are both 65 and older. .

Both Senate and House versions abolish state and local tax deductions, with the exception of up to $10,000 in property taxes. Residents in high-tax states such as California, Connecticut, New Jersey and New York, would pay higher taxes, adds Strauss.

For home owners, Strauss notes that the Senate plan leaves interest deduction limits at $1 million, while the House bill lowers the mortgage interest deduction limit to $500,000 and no longer allows it to be used for second homes, says Strauss.. Individuals would also continue to get up to $250,000 tax-free from the sale of a home (up to $500,000 for couples). But, both bills require sellers to live in the property five of the eight years prior to a sale, up from the current requirement of two of the last five years,” adds Strauss.

At press time, dozens of newspapers are reporting that Americans across the nation are protesting the passage of GOP tax bill that makes the biggest changes to the U.S. tax code in 30 years, calling it a “scam.” AARP and NCPSSM are mobilizing their millions of members to protect Medicare, Social Security and Medicaid.

While Trump told Senators at a lunch meeting held on December 5 at the White House that the Republican tax plan was becoming “more popular,” two recently released polls are telling us a completely different story. According to a Gallup national poll, a majority of independents (56 percent) join 87 percent of Democrats in opposing the tax plan. Only 29 percent of Americans overall approve of the proposed GOP changes to the nation’s tax code. Reflecting Gallup’s finding, the Quinnipiac University national poll found that 53 percent of American voters disapprove of the tax plan, while only 29 approve.

With mid-term Congressional elections less than a year away, Trump and the GOP-controlled Congress continued push to dismantle Obamacare, leaving millions without health care coverage and creating a tax code that would destroy Medicare, may well bring millions of older taxpayers to the polls to clean house. We’ll see.

House Budget Committee Plan Calls for Privatization of Medicare

Published in Woonsocket Call on July 23, 2017

Over four months ago President Trump released his draconian FY 2018 Budget, now Congress begins to hammer out its budgetary spending plan. Last Wednesday, the House Budget Committee, chaired by Rep. Diane Black (R-TN), sent the Republican drafted budget plan to the House floor for consideration. After a 12-hour markup held in Room 1334 Longworth HOB, the budgetary blueprint passed by a vote of 22 to 14, along party line. Rep. Black’s GOP controlled panel defeated 28 amendments offered by Democrats.

Once the House and Senate pass their budget resolutions, the House and Senate Appropriations subcommittees “markup” appropriations bills. The House and Senate vote on appropriations bills and reconcile differences.

Rep. Black says that the GOP FY 2018 Budget Resolution, “Building a Better America,” passed on July 19, will balance the federal budget within 10 years by cutting spending, reforming government and growing the economy. According to the House Budget chair, the recently released budget achieves $ 6.5 trillion in total reduction over 10 years. It sets overall discretionary spending for the fiscal budget at $1.132 trillion ($621.5 billion in defense discretionary spending and $511 billion in non-defense discretionary spending).

The House budget plan is the first step that Republicans must take to begin their efforts to overhaul the nation’s tax code to grow the economy. It also provides increased funding for defense and the building of Trump’s border wall. It also requires food stamp recipients to work for their benefits.

Although the Social Security program is spared, it bars recipients from receiving Social Security Disability Income recipients from also receiving unemployment benefits. But, most worrisome to aging group advocates, the passed House Budget Committee budget makes major cuts to Medicaid, turning the Medicare program into a voucher program. But, Medicare is targeted for major changes.

In the Eyes of the Political Beholder

Upon passage, the House Budget Chair, Rep. Black, said in a statement, “I am proud of the work done by the members of the committee. We’ve spent months reviewing all aspects of the federal government and have put together a plan that will balance the budget, promote economic growth, strengthen our national defense, and make Washington more accountable to taxpayers. Our budget also takes the crucial first step in the reconciliation process to fix our broken tax code and make long overdue mandatory spending cuts and reforms.”

But, Rep. John Yarmuth (D-KY), Ranking Member of the House Budget Committee, in a statement expressed a vastly different opinion as to the impact of the panel’s passed budget resolution. “Republicans on the House Budget Committee just approved a budget that the American people do not want and do not deserve from their government. Their budget adopts the worst extremes of the Trump proposal by cutting taxes for millionaires and billionaires at the expense of everyone else. It cuts at least $1.5 trillion from Medicare and Medicaid, and puts at risk investments in nearly every national priority, from education and veteran services, to transportation, environmental protections, and medical research. Democrats believe we should be investing in the American people, our economy, and greater opportunity for all, and we will continue to fight against this irresponsible budget when—or if—it is brought to the House floor,” he said.

House Budget Plan Calls for Substantial Changes to Medicare

Medicare takes a huge hit, $ 487 billion over a ten-year period, in the House Budget Committee’s passed FY 2018 Budget, says Paul N. Van De Water, in a blog post on the website of Center on Budget and Policy Priorities (CBPP). The Senior Fellow serving as CBPP’s Director, Policy Futures, says that the budget plan’s changes to Medicare include higher income-related premiums for those making $85,000 and over (twice the amount for couples), limits on malpractice awards, raising Medicare’s eligibility age from 65 to 67, also increasing cost sharing of beneficiaries.

In his posting, Van De Water details the substantial changes made to Medicare, one of the nation’s largest entitlement programs, in the House Budget Committee’s passed budget. He notes, it would “replace Medicare’s guarantee of health coverage with a flat premium support payment or voucher, [starting in 2024] that beneficiaries would use to help buy either private health insurance or a form of traditional Medicare.” Although there are no details in the House Budget Committee’s plan to determine its impact on beneficiaries, he says that most people enrolled in traditional Medicare would pay more with the new changes than under the current law, according to a previous Congressional Budget Office analysis.

NCPSSM Sounds the Alarm About Privatization of Medicare

As the House Budget Committee began its markup of the FY 2018 budget, Max Richtman, President of the National Committee to Preserve Social Security and Medicare (NCPSSM) warned in a statement that the GOP-controlled panel “is targeting the health and financial well-being of America’s seniors by making another attempt to privatize Medicare.”

“Recent polling indicates that large majorities of Americans across party lines prefer that Medicare be kept the way it is, not to mention that President Trump repeatedly promised to protect the program during the 2016 campaign,” says Richtman.

Richtman says that converting Medicare into a voucher program is an existential threat to the program itself. “Over time, giving seniors vouchers to purchase health insurance would dramatically increase their out of pocket costs since the fixed amount of the voucher is unlikely to keep up with the rising costs of health care,” he says. “And, as healthier seniors choose less costly private plans, sicker and poorer seniors would remain in traditional Medicare, leading to untenable costs, diminished coverage, and an eventual demise of traditional Medicare, plain and simple. Of course, raising the eligibility age to 67 – as the House spending plan also proposes – is a drastic benefit cut.”

Undermining Medicare has been a long-held dream of fiscal conservatives. Their “premium support” proposal is a thinly veiled scheme to allow traditional Medicare to “wither on the vine,” as former House Speaker Newt Gingrich once put it,” adds Richtman.

Privatization is being sold as “improving customer choice,” but based on the way current Medicare Advantage plans work, private insurance will continue to offer fewer choices of doctors than traditional Medicare does. If traditional Medicare is allowed to shrink and collapse, true choice will disappear, too, says Richtman.

Stay tuned….

Herb Weiss, LRI’12 is a Pawtucket writer covering aging, health care and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.

Social Security, Medicare Are Solvent…at least for Now

Published in Woonsocket Call on July 16, 2017

Just days ago, a released annual federal report, the 2017 Annual Report of the Board of Trustees of the Federal Old-Age and Survivors Insurance and Federal Disability Insurance Trust Funds, says the nation’s Social Security and Medicare programs continue to work, are fiscally solvent, but future fixes will be needed to maintain their long-term actuarial balance.

The Social Security Administration’s (SSA) annual snap shot of the fiscal health of Social Security and Medicare, two of the nation’s largest entitlement programs, released on July 13, is important to millions of beneficiaries. According to the federal agency, in 2017 over 62 million Americans (retired, disabled and survivors) received income from programs administered by SSA, receiving approximately $955 billion in Social Security benefits.

The Good News

The trustee’s report projects that Social Security will be financially solvent until 2034 (unchanged from last year), after which SSA can pay 77 percent of benefits if there are no changes in the program. The 269-page report also noted that the Medicare Trust Fund for hospital care has sufficient funds to cover its obligations until 2029, one year longer than projected last year, then 88 percent afterward if nothing is done to strengthen the system’s finances

The trustees report says that there is now $2.847 trillion in the Social Security Trust Fund, which is $35.2 billion more than last year — and that it will continue to grow by payroll contributions and interest on the Trust Fund’s assets.

Social Security Administration efficiently manages its entitlement program, says the trustee report. The cost of $6.2 billion to administer to program in 2016 was a very low 0.7 percent of the total agency’s expenditures.

The trustee’s project a 2.2 percent cost-of-living adjustment (COLA) for Social Security beneficiaries in 2018, the largest increase in years. In addition, Medicare Part B premiums will also remain unchanged next year. Most beneficiaries pay a monthly premium of $134 (this amount increases for those with higher incomes.)

Social Security is “Stable and Healthy for Now”

According to the National Committee to Preserve Social Security (NCPSSM), the recently released trustee’s report confirms that the federal entitlement program is “stable and healthy for now,” while acknowledging there will be future challenges if “corrective action is not taken.”

“Forty percent of seniors (and 90 percent unmarried seniors) rely on Social Security for all or most of their income. The average monthly retirement benefit of $1,355 is barely enough to meet basic needs, and the Trustees’ latest projected cost-of-living increase of 2.2 percent will not keep pace with seniors’ true expenses. Under these circumstances, any benefit cuts (including raising the retirement age to 70 as some propose) would be truly painful for our nation’s retirees,” says Max Richtman, NCPSSM’s president and CEO, in a statement responding to the release of the federal report.

“Opponents of Social Security may once again try to use this report as an excuse to cut benefits, including raising the retirement age,” warns Max Richtman. “We must, instead, look to modest and manageable solutions that will keep Social Security solvent well into the future without punishing seniors and disabled Americans,” he says.

Depending on what the final Senate health bill looks like, the legislation could reduce the solvency of Medicare by two years, say Richtman. “The National Committee opposes the GOP health plan and rejects efforts to privatize Medicare. We advocate innovation and continuing efficiencies in the delivery of care, allowing Medicare to negotiate prescription drug prices, and restoring rebates the pharmaceutical companies used to pay the federal government for drugs prescribed to “dual-eligibles” (those who qualify for both Medicare and Medicaid) – in order to keep Medicare in sound financial health,” he says.

Safeguarding and Expanding Social Security Benefits

In a statement, Richard Fiesta, Executive Director of the Washington, DC-based Alliance of Retired Americans, notes that the Trustees project that the Social Security Disability Insurance (SSDI) trust will be fully solvent until 2028, five years longer than last year’s report. “In light of this data, it makes no sense that the President’s FY 2018 budget seeks to cut Social Security Disability Insurance funding by $63 billion,” he says.

Despite the trustees’ strong report, Fiesta believes that improvements can be made that would benefit all workers and retirees. His organization supports safeguarding and expanding Social Security benefits, providing a more accurate formula for cost-of-living adjustments, and lifting the cap on earnings for the wealthiest Americans.

Fiesta adds, “reining in the prices of prescription drugs would strengthen Medicare for the future and reduce costs to retirees.”

AARP CEO Jo Ann Jenkins, in a statement, calls for bipartisan action in Congress and the Trump administration to ensure the strong fiscal health of Social Security and Medicare programs. “Social Security should remain separate from the budget. Medicare can improve if we reduce the overall cost of health care, rather than impose an age tax, and if we lower prescription costs, instead of giving tax breaks to drug and insurance companies,” she says.

Finally, in a statement, Nancy Altman, President of Social Security Works, also chairing the Strengthen Social Security Coalition, says that this year’s trustee’s report clearly indicates that the nation can fully afford an expanded Social Security. Altman says that polling continues to show that Americans support expanding the program’s benefits.

Altman believes the Social Security program can solve the nation’s “looming retirement income crisis, the increasing economic squeeze on middle-class families, and the perilous and growing income and wealth inequality.” So, when confronting these challenges, she says, “the question is not how can we afford to expand Social Security, but, rather, how can we afford not to expand it.”

Ensuring the Long-Term Solvency of Social Security

Those nearing retirement or retired will be assured existing Social Security benefits, promises the 2016 Republican Party Platform. “Of the many reforms being proposed, all options should be considered to preserve Social Security. As Republicans, we oppose tax increases and believe in the power of markets to create wealth and to help secure the future of our Social Security system,” says the Platform. Simply put, the GOP opposes the raising of payroll taxes on higher income taxpayers to stabilize or expand Social security and supports privatization, allowing Wall Street to control your Social Security benefits.

On the other hand, last year’s Democratic Party Platform opposed Social Security cuts, privatization or the weakening of the retirement program, along with GOP attempts to raise the retirement age, slash benefits by cutting cost-of-living adjustments, or reducing earned benefits. The Democratic Platform called for taxing people making above $250,000 will bring additional funding into the entitlement program.

Congressional gridlock has not blocked legislation from being introduced to fix the nation’s Social Security program. According to Social Security Works, over 20 Social Security expansion bills have been introduced in the House and Senate since 2015. Recently, the Social Security 2100 Act, introduced by Rep. John Larson (D-CT), has 162 House cosponsors —around 85 percent of all Democratic representatives. Similarly, around 90 percent of Senate Democrats are on record in favor of expanding, not cutting Social Security.

Many consider Social Security to be the “third rail of a nations politics.” Wikipedia notes that this metaphor comes 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.” With the Social Security and Medicare programs now on firm financial footing, it is now time for Congress to seriously consider legislative actions to ensure the longevity and expansion of these programs. When the dust settles after the upcoming November 2018 elections, we’ll see if Social Security is truly “a third rail.”