Attacking Rising Prescription Drug Costs

Published in the Woonsocket Call on April 7, 2019

The Washington, DC-based AARP timed the release of its latest Rx Price Watch report as the House Energy Commerce Committee marked up and passed a dozen bills just days ago, six that would lower prescription drug costs. The legislative proposals now go to the House floor for consideration.

AARP’s new report, a continuation of a series that has been tracking price changes for widely used prescription drugs since 2004, was circulated to House Committee members before their markup and vote and its findings sent a message to the lawmakers that they hear from their older constituents, that is the costs of pharmaceutical drugs is skyrocketing, making it difficult to fill needed prescriptions.

Poll after poll findings reflect the concerns of seniors about their ability to pay for prescribed medications. According to a Kaiser Family Foundation poll released last month, 79 percent of survey respondents view drug prices to be “unreasonable,” while just 17 percent found the costs to be “reasonable.” Twenty-four percent of these respondents found it difficult to pay the costs of their prescription drugs.

Generic Drugs Can Save Dollars

According to the new AARP Public Policy Institute (PPI) report, by Leigh Purvis and Dr. Stephen W. Schondelmeyer, the average annual cost of therapy for one widely used brand-name prescription drug in 2017 was over 18 times higher than the cost of therapy for one generic drug. The cost for a generic medication used on a chronic basis averaged $365 per year. In contrast, the average annual cost for a brand-name prescription drug was $6,798. But, four years earlier the price differential between these same market baskets was substantially smaller ($4,308 verses $751 respectively).

“Generics account for nearly nine out of every 10 prescriptions filled in the U.S. but represent less than a quarter of the country’s drug spending,” said Debra Whitman, Executive Vice President and Chief Public Policy Officer at AARP, in a statement released with the PPI’s 28 page report “These results highlight the importance of eliminating anticompetitive behavior by brand-name drug companies so that we get more lower-priced generic drugs on the market,” says Whitman.

AARP’s PPI report, entitled “Trends in Retail Prices of Generic Prescription Drugs Widely Used by Older Americans,” found that retail prices for 390 generic prescription drugs commonly used by older adults, including Medicare beneficiaries, decreased by an average of 9.3 percent in 2017, compared to the general inflation rate of 2.1 percent. The decline follows two consecutive years of substantial generic drug price decreases; the previous two consecutive years saw increases in generic drug prices. All but three of the 390 generic prescription drugs analyzed in AARP’s report had a retail price change in 2017. While prices for 297 (76 percent) drug products decreased, 90 (23 percent) products had price increases.
Six commonly used generic drug products had retail price increases of greater than 70 percent, including a nearly 200 percent increase for sertraline HCL, an antidepressant, finds the AARP.

AARP’s PPI report found that with older adults taking an average of 4.5 prescription drugs every month, those using generic prescription drugs were likely to have an average annual retail cost of $1,642 in 2017.

“The gap between average annual brand-name and generic drug prices has increased dramatically—brand name drug prices were six times higher than generic drug prices in 2013 but more than 18 times higher in 2017,” said Leigh Purvis, Director of Health Services Research, AARP Policy Institute, and co-author of the report. “As long as brand name drug prices continue to skyrocket, the value of prohibiting brand name drug company practices that slow or prevent competition from generic and biosimilar drugs cannot be overstated.”

AARP Pushes for Passage of Bills to Lower Drug Costs

Before the Committee on Energy and Commerce vote on April 3, in correspondence AARP urged Chairman Frank Pallone, Jr. (D-N.J.) and Ranking Member Greg Walden (R-Ore) to enact two bills (along with four other proposals) being considered at the morning markup session. These legislative proposals would lower prescription drug costs and had previously been approved by the Energy and Commerce Health Subcommittee.

In the correspondence, AARP’s Nancy A. LeaMond, Executive Vice President and Chief Advocacy and Engagement Officer, pushed for passage of H.R., 1499. the “Protecting Consumer Access to Generic Drugs Act of 2019.” introduced by Rep. Bobby Rush (D-IL). This proposal would make it illegal for brand-name and generic drug manufacturers to enter into agreements in which the brand-name drug manufacturer pays the generic manufacturer to keep a generic equivalent off the market. The bill was passed by voice vote.

LeaMond also supported H.R., 965, the “Creating and Restoring Equal Access to Equivalent Samples (CREATES) Act of 2019,” introduced by Reps. David Cicilline (D-RI), Jim Sensenbrenner (R-WI), Jerrold Nadler (D-NY), Doug Collins (R-GA), Peter Welch (D-VT), and David McKinley (R-WV). The proposal would establish a process by which generic manufacturers could obtain sufficient quantities of brand drug samples for testing thereby deterring gaming of safety protocols that brand manufacturers use to delay or impede generic entry. The bill passed by a bipartisan vote of 51-0.

At the markup, Pallone and Walden were able to work out philosophical differences on H.R. 1499 and H.R. 965. The two lawmakers also hammered out a compromise on H.R. 1503, the “Organize Book Transparency Act of 2019,” that would ensure that the Orange book, which identifies drug products approved on the basis of safety and effectiveness by the Food and Drug Administration, is accurate and up-to-date.

Washington Insiders say that Democratic control of the House will ensure the passage of these legislative proposals on the House floor and the bipartisan vote on the CREATES Act in the lower chamber creates an opportunity for Senate Finance Committee Chairman Chuck Grassley (R-Iowa) to successfully push his CREATES Act companion measure in the Senate.

Grassley says the broad, bipartisan action by the House Energy and Commerce Committee to advance the CREATES Act is a major win for consumers. “I look forward to advancing this bill because it will cut down on abuses in the system that keep prices high for patients. I’m also pleased that the committee advanced a bill to address pay-for-delay schemes. Although that bill is not identical to the bill I’ve sponsored in the Senate, the bill’s movement shows that the committee is serious about addressing the pay-for-delay problem,” says the Senator.

As They See It…

AARP’s LeaMond, says “Brand-name drug companies want to stifle generic competition to protect their monopolies and profits. AARP believes that eliminating these deliberate anticompetitive behaviors will result in a more robust generic drug market and greater savings for both patients and taxpayers. The Congressional Budget Office estimated that legislation such as the CREATES Act could save taxpayers more than $3 billion over a decade, and the Federal Trade Commission estimated pay-for-delay deals cost consumers and taxpayers $3.5 billion a year.

“We have long supported the CREATES Act and banning pay-for-delay agreements, and are heartened that Congress is acting to improve access to generic drugs. These bills will promote competition driving down costs for seniors,” says Lisa Swirsky, Senior Policy Analyst, at the National Committee to Preserve Social Security and Medicare.

“Congressman Cicilline has been a leader in our caucus for putting prescription drug prices at the front of our agenda. Moving generics to market faster is an important step to lower prescription drug costs for every American,” said House Speaker Nancy Pelosi. “House Democrats have made it a top priority to lower Americans’ health costs by reducing the price of prescription drugs, and these bipartisan bills show we mean to deliver,” she says.

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Congress Gears Up its Legislative Efforts in its Fight Against Age Discrimination

Published in Woonsocket Call on March 3, 2019

With the 116th Congress beginning on January 3, 2019, Congress moves quickly to protect older Americans from rampant age discrimination. It is a key reason why Americans, age 40 and over, are fired or offered buyouts (with younger persons being hired in their place) and why they can’t find work after a period of unemployment and struggle to return to the workforce.

On Valentine’s Day, U.S. Sen. Bob Casey (D-Pa.), Ranking Member of the Special Committee on Aging, with cosponsors Sens. Chuck Grassley (R-Iowa), Patrick Leahy (D-Vt.) and Susan Collins (R-Maine) re-introduced S 485, The Protecting Older Workers Against Discrimination Act (POWADA). The bill was referred to the Senate Committee on Health, Education, Labor and Pensions.

Fixing a Supreme Court Ruling

Over a decade ago, a U.S. Supreme Court ruling in Gross v. FBL Financial Services weakened the Age Discrimination in Employment Act (ADEA) by imposing a significantly higher burden of proof on older workers alleging age discrimination than is required of workers alleging other forms of workplace discrimination. As a result, workers that allege age discrimination must meet an undue legal burden not faced by workers alleging discrimination based on race, sex, national origin or religion. This sent a clear signal to employers: some age discrimination is perfectly fine.

Enacting the bipartisan POWADA bill would restore the pre-Gross standard, recognizing once again the legitimacy of so-called “mixed-motive” claims in which discrimination is a, if not the deciding, factor. It would also reaffirm that workers may use any type of admissible evidence to prove their claims.

Rep. Bobby Scott (D-Va.), Chairman of the House Committee on Education and Labor and seven original cosponsors have introduced a House companion bill, H.R. 1230. Scott’s bill should get traction in the House because it’s referred to his committee.

Rep. David Cicilline (D-R.I), who serves on the House Seniors Task Force, has requested to be added as a cosponsor. “There is no place for age discrimination in this country,” says Cicilline, when explaining his support for POWADA. With the Rhode Island congressman recently being elected to House leadership, taking the position of Chairman of Democratic Policy and Communication Committee, the bill will most certainly get attention.

Here is a sampling of organizations that are lining up to support POWADA: AARP, American Association of People with Disabilities, Leadership Conference for Civil and Human Rights, National Employment Law Project, National Employment Lawyers Association, and National Partnership for Women and Families and Paralyzed Veterans of America.

Efforts Begin in 116th Congress to Tackle Age Discrimination

“As a lawyer I worked on age discrimination cases, and I relied heavily on the ADEA to help workers fight back,” said Casey in a statement released when the bill was thrown into the legislative hopper. “More Americans are continuing to work until later in life and we must recognize and address the challenges they face. We must make clear to employers that no amount of age discrimination is acceptable, and we must strengthen antidiscrimination protections that are being eroded,” said the Pennsylvania Senator.

“The Supreme Court case involving Iowan Jack Gross affected employment discrimination litigation across the country. It’s long past time we clarify the intent of Congress to make sure people like Jack Gross don’t face discrimination due to age,” said Grassley, who served as Chair of the Senate Aging Committee from 1997-2001.

“No matter whether it is a determinative or contributing factor in an employment decision, discrimination is wrong and should be treated as such. I am proud to once again cosponsor legislation that reinforces these fundamental rights for our nation’s seniors,” says Leahy.

Adds, Senator Collins, current Chair of the Senate Aging Committee, “Older employees bring a wealth of knowledge and expertise to the workplace. Individuals who are willing and able to remain in the workforce longer can also improve their retirement security for their golden years. We should do all we can to ensure that these employees are not faced with age-related bias while doing their jobs.”

Adds, Virginia Congressman Scott, who introduced the House companion measure, “Discrimination shuts too many people out of good paying jobs. All Americans – regardless of their age – should be able to go to work every day knowing that they are protected from discrimination.”

AARP Calls for Congress to Act

“We commend these lawmakers for sponsoring this crucial legislation,” said Nancy LeaMond, AARP Executive Vice President and Chief Advocacy & Engagement Officer. “Too many older workers have been victims of unfair age discrimination and are denied a fair shake in our justice system. The time for Congress to act is now.”

According to AARP, the legislation is especially needed with the graying of the nation’s workforce. By 2022, 35 percent of the U.S. workforce will be 50 or older, and workers age 65-plus are the fastest growing age group in the workforce. Three in five older workers report they have seen or experienced age discrimination in the workplace. POWADA would restore the ADE’s longstanding protections and fix the same problem under two other civil rights laws.

An AARP survey, “The Value of Experience: Age Discrimination Against Older Workers Persist,” published in 2018, found that older workers still face discrimination at their workplace.

The researchers noted that more than 9 in 10 of these older survey respondents say they see age discrimination as somewhat or very common. At work, more than 61 percent report they’ve seen or experienced age discrimination on the job, and of those concerned about losing their job in the next year, 34 percent list age discrimination as either a major or minor reason. Only 3 percent report they have made a formal complaint to a supervisor, human resource representative, another organization or a government agency.

On the job hunt, almost 44 percent) of older job applicants say they have been asked for age-related information from a potential employer.

The older AARP survey respondents would support the recently introduced POWADA, too. Nearly 59 percent strongly supported strengthening the nation’s age discrimination laws.

We need vigilance at every regulatory level and awareness and compliance in every workplace,” says AARP Rhode Island State Director Kathleen Connell. “Most workers reach a point in their lives when society wants to diminish their relevance and dismiss their knowledge and abilities by simply adding the prefix ‘older-’ to worker or employee. It’s not acceptable and can be proven to be unlawful. I would add that is can be disturbing to many others in the workplace. We all get older every day. No one – even younger workers – should be comfortable thinking it is okay to deny employment, harass or terminate someone on the basis of age.

“The problem goes beyond hiring and firing or being denied a promotion over a younger, less capable co-worker,” Connell added. “Day to day negative comments that point to age or suggest someone should just retire ‘and give someone younger a chance to advance’ also can make people feel disrespected and vulnerable. POWDA is important because it codifies the notion we all have to take this as seriously as other, more familiar, types of workplace discrimination.

“Age discrimination is a big part of AARP’s effort to ‘Disrupt Aging,’” Connell Concluded. “As promised at http://www.aarp.org/DisruptAging (and in CEO Jo Ann Jenkins’ book of the same title), AARP ‘will celebrate all those who own their age. We will hold a mirror up to the ageist beliefs around us. We will feature new ways of living and aging, and the products and solutions that make this possible. We will partner with companies and communities to create new solutions that work for all of us at any age. And we will get this story — our story — out there. It’s time to change the conversation.’

“Society as a whole needs to be a part of this change. Everyone will benefit now and when they are … older.”

Third Time’s the Charm

In 2009, the initial POWADA bill was introduced in the Senate chamber by Grassley and Sen. Harkin (D-Iowa). No action was taken. In 2015 Casey and Sen. Mark Kirk (R-Illinois) reintroduced it. Again no action was taken. Now, with the POWADA bill again being reintroduced this month, Congress now has the opportunity to make the needed legislative fix to a Supreme Court ruling to restore protections of the ADEA to older workers. Congressional action will put the brakes to an epidemic of age discrimination complaints. Those pushing for passage express the hope that “The third time is the charm.” Yes, it is finally time to pass POWADA once and for all.

Any individual who believes that they have been or are being the victim of age-related employment discrimination can call the RI Commission for Human Rights at (401) 222-2661 or visit the office at 180 Westminster Street, 3rd floor, in Providence, to talk with staff to file a complaint.

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

Caregivers Taking Care of Persons with Dementia Have Unique Needs

Published in the Woonsocket Call on December 9, 2018

Being a caregiver 24/7 to a person in relatively good health is a tough job. But, caring for someone with dementia, becomes a 36 hour, say Authors Nancy L. Mace and Peter V. Rabins, in their ground-breaking book (published in 1981) on providing care for those with the devastating mental disorder.

The Washington, DC-based AARP releases survey findings last month that takes a look at this “unique subset of caregivers” who are taking care of persons with dementia and other cognitive disorders. Caregiving takes a physical, and emotional toll on these individuals, forcing them to put in longer hours providing care and making adjustments at work and in their personal relationships, says the findings of the newly released study.

The AARP online national survey (of caregivers 18 and older) takes a look at the demands on 700 caregivers taking care of persons with dementia or other forms of cognitive impairments (most often their parents), as well as 400 caregivers who were providing care for a loved one without dementia. Regardless of the situation, on average, caregivers report having been caring for their loved one for almost 3 years.

“Family caregivers take on big responsibilities that can be physically, emotionally and financially challenging. AARP’s new research shows that this can be particularly true for those caring for loved ones with dementia,” said Nancy LeaMond, AARP Chief Advocacy and Engagement Officer, in a statement released with the study report, Caring for People with Dementia: Caregivers’ Experiences. “That’s why AARP has developed resources to help family caregivers balance their own needs with the needs of their loved one,” adds LeaMond.

The AARP Study Found…

Obviously, it is time consuming to be a caregiver. The AARP Survey’s findings, released on November 30, 2018, found that 7 in 10 of those surveyed spend less time with friends and more than half spend less time with other family members because of the intensity of caregiving responsibilities While 75 percent of the survey respondents reported that caring for someone with dementia has brought about closer relationships and more meaning to their lives, the findings also indicate that caregiving experiences bring greater challenges to their lives, too.

According to the 26-page AARP report’s findings, those caring for persons with dementia (more likely a parent) spend on average 13.7 hours per week caregiving while caregivers, taking care of persons with no cognitive afflictions, spend 11.7 hours (more likely a spouse or partner or a friend or neighbor). Three in ten of the caregiver respondents (over age 35) spend over 21 hours per week caregiving, says Study’s findings.

Most of the caregiver respondents providing care to persons with dementia see the devastating disorder’s slowly progressing over time. But younger caregivers perceive that the onset of cognitive decline as suddenly happening.

About 32 percent of the caregiver respondents providing more intense caregiving to persons with dementia say managing their emotions and the demands of care (26 percent) they deliver as the biggest challenges the face.

Caregivers taking care of persons with dementia also reported negative health behaviors. They slept less (71 percent), had more anxiety (65 percent) and depression (54 percent), and spent less time on themselves and with their friends. Research studies reveal that social isolation and loneliness are linked to poorer physical and mental health outcomes.

Not only are the millions of family caregivers for those with dementia less socially connected, they are significantly more likely to put off medical care – over half (55 percent) have done so, compared to just 38 percent among the total caregiver population. However, there were positive health behaviors identified in the poll as well – 79 percent took steps to maintain or improve their brain health and 47 percent exercised more.

About 62 percent of those taking care of persons with dementia state that their intense caregiving responsibilities have led them to working different hours, leaving work early (62 percent) or take paid (53 percent) and unpaid time off (47 percent) for caregiving duties, and also worry about their finances.

But, two-thirds of all caregivers surveyed say they feel closer to their loved one, but those taking care of persons with dementia were more likely to say their relationship with their loved one over time had grown further apart (22 percent) than others. Those caregivers of persons with dementia were more likely to say the relationship with other family has been strained.

Finally, caregiver respondents say that they are receiving what they need from health care providers yet those caring for someone with dementia also have sought out more information about caregiving and from a greater variety of sources.

The AARP survey was conducted October 1-10, 2018. Data are weighted by income, gender, and age according to caregiver benchmarks obtained in Caregiving in the U.S. (2015).

Finding Caregiver Resources

AARP helps family caregivers find the information and support they need to manage their own care along with their loved one’s care. Go to http://www.aarp.org/caregiving for more resources and information on family caregiving, including AARP’s Dementia Care Guide and the Community Resource Finder.

For more info, contact AARP Researcher G. Oscar Anderson at ganderson@aarp.org.

Dems Listening to Calls to Strengthen and Expand Social Security, Medicare

Published in the Woonsocket Call on September 23, 2018

The political clock is ticking…The midterm elections are less than 50 days away and just days ago, the Washington, D.C.-based AARP released a poll of age 50 and older Ohio voters who say they are especially concerned about their health care and personal financial issues.

The Politico-AARP poll, conducted by Morning Consult, surveyed 1,592 registered voters in Ohio from September 2 to 11, 2018 with a margin of error of +/- 2 percentage points. For voters 50 and older, the poll surveyed 841 registered voters and has a margin of error of +/- 3 percentage points.

Don’t Touch Our Social Security, Medicare”

According to the newly released AARP-Politico poll findings, the older voters identified key issues that will influence how they will cast their vote in November at the polls. The respondents viewed health care (81 percent) the most important campaign issue followed by Social Security (80 percent) and Medicare (76 percent) and prescription drugs (65 percent). But, a strong majority (74 percent) support preserving the state’s Medicaid expansion, says the pollsters. .

“With less than 50 days to go before Election Day, candidates in Ohio would be wise to listen to the state’s most powerful voting group: 50-plus voters,” said Nancy LeaMond, AARP’s Executive Vice President and Chief Advocacy & Engagement Officer in a statement releasing the polls findings. “History shows older voters turn out in force in every election, and AARP is making sure they are energized and know where candidates stand on the issues.”

AARP is partnering with Politico to create a series titled “The Deciders,” (www.politico.com/magazine/thedeciders) that integrates original polling focused on 50-plus voters, reporting, data analysis and cutting-edge data visualization tools built by Politico’s specialized interactive team. The third edition in the series is focused on Ohio, a key election battleground state. Other recent polls surveyed voters in Arizona and Florida.

The AARP-Political Ohio poll findings say that 74 percent of age 50-plus voters “strongly support” (42 percent) or “somewhat support” (32 percent) preserving Ohio’s Medicaid expansion which extended Medicaid eligibility for low-income residents under the Affordable Care Act.

Ninety one percent of the older voter respondents say they are “very concerned” (55 percent) or “somewhat concerned” (36 percent) about their utility bills increasing. In addition, 69 percent of these respondents “strongly support” (27 percent) or “somewhat support” (42 percent) creating an Ohio retirement savings plan.

The AARP-Political poll also noted that 74 percent of 50-plus voters say opioid addiction is “a very serious problem” in the state right now, and 61 percent say the government is not doing enough to address it. And, 70 percent of the older voters “strongly agree” that jobs and the economy are major issues this election season. Only one in five (23 percent) feel “well-prepared” to get and keep a job, says the researchers.

Finally, nearly half (46 percent) of 50-plus voters think government is unprepared to prevent a cyber-attack on public infrastructure.

Democrats Zero in on Senior Issues

While poll after poll of older voters sends the message “Don’t touch my Social Security or Medicare” the GOP turns a deaf ear, but the Democrats listen. Following President Donald Trump’s claim that Democrats are trying to cut Social Security at a campaign rally in Montana, Sens. Bernie Sanders (I-Vt.) and Elizabeth Warren (D-Mass.) and Reps. John Larson (D-Conn.), Terri A. Sewell (D-Ala.) and Debbie Dingell (D-Mich.) on September 13, announced the bicameral Expand Social Security Caucus, over 150 members, including 18 Senators.

Senator Sheldon Whitehouse (D-R.I.) David Cicilline (D-RI) James Langevin (D-RI) are members of the newly formed Expand Social Security Caucus.

Alex Lawson, Executive Director of Social Security Works, an advocacy nonprofit group pushing for expanding Social Security, emceed the press conference and co-authored an opinion piece in The Hill celebrating the caucus launch.

Lawson noted, “We have members in the caucus from all corners of the country, from all parts of the Democratic Party. We’re waiting on some Republicans who might join, but they’ll be welcome when they realize that the American people are united in calling for an expansion of Social Security.”

The mission of this new congressional caucus is to push for the expansion of Social Security, one of the most popular and successful government programs. Last year alone, Social Security lifted 22 million Americans, including more than 15 million seniors, out of poverty. Before Social Security, nearly half of the nation’s seniors were living in poverty, says a caucus press release.

The caucus will ensure that expanding Social Security is a key part of the Democratic agenda before the midterm elections and next year and beyond. Over a dozen bills have already been introduced in the Senate and House to expand Social Security. With the caucus now playing a key role in expanding and strengthening Social Security, look for more bills to be introduced next Congress.

At the official unveiling of the new Congressional caucus, Sanders said, “We are here today to say very loudly and very clearly that at a time when millions of seniors are trying to survive on $12,000 or $13,000 a year, our job is not to cut Social Security. Our job is to expand Social Security so that everyone in America can retire with dignity and respect.” T

“Social Security is a lifeline for seniors and Americans with disabilities. We won’t let it be cut by one cent – and instead we will fight to expand it,” Co-chair Warren said. “The rich and powerful have rigged our economy to make themselves richer, while working families face a massive retirement crisis. If this government really works for the people, it should protect and expand Social Security.”

“A number of bills have been introduced in the Senate and House to expand Social Security, including legislation written by Sanders last year to lift the cap on taxable income that goes into Social Security, requiring the wealthiest Americans – those who make over $250,000 a year – to pay their fair share of Social Security taxes. That bill would increase Social Security benefits and extend the program’s solvency for the next 60 years.

Joining the caucus leadership Thursday were Social Security Works, the Alliance for Retired Americans, the Paralyzed Veterans of America, Latinos for a Secure Retirement, the National Committee to Preserve Social Security and Medicare, the American Federation of Government Employees, the Arc of the United States, the Center for Responsible Lending and Global Policy Solutions.

With the midterm elections looming, the progressive and centralists of the Democratic party must put aside their differences to work together to support Democratic Congressional candidates who can win. One unifying political issue may well be supporting the expansion and strengthening of Social Security, Medicare and ensuring that Americans can be covered by affordable health insurance. Stay tuned.

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.

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.

Senate Health Bill Vote Expected Next Week

Published in Woonsocket Call on June 25, 2017

The long-awaited Senate health bill text crafted by a group of 13 GOP senators (all male) appointed by Senate Majority Leader Mitch McConnell of Kentucky to replace and repeal President Obama’s Affordable Care Act of 2017 (ACA), popularly, called Obamacare, was unveiled days ago. Republican lawmakers have worked for over seven years to dismantle the Democratic president’s landmark health care law. Supporters say that ACA brought health care coverage to an estimated 20 million Americans, covered between marketplace, Medicaid expansion, young adults staying on their parent’s plan, and other coverage provisions. Critics charge that Obamacare imposed too many costs to business owners.

Minority Leader Chuck Schumer and Senate Democrats lashed out at GOP Senate leadership charging that the Senate health bill, titled “Better Care Reconciliation Act of 2017,” was written behind closed doors without a single committee hearing being held or draft bill text being circulated to the public. Some Republican senators also expressed frustration for not seeing the details of the GOP bill before its release on June 22, 2017.

Like Senate Democrats, Health and Human Secretary Tom Price was left in the dark, too. At a Senate hearing before the release of the Senate bill the Trump Administration’s top health official stated that he had not seen any legislative language.

Senate Health Bill “Meaner” than House Version

Despite President Trump’s campaign pledge not to touch popular entitlement programs, like Medicare and Medicaid, he strongly endorsed the House Republican passed health bill, the American Health Care Act of 2017 (AHCA). At the eleventh hour, Trump twisted the arms of reluctant GOOP House members to gain their support of the controversial health care bill. Celebrating the passage of AHCA at the White House Rose garden, the president told the attending Republican lawmakers and guests that the GOP health bill was a “great plan,” adding that it was “very, very, incredibly well-crafted.” It was reported weeks later, after a closed-door luncheon with 15 Republican Senators, Trump had called AHCA “mean” and urged the attending Senators make their legislative proposal “more generous.”

With the release of the Senate health bill, Senate Minority Leader Schumer called the bill “meaner” than the House passed version, stressing its negative impact was far worse than AHCA. Trump called the House health bill “mean.” Schumer views the Senate’s version “meaner.”

GOP Senate leadership is pressing for a floor vote before the upcoming July 4th Congressional recess. To meet this deadline, this vote must take place by the end of next week, either Thursday or Friday, after 20 hours of debate. Early next week the Congressional Budget Office will release its score, detailing cost and coverage impact, on the Senate health bill. Moderate Republican senators might just be influenced not to vote for the bill if reduces health coverage for millions of Americans.

It usually takes 60 votes to pass a bill in the Senate. But, GOP Senate leadership is using a technical parliamentary procedure, referred to as reconciliation, to allow the Senate health bill to pass with only 50 votes, including the Vice President as a tiebreaker.

At press time, there are four conservative senators (Rand Paul of Kentucky, Ted Cruz of Texas, Mike Lee of Utah and Ron Johnson of Wisconsin) and one moderate senator (Dean Heller of Nevada)., who have publicly expressed their opposition to the Senate health bill. With all Democratic and Independent senators in their caucus opposing passage of the bill, GOP Senate leadership can only afford the defection of two Republican senators if they want their bill to pass.

Meanwhile, a 100-year old organization, Planned Parenthood, is gearing up to fight a provision of the Senate health bill that would cut $555 million in funding. Two moderate GOP Senators, Susan Collins of Maine and Lisa Murkowski of Alaska, are on the fence voting for the bill if cuts are made to Planned Parenthood.

Aging Groups See Writing on Wall if Senate Passes Health Bill

The released 142-page GOP Senate health bill, written hastily behind closed doors, will overhaul the nation’s health care system, impacting on one-sixth of the nation’s economy. Dozens of aging, health care and medical groups, including AARP, National Committee to Preserve Social Security and Medicare (NCPSSM), the American Medical Association, and the American Hospital Association, are voicing their strong opposition to the GOP Senate’s health care fix.

And this list keeps growing as next week’s Senate vote approaches.

The Washington, DC-based AARP, representing a whopping 38 million members, vows to hold GOP Senators accountable for a bill that hurts older Americans. The nonprofit group charges that “the legislation imposes an “Age Tax” on older adults – increasing health care premiums and reducing tax credits [that made insurance more affordable under Obamacare], makes cuts to both Medicaid funding, and yet gives billions of dollars in take breaks to drug and insurance companies.”

“AARP is also deeply concerned that the Senate bill cuts Medicaid funding that would strip health coverage from millions of low-income and vulnerable Americans who depend on the coverage, including 17 million poor seniors and children and adults with disabilities. The proposed Medicaid cuts would leave millions, including our most vulnerable seniors, at risk of losing the care they need and erode seniors’ ability to live in their homes and communities,” says
AARP Executive Vice President Nancy LeaMond, in a statement.

“The Senate bill also cuts funding for Medicare which weakens the programs ability to pay benefits and leaves the door wide open to benefit cuts and Medicare vouchers. AARP has long opposed proposals that cut benefits or weaken Medicare, adds LeaMond.

LeaMond says, “As we did with all 435 Members of the House of Representatives, AARP will also hold all 100 Senators accountable for their votes on this harmful health care bill. Our members care deeply about their health care and have told us repeatedly that they want to know where their elected officials stand. We strongly urge the Senate to reject this bill.”

Another Washington-DC based organization, the National Committee to Preserve Social Security and Medicare, an advocacy group whose mission is to protect Social Security and Medicare, issued a stinging statement criticizing the Senate health bill.

“The Senate’s version of AHCA is an exercise in political expediency that does nothing to safeguard access to quality healthcare for older Americans. President Trump rightly called the House-passed bill ‘mean’ and lacking ‘heart.’ Unfortunately, the Senate bill is only marginally less mean in some ways, and even more heartless in others, says Max Richtman, President & CEO of the National Committee to Preserve Social Security and Medicare.

Adds, Richtman, “The Senate health bill is “a lose-lose for seniors and the American people. The biggest loss is that the AHCA ends the Medicaid program as we know it. Astoundingly, the Senate bill makes even deeper cuts to Medicaid than the House did. This is devastating news for today’s and tomorrow’s seniors suffering from Alzheimer’s, cancer, the after-effects of stroke and other serious conditions who depend on Medicaid to pay for long-term care. Millions will lose Medicaid coverage over the next ten years.”

“Despite some tweaks to premium subsidies, the Senate legislation will make healthcare unaffordable for many near seniors aged 50-64. The legislation allows insurers to charge older Americans five times as much as younger adults. Though the Senate bill nominally protects people with pre-existing conditions, the waiver of essential benefits means older patients with pre-existing conditions like diabetes, cancer, and heart disease will pay sky-high premiums [making these premiums unaffordable to most]. Finally, the bill weakens Medicare by reducing the solvency of the Part A Trust fund,” notes Richtman.

Looking at a Crystal Ball

Darrell M. West, vice president and director of Governance Studies at the Washington, D.C.-based the Brookings Institution, says that the Senate health bill does not fix the issues critics had with the House version. “It moves Medicaid from an entitlement to a discretionary program. It uses a longer phase-in period than the House, but imposes deeper cuts on the program. This is very problematic from the standpoint of poor and disabled people who need help,” says West.

According to West, Republican Senators from more moderate states already have said they will not support the current version. There also are conservative Senators who feel the bill does not go far enough in repealing Obamacare. If those positions hold up, it doesn’t look like the bill will pass.

West warns those who oppose the passage of the Senate health bill to not underestimate Senate Majority Leader Mitch McConnell. “He is willing to negotiate with individual Senators to get their votes so it is premature to call the bill dead. McConnell knows the Senate well and understands what compromises need to be made to get to 50 votes,” notes West.

If Senate Republicans pass their health care bill next week, I predict they might just find out that they have “awakened a sleeping giant,” the Democrats. When the dust settles after the 2018 mid-term elections we will find this out.