“Bosom Buddies” Brings Healing to Breast Cancer Survivors

Published in the Woonsocket Call on November 26, 2017

Sometimes a personal health-related issue and one’s professional life experiences blend together almost seamlessly to create an opportunity to help others in similar situations. It took over 20 years for Mary Jane Condon Bohlen, a Cranston resident, professional photographer, artist, former teacher and breast cancer survivor, to do just that, achieving her dream of publishing her book, “Bosom Buddies.”

Each photograph of the 29 women posing in “Bosom Buddies” reveals the scars of breast reconstruction and the coffee table book also features an essay, poem, or other writing from the model on the opposite page, providing further insight into the journey through breast cancer.

“I chose the name “Bosom Buddies” as the title of this book and photographed my “buddies” kayaking, riding horses, working in their gardens, singing, doing yoga and other loves,” says Bohlen. “I sought to reveal the thoughts, fears, inner spirit and especially the hopes of those brave enough to bare their bodies and show their beauty,” in a book that took two years to complete.

In May of 2008, after living with a mastectomy of her right breast for 16 years, she was told that cancer had returned to her left side. Now with two mastectomies, breast cancer gave her the insight and wisdom to photograph women in a very vulnerable health state that appear in “Bosom Buddies.” The women photographed are typical of women who “battle breast cancer every day.”

“They have taken their bravery one step further by allowing themselves to be photographed in subtle and delicate settings,” says Bohlen.

The Inspiration

As a fourth grader, Bohlen began taking pictures with a camera that her parents gave her. In later years, as a medical photographer working in hospitals all over the City of Boston, she photographed artificial hearts being implanted in pigs and cows, cutting edge surgeries on humans, a 16mm movie of a lung transplant in a rat photographed through a microscope, social events that included dignitaries, film, TV, and Broadway stars, weddings, Bar Mitzvahs, PR work, in addition to her own fine art photography, including the publishing of “Bosom Buddies.”

Bohlen, 73, remembers that her desire to publish “Bosom Buddies” began in 1993 in Ledyard, Connecticut, one year after she was diagnosed and treated for breast cancer. Standing by a magnificent tree over 400 years old, 90 feet high with a circumference of over 26 feet, where Native Americans gathered to vote on tribal issues, Bohlen began snapping photos of the remains of the dead tree damaged by gypsy moths over the centuries. Upon close inspection of the printed images she saw a one breasted figure and that immediately inspired her to create an aquatint etching, she would call “Bosom Buddy.”

“The Ledyard Oak became my “Bosom Buddy” and helped me to relate to my inner beauty that was so much more meaningful than what was found beneath my clothing,” says Bohlen.

Ultimately her etching would lead to the publishing of a coffee table book including photos and essays of breast cancer survivors expressing how breast cancer may have affected their lives. A short biography about what they are now doing with their life is also included. “I wanted the world to know that there is life after breast cancer. Life goes on and it isn’t always a death sentence,” she says.

Reflections from “Bosom Buddies”

Sharyn Vicente, 52, of Cumberland, was photographed at a spa in Arizona during a very special trip. In 2008, Vicente was diagnosed with cancer at the age of 41. Initially she did not wish to be photographed but went outside of her comfort level to participate in the project.

Vicente details in her essay in “Bosom Buddies” how breast cancer impacted her life. “It was a long road with many unexpected bumps along the way. In three short years, I had both breasts removed, half of my right kidney, my uterus and both ovaries. While I felt that my body was systematically being hollowed out, I thought that I really didn’t deserve yet another escape from the grim reaper. This all also made me feel as though I was no longer a woman.”

But, “Cancer did not and will not rule my life,” says a reflective Vicente in her biography, noting that she spends time fundraising for the Gloria Gemma Breast Cancer Resource Foundation (GGBCRF) and mentoring woman going through the diagnosis and treatment of breast cancer. Participating in this book project began the healing process

Nicole Bourget-Brien, 47, a two-time breast cancer survivor celebrating a decade of being cancer free was photographed lifting hand weights in her brother-in-law’s gym. The photograph captured how she felt that day, “strong”

The Woonsocket resident was warned that after the mastectomy she might not be able to exercise at the same level as before the surgery. But, “I have proven that to be false. I am working out more vigorously now than I did when I was in my twenties,” she says.

In her biography in the book, Bourget-Brien says, “I have made a choice to live and not just exist after my cancer diagnosis. I have learned to breathe- to remember that the rearview mirror is smaller because it is where we have been and to look thru the windshield to enjoy what lies ahead.”

Tracey Donahue Henebury, 48, sits on a rock by a pond sunning herself. She urges readers of “Bosom Buddies” to “look beyond the scars and nudity and read each and every heartwarming story which describes the strength, sacrifices, and fears each one of us has faced.” The book is just “breathtaking,” she says.

Over the last couple of years, she has been on “an emotional roller coaster due to the complications of her mastectomy,” admits Henebury. In “Bosom Buddies,”she states “Nothing has knocked me down where I don’t get back up on my feet.” Support from family and friends and The Gloria Gemma Foundation “enhanced my scars as beauty and strength.”

Of course, you will find a self-portrait showing Bohlen wearing boxing gloves, ready to fight a battle against cancer. After her second mastectomy, neither her friends nor her family “got it.” “No one to tell me they knew what I was going through, no one to ask questions about what to expect. I knew no one else with breast cancer, it was a lonely journey,” she says in her essay in “Bosom Buddies.”

Relocating to Rhode Island and connecting with the Pawtucket-based GGBCRF changed her life, providing her with a support system and friends. She supports the nonprofit by donating 50 percent of the profits of her $40 book to the Foundation.

Bohlen now resides with her husband of almost 47 years, Bob, in Cranston, her daughter, Nie and 8-year-old grandson, Sam, along with her youngest son, Patrick live close by while her older son, Bobby lives in Portland, OR.

There is a real need for this book to find its way to women recently diagnosed with breast cancer and to their families and friends. In 2017, Breast cancer will claim the lives of 40,610 woman throughout the nation, predicts the American Cancer Society, a nationwide voluntary health organization dedicated to eliminating cancer. More than 300,000 women in the U.S. will become breast cancer survivors.

“Bosom Buddies” has allowed the breast cancer survivors participating in this unique book project to come to terms with their inner and exterior scars, and has enhanced their body image after a mastectomy. Bohlen knows that this healing will take place in the readers as well.

At the 2016 National Indie Excellence Awards, Bohlen’s book, “Bosom Buddies” was one of three Finalists in the Photography division and the winner in the Cancer books division.

To purchase, call Mary Jane Condon Bohlen at 401-474-8903 or email to bosombuddies1@verizon.net.

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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.

 

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.”

AARP Scorecard: Taking a Closer Look at Rhode Island’s Long-Term Services and Support to Older Adults

Published in Woonsocket Call on June 18, 2017

With America’s baby boomers beginning to turn age 80 in 2026, days ago the Washington, DC-based AARP released Scorecards detailing how each state spends its dollars on long-term services and supports (LTSS) to assist older adults and adults with disabilities. The report findings revealed a need for state legislatures to quicken the pace of improving LTSS for their older residents. LTSS include assistance with activities of daily living provided to older adults and people with disabilities who cannot perform these activities on their own because of physical, cognitive, or chronic health conditions. The types of assistance include such things as help with bathing, dressing, managing medications, preparing meals, and transportation, as well as support for family caregivers.

The latest comprehensive state-by-state Scorecard report was funded by AARP Foundation with support of the nation’s leading organizations behind quality long-term care, The Commonwealth Fund and SCAN Foundation. This is the third edition of the Scorecard, initially released in 2011 and again in 2014.

AARP’s 2017 report, “Picking Up the Pace of Change: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers (“Scorecard”), released on June 14, finds that although Rhode Island and most states have taken small steps to make some progress, this pace of change overall remains too slow and has not kept up with demographic demands.

“This Scorecard sounds the alarm, but it also provides a range of tools states can use to spark new solutions and create systems that are aligned with the new realities of aging and living with a disability,” said Susan Reinhard, RN, PhD, Senior Vice President and Director, AARP Public Policy Institute. “The proposed cuts to Medicaid—the largest public payer of long-term assistance—would result in millions of older adults and people with disabilities losing lifesaving supports.”

“This new Scorecard shows that it’s time for all states to accelerate care improvements for older adults and people with disabilities,” said Bruce Chernof, MD, FACP, President and CEO of The SCAN Foundation. “States that consistently rank at the top have strategically planned for their aging population across the main sectors of health, housing, transportation and family caregiving.”

Like previous two LTSS scorecards, states are ranked on their performance in five categories: Affordability and access, Choice of setting and provider; Quality of life and quality of care; Support for family caregivers; and Effective transitions between nursing homes, hospitals and homes. Within the five categories, states are scored on their performance in 25 specific indicators, including such things as Medicaid spending, nursing home cost, home health aide supply, antipsychotic medication use in nursing home residents, long nursing home stays, employment rate of people with disabilities, and support of working caregivers.

But this year, AARP has made changes in LTSS Scores in the way information is presented on its interactive website (www.longtermscorecard.org), making it easier for a user to customize data to suit their specific needs. Visitors to the Scorecard site will be able to access videos, called Impact Stories, that show how improving on the Scorecard can impact the lives of real people.

Users can also download Promising Practices as well as Emerging Innovations (updated throughout the year) that state officials can use as they work to improve their long-term care delivery systems.

Rhode Island Improves in Delivering LTC Services

In the 2017 AARP report, Rhode Island ranks 32nd overall when it comes to meeting the long-term care needs of older residents and people with disabilities, but showed improvement in all but one Scorecard category. AARP warns more must be done, at an accelerated pace, to meet changing demographic demands. Rhode Island ranks 22nd nationally Support for Family Caregivers and 24th in Quality of Life & Quality of Care. The state ranks 35th in Effective Transitions – the only category in decline

“The vast majority of older Rhode Islanders want to live independently, at home, as they age—most with the help of unpaid family caregivers,” says Kathleen Connell, State Director of AARP Rhode Island, which serves more than 138,00 members age 50 and older in the state. “Even facing tight budgets, Rhode Island is making progress to help our older residents achieve that goal. However, this Scorecard shows we have more to do, and we need to pick up the pace.”

According to Connell, today, unpaid family caregivers provide the bulk of care for older Rhode Islanders in part because the cost of long-term care remains unaffordable for most middle-income families. In Rhode Island, more than 134,000 residents help their aging parents, spouses and other loved ones stay at home by helping with bathing and dressing, transportation, finances, complex medical tasks like wound care and injections, and more. The value of this unpaid care totals about $1.78 billion.

“When it comes to helping older Rhode, Islanders live in the setting of their choice, family caregivers take on big responsibilities,” explains Connell. “Many juggle full-time jobs with their caregiving duties; others provide 24/7 care for their loved ones. With every task they undertake, these family caregivers save the state money by keeping their loved ones out of costly nursing homes – most often paid for Medicaid. They have earned some basic support.”

“That’s why AARP Rhode Island has fought for Caregiver, Advise, Record, Enable (CARE) Act; caregiver temporary leave insurance; and caregiver tax credits, adds Connell.

Rhode Island has made progress to improve long-term services and supports for older adults and people with disabilities, as highlighted in this Scorecard. But, proposals in Washington, D.C. to drastically cut federal Medicaid funding would threaten these advancements, likely resulting in our most vulnerable citizens losing the lifesaving supports that they count on,” says Connell.

“The single strongest predictor of a state’s long-term care system is the reach of its Medicaid long-term care safety net,” says Connell, noting that’s why AARP fights to expand services provided at home and in the community, by shifting funds away from and more expensive nursing home care. “While the percent of long-stay nursing home residents hospitalized within a six-month period has decreased, the Scorecard highlights additional serious issues related to institutional care in Rhode Island, such as residents with pressure sores and residents with low care needs],” she notes.

While Rhode Island has improved its rank from 50th to 44th in the percentage of Medicaid long-term care dollars for older adults and people with physical disabilities that support care provided at home and in the community—the care setting that most Rhode Islanders prefer—the Scorecard spotlights areas that call for improvement, including choice of setting and provider; and effective transitions.

Specifically, the percent of

• Medicaid and state-funded LTSS going to HCBS;
• Medicaid LTSS users first receiving services in the community;
• People with 90+ day nursing home stays successfully transitioning back to the community;
• Nursing home stays lasting 100 days or more.

“This Scorecard gives us a snapshot of how well Rhode Island serves our older residents, those with disabilities, and family caregivers—and shows us where we must sharpen our focus to better assist hardworking Rhode Islanders,” concludes Connell. “We will continue to work with the governor, legislative leaders and policymakers to take the actions needed now to protect our expanding needs.”

Connell says that of the 25 Scorecard indicators, many may be improved through state policy changes, pointing to the importance of AARP’s multi-state advocacy campaign, launched in 2014, to help older Americans live independently, at home, and the family caregivers that support them.

Director Charles Fogarty, of Rhode Island’s Division of Elderly Affairs, sees the importance of AARP’s Rhode Island’s Scorecard, to evaluate progress in meeting the needs of older Rhode Islanders. “This report reinforces what we already know: while Rhode Island is showing improvements in some areas, there is still much to be done to provide the level of care and services our seniors deserve. Our improved ranking from 50th to 44th in the percentage of Medicaid long-term care dollars spent on home and community care options is a step in the right direction,” says Fogarty.
“We must continue to build upon the success of Reinventing Medicaid and move towards rebalancing of the long-term care system while preserving access and quality of care for older Rhode Islanders,” adds Fogarty.

AARP Scorecard Snap Shot of the National Delivery of LTSS

Washington State and Minnesota are top-ranked states again (followed by Vermont, Oregon and Alaska), but all states lag in helping care for the nation’s growing populations of older persons with people aging and living with disabilities.

AARP’s LTSS Score card noted that the bottom ranking states were Indiana, (No. 51), Kentucky (No. 50, Alabama, (No. 49), Mississippi, (No. 48), and Tennessee (no. 47).

According to researchers, overall, states made incremental LTSS improvements since the previous report in 2014, but the pace of change has been slow and uneven. However, two states—Tennessee and New York—showed the most improvement across measures since the last Scorecard.

States made the most significant progress in reducing inappropriate ‘off label’ use of antipsychotic medications among nursing home residents and increasing support of family caregivers.

In general, states showed the most significant declines in employment rates for people with disabilities and rates of transitioning long-stay nursing home residents back into the community. Notably, the majority of states showed no real change on ‘Affordability and Access,’ meaning that the cost of LTSS over time continues to be much higher than what the majority of families can afford.

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.

Trump Budget Could Eventually Hurt Seniors

Published in Woonsocket Call on June 4, 2017

Last month, President Donald Trump submitted his Fiscal Year 2018 budget proposal to a GOP controlled Congress. Critics of the Republican president and Democratic lawmakers called the 62-page budget proposal, “Dead on Arrival.” Now, with Congressional recess over, look for the House and Senate to begin drafting their own fiscal blueprint.

Massive Cuts to Entitlements and Discretionary Spending

Trump’s $4.1 trillion spending plan proposes historic, massive cuts by eliminating funding for 19 federal agencies to offset the cost of $54 billion to increase defense spending, to pay for infrastructure and the construction of a border wall between Mexico and the U.S., and to fund school voucher programs and a new paid leave initiative. The Trump budget also slashed funding from the budgets of other executive departments and agencies as well. The Environment Protection Agency, the State Department and Agriculture Department took the biggest funding cuts.

The core philosophy of Trump’s first full budget request, “A New Foundation for American Greatness,” can be described as “Taxpayer First,” says Director Mick Mulvaney, of the Office of Management and Budgets.

Mulvaney, a former Republican Congressman now serving as Trump’s budget director, told reporters one day before the release of Trump’s budget, “This is, I think, the first time in a long time that an administration has written a budget through the eyes of the people who are actually paying the taxes.”
We’re not going to measure our success by how much money we spend, but by how many people we actually help,” added Mulvaney.

Many aging advocates fear that Trump’s budget proposal will fray the nation’s social safety net forcing seniors to fall into poverty.
With the release of the Trump Budget proposal, the Washington, DC-based AARP, representing over 38 million members was quick to issue this statement. Executive Vice

President Nancy LeaMond said “AARP opposes the budget proposed today because it explicitly harms the very people we are counting on the President to protect. Today’s budget proposes to cut Social Security benefits, as well as funding for critical health, hunger, housing, and transportation assistance to low and middle-income seniors. This budget sends a powerful message to older Americans and their families that their health and financial security is at risk.”

“We do want to acknowledge the Administration’s paid leave proposal. Although it must be improved so that it addresses the workplace needs of all family caregivers, we hope that it leads to a national conversation about ways to support family caregivers in the workplace,” adds LeaMond.
The Washington, DC-based National Committee to Preserve Social Security and Medicare (NCPSSM), believes Trump’s released budget proposal “literally leaves seniors in the cold.”

“This heartless budget does not reflect true American values,” says Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare in a statement. “In our America, we do not cast seniors into the cold. We do not take food out of their mouths or make it harder to get the healthcare they so desperately need. In short, we do not cut off our most vulnerable citizens at the knees to pay for a massive tax break for the wealthy and big corporations.”

“This budget undermines the President’s promises to seniors. It guts Medicaid, which he promised to protect. The cuts to Social Security Disability Insurance (SSDI), [a program that helps disabled beneficiaries to say at work or return to work] violates his pledge not to tamper with Social Security. It also casts into serious doubt his pledge as a candidate to defend Medicare. No one who is serious about protecting these vital programs would propose a budget so harmful to seniors,” says Richtman.

Richtman says, “Make no mistake: the $64 billion in SSDI cuts are very real – and would cause real pain for Americans with severe disabilities. These are people deemed by the Social Security Administration to be too disabled to work. The qualification requirements are stringent, and the cases dire. Though SSDI helps younger Americans, too, most of its beneficiaries are 55 or over – meaning any cuts to the program will hit older Americans particularly hard. In fact, an average 1 in 6 men on SSDI die within 5 years of claiming benefits. For women, the figure is 1 in 7.”

Trump Budgetary Cuts Hurt Seniors, Poor

According to NCPSSM’s Government Relations and Policy staff, Trump’s budget proposal would drastically slash or eliminate funding for programs that benefit America’s seniors. Here is a sampling of budgetary cuts they identified.

Trump’s budgetary cuts of SSDI has an impact on older disabled persons. It would limit the retroactivity of applications for disability benefits from 12 months to six months and denies unemployment compensation payments to certain SSDI beneficiaries. Finally, it unreasonably caps the amount of payable to individuals who receive SSDI while living with other Supplemental Security Income recipients.

The president’s budget proposal also slashes more than $600 billion from the Medicaid program, which undermines seniors’ access to long-term care. It also eliminates the Community Services Block Grant ($715 million), the Community Development Block Grant ($3 billion) and the Social Service Block Grant ($1.7 billion) which helps fund some Meals-on-Wheels program, delivering hot meals to needy seniors.

Trump calls for eliminating the Low Income Home Energy Assistance Program (LIHEAP) which assists seniors with heating costs. LIHEAP received $3.39 billion in President Obama’s Fiscal Year 2017 budget. Of the 6.8 million household’s assistance, it is estimated that 2.26 million are over age 60.
Federal funding is also reduced for the National Institutes of Health (NIH) by $5.67 billion (including nearly $300 million for the National Institute on Aging), which will negatively impact research into cancer, Alzheimer’s, Parkinson’s and other diseases affecting older Americans.

With flat-line funding in the president’s budget proposal, we can expect longer waits at the local offices of Social Security Administration (SSA) and even extended waits when calling SSA’s telecommunication centers. The agency has been critically underfunded since 2010 – reducing the quality of service to SSA beneficiaries. This will continue.

Finally, Trump’s budget proposal eliminates funding for the Senior Corps programs, including the Retired and Senior Volunteer Program, Foster Grandparents and Senior Companions. These programs enable older adults to remain act in their homes.

Rhode Island Lawmaker Gives His Two Cents

U.S. Rep. David N. Cicilline notes, who serves as Co-Chair of the House Democratic Policy and Communications Committee “If a budget is a statement of your priorities and values, then Donald Trump’s budget shows he doesn’t understand the challenges facing Rhode Island seniors. This budget would cut Medicaid by up to $1.3 trillion over the next decade, jeopardizing health coverage that more than 18,000 Rhode Island seniors rely on to access high-quality affordable care.”

“Additionally, despite the President’s campaign promise not to touch Social Security, this budget carves out tens of billions in cuts to SSDI. That would have a devastating impact on SSDI recipients – most of whom are over the age of 55 – who have worked their entire lives and are physically unable to earn additional income,” says the Democratic lawmaker.

Cicilline warns, “Trump’s proposal to slash $193 billion – over 25 percent of total funding – over a decade to the Supplemental Nutrition Assistance Program (SNAP) would undermine the health and well-being of more than 16,300 Rhode Island seniors who receive assistance for their basic food and nutrition needs every month.”

“This budget would eliminate the Low Income Home Energy Assistance Program (LIHEAP), which helps low-income people, including thousands of seniors, pay their heating and cooling bills. It also eliminates the Social Services Block Grant and State Health Insurance Program, both of which provide critical federal support to help states meet the individualized needs of their seniors,” adds Cicilline.

“Plain and simple, this is a budget written by the wealthiest Americans for the benefit of the wealthiest Americans. But it’s a setback for the middle class and millions of seniors who have worked hard and played by the rules for their entire lives. Along with my colleagues in the House Democratic Leadership, I will do everything I can to reverse these devastating cuts and shape a budget that invests in the future of our country and puts honest, hardworking families first,” says Cicilline.

AARP, NCPSSM and aging advocates, now turn their attention to the House and Senate to keep Trump’s draconian budgetary vision out of the final FY 2018 budget. But, voters must also oppose huge cuts in Medicare, Medicaid and Social Security entitlement programs and discretionary funding for programs for older Americans at town meetings held by their Congressman and Senators.

Midterm elections will take place on Tuesday, November 6, 2018, All 435 seats in the House and 34 of the 100 senate will be up for grabs. Maybe GOP lawmakers will craft a budget proposal that will benefit their constituents, not support their political party’s policy positions.

CBO Numbers Says GOP Health Plan Benefits Young, Healthy…Not Seniors

Published in the Woonsocket Call on May 28, 2017

Weeks ago, the Trump Administration and GOP House leadership mended fences with GOP moderates and conservatives to hammer out a new version of the introduced legislation, the American Health Care Act (AHCA) of 2017 and replace the Affordable Care Act, called Obamacare Care. The GOP health care proposal with its last-minute changes passed on May 4 by a razor-thin vote of 217-213, a slim margin of four votes. All 193 Democrats opposed passage, along with 20 Republican lawmakers.

With passage, AHCA moved to the Senate for deliberation. Senators considered the House passed health care bill “Dead on Arrival.” But, Senate Majority Leader Mitch McConnell (R-Ky.) quickly appointed 13 Republican Senators to hammer out their chamber’s health care bill. Political observers doubt whether McConnell has enough votes to pass legislation this year.

Democratic lawmakers and critics of the House’s passed AHCA legislative proposal expressed outrage that House Speaker Paul Ryan (R-WI) called for a vote, not even waiting for the nonpartisan Congressional Budget Office (CBO) to provide an updated financial analysis of the new version of AHCA. The CBO’s cost analysis of the original bill, pulled moments before a scheduled vote on March 24, 2017, found that the GOP health care bill estimated that if passed 24 million or more Americans could be uninsured by 2026.

Now the long-awaited CBO new numbers are finally in for the House GOP passed health care bill.

According to the CBO analysis released on May 24, 2017, 23 million people will lose health insurance in the next decade under the House GOP’s recently passed health care proposal. The CBO analysis concludes that the AHCA benefits the young and healthy at the expense of older and sicker Americans. The report indicates that “near seniors” (aged 50-64) will be hit particularly hard by the GOP healthcare bill. Specifically, net insurance premium costs for low-income seniors would rise by 700 to 847 percent over the next 10 years under House-passed bill. A 64-year-old with an income of $26,500 per year who paid $1,700 annually for an Obamacare policy would now pay a whopping $13,600 under the Republican plan.

Aging Groups Rally Against Flawed GOP Fix to Nation’s Health Coverage

Aging advocates says that CBO’s analysis of the newer version of AHCA again brings to the forefront the flaws of the GOP’s health care coverage fix.

In a statement, AARP Executive Vice President Nancy LeaMond says the new CBO analysis serves as another example that the House legislation would make harmful changes to the nation’s current health care system. The bill would also hurt older Americans by decreasing the solvency of Medicare, hiking costs for those who can least afford them, eroding seniors’ ability to live independently, and giving tax breaks to big drug companies and health insurance companies, she said.

“AARP reiterates our strong opposition to the harmful bill passed by the House and calls on the Senate to take action by starting a bill from scratch. The CBO analysis found that premiums would go up to unaffordable levels by inflicting an Age Tax and removing current protections for people with common conditions including diabetes and weight gain. Putting a greater financial burden on older Americans is not the way to solve the problems in our health care system,” says LeaMond.

“The CBO report was no surprise to those of us who are looking out for the best interests of older Americans. The GOP leadership was so focused on passing repeal and replace legislation that they failed their due diligence by ignoring an ominous flaw: their bill will drive up seniors’ out-of-pocket costs by repealing subsidies that help defray the cost of premiums,” says Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare in a statement.

The report also confirms that the House bill will only compound the problems faced by near seniors with pre-existing conditions. While an amendment by Rep. Fred Upton (R-MI) adds $8 billion over five years to fund high-risk pools for patients with pre-existing conditions, that will not be nearly enough to offset the extra costs to seniors, warns Richtman.

According to CBO, “People who are less healthy (including those with pre-existing or newly acquired medical conditions) would ultimately be unable to purchase comprehensive non-group health insurance at premiums comparable to those under current law, if they could purchase it at all.”

Seniors who rely on Medicaid will suffer under the GOP’s passed health care bill, said Richtman, noting that the CBO report calculates that the AHCA slashes Medicaid spending by $834 billion. Medicaid currently helps pay for long term care for millions of seniors nationwide.

The CBO estimates that some 14 million Medicaid recipients would lose coverage under the AHCA – or not be able to attain it in the first place – within the next 10 years. In fact, more than half of the increase in uninsured Americans under the AHCA would come from this vulnerable population. In addition, changes to the ACA’s individual market reforms will increase the number of uninsured Americans age 50 to 64 from just over 10 percent under current law to nearly 30 percent, says Richtman.

Richtman charges that the GOP healthcare bill also weakens Medicare by repealing a tax on high wage earners, which would decrease the solvency of the Medicare Part A Trust Fund by three years. Accelerating the exhaustion of the Part A trust fund would likely lead to cuts in Medicare, including privatizing the program, that would be detrimental to current and future beneficiaries.

“The amended American Health Care Act is an assault on the health care of all seniors,” says Richtman. “We can only hope that the Senate will take the CBO’s new figures into consideration – and reverse the provisions that are so demonstrably harmful to our nation’s seniors.”

GOP Defends its Health Care Coverage Fix

As expected, with the release of CBO’s new numbers, the GOP moved quickly to dispute the federal agency’s findings. Republican National Committee Chairwoman Ronna McDaniel stated “The CBO has a history of being way off in their predictions, often giving a different forecast from actual reality.”

Even former House Speaker Newt Gingrich (R-GA) got into the verbal fray, blasting the new CBO analysis on FOX Business’ Lou Dobbs Tonight, calling for “the abolishment of the federal agency.” Gingrich called CBO “a dishonest bureaucratic organization,” suggesting that money might be saved by hiring “outside professional firms, get three to five major scores on bills.”

The Battle on Health Care Reform Moves to the Upper Chamber

On May 22, 2017, more than 75 national organizations recently sent a letter to Senate Majority Leader Mitch McConnell and Ranking Minority Leader Chuck Schumer, calling on the Senators to reject AHCA and to engage in “a transparent, bipartisan dialogue on needed reforms to enhance health care access and affordability.” The correspondence gave notice that these organizations strongly opposed provisions in the AHCA that undermined Medicare’s financing and risk access to essential care for Medicare and Medicaid recipients.

The correspondence cosigners noted that Obamacare imposed a small tax increase on the highest earners that helped” put Medicare on stronger financial footing. The GOP health care bill’s repeal of this tax would result in lost revenues, causing the Medicare Hospital Insurance (Part A) Trust Fund to become insolvent two years earlier than anticipated. The correspondence also expresses alarm that Congress would knowingly vote to undercut the Trust Fund.

The correspondence also charges that the GOP’s AHCA advances devastating Medicaid cuts—per-capita caps—that threaten access to needed care for the 11 million people with Medicare who also depend on Medicaid. One in five people with Medicare rely on Medicaid to cover vital long-term home care and nursing home services, to help afford their Medicare premiums and cost-sharing, and more.

“Federal cuts to Medicaid…would drive states to make hard choices, likely leading states to scale back benefits, impose waiting lists, implement unaffordable financial obligations, or otherwise restrict access to services,” says the correspondence.

Joe Baker, president of the Medicare Rights Center, said, “A Medicaid cut is a Medicare cut. One in five people with Medicare rely on Medicaid to access home and community-based services and nursing home care that they would otherwise go without. Medicaid is also the lifeline that helps millions of older adults and people with disabilities afford their Medicare premiums and cost-sharing. Per-capita caps are not a viable path forward to support our aging nation; the Senate must start from scratch.”

Adds, Kevin Prindiville, executive director of Justice in Aging. “The AHCA risks the health and financial security of millions of older adults in our families and communities. Slashing the program’s funding by over $800 billion eliminates Medicaid’s 50-year guarantee that older adults can count on Medicaid when they need it the most. We call on the Senate to protect seniors and Medicaid.”

“Simply put, this legislation is not a health care bill,” says Judith Stein, executive director of the Center for Medicare Advocacy. “A health care bill would strengthen coverage and delivery programs. AHCA gratuitously weakens Medicare, decimates Medicaid, and guts insurance for 24 million people. We urge the Senate to reject this charade and develop a real health care bill that improves coverage and enhances the Affordable Care Act.”

House GOP Leadership Puts its Health Care Proposal on Fast-Track

Published in Woonsocket Call on March 12, 2017

After years of calling for the dismantling of Obama’s signature health care law, the 2010 Affordable Care Act (ACA), dubbed Obamacare, an emboldened GOP controlling both the White House and two chambers of Congress, began legislative efforts to substantially change the way the federal government subsidizes health coverage for millions of Americans and puts the brakes on Medicaid expansion that extended coverage to millions more.

On March 6, House Speaker Paul Ryan (R-Wis), with the blessing of President Donald Trump, began his legislative efforts to enact the House GOP’s 123 page health care proposal, the new American Health Care Act (AHCA). Democratic lawmakers and aging groups charge that the AHCA lacks a fiscal estimate from the bipartisan Congressional Budget Office as to how many people will lose their health insurance coverage as a result of the bill or how much it will cost.”

According to rating agency S&P Global Ratings, between 6 million and 10 million people could lose health insurance coverage if the GOP’s health care proposal to “repeal and replace” Obamacare passes. Specifically, there would be a decline in enrollment in the individual health insurance plan market of between 2 million and 4 million people. There would also be a decline of between 4 million and 6 million people in the nation’s Medicaid system after 2020 to 2024, says the recently released analysis.

GOP Health Proposal on Fast-Track

Just hours after AHCA was introduced early in the week, the House Energy and Commerce Committee and Ways and Means Committee began holding markups on their specific portions of the GOP’s health care proposal. After deliberating for almost 18 hours the Ways and Means approved its portion by a vote of 23-16, along party lines. After a marathon 27-hour markup session, the AHCA proposal was approved by the second House panel, Energy and Commerce Committee, by voted 31 to 23, by party line, too. Next week, the House Budget and Rules committees is expected to take up the GOP health care proposal, with a full House floor scheduled for the week of March 20. It has been reported that Ryan hopes to have a bill to President Trump for signature before April recess.

“Obamacare is rapidly collapsing. Skyrocketing premiums, soaring deductibles, and dwindling choices are not what the people were promised seven years ago. It’s time to turn a page and rescue our health care system from this disastrous law,” said House Speaker Ryan in a statement released when AHCA was thrown into the legislative hopper.

Ryan asserted that the GOP health care proposal would “drive down costs, encourage competition, and give every American access to quality, affordable health insurance. It protects young adults, patients with pre-existing conditions, and provides a stable transition so that no one has the rug pulled out from under them.”

The GOP health care proposal would keep two of the most popular provisions of Obama’s ACA, specifically providing health care coverage to people with pre-existing conditions (though insurers would be allowed to charge higher premiums to individuals with lapsed health care coverage) and allowing children to stay on their parents’ health plans until the age of 26.

But, the GOP’s efforts to repeal and replace Obama Care has brought aging groups together to put the brakes on House passage.

Aging Groups Come Out Swinging

Seniors’ advocates object to the ACHA’s impact on federal programs that provide both healthcare and long-term care to retirees. The bill rescinds an 0.9% tax on upper income earners’ wages, which had been used to extend the solvency of Medicare until 2028. Removing the tax decreases Medicare’s solvency by four years, which could lead to benefit cuts down the road. Advocates also decry the age-rating provisions in the repeal bill, which would allow insurers to charge older Americans up to five times as much for premiums as younger enrollees pay. The $4,000 tax credits for near seniors (aged 50-64) which replace Obamacare subsidies won’t make a dent in the premiums that this age group will pay under the GOP plan. Older Americans who can’t afford insurance will then arrive at the threshold of Medicare less healthy, putting additional strain on the system.

“This legislation is a triple whammy for seniors. It’s bad for Medicare beneficiaries, bad for near seniors, and bad for the Medicare program,” says Max Richtman, President and CEO of the Washington, D.C.-based National Committee to Preserve Social Security and Medicare.”

Richmond is especially alarmed that the AHCA also makes radical changes to the Medicaid program. The bill cuts $370 billion from Medicaid over 10 years by imposing “per capita caps,” meaning that states will get a fixed federal payment per beneficiary instead of the guaranteed match they now receive. Those fixed payments will not be able to keep pace with rising healthcare costs, leaving the states with significant shortfalls. “Millions of seniors rely on Medicaid for skilled nursing care, both in the home and at community-based facilities. The cut in federal payments will compel states to remove seniors from Medicaid rolls or radically reduce benefits, forcing them and their families into poverty.”

Following the release of the GOP’s AHCA, the Washington, D.C.-based AARP, the nation’s largest advocacy group representing over 37 million members, came out swinging. The GOP legislative proposal would weaken Medicare, leaving the door open to a voucher program that shifts costs and risks to seniors, warned AARP Executive Vice President Nancy LeaMond in a statement.

“Before people even reach retirement age, big insurance companies would be allowed to charge them an age tax that adds up to thousands of dollars more per year. Older Americans need affordable health care services and prescriptions. This plan goes in the opposite direction, increasing insurance premiums for older Americans and not doing anything to lower drug costs, noted LeaMond.

LeaMond charged, “On top of the hefty premium increase for consumers, big drug companies and other special interests get a sweetheart deal. “Finally, Medicaid cuts could impact people of all ages and put at risk the health of 17.4 million children and adults with disabilities and seniors by eliminating much needed services that allow individuals to live independently in their homes and communities.”

“Although no one believes the current health care system is perfect, this harmful legislation would make health care less secure and less affordable,” says LeaMond, noting that her nonprofit aging group will work with either political party to hammer out a health plan that “puts Americans’ health care first, not the special interests.”

Adds Judith Stein, executive director of the Center for Medicare Advocacy in a statement, “the proposed AHCA would also gut key financing mechanisms of the Affordable Care Act that would amount to tax cuts for the wealthy – by some estimates, by hundreds of billions of dollars. Regrettably, these tax cuts include provisions that would jeopardize Medicare’s financial stability. “We fear such cuts will lead to renewed calls to ‘save’ Medicare by privatizing it for future generations,” says Stein.

According to the Center for Medicare Advocacy’s statement, the proposed GOP legislative proposal would dismantle key structural supports of ACA, including eliminating the employer coverage mandate and the individual mandate to obtain health coverage, and instead would impose a 30 percent penalty for lapses in coverage. Instead of the ACA’s subsidies that make health coverage more affordable for millions, the new legislation would offer age-based tax credits ranging from about $2,000 to $4,000 – likely insufficient to pay for meaningful insurance coverage.

The Medicare Advocacy Group also warns that older Americans needing health insurance coverage before becoming Medicare eligible would also be hit hard by the proposed AHCA. The ACA’s protection of older adults that prevents insurance companies from charging no more than three times the premium amount charged of younger individuals (a 3:1 ratio) would be replaced by a higher 5:1 ratio – this dramatically increasing the premium amount insurance companies can charge older adults. Critics call this change an “age tax.”

Finally, the Republican’s AHCA would also phase out ACA’s expansion of Medicaid starting in 2020, structurally reforming virtually the entire Medicaid program (including Medicaid expansion). These changes would have a devastating impact on providing health care by capping federal Medicaid payments to each state to a limited, preset amount per person (often referred to as a “Per Capita Cap”).

Could Political Backlash Happen with Passage of AHCA?

Last Thursday, Ryan, with sleeves rolled up, urged GOP lawmakers to back AHCA, promising tweaks to address Republican conservatives’ concerns. At the 23 minute news conference, Ryan said: “This is the closest we’ve been to repealing and replacing Obamacare and it’s the closest we will ever get to repealing and replacing Obamacare.” It is either voting for the House bill, or let ACA survive, he said.

President Trump also chimed in to the AHCA debate, too, by calling for the controversial health care proposal’s enactment in an afternoon tweet. “Despite what you hear in the press, health care is coming along great. We are talking to many groups and it will end in a beautiful picture!,” he tweeted.

As the Congressional April recess approaches opposition to AHCA is building as physician, nurse and hospital groups warn that the legislative proposal’s enactment will take health care coverage away from millions of Americans. While Democratic and progressive organizations oppose ACA’s passage, too, a growing number of GOP lawmakers and conservative groups, from the Cato Institute, Americans for Prosperity and Tea Party Patriots, are expressing their concerns.

Days ago, Andrev Ostrovskv, chief medical officer for Medicaid at the Baltimore, Maryland-based Centers for Medicare and Medicaid based, risking the wrath of Trump’s political appointees in his federal agency, tweeted his displeasure and opposition. “Despite political messaging from others at HHS [Health and Human Services], I align with the experts from @aafp @AmerAcadPeds @AmerMedicalAssn in opposition to #AHCA,” he tweeted. Dr. Ostrovskv’s agency oversees the administering of Obamacare.

Even if the GOP House Leadership are able to address conservative lawmaker concerns, one being AHCA does not require an earlier halt to Medicaid expansion enrollment, the GOP’s health care proposal appears to have a rocky road to travel in the upper chamber. Senate. Republications, having just a 52-48 slim majority, can only lose two votes.

Says Senator Tom Cotton (R-Arkansas) in a tweet to House GOP Leadership: “ House health-care bill can’t pass Senate w/o major changes. To my friends in House: pause, start over. Get it right, don’t get it fast.”

With the popularity of Obamacare the GOP’s death wish to repeal and replace the law may well be hazardous to the Republican Party’s political health. We’ll find out for sure in the mid-term elections.