Unlike the experience of the general public who access state or federal health care exchanges to choose coverage, the choices offered to Members of Congress are dramatically different than those from many other parts of the nation. For 2017, Members had 57 plan options in "Gold" plans alone on the DC shop exchange. In many areas of the nation, particularly rural ones, Gold plans aren't even available. Unlike the Silver and Bronze level plans, Gold plans have lower deductibles, and cover 80% of costs with patients paying only 20%. Silver plans, for example, typically come with deductibles ranging from ,500 - ,000, and pay 70% of costs while patients pay the other 30%. And in some areas of the country, people are happy if they have a choice of more than six silver plans. Certain parts of the country have only one. .Canada's order will not prevent Americans from crossing the border to buy cheaper drugs; it doesn't affect sales made by brick and mortar pharmacies, according to a fact sheet released by the Canadian government. .Our seniors worked hard all their lives and paid into the system – they've earned the right to true peace of mind. But the COLA formula in place right now just isn't providing that peace of mind. It's imbalanced and creating uncertainly for millions of Americans. .Obama Urges Lawmakers in the State of the Union Address .The CPI-W gives less weight to medical care and housing costs — two categories that have climbed by more than 7 percent and almost 5 percent, respectively, over the past 12 months — and more weight to gasoline, which has deeply plunged over the past year. Older Americans tend to use more medical services and spend more of their budgets on housing than younger workers. Because the CPI-W excludes the spending patterns of people over the age of 62, it does not include things like rising Medicare premiums, which are one of the fastest growing costs in retirement. ."But the time is coming when the states and federal government will be under urgent pressure to cut Medicaid and Medicare costs," says TSCL Chairman, Larry Hyland. "TSCL is concerned that if states and the federal government don't design and implement the changes the right way, beneficiaries' may lose access to medically necessary care and quality." .Rep. Paul Ryan said this week that he would also like to consider reforms to the Medicare program at that time. At an event on Monday, he stated, "There are other issues, like Medicare reform-based issues, that we'd like to enter into this to try and help pay for this … Sometimes you find if you have a problem that's small and intractable, if you make it a little bigger it's actually easier to solve, and that's kind of the way we're looking at the full-time doc fix." .First, on the payroll tax, he delayed payroll tax collections for those making under 4,000. President Trump instructed the U.S. Treasury to halt collection of payroll taxes from Sept. 1 through Dec. 31 for workers who earn under less than ,000 every two weeks (that's people earning under about 4,000 a year). The President has the authority to do this because it is not actually a tax cut, but rather a tax deferral, which will, as we said, have to be repaid by workers at a later date. .I spent the better part of last year trying to determine the cause of, and best treatment for, a mysterious chronic cough. A non-smoker, I'm usually obnoxiously healthy. Last year, though, I went through a battery of four specialists, a long menu of tests, underwent surgery and spent a night in the hospital. Yet by January of this year the cough was worse than ever.