(Washington, DC) – The tax bill being discussed in the U.S. House contains what may be only a fleeting benefit for middle class and older Americans, warns The Senior Citizens League. "The changes under consideration may provide some modestly lower federal income taxes at first, but the benefits for many people would be short - lived," says The Senior Citizens League's Social Security and Medicare policy analyst, Mary Johnson. "Older middle - income Americans could shoulder a disproportionate share of taxes under these changes, and get pushed more quickly into higher tax brackets than they are today," says The Senior Citizens League's Social Security and Medicare policy analyst, Mary Johnson. .In addition, the Congressional Budget Office (CBO), a federal agency within the legislative branch, does its own forecast of the programs. The CBO produces independent analyses of budgetary and economic issues to support the Congressional budget process. Each year, the agency's economists and budget analysts produce dozens of reports and hundreds of cost estimates for proposed legislation. .There is no simple, direct mechanism for regulators or legislators to control pricing. Our laws, in fact, favor business: Medicare is not allowed to engage in price negotiations for medicines covered by its Part D drug plan. The Food and Drug Administration, which will have to approve the manufacturer's vaccine for use as "safe and effective," is not allowed to consider proposed cost. The panels that recommend approval of new drugs generally have no idea how they will be priced. .Medicare supplements tend to have higher premiums than Medicare Advantage plans, but will cover most, or even all of your out-of-pocket costs, depending on which policy "A" –"N" that you choose. Medicare Advantage plans have lower premiums, but you instead pay co-pays for every service. If you get sick or you are hospitalized, your out-of-pocket costs could be thousands of dollars. But unlike Medicare alone, Medicare Advantage plans have annual out-of-pocket maximums to cap what you pay. Those maximums average ,332 in 2017 but can be as high as ,700. .Initial Coverage Period: During this stage of coverage you pay a co-pay or co-insurance of 25% of the cost of covered drugs, and the plan pays 75%, up to a total of ,005 (beneficiary) and ,015 (plan). This includes any applicable deductible. Your plan's full retail drug cost, not your co-pay, is what counts toward entering the coverage gap. Your co-pays or True Out-of-Pocket costs (TrOOP) count toward exiting the coverage gap and qualifying for catastrophic coverage. .Payments for neurologist-prescribed brand name, but not generic, drugs in Medicare Part D increased consistently and well above inflation from 2013-2017. .Medicare is structured to pay more to providers based on how sick people are — not on making them well. Yet about one-half of all adults have at least one chronic condition, which is not only the most costly type of health problem to treat over time, but also the most preventable. .TSCL enthusiastically supports the bills mentioned above, and we were pleased to see support grow for each of them this week. .However, MA insurers have already begun taking steps to reduce their costs in order to account for the cuts from CMS. As was noted in last week's legislative update, UnitedHealth – one of the largest MA plan providers – has dropped thousands of doctors from its networks, leaving many seniors doctor-less. It expects its physician network to be 85 percent of its pre-Obamacare size by the end of this year. TSCL is concerned that additional cuts to MA in 2015 will harm beneficiaries in other ways, by driving up premiums and reducing benefits.