Virtually all of the changes tend to show inflation as growing more slowly. Independent economist John Williams believes that the combined effect understates the measured rate of inflation by an astonishing 7 percentage points. One of the clearest illustrations of the impact of a major change is seen in the following chart of COLAs between 1976 and 1987. .Early Efforts to Hold Congress to Its Promise Leads to a Notch Commission .There seems to be a great disagreement among supporters of Notch reform over who is truly a Notch Victim. What are the facts? .When hold harmless is triggered program-wide as in 2016, however, there is no specific provision of law with which to finance the unpaid portion of Medicare Part B premium increases for the roughly 43 million who are protected by the provision. In the past, Congress has chosen to allow this cost burden to shift to the 30 percent of beneficiaries who are not held harmless. Because the cost is spread over far fewer people instead of all beneficiaries, they pay a far larger share of the costs, thus the Part B premium spikes. .Because the economic fluctuations were highly unusual and unforeseen, logic dictates that Congress could not have intended the benefits that Notch Babies actually received. The disparities in benefits under the actual conditions of double-digit inflation are illustrated in the following chart, which was not developed until 199Even if Congress had developed this chart in 1977, however, they would have seen benefit differences of only 10%-14% shown on the left-hand side of the chart. Instead, the effects of inflation are reflected by benefit differences of 13% to 30% shown on the right. In effect, the actual benefit reductions for many retirees were more than double what original projections would have been at the time. .Following the meeting at the White House, Congressman Welch told reporters: "It simply makes no sense for Medicare to buy wholesale and pay retail prices. As a businessman, President Trump understands that. I hope he helps us enact our legislation to provide urgently needed relief to consumers and taxpayers." In addition, Congressman Cummings said, "We had a productive meeting today … The President committed to reviewing our proposal, and he seemed enthusiastic about the idea." .What are the Notch Reform bills that are in the current Congress? .Two years ago, President Obama bypassed Congress to halt the deportations of almost 5 million unauthorized immigrants. The Supreme Court recently tied on a ruling that allowed a lower court's ruling to stand, barring Obama's executive action. Do you believe President Obama overstepped his constitutional limits? ."The distinction between inpatient or outpatient can make a tremendous difference to what Medicare patients have to pay," says TSCL Executive Director, Shannon Benton. Inpatient stays are covered under Medicare Part A. Inpatients who are hospitalized for three days or more qualify for Medicare's limited nursing home stay coverage. Observation stays are considered outpatient services covered under Part B. Observation patients can have much higher copayments costs and sometimes get hit with huge bills for non-covered drugs.