GOP se­na­tors needed to pro­tect Medi­care

Pawtucket Times - - REGION/OBITUARIES/SENIORS - 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.

Since Pres­i­dent Don­ald Trump took the oath of of­fice on Jan. 20, he is mak­ing good on some of his hun­dreds of cam­paign prom­ises. Dur­ing his first week in of­fice Trump signed three ex­ec­u­tive or­ders declar­ing new gov­ern­ment poli­cies and eight pres­i­den­tial me­moranda de­tail­ing the priorities of his new ad­min­is­tra­tion.

But, for ag­ing groups, with Trump’s ar­rival in Washington, D.C, the skir­mish of­fi­cially be­gins to pro­tect Medi­care in this new ses­sion of Congress.

With Trump and Con­gres­sional Repub­li­can Lead­er­ship on record for their sup­port of re­peal­ing the 2010 Af­ford­able Care Act (pop­u­larly known as Oba­macare) Pres­i­dent and CEO Max Richt­man, of the Na­tional Com­mit­tee to Pre­serve So­cial Se­cu­rity and Medi­care (NCPSSM), clearly sees the writ­ing on the wall. If successful, Richt­man warns that GOP leg­isla­tive ac­tions will se­verely dam­age Medi­care im­pact­ing 57 mil­lion se­niors and dis­abled adults who rely on the pro­gram for their health care.

Build­ing a fire­wall against pri­va­tiz­ing medi­care

With the GOP hold­ing a slim ma­jor­ity of the U.S. Se­nate seats, 52 to the Democrats 48 seats, Richt­man sees sway­ing Repub­li­can Se­na­tors away from their par­ties po­si­tion on pri­va­tiz­ing Medi­care as a way to pro­tect the fed­eral health care pro­gram.

On Jan. 24, Richt­man urged Se­na­tor John McCain (R-AZ), Se­na­tor Su­san Collins (R-ME), Charles Grass­ley (R-IA), and Se­na­tor La­mar Alexan­der (R-TN) to be the Se­nate’s “fire­wall against Medi­care cuts.” His cor­re­spon­dence asked them to vote against pro­pos­als to pri­va­tize Medi­care, raise the Medi­care el­i­gi­bil­ity age from 65 to 67, and re­peal pro­vi­sions in the Af­ford­able Care Act (ACA), Pres­i­dent Barack Obama’s land­mark health care law, that pro­vided ad­di­tional ben­e­fits to ben­e­fi­cia­ries.

Richt­man re­minded the GOP Se­na­tors that the Af­ford­able Care Act (ACA) im­proved Medi­care ben­e­fits and ex­tended the sol­vency of the Part A Hospi­tal In­sur­ance Trust Fund by more than a decade. ACA’s clos­ing of the pre­scrip­tion drug donut hole has put money into the pock­ets of Medi­care ben­e­fi­cia­ries. The health care law also added cov­er­age of an an­nual well­ness visit and elim­i­nated co­pays for pre­ven­tive ser­vices like can­cer screen­ings, he said.

“I am also trou­bled by “pre­mium sup­port” [GOP] pro­pos­als to pri­va­tize Medi­care,” says Richt­man. Ac­cord­ing the ag­ing ad­vo­cate who was a for­mer staff di­rec­tor of the U.S. Se­nate Special Com­mit­tee on Ag­ing and a 16-year vet­eran of Capi­tol Hill, un­der pre­vi­ous pri­va­ti­za­tion plans, ben­e­fi­cia­ries would not en­roll in the cur­rent pro­gram; rather, they would re­ceive a capped pay­ment or voucher to be used to pur­chase pri­vate health in­sur­ance or tra­di­tional Medi­care. Pri­vate plans would have to pro­vide ben­e­fits that are at least ac­tu­ar­i­ally equiv­a­lent to the ben­e­fit pack­age pro­vided by fee-for-ser­vice Medi­care, but they could ma­nip­u­late their plans to at­tract the youngest and health­i­est se­niors. This would leave tra­di­tional Medi­care with older and sicker ben­e­fi­cia­ries whose higher health costs would lead to higher premiums that they and oth­ers may be un­able or un­will­ing to af­ford, re­duc­ing the fee for ser­vice risk pool even fur­ther re­sult­ing in a death spi­ral for tra­di­tional Medi­care.

GOP Medi­care fix fi­nan­cially hurts ben­e­fi­cia­ries

Richt­man also told the GOP Se­na­tors that NCPSSM op­posed the rais­ing of the Medi­care el­i­gi­bil­ity age from age 65 to 67 be­cause the pro­posal would in­crease costs for mil­lions of older Amer­i­cans. Ab­sent the guar­an­tees in the ex­ist­ing ACA, such as re­quir­ing in­sur­ance com­pa­nies to cover peo­ple with pre-ex­ist­ing med­i­cal con­di­tions and lim­it­ing age rat­ing, mil­lions of se­niors 65 and 66 with­out Medi­care would find pri­vate in­sur­ance un­af­ford­able. Rais­ing the el­i­gi­bil­ity age would also in­crease av­er­age costs for Medi­care as younger, health­ier se­niors are elim­i­nated from the risk pool and costs are spread across an older, less-healthy pop­u­la­tion, he says.

Richt­man urged the GOP Se­na­tors to op­pose ef­forts un­der­way in the 115th Congress to block grant Med­ic­aid, cap Med­ic­aid pay­ments on a per-ben­e­fi­ciary ba­sis (per capita caps) and/or re­peal the ACA’s Med­ic­aid ex­pan­sion. He noted that these pol­icy changes would “fi­nan­cially hurt states and lead to states cut­ting ser­vices, qual­ity and el­i­gi­bil­ity for the most vul­ner­a­ble of our se­nior pop­u­la­tion.”

“Many se­niors would not be able to ab­sorb the loss of cov­er­age and in­crease in their costs that would oc­cur if these pro­pos­als be­came law. In fact, half of all Medi­care ben­e­fi­cia­ries in 2014 had in­comes be­low $24,150 and Medi­care house­holds spent over two times more than the av­er­age Amer­i­can house­hold on outof-pocket health care costs,” he says.

“If Se­nate Democrats stand strong, we only need a hand­ful of Repub­li­cans to pro­tect the com­mit­ment to Medi­care,” says Richt­man. “We hope Se­na­tors McCain, Collins, Grass­ley, and Alexan­der to do the right thing for se­niors in their states – and across Amer­ica.”

Richt­man cor­re­spon­dence to the four GOP Se­na­tors is part of NCPSSM’s proac­tive leg­isla­tive strat­egy to pro­tect the ex­ist­ing Medi­care pro­gram. The let­ters sent quan­tify the eco­nomic im­pact that pro­posed Medi­care cuts would have on se­niors in the four GOP Se­na­tors’ states: Ari­zona (with 1.3 mil­lion ben­e­fi­cia­ries), Maine (306,000 ben­e­fi­cia­ries), Iowa (nearly 572,000 ben­e­fi­cia­ries) and Ten­nessee (1.2 mil­lion ben­e­fi­cia­ries).

“We know that these four Repub­li­can Se­na­tors have the wis­dom and judg­ment to pro­tect se­niors in their states from leg­is­la­tion that would im­pose painful Medi­care cuts,” says Richt­man. “It’s time to slam the brakes on any at­tempts to pass harm­ful leg­is­la­tion.”

Se­nate Democrats at­tempt to block HHS nom­i­na­tion

Two days be­fore Trump was sworn in as pres­i­dent, the Se­nate Health, Ed­u­ca­tion, La­bor and Pensions (HELP) Com­mit­tee held con­fir­ma­tion hear­ing on Rep. Tom Price, (R-Ga), Trump’s nom­i­nee to over­see the De­part­ment of Health and Hu­man Ser­vices, the fed­eral agency that oversees the Medi­care pro­gram. In con­firmed, he is ex­pected to play a key role in the GOP’s ef­forts to pri­va­tize Medi­care.

No for­mal vote was taken at the HELP Com­mit­tee hear­ing but the Con­gress­man is sched­uled to tes­tify a week later at the Se­nate Fi­nance Com­mit­tee, which will vote on his nom­i­na­tion.

Dur­ing the four-hour, heated con­fir­ma­tion hear­ing, held in 430 Dirk­sen Se­nate Of­fice Build­ing, HHS nom­i­nee Price dodged ques­tions lobbed by Democrats about the Trump Ad­min­is­tra­tions po­si­tion on the future of Medi­care. They also ze­roed in on his per­sonal fi­nan­cial in­vest­ments in health care com­pa­nies, call­ing them con­flicts of in­ter­est which the de­nied.

Price, an or­tho­pe­dic sur­geon and a six-term con­gress­man, con­sid­ered to be one of the most vo­cal crit­ics of Oba­macare on Capi­tol Hill, is ex­pected play a key role in the GOP’s ef­forts to re­peal and re­place the Af­ford­able Care Act.

Rhode Is­land Sen. Shel­don White­house, sit­ting on the HELP Com­mit­tee, gave this take on Price af­ter the first of two con­fir­ma­tion hear­ings: “Price hasn’t been able to win Demo­cratic sup­port for any of his health care leg­is­la­tion [in the House] and to­day con­firmed that he and his al­lies have no plan that can win sup­port from across the aisle or the mil­lions of Amer­i­cans who would be af­fected by tear­ing down the Af­ford­able Care Act. He con­ceded that he should not stop Amer­i­cans un­der twenty-six from stay­ing on their par­ents’ in­sur­ance, re­open the dreaded pre­scrip­tion drug dough­nut hole for se­niors, deny cov­er­age to those with pre-ex­ist­ing con­di­tions, and re­in­state life­time lim­its on care. But he has no plan to make that hap­pen.”

Added White­house, “Price also failed to re­as­sure the Rhode Is­landers I serve who rely on Medi­care for their care. He has fought to voucher­ize the pro­gram, which would grad­u­ally un­load costs onto se­niors while erod­ing their ben­e­fits. He needed to tell the Amer­i­can peo­ple they could de­pend on him to faith­fully ad­min­is­ter Medi­care and keep the sa­cred prom­ise we’ve made to our se­niors of a dig­ni­fied re­tire­ment with ac­cess to good health care. He did not.”

“Congress must pro­tect So­cial Se­cu­rity and Medi­care, but many Repub­li­cans see the lat­est elec­tion re­sults as an op­por­tu­nity to hol­low out these vi­tal pro­grams. Pres­i­dent Trump’s pick to over­see Medi­care has long cham­pi­oned ef­forts to pri­va­tize Medi­care, which I strongly op­pose. Cut­ting ben­e­fits and pri­va­tiz­ing these pro­grams could hurt mil­lions of Amer­i­cans and harm our econ­omy,” said Sen. Jack Reed, not­ing that these pro­grams re­duce poverty and im­prove pub­lic health in ways that ben­e­fit all Amer­i­cans.

As NCPSSM’s Richt­man con­tin­ues his ef­fort to sway GOP Se­na­tors, ral­ly­ing the troops at the state-level may well be the path to block­ing GOP at­tempts to pri­va­tize Medi­care. Vot­ers in states with Repub­li­can Se­na­tors must send this message to their elected of­fi­cial, “don’t touch my Medi­care.”

Let the move­ment to strengthen Medi­care in these states be­gin to­day.

Herb Weiss

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