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. .The following Members of Congress, among many others, will be holding town hall meetings this week: Sen. Michael Crapo (ID), Sen. Jerry Moran (KS), Rep. John Ratcliffe (TX-4), Rep. Gus Bilirakis (FL-12), Rep. Bradley Byrne (AL-1), Rep. Tom Cole (OK-4), Rep. Tom Emmer (MN-6), Rep. Tom Graves (GA-14), Rep. Doug LaMalfa (CA-1), Rep. Thomas Massie (KY-4), Rep. Susan Brooks (IN-5), and Rep. Robert Pittenger (NC-9). . Basing a decision on amenities and features. Just because the facility markets itself like a five - star hotel or is located near a great golf course does not equate to five - star standards of care. Look around and get a feel for the number of staff to residents. Try to meet a few residents. Are they happy? Does the staff look like they get satisfaction from their work? The office of your local Long Term Care Ombudsman can tell you about documented issues and problems that facilities have had in the past. .Out-of-pocket spending on prescription drugs was the fastest rising expense of retirees from 2000 to 2019, according to a recent study of retiree costs by TSCL. While the annual cost-of-living adjustment (COLA) increased Social Security benefits by 50 percent over the period, out-of-pocket spending on prescription drugs rose more than five times faster — 253%. .The Medicare Part D "doughnut hole" – the gap in coverage that occurs when beneficiaries reach their initial annual payment limit – is costing many older Americans thousands of dollars per year. Not all beneficiaries hit the limit each year, but in a recent survey of TSCL's members and supporters, we learned that 28%, more than one-in-four respondents, fell into the doughnut hole in 2015. .As a country, we need to be ready to fix this problem once our economy recovers by making reforms that strengthen both programs. Once this occurs, more money will flow back into the trust funds to bolster their coffers. To address this issue I introduced H.R. 1517, the Social Security and Medicare Lock-Box Act, which would establish separate surplus accounts for both the Social Security and Medicare Part A trust fund and help protect against anyone in Washington from spending those resources on unrelated projects. Washington may be broken but legislation like H.R. 1517 will help ensure retirees' hard-earned tax dollars are protected and our promise to seniors is kept. .This week, the Ways and Means Committee advanced a bill that would repeal the Affordable Care Act's (ACA's) Independent Payment Advisory Board (IPAB), and The Senior Citizens League (TSCL) saw one key bills gain support. .Sen. Sherrod Brown (OH) introduced S. 569 on March 14, 201It has since been referred to the Committee on Finance. .Who are these beneficiaries? The Inspector General's report refers to these beneficiaries as dependents and survivors of other Social Security beneficiaries and subject to the Social Security Alien Nonpayment Provision (ANP) law. The ANP forbids payment of retirement, survivor and disability benefits when non-citizens have been outside the United States for more than 6 months. But as is so often the case with Social Security law, there are several exceptions; for example, if the non-citizen is from a foreign country that has its own social insurance system and meets certain conditions. Mexico is on the list of countries that meet the conditions of the exception.