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5 Ways Paul Ryan’s Budget Screws Seniors

5 Ways Paul Ryan’s Budget Screws Seniors

paulryanofficial

Republicans marched to their biggest landslide victory since before the Great Depression in 2010, buoyed by a terrible economy and the withering attack that Democrats had cut Medicare to fund Obamacare.

Democrats saw their 4-point advantage with voters over 65 in 2008 turned into a 6 percent disadvantage in 2010. In 2012 Democrats won 2 percent back but the GOP still retains a 3 percent advantage with the nation’s most reliable voters — though polling has shown that Republicans  may be alienating this crucial voting bloc with extremism and a willingness to gut essential services.

Rep. Paul Ryan (R-WI), who famously campaigned with his senior-citizen mother in 2012 as Mitt Romney’s running mate, has decided to see if he can erase what’s left of the GOP’s advantage with seniors by releasing another budget. As with each preceding budget, he has made his cuts to Medicare — which are all delayed for 10 years in an attempt to blunt the political damage — slightly less severe, hoping to dull the reputation as the guy who wants to maim Medicare, a position that won him jeers while speaking to AARP.

But Ryan’s budget is even more brutal this time to older Americans, especially the nation’s poorest seniors, while still promising $200,000 annually in tax breaks to those who earn over a million dollars a year.

Here are five ways Ryan’s latest budget would cause real pain for seniors.

Higher Medicare Costs Now

hands off medicare

Republicans often point out that Obamacare cuts Medicare Advantage and reforms the program. But they fail to mention, as Democrats often do, the benefits the president’s health law has given to current Medicare beneficiaries.

The National Committee to Preserve Social Security and Medicare reports:

The Centers for Medicare and Medicaid Services recently reported that since the passage of the ACA, over 7.9 million Medicare beneficiaries in the Medicare Part D donut hole have saved $9.9 billion on their prescription drugs, an average of $1,265 per person.  Also, 37.2 million people with Medicare took advantage of at least one preventive service with no cost sharing, including an estimated 26.5 million people with traditional Medicare, and more than 4 million who took advantage of the Annual Wellness Visit.

Ryan’s budget would repeal those benefits while keeping the cuts Republicans have been campaigning against for four years now.

Obamacare reforms have also lowered the growth of Medicare’s costs to zero. If this trend continues, the program would be solvent even through the peak of Baby Boomer retirements, protecting seniors from future benefit cuts.

Photo: joetta@sbcglobal.net via Flickr

It Cuts Programs Seniors Depend On

mealsonwheels

In an effort to balance the budget in 10 years while keeping tax cuts that mostly benefit the rich, Ryan would cut a slew of programs seniors have relied on.

“Funding for Older Americans Act programs like Meals on Wheels, family caregiver support, job training, senior centers, and disease prevention programs, would suffer significant cuts when the need for these services is increasing,” the National Council on Aging (NCOA) reports. “Over time, these programs—which are NOT contributing to the federal budget deficit—would be cut by 22 percent below current levels.”

Another $137 billion would be cut from the Supplemental Nutritional Assistance Program, aka food stamps. Currently, 9 million seniors and people with disabilities receive SNAP benefits. And the Social Services Block Grant (SSBG) that helps with the home delivery and support of seniors in their homes would completely eliminated.

The Senior Corps, which gives older Americans a chance to give back, would be completely eliminated right as millions of vital Boomers hit retirement, according to the NCOA.

Photo: Mike Rosati via Flickr

Medicaid Would Be Gutted And Left To The States

Rick Perry

Seniors know that Medicaid isn’t just a program that helps low-income Americans. It’s a vital lifeline for seniors as “the largest payer of nursing home and other long-term care, covering 49 percent of all such costs,” according to Families USA. More than 15 percent of seniors depend on the program. That share rises to 44.6 percent for seniors with disabilities.

Ryan’s budget would cut the program by $732 billion as it changes the funding into block grants for the states, which could then evade federal regulations that help ensure quality care.

Photo: The Texas Tribune via Flickr

Supplemental Security Income (SSI) Cuts For 2 Million Seniors

medicareprotestseniors

Ryan’s plan also calls for $500 billion in cuts to “other mandatory” programs, which could include cuts to SSI for up to 2 million seniors, according to the NCOA.

The seniors who receive SSI are America’s poorest retirees, often those without any savings or familial support. This is the kind of cut that could turn the hyperbolic attack that seniors would be forced to eat cat food into reality.

Ryan doesn’t make this cut explicit, possibly because the insanity of eliminating a few dollars a day for the neediest Americans while offering millionaires more than $500 a day in tax breaks is too cruel to admit.

Photo: ProgressOhio via Flickr

Ends Medicare As We Know It

Seniors Medicare

Paul Ryan despises Obamacare. So why does he want to turn Medicare into Obamacare?

While eliminating the reforms that extend the life of traditional Medicare, Ryan would cut benefits for future retirees in four ways.

“The proposal would increase the Medicare eligibility age, raise the deductible amount for doctor visits, penalize or prohibit people from buying first-dollar private Medigap coverage, and increase monthly premiums for middle-class seniors with incomes over $46,000 per year,” the NCOA reports.

Ryan would turn the single-payer program that promises all of America’s seniors basic health care into a “premium support” model that’s much closer to Obamacare with a “public option” than today’s Medicare. And by raising the retirement age and eliminating Obamacare’s Medicaid expansion and subsidies, Ryan would leave millions of future 65- and 66-year-olds without any health insurance at all.

Photo: longislandwins via Flickr

Medicare Advantage Payments Won’t Be Cut Next Year

Medicare Advantage Payments Won’t Be Cut Next Year

By Tony Pugh, McClatchy Washington Bureau

WASHINGTON — The Obama administration reversed itself on Monday, announcing that private health plans that provide Medicare benefits will receive a slight increase in government payments next year, rather than the reduction that was proposed earlier.

Congressional Democrats, many facing tough re-election campaigns, recently joined Republicans in asking that the private health plans, known as Medicare Advantage, be spared from payment cuts next year, even though they receive an average of 6 percent, or $8 billion, more this year to cover their enrollees than it would cost under the traditional Medicare program.

The administration had proposed a 2 percent cut in Medicare Advantage payment rates in February under the Affordable Care Act, to help bring the payments more in line with the regular Medicare program.

The reduced payments would cause some plans to reduce benefits, but they would still have to provide all the benefits covered by traditional Medicare.

A February report from Barclay’s projects that advantage plans “have ample room to adjust benefits downward while maintaining benefit levels that are better for their members than the traditional (Medicare) fee for service program.”

But a series of attack ads by the insurance industry and Republican-backed groups claimed that the Medicare Advantage cuts would reduce benefits for seniors, cause premiums to increase and force some plans to pull out of certain markets altogether, making access to coverage more difficult.

The ads helped Republican David Jolly narrowly defeat Democrat Alex Sink in a House race in the Tampa, Fla., area last month that was largely viewed as an early test of how health care could affect the November mid-term elections.

Senate Democrats, including Al Franken of Minnesota and Chuck Schumer of New York, joined House Democrats like Reps. John Barrow of Georgia and Patrick Murphy of Florida in asking that Medicare Advantage payment rates remain untouched next year.

They got their wish on Monday when Jonathan Blum, principal deputy administrator at the government’s Centers for Medicare and Medicaid Services, announced an average payment increase of about 0.4 percent next year. Actual payment rates will vary by plan based on location, a plan’s quality rating and other factors, Blum said.

Many Democrats expressed relief.

“This proposed cut would have been disproportionate, hurting seniors who would lose doctors or pay more,” Schumer said in a statement on Monday. “We’re glad the administration heeded our call and reversed the policy.”

Not everyone, however, was pleased with the decision. Max Richtman, president and chief executive of the National Committee to Preserve Social Security and Medicare, called the move “bad policy and bad economics for the Medicare program.”

“Since 2003, all seniors in Medicare (including those not even enrolled in Medicare Advantage) have paid higher premiums to help fund the billions in government overpayments to private Medicare Advantage insurance companies,” Richtman said in a written statement. “This annual drama with private insurers in Medicare proves, once again, that when private Medicare Advantage plans are unwilling to compete on a level playing field with traditional Medicare, seniors will ultimately pay the price.”

House Speaker John Boehner said the policy change does little to address ongoing conerns about the Affordable Care Act.

“We have called on the president and his Cabinet to develop a plan to help American seniors deal with the consequences, both now and in the future, of this destructive law. Thus far we’ve seen no such plan,” Boehner said in a written statement.

Nearly 16 million seniors, about 30 percent of Medicare’s 52 million beneficiaries, are enrolled in Medicare Advantage plans, up from 14.6 million enrollees in 2013, according to Avalere Health, a health-care consulting firm.

The Medicare Advantage program allows private managed care plans, typically HMOs and PPOs, to provide hospital coverage and physician services for Medicare enrollees. Rather than bill Medicare for each medical service, the plans receive a flat monthly sum to cover each patient and a separate payment to provide prescription drug benefits. The plans typically provide extra benefits like coverage for eyeglasses, hearing aids and gym memberships.

The extra benefits have helped fuel the funding disparity between Medicare Advantage plans and the traditional Medicare program.

To address these concerns, the Affordable Care Act, passed in 2010, changed the formula for paying Medicare Advantage plans, with the goal of saving more than $130 billion over 10 years. The law phases in payment reductions to the Medicare Advantage plans that bring them more in line with payments for services under the traditional Medicare program.

That plan has worked. Medicare Advantage used to cost 14 percent more to care for enrollees than the traditional program. That payment disparity is now down to 6 percent, according to the Medicare Payment Advisory Commission, an independent congressional agency that advises Congress about Medicare.

Blum said the trajectory of lower payments will continue in spite of the slight payment increase next year. He said overall program costs won’t rise as quickly in coming years as healthier, less costly baby boomers continue to join the program.

Photo: joetta@sbcglobal.net via Flickr

Another Round Of Food Stamp Cuts Hits States

Another Round Of Food Stamp Cuts Hits States

By Jake Grovum, Stateline.org

WASHINGTON — A fresh round of food stamp cuts at the state level are underway, on top of federal food stamp reductions that hit millions of Americans twice since November. In some states, policymakers have imposed additional cuts that jeopardize benefits for hundreds of thousands.

The impact of the reductions is just beginning to take hold, or soon will.

“They’re getting cut off and seeking help,” said Debi Kreutzman of the Kansas Food Bank, which is dealing with changes that could affect 20,000 Kansans. “We’re starting to see that come into play now, and I’m afraid it’s only going to get worse.”

The state cuts target a relatively small portion of the food stamp population: low-income able-bodied adults, without children, 18 to 50 years old — estimated to be about 10 percent of the more than 47 million in the program. In some states, recipients are losing benefits because of reinstated work requirements as a condition of qualifying for food stamps.

These cuts come on top of an across-the-board 5 percent reduction of benefits to all food stamp recipients’ benefits last November. As part of the farm bill earlier this year, Congress also closed a loophole and cut benefits for 850,000 households, although many states affected are moving to block the cuts for now.

The federal food stamp program (formally known as the Supplemental Nutrition Assistance Program) limits how long low-income childless, able-bodied adults can receive food stamps to three months in a three-year period, unless they are working or participating in a training or workfare program for at least 20 hours a week. Other food stamp recipients face less stringent work requirements, and there are exemptions for those with children or other caregivers.

The 2009 stimulus bill suspended these requirements through 2010, and after that states were allowed to waive them if they met certain conditions based on their economies and job markets. Most every state has waived the requirements since 2011.

In recent years, though, some states — many controlled by Republicans — began to rethink the waivers, which were part of the 1996 welfare reforms and designed to give states flexibility in times of high unemployment. With the start of the new federal fiscal year last October, eight went back to enforcing the requirements, and 10 waived them only in part of their state or for part of this year. The changes are just beginning to be felt in some of those states.

In Delaware, officials insist a waiver is unnecessary because the state’s work-training and placement program has been able to manage the growing ranks of the jobless. But the Food Bank of Delaware said some recipients have hit the three-month cutoff unable to find work. The state might soon reconsider the requirements.

“The case load is growing pretty dramatically,” said Elaine Archangelo, director of the Division of Social Services for Delaware. “So we have been considering if there are areas where we could, should request a waiver.”

Of states without waivers, Iowa, Nebraska and Wyoming were no longer eligible, because their economies and job markets had improved, as measured by the eight factors considered by the federal government when determining waiver eligibility. Others, such as Delaware, Kansas, Oklahoma, Utah and Virginia, are going without them despite being eligible for at least partial waivers.

Ohio, Colorado, New York, Texas and Wisconsin are all waiving the work requirements for only part of the year or in certain areas, even though they were eligible for full coverage. Minnesota, New Hampshire, North Dakota, South Dakota and Vermont were eligible only for partial waivers.

Ohio chose to go without a waiver for most of the state. Only 16 out of 88 counties are exempt — mainly rural, Appalachian regions where the average unemployment rate was 10.2 percent or higher in 2011 through 2012. The situation left food banks and food stamp outreach workers in Ohio scrambling, facing a shortage of jobs and training opportunities.

“It’s a lack of jobs, not a lack of willingness to work,” said Lisa Hamler-Fugitt of the Ohio Association of Food Banks. “In an environment where we have college graduates that are now competing for low-wage jobs, for folks with multiple barriers to employment, it’s going to be difficult for them to find work.”

Exact figures on the effect in Ohio are hard to come by. Of the nearly 141,000 people in the affected category receiving food stamps before, 98,000 were still receiving them in January, but it’s impossible to know exactly why people left the program. According to the Ohio Department of Job and Family Services, in January more than 16,000 were suspended or kicked off the program due to the work requirements.

Ben Johnson of the Ohio Department of Job and Family Services disagreed with Hamler-Fugitt’s assertion that jobs aren’t available. “Our only goal was to provide benefits and job training where appropriate,” he said. “We’ve worked very hard, and our county partners have worked especially hard, to notify individuals and bring them in and find appropriate training and employment activities.”

Passed by the Republican-controlled legislature, Wisconsin will re-impose the work requirements this year as part of a job-growth pitch from Republican Gov. Scott Walker. The changes — which were part of a jobs package that also included $35 million for job training — will phase in starting in July and cover the entire state by next January. About 63,000 could be affected.

In some states, the decision to reinstate work requirements was part of an effort to push people off food stamps and back to the workforce, as in Kansas, where officials said jobs, not public welfare, was the cure for poverty.

In Oklahoma, Republican House Speaker T.W. Shannon, who’s now running for U.S. Senate, pushed the change as welfare reform. As many as 233,000 were put under review, according to the Regional Food Bank of Oklahoma, many more than originally expected.

“Unfortunately, some believe compassion is measured by how many people you can keep on a government aid program,” Shannon said in a statement when fellow Republican Gov. Mary Fallin signed his bill. “Through personal responsibility, hard work and a drive to better one’s situation, people can establish their independence and begin down the road of prosperity.”

Food banks and other advocates see things differently. They say the economy hasn’t recovered enough to support reinstating the work requirements. Many affected are very poor, often uneducated, sometimes homeless who would have difficulty meeting the requirements anyway.

“Certainly a lot of people max out with that three-month period,” said Matt Talley, who works on outreach for the Food Bank of Delaware, which includes helping those who lack transportation or have other barriers to meeting requirements. “It’s just a matter of trying to help them find work, or help them find an opportunity to participate in a job training program.”

The changes in states are coming as part of a broader effort in Congress to trim food stamps, after spending hit a record high of $82 billion in fiscal year 2013.

The work requirements have been a popular subject in that debate. House Republicans in Congress proposed reinstating the requirements nationwide last year, citing a recovering economy and warning about the cost of suspending the requirements for too long. But Democrats rejected that, leaving states to enact the changes themselves.

“In general, having a work requirement is good policy,” said Rachel Sheffield of the conservative Heritage Foundation. “It serves as a gatekeeper to ensure that those who need assistance are able to get it, but at the same time encourages those who might not necessarily need it to look for work first.”

Safety net advocates say the average monthly benefit of about $275 is hardly enough to lull people into complacency and out of the workforce. And in many areas, it’s possible the economy hasn’t yet recovered enough for such strict requirements.

“What happens to an able-bodied adult without dependents that is actively looking and trying to get into the workforce but is unable to?” asked Helly Lee of the Center for Law and Social Policy, an advocacy group for low-income people. “It’s a downward spiral if you’re unable to find jobs. It’s hard to climb out of it if there are constantly barriers along the way.”

Photo: USDAgov via Flickr

Why Is The White House Considering “Significant” Cuts To Social Security?

Republican leaders in Congress, who were staring down the Democrats over a potentially disastrous debt default only days ago, are suddenly blinking so fast that they might be signaling in Morse code. Although their message is muddled and illogical – with House Majority Leader Eric Cantor (R-VA) saying he can accept closing tax loopholes only if such measures are “revenue neutral,” thus canceling their budgetary value – the Republicans now clearly understand that they will be blamed if the negotiations collapse.

And Democrats appear to understand that they have the advantage, as they voiced support for a proposal by Senate Budget Committee chair Kent Conrad (D-ND) to reduce future deficits by $4 trillion with an even split between increased revenues and reduced spending.

But just when the Republicans are showing fear and losing momentum, there is one important Democrat who seems to think it is time to wave the white flag– and give his enemies an historic victory on the eve of his own reelection bid.

According to the Washington Post, President Obama will propose “significant” cuts to Social Security and Medicare in exchange for Republican agreement to let tax breaks for the nation’s wealthiest families to expire at the end of this year.

Why would the President abruptly undermine his party’s longstanding support for the two highly popular federal programs – especially when polls consistently show overwhelming majorities in both parties oppose cutting Social Security and Medicare benefits? It isn’t as if there is any great enthusiasm for him or his economic leadership among Democratic voters. Indeed, he and Congressional Democrats only began to achieve political traction again, for the first time since the midterm elections, when the Republicans foolishly lined up behind House Budget chairman Paul Ryan’s plan to transform Medicare from a public entitlement to a privatized voucher.

Over the past few weeks, Democrats pressed that advantage by portraying the Republicans as defenders of tax loopholes for corporate jet owners and oil companies and enemies of middle-class families – and the Republicans eagerly leaped into that trap. The Democratic strategy worked so well that even the most extreme elements in the Republican leadership – such as Cantor – suddenly saw that they had closed themselves into a very dangerous box.

That is why Cantor – and Senate Minority Whip Jon Kyl (R-AZ)– began to babble about “increased revenues,” “user fees,” and “closing loopholes” over the past two days, using language that directly contradicts their own earlier hard-line rhetoric.

Of course, Republican support for increased fees and closed loopholes that add up to a negligible amount – or to nothing at all, as Cantor apparently prefers – won’t satisfy Democrats who now know that pushing back works. They might well imitate the Republicans, accept the concessions by Kyl and Cantor, and push back even harder.

The Senate Democratic budget plan would reduce the deficit from $4 trillion to $5 trillion over the coming decade, according to Conrad’s calculations. By requiring that half of the total come from tax increases and ending tax loopholes, Conrad would raise roughly $2 trillion to match a similar amount in spending cuts – far more than the President has proposed. Last spring, for instance, the White House suggested that Congress should cut $3 in spending for every dollar in revenue raised.

Conrad is among the most conservative Democrats, but he is retiring after this year. What he proposes would be fairer to American families, better for the American economy, and more desirable for his party, too. But the restored courage demonstrated by Democratic Senators in support of his plan will not accomplish much if the president is determined to capitulate on fundamental principles. Should he prove to be so foolish, then he will find himself another step closer to the end of his presidency.