New research, however, suggests that Medigap substantially increases Medicare spending, because seniors with the policies are insulated from costs. Those with polices tend to receive more medical care than people who are required to pay some or all of the costs of their care out-of-pocket. According to the CBO, a 2010 study found that Medicare beneficiaries responded to increases in their cost sharing by reducing visits to physicians and use of prescription drugs.[2] "Making seniors pay higher initial Medigap cost-sharing affects both senior budgets, and senior health — especially if seniors forego necessary care," Cates notes. .But he cautions that the amount of benefit from flu vaccination could be different in a different group of people. "There is a protective effect," he says. "How much is something that needs to be quantified with a more intensive study." .Also last week, House Democrats unveiled a range of health care measures to be included in their coming .5 trillion package, including provisions to lower prescription drug prices and expand Medicaid in the 12 GOP-led states that have refused to do so. The measure unveiled by the House Energy and Commerce Committee includes legislation to allow the Secretary of Health and Human Services to negotiate lower drug prices, known as H.R. 3. .Under the Affordable Care Act, or Obamacare, private and public sector large employers are responsible for providing health insurance for employees and contributing toward the cost of insurance. Generally, the federal health insurance exchange is only available for people who can't otherwise afford to purchase the insurance offered by their employer (according to thresholds set by law). But the fight to pass the 2010 Affordable Care Act was so contentious and controversial that some Members of Congress insisted that their colleagues set an example and be required to have the same coverage as all other Americans. .Members on both sides of the aisle seemed eager to tackle corporate tax reform, but there was a clear divide on the panel when it came to the Social Security payroll tax holiday. Co-chair Patty Murray (WA) and Senate Minority Whip Jon Kyl (AZ) both seemed skeptical about President Obama's recent proposal to cut the payroll tax in half for both employees and employers next year. When asked whether short-term tax cuts typically succeed in stimulating the economy, Barthold responded "yes" without hesitation. However, he said that such short-term cuts for employers generally do not lead to job creation. .This week, HHS announced several important numbers that will affect Social Security and Medicare benefits beginning in January. On Monday, the Centers for Medicare and Medicaid Services (CMS) announced that the Medicare Part B monthly premium will be left unchanged in 2014, and it will be set at 4.90. The Part B deductible will also be left unchanged, and it will remain at CMS officials noted on Monday that the past five years have been among the slowest-growing for Part B premiums in the Medicare program's history. .On Tuesday – despite projections that showed large gains for Democrats on Capitol Hill – lawmakers on the right swept elections across the country. For the first time in eight years, Republicans will control the House, the Senate, and the White House when the 115th Congress begins in January. Senator Roy Blunt (MO), who narrowly held on to his Senate seat on Tuesday, told reporters: "A Republican president and a Republican Senate and a Republican House can do things to change this country." ."Another factor affecting retirement income is the amount of the initial Social Security benefit when one first retires. Social Security benefits are not growing as quickly as in in previous decades," Johnson says. This is particularly true for middle to lower earning workers due to the slow growth in real wages over decades. According to a report by the Congressional Research Service, between 1979 to 2018, real wages have grown for top earners, but have stagnated or fallen for middle to lower earners. "That is reflected in the (often disappointing) initial Social Security benefits of new retirees," Johnson says. .Last year Congress considered a major Medicaid overhaul that would transition the program from one that covers qualified applicants whose incomes are low enough, to a system that provides a fixed per capita payment or block grant to states. The Congressional Budget Office estimated this change would cut federal spending on Medicaid by more than 25% over the next decade. Despite lawmakers' failure to enact the change to Medicaid last year, some lawmakers in Congress and president Trump may try again this year.