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.

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Aging Groups: House GOP Tax Rewrite a Turkey

Published in the Woonsocket Call on November 19, 2017

Thanksgiving approaches the GOP-Controlled House has passed H.R. 1, “Tax Cuts and Jobs Act,” its tax reform legislation, on November 16, by a partisan vote of 227 to 206, with 13 Republicans siding with the Democrats. The House tax bill would dramatically reduce corporate and individual income taxes and would increase the deficit by $ 1.7 trillion over 10 years — — possibly offset by $ $338 billion saved by repealing the Affordable Care Act’s (ACA) individual mandate.

On Thursday, after four days of debate, members of the Senate Finance Committee voted 14 to 12 along party lines to approve their version of the tax package. Now the full Senate is expected to consider the bill after Thanksgiving hoping to quickly get it to President Donald Trump’s desk for his signature.

Medicare and ACA Takes a Hit

Matt Shepard, of the Center for Medicare Advocacy, warns that the GOP’s attempt to overhaul to nation’s tax code is an immediate threat to the Medicare program and healthcare coverage to millions of Americans covered by ACA.

According to Shepard, the nonpartisan Congressional Budget Office projects that the huge cost for the Republican tax plan would result in immediate, automatic and ongoing cuss to Medicare — $25 billion in 2018 alone.

After the GOP’s failed attempts to repeal the ACA, the Senate now uses a provision in its tax rewrite plan to finally repeal the ACA’s individual mandate to purchase insurance coverage in order to help pay for tax cuts, he says. If the GOP tax reform legislation becomes law, 13 million more people will be without health coverage and increasing premiums will disproportionately affect people age 50 who are not yet eligible for Medicare.

“These new dangers are on top of an already bad bill. Congress is engaged in a rushed effort to push through a massive tax cut for corporations and the wealthy, presenting a clear and present danger to health coverage, other vital programs, and families throughout the nation,” says Shepard.

“After adding $1.5 trillion to the federal debt, policymakers will use the higher debt – created by the tax cuts – to argue that deep cuts to Medicare, Medicaid, Social Security, and other bedrock programs are necessary,” predicts Shepard.

Responding to the House passage of its tax reform bill, just days ago, in a statement AARP Executive Vice President and Chief Advocacy & Engagement Officer Nancy LeaMond expressed disappointment in passage, warning that the legislation is harmful to millions of Americans age 65 and over.

Older Tax Payers Get Financial Hit with GOP Tax Code Fix

“AARP estimates H.R. 1 will raise taxes on 1.2 million seniors next year alone. Millions more older Americans will see tax increases in the future, or at best, no tax relief at all,” says LeaMond.

As Congress continues its debate to hammer out tax reform, LeaMond calls on lawmakers to retain the medical expense deduction at the 7.5% income threshold for older tax filers. “Nearly three-quarters of tax filers who claim the medical expense deduction are age 50 or older and live with a chronic health condition or illness. Seventy percent of filers who claim this deduction have income below $75,000.,” she says, urging that Congress also retain the standard deduction for older taxpayers, which helps reduce tax liability and can help seniors avoid a tax increase.

AARP also urges Congress to assist working family caregivers in a new tax code that creates a new, non-refundable tax credit to offset the often high out-of-pocket costs associated with caring for a loved one.

Finally, LeaMond calls on Congress to reject adding a provision in the tax bill that will lead to higher premium costs in the individual insurance market, as well as 13 million Americans losing their health coverage, including 2 million Americans who would lose employer-sponsored coverage.

In a statement, Max Richtman, President and CEO, National Committee to Preserve Social Security and Medicare, calls the House passed tax rewrite, “Robin Hood-in-Reverse tax legislation.” Now, the House Republicans have sent out a “crystal-clear message “that the elderly, disabled, poor, and working class are no longer part of the GOP’s vision for America,” he says.

Blooming Deficit Might Trigger Raid Social Security

“This craven giveaway to the wealthy and big corporations at the expense of everyone else flies in the face of public opinion, basic decency, and good old common sense, says Richtman, “By ballooning the deficit, Republicans have teed up a raid on Social Security, Medicare, and Medicaid to make up the difference,” he warns.

“The repeal of the medical expense deduction will punish seniors paying out of pocket for treatment of chronic and serious diseases – or long-term care., says Richtman.

With Senate Republicans gearing up their efforts to pass their version of the House’s “Tax Cuts and Jobs Act,” Richtman calls on Senators “to show courage and to do what House Republicans refused to [do]: stop the tax juggernaut before it does irreparable harm to our nation.”

If the GOP tax reform legislation is passed by Congress and signed into law by President Trump, we will quickly find out by Christmas if it a financial gift to America’s middle class or a lump of coal in their stockings. Aging groups already know this answer.

Senate Aging Panel Calls for Improved Emergency Preparation and Response

Published in the Woonsocket call on October 8, 2017

“Those who cannot remember the past are condemned to repeat it” — George Santayana, a philosopher, essayist, poet, and novelist

In the wake of Hurricanes Irma and Harvey, after the death of at least nine nursing facility residents due to heat-related illness due to sweltering heat at a Hollywood, Florida-based facility that had lost power to run its air conditioner, the Senate Special Committee on Aging put the spotlight on the challenges facing seniors during natural disasters at a hearing on Sept. 20, 2017.

News coverage of Hurricanes Irma and Harvey provided heartbreaking reminders that seniors and persons with disabilities are particularly vulnerable during a natural disaster. On Florida’s Gulf Coast, an assisted care facility for dementia patients lost electrical power for three days, causing 20 seniors to suffer from high indoor temperatures. Meanwhile, in Dickinson, Texas, a widely-shared photo showed elderly residents of an assisted-living center awaiting rescue as flood waters rose waist deep inside the facility.

Heeding the Lessons from Past Disasters

When Hurricane Katrina slammed into the Gulf Coast 12 years ago, more than half of those who died were seniors, according to a report from the National Institutes of Health. Since that devastating storm, disaster response officials have placed much emphasis at the national, state, and local level to better protect older Americans during an emergency.

“As we have learned from Hurricanes Irma and Harvey as well as past catastrophes such as Hurricane Katrina, some of our neighbors – especially seniors – face many obstacles during a crisis, and we must focus on the attention older adults may need,” said Senators Susan Collins (R-ME) and Bob Casey (D-PA), Chairman and Ranking Member of the Senate Aging Committee in a statement announcing the Senate panel hearing held in 562 Dirksen Senate Office Building.

In her testimony, Dr. Karen B. DeSalvo the former health commissioner for New Orleans after Hurricane Katrina hit the city in 2005, noted that medical records for most patients at the time of Katrina were kept only on paper and were destroyed, “turning to useless bricks,” or lost because of the disaster. For clinicians, treating patients who lost their medicines became a major challenge, she said.

Creating Registries to Protect the Vulnerable

Since Katrina, the New Orleans Health Department has been “working aggressively, to create a medical special needs digitized registry to maintain a list of high-risk individuals, those most in need of medical assistance for evacuation during preparations or in response operations, says Dr. DeSalvo

Dr. DeSalvo called for “leveraging data and technology” as a way of creating more efficient and effective strategies of identifying the most vulnerable in a community. All communities could create such registries by using state Medicaid data to locate where residents who are electricity-dependent live. The electronic system, called emPOWER, is available for use nationally, and she recommended Congress fund training exercises to respond to disasters. response.

A witness, Jay Delaney, fire chief and management coordinator for the City of Wilkes-Barre, Pennsylvania, suggests that Congress continue to fully fund the National Weather Service and the Federal Emergency Management Agency (FEMA). Investing in surveillance tools can enhance decision making by making crucial weather data available before, during, and after a disaster.

For nursing homes and assisted living facilities, it is “critical” they have detailed shelter-in-place emergency plans, says Delaney, but for those who stubbornly choose to not leave their homes during a disaster, preparedness for those is a “tough nut to crack.”

“When you have to evacuate 15,000 people in 10 hours, you don’t have time to say, ‘Mam or sir, here’s why you have to go,’” Delaney said.

In his testimony, Paul Timmons Jr., CEO and president of Portlight Inclusive Disaster Strategies, proposed the establishment of a National Center for Excellence inclusive Disability and Aging Emergency Management to improve emergency management responses to disasters to reduce injuries and save lives. “The initial focus of the center should include community engagement, leadership, training and exercise development, evacuation, sheltering, housing and universal accessibility,” he said, suggesting a five-year, $1 billion budget.

Finally, Witness Kathryn Hyer, a professor in the School of Aging Studies at the University of South Florida in Tampa, provided eight tips for the Senate Aging panel to protect seniors during disasters. She called for emergency plan for nursing homes and assisted living; required generators to support generators in the event of a power failure, more research on what types of patients will benefit from evacuation or sheltering in place; construction of facilities in places that minimize flooding risk; identification of and prioritization for nursing homes and assisted living communities by state and local management organizations for restoration of services; litigation protection for facilities that abide by regulations and provide care during disaster scenarios; and continued commitment to geriatric education programs.

Prioritizing Senior’s Needs in Disasters

On Sept. 26, one week after the Senate Special Committee on Aging hearing on disaster preparedness and seniors, Senators Collins and Casey called for a swift federal response to the growing humanitarian crisis in Puerto Rico and the U.S. Virgin Islands. In correspondence to three federal agencies, they urged the Administration to take all available steps to act swiftly and prioritize seniors in the response to Hurricane Maria The senators also urged the federal agencies to prioritize not only patients in acute health care facilities, but individuals in nursing homes and assisted living facilities, as well as seniors living at home.

“We urge the Administration to heed the lessons of the recent hurricane response efforts in Florida and Texas and take all available steps to prioritize seniors in the response to this devastating storm,” the senators wrote. “Seniors must be quickly identified and resources deployed to ensure that no older American is left in unbearable heat without air conditioning or without water and food as response efforts continue… During this recovery period, it is even more important to multiply our efforts and deploy sufficient resources to support and rescue seniors.

It has been reported that the intensity of North Atlantic hurricanes and the number of Category 4 and 5 hurricanes are increasing. With a high concentration of people and properties in coastal areas were hurricanes strike, it become crucial to learn emergency management lessons gleaned from past hurricanes and disasters, from Hurricane Katrina to Hurricane Irma. The Senate Select Committee on Aging is on the right track in seeking ways to put disaster emergency preparedness on the nation’s policy agenda. Now, it’s time for Congressional standing committees to adequate fund FEMA and the National Weather Service and strengthen emergency preparedness laws.

Senate Republicans Pushing to Vote on Latest Health Care Proposal

Published in the Woonsocket Call on September 24, 2017

With the September 30 expiration of its special Senate budget reconciliations status that allows the chamber to repeal and replace Obamacare with just a simple majority, Senate Republicains are rushing to bring their latest health care fix up for vote by the end of next week. The GOP’s last attempt failed by a razor thin margin.

Critics charge that the Senate Republicans push to quickly vote on their latest health care bill, crafted by Republican Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana, comes before the issuance of a complete analysis of the Congressional Budget Office (CB)) that would detail the legislative proposal would impact coverage nationwide.

AARP, the National Committee to Preserve Social Security and health care provider groups say that Graham-Cassidy’s fix to put the brakes to rising health care costs will increase premium and out-of-pocket costs for millions. They say that the nonpartisan CBO would give the details to its negative impact.

Even Gov. Chris Christie came out opposing the GOP health care over haul bill that Senate Republicans are pushing. “I can’t support a bill that takes $3.9 billion away from the people of the state of New Jersey,” said the New Jersey Governor, reported last Wednesday by the Trentonian News. Democratic Colorado Gov. John Hickenlooper and Gov. Republican Governor John Kasich, of Ohio, held a bipartisan news conference this week calling for a bipartisan approach to reforming health care.

Talk Show Host Jimmy Kimmel also came out swinging against the Graham-Cassidy proposal, calling Sen. Cassidy, a co-sponsor of the bill, a liar. Earlier this year the Republican Senator had appeared on his show and after hearing that Kimmel had an infant son with a heart condition, he assure Kimmel that any GOP proposal would protect those with pre-existing conditions. It does not, at least to Kimmel’s satisfaction.

For days, aging and provider groups and even Democrats on cable shows expressed concern that the Graham-Cassidy Bill would allow states to permit insurance companies to charge people with preexisting conditions (an estimated 25 million Americans age 50 to 64) just because they have cancer, diabetes, high blood pressure, asthma, etc.

Age Tax Hits Seniors Right in their Wallets

On September 20, 2017, AARP writer Dena Bunis, charges in a blog posting, “Latest Senate Health Care Bill Revives Age Tax for Older Americans,” the GOP’s latest effort to repeal President Obama’s landmark Affordable Care Act (ACA), imposes an “age tax” on older Americans by eliminating premium tax credits and cost sharing payments that helped low-income persons afford deductibles and copayments for medical services.

The Graham-Cassidy bill would also allow states to get federal waivers for insurers to charge older Americans more so as to lower the cost for younger policyholders. The ACA limits the expense for older policyholders at three times the amount younger ones pay, says Bunis.

To illustrate the “age tax” Bunis, citing an AARP analysis, notes, that for a 60-year-old earning $25,000 a year, premiums and out-of-pocket costs could increase by as much as $16,174 a year. If that 60-year-old lives in a state that allows insurers to charge older individuals dramatically higher premiums, he or she would face an additional $4,124 increase in premiums,” she says.

The Graham-Cassidy bill takes away the premium tax credits that help older adults pay for their health care coverage, notes Bunis. . “About 6 million 50- to 64-year-olds buy their health coverage in the individual market, and about half of those individuals receive tax credits to help pay their premiums, she says, citing an analysis by the AARP Public Policy Institute.

The Graham-Cassidy bill would also eliminate vital cost-sharing payments that help low-income persons — especially those over age 50 — afford deductibles and copayments for medical services, too, adds Bunis, noting that “about 58 percent of adults enrolled in ACA marketplace plans get cost-sharing assistance, and 35 percent of those individuals are between 50 and 64 years old.”

Bunis notes that the latest Senate health care proposal would shift federal funds to the state through block grants that would allow each state to develop their own specific health care coverage initiatives to reduce costs. But, she says that Medicaid per capita cap or block grants funding proposals, “fundamentally change the Medicaid program [covering 17.4 million older Americans and people with disabilities], which has been a safety net for millions of poor Americans and people with disabilities.

Receiving Medicaid eligibility for coverage and services would leave fewer doctors and other providers willing to take Medicaid patients or provide needed care because reimbursement is too low.

Block grants, mandated by the Graham-Cassidy bill, would only last through 2026, offering no replacement health care plan, says Bunis. “Over 20 years, Graham-Cassidy would slash Medicaid funding by $1.2 trillion to $3.2 trillion, turning control of the program to the states and shifting costs over time to states and Medicaid enrollees,” she says.

“Americans have a right to know how this bill would impact them. Regretfully, the Majority Leadership is rushing the Senate to blindly consider Graham-Cassidy without fully vetting this proposal in committee hearings and mark-up, where amendments could be considered, and without a full Congressional Budget Office (CBO) score. CBO previously estimated that repeal-without-replace would cause 32 million people to lose health coverage,” said Max Richtman, President and Chief Executive Officer of the National Committee to Preserve Social Security and Medicare (NCPSSM), in a statement to Senate Finance. The Senate panel is scheduled to hold a hearing on the Graham-Cassidy bill next week.

“Senate consideration of any bill that would change the accessibility and affordability of essential health care for millions of Americans without a complete CBO analysis and committee debate would be the height of legislative malpractice,” says Richtman.

NCPSSM calls the latest GOP Senate Health care proposal “deeply flawed” and suggests that it be referred to the Senate Committee on Health, Education, Labor and Pensions where Chairman Lamar Alexander and Ranking Member Patty Murray are attempting to hammer out a bipartisan solution to strengthen the ACA’s individual health insurance market reforms.

A Final Take

A press time, Republican Sens. Ron Paul (Kentucky) and John McCain (Arizona) give thumbs down to the Graham-Cassidy bill with the Portland Press Herald reporting that Sen. Susan Collins of Maine, saying “I’m leaning against the bill.” Fifty Republican Senators must give their thumbs up, with Vice President Mike Pence casting the tie-breaking vote, to get a simple majority for passage. Now, the votes are just not there for passage.

But, one long-time Republican Senator speaks honestly on the record why President Donald Trump his fellow Senate caucus members are pushing so hard for passage of the latest Senate health care proposal. “You know, I could maybe give you 10 reasons why this bill shouldn’t be considered,” Iowa Republican Senator Chuck Grassley. “But Republicans campaigned on this so often that you have a responsibility to carry out what you said in the campaign. That’s pretty much as much of a reason as the substance of the bill.”

Sadly, if true the Republican-controlled Congress has put millions of Americans at risk of losing their health care coverage and at risk for the sake of a political promise. Our lawmakers must become statesmen and vote on legislative proposals because it is the right thing to do, not politicians who vote by party-line.

It’s Time to Pass RAISE Family Caregivers Act

Published in the Pawtucket Times on September 18, 2017

Editor’s Note: Four months after S. 1028, titled the Recognize, Assist, Include, Support, and Engage (RAISE) Family Caregivers Act, was introduced in the Senate, an updated House companion bill (H.R. 3759) gets dropped into the chamber’s legislative hopper. On September 13, Reps. Gregg Harper (R-MS) and Kathy Castor (D-FL) along with original cosponsors Reps Michelle Lujan Grisham (D-NM) and Elise Stefanik (R-NY) introduced the legislation that calls for the development of a strategy to support family caregivers. It was referred to House Committee on Education and the Workforce. At press time, Rep. David Cicilline (D-RI) will shortly become a cosponsor of H.R. 3759.

On May 3, Sens. Susan Collins (R-ME), the Chairman of Senate Aging Committee, and Tammy Baldwin (D-WI) reintroduced the RAISE Family Caregivers Act, with Sens. Lisa Murkowski (R-AK) Michael Bennet (D-CO) signing on as cosponsors. At press time, there are now 12 cosponsors. Sen. Collins and Baldwin and Reps. Harper and Castor first introduced the family caregiver legislation in July 2015, and it passed the Senate unanimously in December 2015.

Eight days later the Senate Health, Education, Labor and Pensions Committee unanimously passed this legislation by a voice vote later that month and the bipartisan legislation will now be considered by the full Senate.

The Nuts and Bolts

The House bill introduced this week is updated from the Senate version introduced in early May. That Senate version is almost identical to the Senate-passed version from 2015.

The RAISE Family Caregivers Act directs the Secretary of Health and Human Services to develop and update a national strategy to support family caregivers. The legislation would also create a Family Caregiving Advisory Council comprised of relevant Federal agencies and non-federal members, also including family caregivers, older adults with long-term care needs, individuals with disabilities, employers, health and social service providers, advocacy organizations engaged in family caregiving, state and local officials, and others with expertise in family caregiving.

The newly established Advisory Council would be charged with making recommendations to the Secretary. The strategy would be updated to reflect new
developments. The Advisory Council’s initial report would include an initial inventory and assessment of federally funded caregiver efforts that would be incorporated into the initial strategy. The strategy would then identify recommended actions that government, providers, communities, and others could take to support family caregivers.

The activities under the bill would be funded from existing funding appropriated for the Department of Health and Human Services. No new funding is
authorized and it would sunset in five years.

This bipartisan caregiver legislation has been endorsed by over 60 aging and disability organizations, including the AARP, the Alzheimer’s Association, the w Michael J. Fox Foundation and the Arc.

Shouldering Caregiver Burdens

“Every day, more than 40 million ordinary Americans take on the challenge of caring for parents, spouses, children and adults with disabilities, and other loved ones so they can live independently at home and in their communities,” says AARP Chief Advocacy & Engagement Officer Nancy A. LeaMond. “The RAISE Family Caregivers Act is a commonsense, bipartisan step to recognize and support our nation’s family caregivers. AARP appreciates the leadership of Representatives Harper and Castor, and we urge Congress to pass this important piece of legislation,” she notes.

According to LeaMond, the nation’s family caregivers assist loved ones with eating, bathing, dressing, transportation, medical tasks, managing finances, and more. Many do this while working full time and raising families. The unpaid care family caregivers provide—37 billion hours valued at about $470 billion annually—helps delay or prevent more costly care and unnecessary hospitalizations, saving taxpayer dollars.

“Caregiving is, in one way or another, now an inevitable part of everyone’s future,” said AARP Rhode Island State Director Kathleen Connell. “It has been said that if you ask people about caregiving they fall into one of three or more categories: They know a caregiver, they are a caregiver or they will require a caregiver. AARP works hard at the state and federal level to direct resources and support to family caregivers. In Rhode Island, we have fought successfully for temporary caregiver insurance (TCI), the CARE Act, accessory dwelling unit legislation and a new fund to help offset the cost of ‘livable’ home improvements that benefit caregiving and make aging in place easier.”

“In the upcoming special session of the General Assembly, another key caregiving bill will be before lawmakers,” Connell added. “Earned Paid Sick Leave will be especially helpful to working family caregivers whose employers do not offer paid time off. Temporary caregiver insurance requires several days advanced notice. That can be helpful, for example, if a family member has a scheduled test or medical procedure. Earned paid sick leave would allow employees to used paid sick time when they are called away to attend to immediate emergencies.”

“The RAISE Family Caregivers Act is intended to provide a policy framework for improving caregiver support from national level down to states, cities and towns. In short, where the caregiver rubber meets the road,” Connell said.

Caregiver Legislative Proposal a Bipartisan Issue

According to AARP’s Public Policy Institute, there are 40 million family caregivers in the United States who provided an estimated $470 billion in uncompensated long-term care in 2013. In the Ocean State at any time during the year, an estimated 134,000 Rhode Island family caregivers step up to provide 124 million hours of care for an aging parent or loved one, most often helping them to live independently in their own homes.

With many caregivers putting their own health at risk, experiencing experience high-levels of stress and have a greater incidence of chronic conditions like heart disease, cancer, and depression, these individuals need the support and assistance that the enactment of the RAISE Family Caregivers Act could help bring about. Both sides of the aisle must put their political differences aside and push for passage. Both Republicans and Democrats shoulder caregiving duties.

Quickly passing the RAISE Family Caregivers Act in the Senate and House and sending it to the desk of President Donald Trump for his signature is the right thing to do.

On Taking a Stand Against Racism and Antisemitism

Published in Woonsocket Call on August 27, 2017

Morris Nathanson, an 89-year-old who served in the United States Navy in World War II, was outraged for President Trump’s failure to strongly speak out against the hateful philosophy of neo-Nazis, white nationalists, Ku Klux Klan (KKK) and militia groups exhibited at a violent protest that escalated out of control in the streets around the University of Virginia campus in Charlottesville, Va.

Growing up Jewish, Nathanson is horrified about the growing racism and antisemitism so visibly flaunted at the Charlottesville rally and seen throughout nation. Before the Second World War, his parents had escaped the violent pogroms in Russia, ultimately settling in a three decker house with relatives in Pawtucket. Family members who remained in Europe were killed, victims of the Holocaust, he said.

“It’s is indefensible,” says Nathanson, an Eastside resident who in an internationally acclaimed artist and semi-retired restaurant designer, for Trump to not outright denounce the neo-Nazi groups. He warns, “We must recognize the growth of the neo-Nazi movement for what it is, a terrible disease that must be eliminated.”

The jarring historical imagery of the torchlight procession of supporters of Adolf Hitler moving through the Wilhelmstrasse in Berlin on the evening of January 30, 1933, came to life for Nathanson and millions of Americans last weekend when hundreds of neo Nazis, white nationalists, KKK, militia members and other right-wing groups gathered for a “Unite the Right” rally in Charlottesville, Va. Carrying tiki torches, flags with swastikas and confederate flags, they came to the City’s Emancipation Park to ostensibly support a protest against the removal of a statue of Civil War confederate General Robert E. Lee. But it was really an opportunity to display their strength.

Battle Lines Drawn

On the evening of Friday August 11 at 10:00 p.m., the torch bearing marchers, some wearing Nazi-style helmets, carrying clubs, sticks and round makeshift shields emblazoned with swastikas and other Fascist symbols, and others entered the one-block square in downtown Charlottesville, the site of the controversial monument, chanting “Jews will not replace us”, “Blood and Soil” (a Nazi rallying cry), “White Lives Matter,” along with homophobic, racists and misogynistic slurs. Heavily armed militia members, carrying semi-automatic weapons and dressed in camouflage military fatigues came to support and embolden their fellow extremist groups that identify as the “alt-right”.

At the site of the controversial monument in the City’s park and surrounding streets, throughout Friday evening and Saturday, August 12, members of alt-right groups opposed counter-protestors including Antifa, a far-left militant political movement that opposes fascist groups, members of Black Lives Matter, and church groups along with others who oppose racial bigotry and antisemitism. During the weekend rally, it was reported that 15 people were injured. On Saturday, James Alex Fields Jr., a 20- year-old, drove his gray Dodge Challenger into a group of counter-protesters, killing 32 year old Heather Heyer and injuring 19 other counter-protestors. Two Virginia State Police officers, monitoring the protests, died when their helicopter crashed.

Immediately following the rally on Saturday and the death of Heyer, Trump went to Twitter and posted an opened ended statement, calling the nation to “condemn all that hate stands for.” Following this tweet, on Sunday, August 13, he issued a statement at his golf club in Bedford New Jersey, stating, “We condemn in the strongest possible terms this egregious display of hatred, bigotry and violence on many sides.”

Trump Vacillates on Who’s to Blame

On Monday, August 14, intense political pressure would force Trump to make a statement at the White House to strongly condemn KKK and neo-Nazi groups after he blamed violence at the Charlottesville, Va., two days earlier in a tweet on “many sides”

By Tuesday August 15, Trump had backed off his public scolding of America’s hate groups At an impromptu press conference held at Trump Tower, he cast blame for Charlottesville’s violence equally on the “alt-right” and “alt-left” counter- protestors. “You had a group on one side that was bad, and you had a group on the other side that was also very violent,” Trump said, noting that “Nobody wants to say that, but l say it.”

“Not all of those people were neo-Nazis and white supremacists, believe me,” says the president, noting that some protestors wanted to stop the removal of the Robert E. Lee statue. Some were “nice people” he stated.

“So this week, it’s Robert E. Lee, I noticed that Stonewall Jackson’s coming down. I wonder, is it George Washington next week? And is it Thomas Jefferson the week after. You know, you really do have to ask yourself, where does it stop?” said Trump.

Trump’s comments that not all rally marchers were neo-Nazis or white supremacists caused a political tsunami, with critics pointing out that these individuals marching with the neo-Nazis were not “nice people”. It was guilt by association.

The two former Bush Presidents joined world leaders, GOP and Democrat Senators, Governors, and rank-and-file Republicans, Democrats, and Fortune 500 Executives to chastise Trump for his failure to speak out against Nazi and white supremacist ideology and that his comments trivialized the antisemitism and racism of these extremist alt-right groups.

Even the members of the Joint Chiefs of Staff, the senior uniformed military leaders in the United States Department of Defense who advise the President, posted tweets denouncing the alt-right extremists and blaming them for Saturday’s bloody violence in Charlottesville.

However, white supremacists took Trump’s Charlottesville statements as an endorsement to their legitimacy and acceptance to allow their members to become more visible in society. David Duke, a white nationalist and former Imperial Wizard of the KKK, tweeted, “Thank You Mr. President Tamp; God Bless You for setting the record straight for All Americans.” The Daily Stormer, a neo-Nazi website, quickly called Trump’s statements on blaming both sides a sign that he implicitly supported their goals and objectives.

The Increasing Visibility of Racism and Antisemitism

Ray Rickman, 65, Executive Director of the nonprofit Stages of Freedom, says, “I am deeply worried about the piercing images of men marching with Nazi torch lights on the University of Virginia campus. These men were screaming “Jews won’t replace us.” It was Nazi Germany all over again. The idea of seeing a Nazi flag, the most vicious symbol of antisemitism on American soil, is almost unbelievable to me. All of this is followed by the deeply divisive comments from Mr. Trump”, says the long-time Rhode Island activist.

“This man in the White House has shown total disrespect for the millions of American soldiers both living and dead who died to save the world from the Nazis,” adds Rickman, noting that “It’s the first time since Woodrow Wilson that a president has refused to condemn racism after such an act of violence.”

Rickman says that the neo-Nazi groups used the Charlottesville gathering as a public show of force and to promote hatred. “Maintaining the Robert E. Lee Monument was just an excuse to attack Jews and Blacks,” he says, noting that the three-day protest was planned as a “hateful rally by people who hate people of color and Jews. It is as simple as that.”

One of the most interesting aspects of beliefs held by General Lee was that he was not in favor of raising Confederate monuments, says Rickman, noting that in 1869 he wrote that it would be wiser “not to keep open the sores of war but to follow those nations who endeavored to obliterate the mark of civil strife.”

Combating Intolerance and Hatred

While both GOP and Democrat lawmakers lambasted Trump’s choice of words for laying the blame of violence at the Charlottesville rally on both the far right demonstrators and counter protestors, there were some who remained silent or defended his comments, saying his words were adequate.

With the increased public visibility of the neo-Nazis, white supremacist and other hate groups, if Trump fails to use his national bully pulpit, and the moral authority of the Office of the Presidency to steadfastly condemn hate groups, national and state elected officials and Americans of all walks of life must take on this responsibility.

In response to the violent weekend in Charlottesville, Va., the Illinois Senate adopted a resolution, sponsored by Sen. Don Harmon, D-Oak Park, urging law officials to recognize white nationalists and neo-Nazi groups as terrorist organizations.

Nathanson, who in 1965 marched with Martin Luther King in Selma, Alabama to fight racism, calls for organizing rallies at the state and national level to “reduce the damage of Trump’s comments.”

It would be an appropriate time to remember the speech given by Martin Niemoller, a German Lutheran minister who opposed the Nazis and was sent to several concentration camps. He survived the war and explained:

First they came for the Jews. I was silent. I was not a Jew.
Then they came for the Communists. I was silent. I was not a Communist.
Then they came for the trade unionists. I was silent. I was not a trade unionist.
Then they came for me. There was no one left to speak for me.

 

Three GOP Senators Derail ‘Skinny’ Repeal Maneuvers

Published in the Woonsocket Call on July 30, 2017

After seven years of vowing to repeal and replace President Obama’s Affordable Care Act, nicknamed Obamacare, Congressional GOP efforts went down in flames on Friday when Sens. John McCain, of Arizona, Susan Collins of Maine, and Lisa Murkowski, of Alaska, voted nay in supporting the Senate Republican’s “skinny” repeal bill.

Sen. McCain, giving his no vote with a thumb down gesture, left Republican Senators gasping and Democratic Senators clapping. The 80-year old Arizona Senator, recently diagnosed with an aggressive brain cancer, had flown back to vote. The Senator’s vote was considered the decisive vote to derail the GOP’s long-time efforts to repeal and replace Obamacare.

Senate Republicans Begin Efforts to Repeal Obamacare

On July 25, GOP leadership began its efforts to begin debate on the Senate health care bill to repeal AHA. On that Tuesday afternoon, the Senate passed a “motion to proceed” vote by 51-50, the deciding vote being cast by Vice President Mike Pence. The votes outcome allowed the upper chamber to begin debate on the Senate Republican’s Obamacare repeal-and-replace proposal. Sens. Collins and Murkowski had opposed this motion, but McCain, returning to Washington, D.C. after being diagnosed with brain cancer, voted yes to proceed with the debate.

Senators began a 20- hour period of debate, considering various amendments to the House version of the health care bill. By a vote of 43 to 57, the Senate rejected one version that included Sen. Ted Cruz’s (R-TX) controversial amendment that would have allowed those with pre-existing conditions to be separated into plans with much higher premiums. The Senate also rejected, by a vote of 45 to 55, another version that would have repealed the ACA with no replacement but with a two-year delay, giving GOP senators more time to create their replacement.

Late Thursday evening, GOP Senate leadership finally unveil its expected “skinny” repeal bill, formally called the Health Care Freedom Act, that would repeal ACA’s individual and employer mandates, temporarily repeal the medical device tax, and give states more flexibility to allow insurance that doesn’t comply with Obamacare regulations.

CBO’s analysis of the “skinny” repeal bill, estimated that 15 million more people would be uninsured next year than under Obamacare, with 16 million more in 2026, and that premiums would increase 20 percent next year, compared to current law.

Earlier that day, Sen. McCain and Republican Senators Lindsey Graham of South Carolina and Ron Johnson of Wisconsin, held a news conference threatening to oppose the “skinny” repeal bill if the House Speaker did not offer sound guarantees that the House would enter negotiations after the Senate passed it. They feared that the House would end up passing “the skinny bill” rather than a more comprehensive bill hammered out in conference committee.

Ryan’s carefully crafted statement to the concerned Senators that the House would be willing to go to a conference committee did not include a specific guarantee that the House would not vote on the Senate’s proposal. Both Graham and Johnson went on to vote for the legislation. But, after his surprising vote it seems that McCain still had his concerns.

Before the Senate vote, President Trump even tweeted his displeasure of Murkowski’s opposition, her no vote against debating Obamacare repeal, says the Alaska Dispatch News. The state’s daily newspaper reported that Interior Secretary Ryan Zinke called the state’s Senators, Murkowski and Dan Sullivan, to inform them that Murkowski’s vote would “put Alaska’s future with the administration in jeopardy.”

After Zinke’s call, “Murkowski, who chairs the Senate and Natural Resources Committee, sent a message back to the Interior Secretary and Trump. Overseeing the agencies confirmation process, a committee hearing on nominations to the Interior and Energy departments, was “postponed indefinitely” with no reason given, stated the Alaska Dispatch News.

Finally, early Friday, by a vote of 49-51, Senate Republicans failed to repeal Obamacare with three Republican senators — McCain, Collins and Murkowski – joining 48 Democrats to vote against the “skinny” repeal bill. Sen. McCain’s reputation as a political maverick was evident when he voted against GOP Senate leadership. But, this vote will be considered his political legacy.

A Sigh of Relief

Reacting to the defeat of the Senate’s ‘skinny’ repeal bill, AARP Executive Vice President Nancy LeaMond, in a statement, called the vote “a victory for Americans age 50-plus.”

“The ‘skinny’ bill the Senate defeated would have dramatically increased health care costs, caused millions to lose their health coverage, and destabilized the insurance market,” says LeaMond.” She also thanked Senators Collins, McCain, and Murkowski, Senate Democrats and Independents who “called, emailed, rallied and wrote to object to this seriously flawed bill.”

Max Richtman, President and CEO of the National Committee to Preserve Social Security, in a statement stated, “Senators Susan Collins, Lisa Murkowski and John McCain were under extreme pressure from the White House and their colleagues to vote with the party instead of voting for the American people. It’s important to applaud them for stopping this train wreck of a healthcare bill. We have to wonder, however, why other Senators were willing to put their constituents at risk by cutting off their healthcare coverage.”

“We urge the majority party to put raw politics aside and work with Democrats to improve the Affordable Care Act in a way that benefits millions of American families in both blue states and red states. Let’s move forward, not back,” said Richtman.

A Bipartisan Approach

President Trump and Congress must finally listen to listen to their constituents to create policies to bring health care coverage to those in need. It is time to put politics aside and work in a bipartisan manner to hammer out a viable solution to provide affordable health care insurance to millions of Americans without coverage. McCain, Collins, and Murkowski, did just that when they resisted their party’s pressure to vote their own personal conscience not party line. They believed that the bill they voted against would do more harm than good.

Obamacare can be reworked to become more cost effective and to provide more health insurance to those in need of coverage. A recently released USA Today/Suffolk University poll at the end of June says that “just 12 percent of Americans support the Senate Republican health care plan. But, “a 53 percent majority say Congress should either leave the law known as Obamacare alone or work to fix its problems while keeping its framework intact.”

The majority of America says keep Obamacare, but make it better. Hopefully, lawmakers will listen.