Medicare Overhaul: Some GOP Senators Not Interested in Ryan’s Vouchers

Republican Senators including Susan Collins of Maine, Lamar Alexander of Tennessee, John McCain of Arizona and Orrin Hatch of Utah have indicated they don’t support privatizing Medicare with vouchers according to Social Security Works, an advocacy organization defending Medicare and Social Security.     House Speaker Paul Ryan said on “60 Minutes” broadcast on Sunday night that he hasn’t even discussed Medicare with Donald Trump yet.   Moving forward to privatize Medicare is not one of one of the first issue priorities for the new administration.    However, it may not even get out of the starting blocks if the four Republicans and perhaps others refuse to support it.

Trump claimed during the campaign on his website that he wouldn’t cut Social Security and Medicare and said he was the only Republican who wouldn’t.    However, he has more recently approved statements saying he wanted to “modernize” Medicare.  And, he has appointed Congressman Tom Price of Georgia who supports Ryan’s plan to head the Department of Health and Human Services which oversees Medicare.

Collins,  the Chair of the Senate Aging Committee, told the Portland Maine Press Herald, “A complete upending of a program that  by and large serves seniors well is not something that appeals to me.”  Senator Alexander, chair of the Health Committee, said that overhauling Medicare was “biting off more than we can chew.” It would only take three Republican senators to go against the Ryan plan to stop it, assuming all the Democratic senators refused to go along as well.

Ryan says that Medicare has to be cut because of a long term financial problem.  Ryan has decided that the program in its current form shouldn’t continue.  He is using funding issues as a an excuse to dismantle the program and turn it over to the private sector but with a Medicare sponsored plan that would probably not be able to compete if it had too many sicker persons in it.

Ryan’s plan would actually keep the traditional Medicare program but put it into competition with private plans with a set “voucher” amount.  How older and sicker beneficiaries would fare under this system is the great concern.  It seems that the Ryan plan is designed to “save” Medicare by making cuts, claiming competition will keep costs down.  However, as with all these types of efforts turning the program over to the private sector, plans will be designed to “cherry pick” the younger, healthier beneficiaries and the sicker ones will not have enough in the voucher.  They will see their out of pocket costs escalate unless there is a reasonable out of pocket cap on total expenses for each beneficiary.

Social Security Works says national senior organizations already have collected 750,000 signatures on petitions calling on Congress to protect Medicare  and Social Security.


Health Care Chaos Coming if ACA is Repealed without Alternate Plan for Coverage

If the Affordable Care Act is repealed as promised by Donald Trump and Republicans in Congress, the delicate balance of the act will undone and the result will be chaos.  The ACA is not a perfect program but repeal could lead to insurance companies pulling out of the program as they see it is being ended or substantially changed.  And, if Medicaid expansion is rolled back and the program turned into a block grant, more chaos will ensue.  On top of all that, the Affordable Care Act included many changes in Medicare as well including higher premiums for those with higher incomes.   Repealing those increases will blow a bigger hole in the Medicare budget. Also, coverage in the “donut hole” for Medicare drug coverage is gradually being increased.  That would have to be saved or costs would go up for beneficiaries.

There is no magic cure for health care.  Republican Congressional leaders want to cut costs but Donald Trump campaigned saying that Obamacare would be repealed and that coverage would be much better.  He offered few specifics but his thoughts might run into deficit hawks in the Republican Congress.    In fact, Trump has talked of the need for universal coverage.  However, the man he is putting in charge of the Department of Health and Human Services is Congressman Tom Price of Georgia who wants to destroy the Affordable Care Act and dismantle Medicaid and Medicare.

It is going to be incumbent on health care advocates to constantly remind lawmakers and the media what the issue is all about, the ability of everyone in this country to have health care at every age.  It will be important to document the  health problems people face and how changes in legislation effect them in very personal terms.    This is always how progress has been made, by having the facts and shining a light on the plight of those in need.     We have to make every member of Congress understand the impact of proposals offered and make sure they respond to needs.  Health care is a pubic service and must be a right and not just another commodity in the marketplace.


Election: NY State Senate Control Still in Doubt; Four New Members of Congress from New York

The New York State Assembly will again have 107 Democrats and 43 Republicans.  In the Senate,  two races are undecided on Long Island with a Democrat ahead in one and a Republican leading in the other.  The count of absentee ballots could take several weeks before a winner is known in one race on Long Island separated by just 33 votes.  If the current leaders in the two unresolved races win, there will be 32 Democrats  and 31 Republicans.  However, one of the Democrats, Simcha Felder, has always caucused with the Republicans and would again give them outright majority.

The Independent Democratic Caucus (IDC) has seven members and they have also worked with the Republicans in the past.  If the Democrats in the IDC and the mainline caucus were to join and entice Felder to join them, they would have the majority.   Republicans re-elected John Flanagan as their leader and Andrea Stewart-Cousins will remain as the leader of the mainline Democrats.

New York State has four new members of Congress:  Democrat Thomas Suozzi who replaces Steve Israel, Democrat Adriano Espiallat who replaces Charles Rangel and Republicans John Faso who replaces Chris Gibson and Claudia Tenney who replaces Richard Hanna.  Democrats had hoped to pick up several House seats in New York but failed to do so.

We Can Defeat Paul Ryan’s Plans for Medicare Private Vouchers

Here we go again.  The privatizers are going to be back in charge and they are already getting their plans ready for Medicare and Social Security.  Their plans aren’t supported by the general public and we will need to fight and prove that by defeating their proposals.

House Speaker Paul Ryan said after the election he intends to push for his plan to privatize Medicare by turning it into a voucher program.  Apparently he didn’t get the message that economic anxiety in the middle class was the story of this election.  Turning the guarantee of Medicare coverage into a voucher that will be capped offers no security and probably will lead to major increases in costs for older and disabled persons.

I am sure we will hear all kinds of bromides about how this change is necessary and won’t hurt people.  It will make the system more efficient.  However, the proposal is being made in order to cut funding for Medicare by forcing beneficiaries to have to fend with a set amount of money.   There will almost certainly be no attempt to restrain what insurers charge for the coverage as well as what drug companies.  We will be told that competition will keep prices in line.  With less money in the system insurers will raise their rates as they look to cherry pick those the healthier persons who cost less to cover.  As always, those with the greatest needs and costs will be hurt the most.

Of course, we won’t hear much about how the private insurers will spend loads of money on advertising and overhead plus high salaries to their executives.  They will spend a lot less of the Medicare dollar on patients than the federal Medicare program does now.

Ryan’s proposal may not even have the support of Donald Trump.  His own members in Congress will also have to worry about a backlash, just like the one that occurred the last time he pushed this and like when President Bush tried to privatize Social Security in 2005.   We will wait to see exactly what is proposed but it is not likely to be good.  The way to win this battle is to organize with the facts and prove how it will make life worse for Medicare beneficiaries. When that happens, as it did before, even many Republicans in states like New York refused to go along.

NY Senate Control up for Grabs in Election; Key Congressional Races in Play

Those who follow state politics have lots to focus on heading into next week’s general election.    Democrats are hoping to pick up several seats in New York State to wittle down the 30 seat national advantage of Republicans in the House.  There are many hotly contested races for Congress in the state with the one between Democrat Zephyr Teachout and Republican John Faso drawing the most money and attention.  A new poll today shows Teachout leading by 3% to fill the seat of retiring Republican Chris Gibson.  The seat had been previously held by Democrats Scott Murphy and Kirsten Gillibrand, though it was slightly altered in 2010 re-districting.  It stretches from the eastern part of the state along the Hudson River out toward Cooperstown.   Another big race is to succeed the retiring Republican Richard Hanna in central New York.   Assemblywoman Claudia Tenney is the Republican candidate and leads  in the polls against Democrat Kim Myers and a third party candidate.   Former Army officer Mike Derrick, a Democrat, is facing Republican incumbent Elise Stefanik and Green candidate  Matt Funicello in the North Country. There are a few big races on Long Island with Republican State Senator Jack Martins taking on former Nassau County Executive Thomas Suozzi who has led in the polls.

Control of the New York State Senate is again up for grabs and the results of who will be in control will again depend on which way the Independent Democrat Caucus goes.   Senator Jeff Klein, the leader of that caucus, has often worked with Republicans to run the chamber. The independent caucus might actually grow in numbers after the election with some candidates saying they will join it if they win.  Governor Andrew Cuomo has finally begun to aggressively campaign for Democratic control.  His past efforts were often criticized for not being enthusiastic enough about winning the chamber back for his party.

Albany lobbyists in the health field are watching the race between longtime Republican Senator Kemp Hannon, chair of the Health Committee, and Democrat Ryan Cronin who lost to Hannon four years ago by a small margin.   Hannon has the support of many hospital leaders and workers.  Democrats are hoping to win not only Hannon’s seat on Long Island but are aggressively challenging others including first term incumbent Michael Venditto who won the seat vacated by Charles Fuschillo when he became head of the Alzheimers Foundation of America.  A scandal on Long Island that led to the arrest of Nassau County Executive Edward Mangano in October is putting Republicans are on the defensive, coming less than a year after the conviction of former  Republican Senate Majority Leader Dean Skelos of Long Island.

Upstate, Democrat Terry Gipson is trying to win back his seat in the Hudson Valley that he lost to Senator Sue Serrino two years ago.  Assemblyman James Tedisco is trying to win the seat of retiring Senator Hugh Farley.  Sara Niccoli is trying to unseat Republican George Amedore in a district to the west and south of Albany.  These are among several other races upstate that are being hotly contested.

If the mainline and independent Democrats win an outright majority, and they only need one new seat to do that, they will be under great pressure to unite and take control of the chamber.

Albany County Embarks on Age Friendly Community Status

Albany County Executive Daniel McCoy held a press conference at his annual Senior Summit on October 26 to announce  that the county has been designated as the 101st community in the country to receive “age friendly” certification from AARP and the World Health Organization.  The county is now going to form a committee to begin the process of reviewing guidelines and benchmarks that are suggested for communities that want to enact policies and programs that are deemed age friendly.

AARP serves as the United States partner with the World Health Organization (WHO) which has organized the age friendly designations and encouraged communities around the world to apply for this status.  There are over 200 communities worldwide which has been designated.

Over 250 seniors and staff from provider agencies attended the third annual summit that McCoy’s office has convened with the Albany County Office for the Aging.  The event was held at St. Sophia’s Church in Albany which is in an area designated as  a “neighborhood NORC” or Naturally Occurring Retirement Community as designated and funded by the State Office for the Aging.

I was pleased along with Dr. Pat Binzer to be asked to co-chair the county’s age friendly initiative.  We will be forming a committee to begin meeting soon.  In my remarks at the press conference, I noted that Albany County is “age friendly” already as evidenced by the large turnout and the new designation by the WHO provides a framework for the grassroots activism  in the area.   Ultimately, it is the commitment and support of neighbors,  nonprofits, businesses and government at the community and neighborhood levels that makes it possible for older residents to be able to have a good quality of life.

Clinton Leads Trump in NY 54%-30%; 55%-40% Among New Yorkers 55+

Older persons in New York State favor Hillary Clinton by a wide margin according to a Siena College – New York Times poll in mid-October.   Clinton led 55% to 40% over Trump.  Younger age groups favor Clinton by even wider margins of 38% for voters under 35 and 27% for those between 35 and 54.   Clinton’s overall lead in her home state is  54% to Trump’s 30%.   Libertarian Gary Johnson was favored by 5% and Green Party candidate had 4% though Stein got 10% and Johnson 9% among independent voters.

Trump usually does best among older voters and worst among younger voters.  In fact, in New York State, voters under 35 give Trump only 20% of their votes and he is not far ahead of Jill Stein who gets 14% of those in the 18-34 age group.

Clinton leads in almost all subsets of the New York population by age, race and geography. She even leads in upstate New York by 43-37%.    She leads in the New York City suburbs by 9% and has a huge lead in New York City of 73%-17%  She has a huge lead among blacks and Hispanics and a small lead among white voters.  She leads among Protestants by a small margin and has a big lead among Jewish voters.  Catholic voters are the only group she does not lead with, though she is tied at 44% with Donald Trump.