Specialists are already warning that under the new "quality initiatives" some patients may have difficulty finding services under the new system as doctors join larger practices or stop accepting patients. As doctors reorganize and move into new HMO - like Accountable Care Organizations, all sorts of new questions are coming up. Does this payment system create an incentive to send unprofitably sick patients with complicated conditions elsewhere for care? How will the government measure quality, and what evidence will the Administration use to determine successful doctor performance? .In addition, next week lawmakers will continue working on a spending package that will fund the federal government past December 9th. Negotiations have already begun to pass a continuing resolution (CR) that will provide short-term funding through January 201However, if those in the House and Senate fail to reach a compromise before the looming deadline, the government will shut down like it did in 2013 and Social Security beneficiaries could see negative impacts. .In Washington, my priority is helping improve the lives of the American people, and that includes addressing our nation's retirement system to ensure it serves our seniors more effectively. One way Congress did this was by passing the Setting Every Community Up for Retirement Enhancement (SECURE) Act of 201This bill, which passed with my support, will streamline and update our nation's retirement system in several ways, including removing the age limitation on IRA contributions, increasing access to retirement plans by allowing small businesses to join together to offer plans, and allowing penalty-free distributions from a retirement account for the birth or adoption of a child. This legislation isn't perfect, but it is a step forward, and I am glad the SECURE Act was passed into law at the end of 201While approximately half of American households still don't have an option for work-based retirement plans, as a nation we must continue to work to advance access to retirement savings vehicles and decrease barriers to entry for small employers who want to offer savings plans to their employees. .One new cosponsor also signed on to Rep. Eliot Engel's (NY-16) Guaranteed 3% COLA Act (H.R. 1585) this week. His bill would ensure that the annual COLA is no less than 3 percent. Rep. Matt Cartwright (PA-17) signed on, and he is the bill's first cosponsor. .Indeed, during the 2005 debate over Social Security reform, one of the leading proposals would make changes to the benefit formula similar to those made in 197The proposal would tie the calculation of the initial retirement benefit to changes in price inflation. According to an analysis of a leading proposal by the Congressional Budget Office, when benefits are charted on a graph as shown here, they illustrate a "precipitous decline" in benefits and an all too familiar "V" shaped Notch. .In order to correct the wrong done to those born during the Notch years, TSCL believes that some compensation should be provided. The Notch Fairness Act would provide victims of the Social Security Notch with a modest settlement payment or an increased monthly benefit calculation. ."Public health officials were quick to tout J&J's data as a strong result, particularly given that regulators initially said a vaccine would only have to be 50% effective to be authorized. A vaccine that is 66% effective is an incredibly powerful tool in fighting respiratory viruses, they stressed. ‘We would be celebrating a seasonal influenza vaccine with 60% efficacy,' Jay Butler, the deputy director for infectious diseases at the CDC, told reporters. .TSCL supports legislation that would raise the taxable maximum. "TSCL believes that cutting Social Security benefits can't be justified when moderate payroll tax adjustments can keep the system solvent for decades," says TSCL Executive Director Shannon Benton. "Requiring everyone to pay their full share would add years of solvency to the Social Security," Benton says. .This week, The Senior Citizens League was pleased to see support grow for two key bills that would improve the Social Security and Medicare programs if adopted.