House Fails to Pass GOP’s Balanced Budget Amendment

Published in Woonsocket Call on April 15, 2018

Following the recent passage of the $ 1.3 trillion omnibus government spending bill and the massive GOP tax cut bill that added more than a $1 trillion to the nation’s despite economic growth, and with midterm elections looming, the House GOP leadership quickly acted to tackle the spiraling nation’s deficit by bringing H.J. Res. 2, a balanced budget amendment (BBA), to the floor for a vote. Simply put, the amendment requires that total annual outlays not exceed total annual receipts. It also requires a true majority of each chamber to pass tax increases and a three-fifths majority to raise the debt limit.

House Judiciary Chairman Bob Goodlatte (R-Va.), introduced H.J. Res. 2, which he notes is nearly identical to text in legislation that passed the House in 1995, but failed in the Senate by one vote. This would be the Virginia Congressman’s last chance to push for passage of a BBA because he is not seeking re-election at the end of this term.

Last October. House Speake Paul Ryan (R-WI) agreed to vote on Goodlatte’s BBA, in exchange for conservative votes from the Republican Study Committee, chaired by Mark Walker (R-NC), on a procedural budget measure needed for Republicans to move forward on tax reform.

BBA Gets Thumbs Down by House Lawmakers

As expect, the House GOP’s BBA was defeated by a vote of 233 to 184, falling far short (by 57 lawmakers) of the two-thirds vote required for passage of an amendment under the Constitution. Six Republicans voted against it while only seven Democrats voted for it. But, the GOP’s BBA had little chance of becoming law because the required support of two-thirds in the Senate and Democratic Senators unified in their opposition, and finally the requirement that 38 states ratify the constitutional amendment.

“Our extraordinary fiscal crisis demands an extraordinary solution. We must rise above partisanship and join together to send a balanced budget amendment to the states for ratification.

I urge all my colleagues to join me in supporting this amendment and in freeing our children and grandchildren from the burden of a crippling debt they had no hand in creating, so they can be free to chart their own futures for themselves and for their own posterity,” Goodlatte said during the House floor on Thursday evening.

During the four-hour debate, House Republican Conference Chair Cathy McMorris Rodgers (R-WA), asked Congress to balance its budget like typical families do. She said,“Families across the country sit down at their kitchen tables every month and make tough decisions to balance their budget so that they can make ends meet. Just like American families, the federal government should spend within its means. A Balanced Budget Amendment, which requires a two-third majority in both chambers of Congress to pass, is a needed and important mechanism to restore fiscal discipline. “

On the House Floor, Democratic Leader Nancy Pelosi called the BBA “a brazen assault on seniors, children and working families – the American people we were elected to protect.”

“Make no mistake, this GOP con job has nothing to do with fiscal responsibility. It is not balanced in terms of money because of their GOP Tax Scam that’s placed us in a bad spot fiscally and it’s not balanced in terms of values,” says Pelosi, noting that GOP fiscal responsibility comes down to “ransacking Medicare, Medicaid and Social Security and breaking our nation’s sacred promise of dignity and security for seniors and families.”

Before the House vote on the BBA, Darrell M. West, vice president and director of Governance Studies at the Washington, D.C.-based the Brookings Institution, stated “I would be surprised if the bill made it through Congress.” He added, “It’s hypocritical for Republicans to support a balanced budget amendment after they cut taxes by $1.5 trillion and added significantly to the federal deficit. Voters will see through that and understand the vote is about scoring political points and not making good public policy.”

House Lawmakers Bombarded with Opposition Letters

Days before the House vote the National Committee to Preserve Social Security and Medicare (NCPSSM), AARP expressed opposition to the passage of the BBA by sending a letter to the Hill, urging House lawmakers to reject the GOP’s constitutional amendment. Hundreds of aging, health care, educational, unions, and business groups were cited in the April 12, 2018 issue of the The Congressional Record as opposing the amendment.

Max Richtman, NCPSSM’s President and CEO, wrote House lawmakers warning that a BBA would unravel the nation’s social safety net by making gigantic entitlement cuts by blocking benefit payments from the Social Security and Medicare Part A trust funds because “all federal expenditures, including these earned benefits, would have to be covered by revenue collected in the same year. “

A BBA would also force Congress to make huge spending cuts to Medicare Parts B, C and D, Medicaid, and many other social safety net programs for seniors, to rein in the nation’s deficit and pushing lawmakers to make “massive new tax cuts.,” says Richtman.

“While the balanced budget amendment did not dictate any particular approach to deficit reduction, by altering established Congressional voting procedures it would have increased the likelihood that the fiscal policies adopted in coming decades would favor the well-off at the expense of middle- and low-income Americans. The amendment would have required a two-thirds vote of the full membership of the House and Senate to raise taxes. Spending cuts, by contrast, would continue to require only a majority of those present and voting and could be passed on a voice vote,” observed Richtman.

Finally, Richtman noted that the risk of a federal government default would increase because a BBA requires a three-fifths vote of both the House and the Senate to raise the national debt limit, rather than the current simple majority.

AARP Executive Vice President Nancy LeaMond also expressed opposition to the BBA in a letter to House lawmakers charging that the amendment would impact the solvency of Social Security and Medicare, “subjecting both programs to potentially deep cuts without regard to the impact on the health and financial security of individuals.” Programs that provide meals or heating assistance to low income seniors would also see available resources diminish, she predicted, she said.

The lack of a dependable Social Security and Medicare benefit [if a BBA was passed] would be devastating for millions of Americans. Social Security is currently the principal source of income for half of older American households receiving benefits, and roughly one in five households depend on Social Security benefits for nearly all (90 percent or more) of their income. Over 50 million Americans depend on Medicare, half of whom have incomes of less than $24,150. Even small fluctuations in premiums and cost sharing would have a significant impact on the personal finances of older and disabled Americans,” said LeaMond.

Midterm Elections Just Six Months Away

The nonpartisan Congressional Budget Office (CBO) predicted early this week that the annual government’s deficit is projected to be $ 1 trillion next year. And the nation’s $21 trillion debt would skyrocket to 33 trillion by 20028. With the midterm elections just six months away, combined with the CBO’s recently released economic analysis, the Republican party’s image as being the fiscally responsible political party is now shattered.

Even controlling both chambers of Congress and with President Donald Trump in the White House, GOP lawmakers must now look for political issues that may resonate with their constituents. Further attempts to dismantle Socials Security and Medicare may not be the way to go.

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Older Americans to Benefit from Bipartisan Budget Act

Published in the Woonsocket Call on February 11, 2018

While many were sleeping, funding to operate the federal government expired midnight Thursday, though it was restored about eight and a half hours later with action from Congress to end the brief government shutdown, when President Donald Trump signing the 652-page Bipartisan Budget Act of 2018 early Friday morning.

The $400 billion budget agreement funds the federal government through March 23 to give lawmakers time to pull together the details needed to craft full appropriations bills that become the official federal budget.

Lawmakers had expected the massive budget bill to pass before the midnight deadline to avoid a government shutdown but Sen. Rand Paul (R-Ky.), delayed the Senate vote past midnight to protest the additional billions of dollars being added to the federal budget deficit by the legislation.

Ultimately the House approved the bill by 240 votes to 186, almost four hours after the Senate had passed the budget bill by 71 to 28 three hours earlier. The GOP-controlled House needed the help of 73 Democratic lawmakers to pass the budget bill because 67 House Republicans voted against the legislation.

The Nuts and Bolts

The two-year budget deal eliminates strict budget caps that were set in 2011 to reduce the federal deficit and allows Congress to increase military and domestic spending by $300 billion, along with adding another $90 billion for emergency disaster aid for Texas, Florida and Puerto Rico and throws in billions more for infrastructure, the opioid epidemic and health programs. It also suspends the debt limit for one year – until after the upcoming midterm elections.

Specifically, the newly enacted Bipartisan Budget Act of 2018, would allocate $165 billion to the Pentagon and defense spending while $131 billion would be directed to domestic programs. In addition, $20 billion would be spent on infrastructure programs such as surface transportation, rural water and wastewater systems, $ 7 billion in community health centers to provide care to low-income people, $6 billion to fight the opioid crisis, and $4 billion directed to veteran’s health care.

The budget agreement also repeals the controversial Obamacare’s Independent Payment Advisory Board (IPAB), which was designed to limit Medicare costs. It also gives a ten-year extension to the Children’s Health Insurance Program (CHIP), which is four years longer than the previous spending bill passed last month. Finally, the legislation did not address the dilemma of 700,000 “Dreamer immigrants who are in the United States illegally after being brought here as children and who” are enrolled in the Deferred Action for Childhood Arrivals program, set to expire on March 5, nor did it provide funding for President Trump’s proposed southern border wall.

“A Pretty Good Deal for Seniors”

Max Richtman, President and CEO of the Washington, D.C.-based National Committee to Preserve Social Security and Medicare, sees the Bipartisan Budget Bill of 2018 “a pretty good deal for seniors.”

“Seniors will feel these changes in their pocketbooks and even in the way they feel physically,” says Richtman, in a released statement. “We have been fighting for these measures for quite some time and are happy to see Congress take action on a bipartisan basis.”

According to Richtman, the Bipartisan Budget Act of 2018 closes Medicare Part D “donut hole” in 2019. The prescription drug coverage gap embedded in the original law, which the Affordable Care Act has been gradually closing, will be altogether eliminated one year early. This will save seniors thousands of dollars in out-of-pocket prescription drug costs., he says.

Richtman says that the enacted Budget agreement also repeals Medicare therapy caps. The bill scraps arbitrary caps on physical, speech, language and occupational therapies that have cost senior’s money – or delayed care at crucial times. Beneficiaries will now find it easier – and more affordable – to get the therapies they need without undue interruption, he notes.

The Bipartisan Budget Act of 2018 also lifts non-defense domestic spending caps, allowing Congress to appropriate more adequate funding for the Social Security Administration’s (SSA) operating budget, says Richtman, noting that the federal agency has suffered from draconian budget cuts since 2011 which have impinged on customer service, even as 10,000 Baby Boomers retire every day. He notes that “this badly-needed (but yet unspecified) higher level of funding should allow SSA to improve customer service for the program’s 67 million beneficiaries.”

But, on the negative side, says Richtman, the new law increases Medicare premiums for some individuals by further expanding Medicare means-testing. “Congress continues to expand Medicare means-testing, and they will not stop until middle-class seniors are burdened with higher Medicare premiums,” he warns.

“We are particularly pleased that this legislation permanently repeals Medicare’s therapy caps, something that AARP has long supported. Millions of vulnerable patients who need occupational, physical, and speech-language therapy will now be protected from an arbitrary limit on how much Medicare will pay for needed therapy,” said Nancy LeaMond, AARP’s Executive Vice President and Chief Advocacy & Engagement Officer, in a released statement..

“AARP is also pleased that Congress expedited the closing of the Medicare prescription drug coverage gap known as the ‘donut hole,’ which will now close in 2019, one year earlier than currently scheduled. Medicare beneficiaries will soon get permanent relief from higher out-of-pocket costs for prescription drugs. We also applaud the provision that adds biosimilar drugs to the Medicare Part D Coverage Gap Discount Program. This change will lower out-of-pocket costs and encourage the development and use of these drugs,” adds LeaMond.

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.

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 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.

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.

House Budget Committee Plan Calls for Privatization of Medicare

Published in Woonsocket Call on July 23, 2017

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

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

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

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

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

In the Eyes of the Political Beholder

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

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

House Budget Plan Calls for Substantial Changes to Medicare

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

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

NCPSSM Sounds the Alarm About Privatization of Medicare

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

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

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

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

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

Stay tuned….

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