We know from past surveys and email comments that you want the freedom to choose how you receive your Medicare benefits — either through a Medigap supplement and Part D plan, or a Medicare Advantage plan that includes drug coverage. Nobody wants to get a cancellation notice or to give up their doctor, hospital or other important provider because their health plan is closing. Maintaining affordable access to quality healthcare coverage is the key issue for every Medicare beneficiary and for TSCL. Coming up with a plan to pay for all this is the hard part which depends heavily on how quickly we can get our economy up and running full speed again and get people back to work. .Beyond funding the government and raising the debt ceiling, TSCL was pleased that the Bipartisan Budget Act included the following three improvements to the Medicare program: .Insurers make major changes in their plans every year, like increasing premiums, co-pays, dropping coverage and even closing plans altogether. But according to a survey conducted by TSCL earlier this year, less than 18 percent of respondents said they switched their Part D or Medicare Advantage health plan for 201Medicare's annual Open Enrollment period starts earlier this year -- on October 15th -- and ends December 7th. Medicare beneficiaries should start the process now to find out what their choices are and how much they could save with a new Part D or Medicare Advantage plan. .While TSCL supports this first legislative step, more work will be needed in the years ahead to provide greater financial certainty for disabled Social Security recipients. What do you think about the recent legislation and fixes for Social Security disability? Take TSCL's 2016 Senior Survey. .By Jessie Gibbons, Legislative Analyst .TSCL continues to work with Members of Congress for stronger protections of Social Security. TSCL supports legislation that would ban the payment of benefits based on illegal work — H.R. 787, "No Social Security for Illegal Immigrants Act," introduced by Representative Dana Rohrabacher (CA-46), and S.95, legislation to prevent Social Security credit from being earned without legal status, introduced by Senator David Vitter (LA). .The alternative to this approach is control by a board of unelected bureaucrats known as the Independent Payment Advisory Board (IPAB). This board will consist of 15 unelected, unaccountable bureaucrats empowered to make decisions about what kind of care people on Medicare can receive. I am greatly concerned that this board is being given way too much authority to determine what benefits are covered and how much physicians are paid. This commission's sole intention will be to determine whether Medicare is spending more than is budgeted and, if so, to offer "fixes" to cut back on Medicare spending that would then be fast-tracked with very little opportunity for Congressional input. President Obama's former Budget Director Peter Orszag called IPAB "the single biggest yielding of power to an independent entity since the creation of the federal reserve." I believe the best way to control costs in Medicare is to increase choice and competition, not cede control of health care decisions to a board of 15 unelected, unaccountable bureaucrats. .While Part D and Medicare Advantage have proven popular with seniors, nobody is lining up at the doors during the fall Open Enrollment to shop for and compare plans. The vast majority of beneficiaries, more than 80% according to TSCL Senior Surveys, don't compare their Part D or Medicare Advantage plan, and consequently don't reap any savings from competition between plans. If Congress were to convert all of Medicare to premium support in the future, the devil will be in the funding details — finding the balance between saving the federal government money while still keeping the program affordable for beneficiaries. And so far premium support hasn't been any magic bullet for reducing federal spending on Medicare. .According to the Congressional Research Service (CRS), for an age 65 retiree with average wages, a maximum benefit disparity of 10% would have arisen between the highest benefit under the old rules and the lowest benefit under the new rules if the 1977 assumptions had materialized. Under the economic conditions that actually arose, the disparity was 25%-two and one half times greater.