Easier Said Than Done: Public Unconvinced That Medicaid Spending Should Be Cut .On Thursday, lawmakers in the House and Senate advanced a two-week stopgap measure to keep the federal government operating past Friday, December 7th. President Trump had not yet signed it into law at the time of writing this week's legislative update, but he is expected to do so before the midnight deadline. As a result, lawmakers have an extra fourteen days to reach a deal to avoid another government shutdown on December 21st. .Just how bad is it? We were stunned to learn just how big the disparity in drug prices can be. Recently I compared the highest and lowest prices of the top ten most-prescribed drugs in the U.S. using the Medicare drug plan finder. In my area, a monthly supply of diabetes drug Lantus Solostar for example, ranges from a high of 2.00 from the mail order pharmacy of First Health Part D Value Plus plan to a low of .75 from the network retail pharmacies for SilverScript Choice. In fact, the cost difference between the highest and lowest-cost plans for the ten drugs compared averaged 3 per month! .As far as the other three orders are concerned, it has been reported that consumers may not notice immediate changes since the orders must be carried out by the federal bureaucracy and could face court challenges. .Gathering with unvaccinated people from more than one other household .Unfortunately, no. The highly controversial U.S. Social Security Totalization Agreement with Mexico that was signed by the Bush Administration is still pending. The agreement has not been submitted for review to the President or Congress, but that could quickly change, particularly in an election year. TSCL believes that if put into effect as it currently is written, the agreement would drain funds away from Social Security that are needed for the benefits of U.S. senior citizens. Totalization agreements were designed to eliminate dual taxation that occurs when a workers from one country works in another country and is required to pay Social Security taxes to both countries on the same earnings. .But when hold harmless is triggered more widely than usual, as we expect to be the case in 2021, there is no provision of law with which to finance the unpaid portion of Medicare Part B premium increases of 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, those who are not protected by hold harmless pay a far larger share of the costs, thus the huge Part B premium jumps. .This study looks at 39 expenditures that are typical for people age 65 and up, comparing the growth in the prices of these goods and services to the growth in the annual COLAs. It includes cost increases in Medicare premiums and out of pocket costs that aren't tracked under the index currently used to calculate the COLA. .Switching Drug Plans Can Save Big Money — Here's Proof