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. .Rapidly climbing prices for consumer goods and services are making financial choices for older adults especially challenging this year. But eventually, these higher prices might mean a higher Social Security cost of living adjustment (COLA) for next year. In the meantime, older consumers are struggling to figure out how to pay for. Buying Power of Social Security Benefits Wiped Out by Soaring Inflation An abrupt jump in inflation in February and March of this year wiped out a short-lived improvement in the buying power of Social Security benefits in 2020, according to TSCL's latest study on rising senior costs. The study, which compares the growth in the Social Security cost of living adjustments (COLA)s with increases in the. Are We Experiencing the Return of Inflation? , editor .Since 2000, COLAs have increased Social Security benefits by a total of 55%, yet typical senior expenses over the same period grew by 101.7%. The average Social Security benefit in 2000 was 6 per month. That benefit grew to ,262.40 by 2021 due to COLA increases. However, because retiree costs are rising at a far more rapid pace than the COLA, this study found that a Social Security benefit of ,645.60 per month in 2020 would be required just to maintain the same level of buying power as in 2000. .Action on Capitol Hill this past week was limited as Congress re-convenes this week. Meanwhile, a Congressional Management Foundation (CMF) report indicates the effects of House member office budget cuts, and the Congressional Budget Office released a report that would save Medicare 500 billion dollars. .Medicare first started covering rehabilitation services in 197Just seven years later in 1979, Congress enacted a cap of 0 on outpatient therapy due to concerns that rehabilitation outpatient services would take over the Medicare budget. The cap – which was indexed to medical inflation – remained in place until the passage of the "Balanced Budget Act of 1997," when a ,500 cap was passed into law and set to take effect in 199However, President Clinton halted the implementation of the ,500 cap, leaving services open to reimbursements by Medicare. Since 1999, several bills introduced in Congress sought to either repeal or keep the spending cap on rehabilitation services, with the cap drawing bipartisan criticism as being unfair to Medicare beneficiaries. .More Funding Sought for Home Health Care .Medicare Advantage plans require very careful scrutiny of potential costs. Some plans have lured seniors with low premiums and deductibles, only for enrollees to discover high undisclosed costs later. .According to a Social Security Administration Issue Paper, when Congress first enacted the tax on Social Security in 1983, it was estimated to affect only 10 percent of Social Security recipients. But the income thresholds have never been adjusted for inflation in more than three decades. "Today, the taxation of benefits hits almost everyone with any income in addition to Social Security benefits —even people with the most modest of bottom lines," Johnson says. "An older couple with ,000 is living at just 155% of the federal poverty level," Johnson points out. Had the income thresholds been adjusted for inflation since 1983, the ,000 threshold would be ,940 and the ,000 threshold would be ,284 according the Bureau of Labor Statistics. .Many expected immigration reform to be a focal point of the President's speech, however, his remarks on the topic were vague and very brief. In one short paragraph, he said, "Republicans and Democrats in the Senate have acted. I know that members of both parties in the House want to do the same … So let's get immigration reform done this year." TSCL has some serious concerns about comprehensive immigration reform, since it would further strain the Social Security and Medicare Trust Funds. We strongly feel that any efforts to reform the system should include loophole-closing legislation that would prevent immigrants from receiving benefits based on a history of illegal work.