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  • Congressional Corner Representative Peter Roskam Il 6

    This sounds similar to the current Medicare Advantage system except for one big difference — the Health and Human Services secretary would be given authority to set beneficiary cost-sharing "based on evidence of the value of services." Under this criterion, who do you think would be more likely to get the best coverage for expensive services like CT scans that can cost ,000 — an 84-year-old, or a 43-year-old mother with two children? Finally, the recommendation would require insurers to pay a surcharge on the Medigap policies that they offer to beneficiaries. This proposal is not new. .Using statistical data from the Social Security Administration, TSCL estimates about 88 percent of Social Security beneficiaries have received benefits during the 2009 – 2015 period and have been impacted the hardest. "With 64 percent of older Americans depending on Social Security for over half of their income, going without a COLA is a loss of income that most beneficiaries simply can't be expected to bear," Cates says. Spiking medical costs are causing retirees to go into debt, and run through their savings," he adds. .Over the past nine years, COLAs have averaged just 1.4%, so it comes as a frustrating surprise to retirees to learn that, in the decade prior to 2000, COLAs averaged 3% per year, more than twice the average today. Because COLAs compound, and the monthly benefit grows over time, lower COLAs mean less Social Security income than retirees might have planned for. That in turn means spending through retirement savings more quickly than planned. … Continued

  • Q August 2018

    Estimating that this new rule would save approximately million over five years, CMS proposes to require Medicare Advantage and prescription drug plans to "involuntarily dis-enroll" people who are in the country illegally, something that may prove difficult for private plans to substantiate. .This week, CMS announced that its cuts to the Medicare Advantage program will total 1.9 percent next year, which is significantly lower than most analysts expected. However, the amount has not been finalized yet, and some say that the figure fails to consider all factors that will affect reimbursements. They expect to see a final rate in the range of 4 to 7 percent. .This week, lawmakers in the House and Senate remained in their home states and districts to continue the fall congressional recess. … Continued

TSCL believes a better approach to Medicare Advantage "risk adjustments" is needed, and should be written into law, rather than left to the discretion of politically appointed Medicare administrators. Congress could do this by writing a method for calculating the adjustment into the law. This approach would make payment for MA plans more like payment for other Medicare providers. .How do I go about writing my Congressman and Senators? .TSCL Presents 2012 Seniors Advocate Award .This has led National Cancer Institute (NCI) Director Ned Sharpless to worry that the trend of patients and physicians postponing essential cancer care will swap the ongoing pandemic for another public health crisis in the form of increased cancer cases and deaths. An NCI analysis estimated, for instance, that pandemic-related delays in breast and colon cancer diagnoses and treatment could lead to 10,000 more deaths over the next decade. "We're very worried about the consequences of … delaying therapy on our patients," Sharpless said. .Legislation to lower the cost of prescription drugs remains one of TSCL's top priorities. Although the House of Representatives has passed a bill to accomplish that priority, Senate Majority Leader Mitch McConnell (R-KY) continues to refuse to bring the bill up for consideration. .TSCL believes this is good news for the Social Security and Medicare systems, but there is no doubt that if the deferred taxes are never re-paid, it will cause major damage to both programs. .The calculation of the COLA is based on the percentage of difference in the average third quarter change in the Consumer Price Index for Urban Clerical Workers and Wage Earners (CPI-W) from one year to the next. In late August of 2005, Hurricane Katrina knocked out petroleum production, causing gasoline and other consumer prices to surge in September. The CPI-W shot up an astonishing 1.5 percent between August and September of that year. But since Katrina, the CPI-W has increased .042 percent on average from August to September. "Even if costs were to rise as much as they did after Katrina, the COLA for 2018 would still be about 2 percent," Johnson says. .In addition, two new cosponsors – Congressmen Jim Langevin (RI-2) and Gregorio Kilili Camacho Sablan (MP) – signed on to the Protecting and Preserving Social Security Act (H.R. 3302), which was recently introduced by Congressman Ted Deutch (FL-22). If adopted, his bill would base the COLA on the CPI-E and cover the cost by removing the Social Security payroll tax cap for high earners. H.R. 3302 now has nine cosponsors in the House. .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.