Senior long-term care and short-term care experts, industry leaders and housing and social program policymakers expressed concerns over the House Republican budget $1.7 trillion cuts for Medicare, Medicaid and Social Security, fearing decreases to medical and prescription drug benefits.
Under the House Republican 2019 budget, “A Brighter American Future,” led by outgoing U.S. House Speaker Paul Ryan (R-Wisc.), the lawmakers would repeal the Affordable Care Act (ACA), also known as Obamacare.
The reductions would affect Medicare, Medicaid and Social Security, the programs connected to the ACA, impacting the elderly, disabled and low-income and moderate income households, whom the American Society on Aging, also known as the ASA, targets with its own programs and policies.
In June 2018, House Republicans in the House Budget Committee voted for a budget that would cut $537 billion from Medicare, $1.5 trillion from Medicaid and $2.6 trillion from nutritional assistance from Supplemental Nutritional Assistance Program (SNAP), Social Security, housing, disability, welfare, public assistance and other programs.
The measure will be voted on in the full House. The entire spending plan is said to add $1 trillion to the nation’s debt even though it is slated to reduce the federal deficit by $302 billion.
Over ten years, lawmakers seek to eliminate $763 billion from Medicaid, $236 billion from Medicare, $213 billion from SNAP or food stamps, $4 billion from Social Security, $72 billion from the Social Security Disability Income (SSDI), Supplemental Security Income (SSI) and unemployment insurance, and $41.2 billion from the U.S. Department of Housing & Urban Development (HUD).
Under the bill, work requirements would be made for food stamps and federal employees would have to contribute more to their retirement plans.
The ACA, signed into law in March 2010, provides seniors under Medicare with a 50 percent discount on brand-name prescription drugs covered by Medicare Part D, free preventive services such as annual wellness visits, mammograms or colonoscopies, doctor-coordinated medical team care, fraud prevention and program strengthening.
About 50 million seniors obtain health care insurance through Medicare and more than 20 percent of recipients live in disadvantaged communities or communities of color.
With Medicare, poverty among seniors with respect to medical care remains steady at little more than 10 percent nationally. Still, with the success of Medicare, many seniors head up low- to moderate-income households and spend much of their income on medical care. The Kaiser Family Foundation reports that 50 percent of Medicare recipients have yearly revenues of under $22,000.
The House action comes months after President Trump signed into law a $1.9 trillion tax plan, which would award 83 percent of tax cuts to the richest 1 percent of the public.
To pay for the tax plan, Trump and some House Republican measures are aimed at gutting the budget by $1.7 trillion, particularly for Medicare, Medicaid, Social Security, SNAP, disability and HUD programs and more.
U.S. Senate Majority Leader Mitch McConnell (R-Ky.), outgoing U.S. House Speaker Paul Ryan (R-Wisc.), U.S. House Budget Chairman Rep. Steve Womack (R-Ark.) and Vice President Mike Pence have worked to win over doubtful senators and lawmakers to the proposals.
Meanwhile, U.S. Rep. John Yarmuth (D-Ky.) and member of the House Budget Committee, U.S. Senate Minority Leader Charles Schumer (D-N.Y.) and U.S. Sen. Nancy Pelosi (D-Md.) are rallying Democratic lawmakers and senators against the conservative proposals and to release their own budget initiatives or reform bills.
Tom Price, ousted leader of the Department of Health and Human Services, and Ryan backed privatizing Medicare and turning it into a voucher system just like the Medical Savings Accounts (MSAs), which were created over the last several years to empower businesses to limit healthcare spending by their employers.
Board member executives of the American Society on Aging, a senior advocacy organization, stated a position that they reiterated at a springtime annual Aging in America Conference by the American Society on Aging where they discussed the budget cuts.
The budget initiatives are based on and build on the provisions of the long-defeated American Health Care Act (AHCA), which the Trump administration and Republican lawmakers sought to push last year in an effort to repeal the ACA. The effort raised a hue and cry with affordable healthcare advocates and lobbyists agitating against and attempting to stop the cuts.
If passed, the AHCA was projected to lead to 14 million individuals not receiving coverage this year and a total of 24 million losing benefits in 2026. This, experts, would mean 52 million without insurance by 2026, compared with 28 million under the original Affordable Care Act.
Bob Blancato, MPA, president of Matz, Blancato & Associates, a D.C.-based government and nonprofit association advocacy consulting firm, and chair of the ASA board, gave the organization’s position at the conference’s “National Forum: A Message to the President on Aging Policy,” stating that lawmakers can work with the federal agencies to block Republican budget efforts.
“There are a number of things that Congress can do without Medicare Act,” Blancato said. “There are a range of options … They can make changes to Medicare and Medicaid … They can do work with [the] requirements. They cannot support provisions in the American Care Health Act.”
He said the agency, the Center for Medicare and Medicaid Services of the U.S. Department of Health and Human Services, could change the regulations against the budget proposal.
“They have authority,” Blancato said. “HHS and CMS can do this. This will be evident … He [Ryan] may have the strategy to work with Democrats. They can have another crack.”
When asked about the ASA’s official position on the Trump’s administration and Republican plans for Medicare and Medicaid, he said the organization opposes them and has urged industry leaders and senior care advocates to phone a hotline to cite their concerns.
“At the conference, [we are] putting out a phone number,” Blancato said.
“Some of them [lawmakers and government policymakers] responded. We [ASA board] generally and very specifically oppose a block grant in Medicaid spending. … We don’t have Medicare and Medicaid provisions taken out [of the federal budget]. It leads to [the] shortening of [the Social Security] trust fund. … [We need to] avoid higher costs to individuals.”
Asked about the ASA plan of action on Medicare, Blancato said the organization is working with other advocacy groups to spread awareness of the budget measures and coordinate action.
“We are the [leading] council on aging organizations on behalf of help for seniors and their rights,” he said, mentioning grassroots advocacy among 5,600 religious ministers around the country.
“[We are for] joint advocacy [and] communication with officials. Many are awakened to these issues and take concrete [advanced or administrative] steps … As a chair, I will talk on issues.”
Kevin Prindiville, Executive Director of Justice in Aging, a California-based organization that enables seniors to challenge Medicare and Medicaid practices in court, pushed for more legal advocacy at the conference’s workshop “ASA and NCOA United: A Stronger Voice for Advocacy.”
“It is a big buzz here and a big concern,” Prindiville said. “It is extremely dangerous and unsafe. Millions got coverage through ACA and will lose coverage from [the budget measures]. It would cut Medicare to families. It would cut assistance to seniors.”
As for the provisions of the Medicare budget measure raising tax credits for seniors compared with lower tax credits for younger Medicaid or ACA recipients, he said those aspects of the bill are misleading.
“I’m not sure people understand the tax credits,” Prindiville said. “[Under the budget measure,] if we are older, you get [more] assistance. They don’t make it more affordable. Companies make costs more for adults. Costs goes up. [The] credit doesn’t reflect the true costs. It doesn’t reflect or keep pace with the costs.”
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