Ryan’s Medicare Voucher Plan Doomed for Now by ACA Repeal Failure

you can read all blog posts at http://www.generationsofnewyork.com

House Speaker Paul Ryan’s dream of turning Medicaid into a block grant to the states with capped funding went up in smoke on Friday when he had to pull his bill to repeal and replace the Affordable Care Act because of a lack of votes.  In drafting the bill, Ryan was enthusiastically touting it to conservative groups as an historic bill that would end a major federal entitlement program.   After he passed the legislation, he was set to go after Medicare and turn it into a voucher program, which would also have ended its entitlement status.   Now, it seems like Ryan’s future as House Speaker is more in doubt than Medicaid and Medicare remaining as entitlement programs.

It is also doubtful that House Republicans will want to follow Ryan with another controversial health care proposal, this one targeting seniors and the disabled.   Turning Medicare into a voucher would be even harder because he does not have the support of President Donald Trump who has refused to change his campaign position of opposing cuts to Medicare and Social Security.  Ryan could still try to damage Medicare in the budget process and go against Trump and Democrats there too.  Perhaps a majority of the Republicans in the House are looking to cut entitlements in order to finance tax cuts and not have to cut other discretionary programs as much.  Again, if more than twenty four of them are not in agreement though they will have trouble passing anything big, on the budget, tax cuts or infrastructure spending.

In fact, we may be seeing more splits between conservative and moderate Republicans.   Media reports suggest that Ryan will remain as Speaker because no one else wants the job or has the votes to defeat him.   What is clear though is that, for now, he is a much weakened figure.  The plan he drafted to repeal and replace the Affordable Care Act was defeated for two  main reasons:  the large outcry from the public at town hall meetings and through other communications with members of Congress and secondly, because the bill was  punitive and made life worse by taking away health care from millions of people who needed it.

Paul Ryan pursued this repeal legislation and his Medicare voucher plan as an ideological dream to reduce the role of the federal government and end entitlements. According to one recent poll, only 17% favored the bill Ryan drafted that he had to pull back in defeat.  I suspect that support to turn Medicare into a voucher has about the same level of support That is why a lot of members of Congress will not be following Paul Ryan’s Medicare crusade.


Capitol Tonight Video – Trump Budget Threatens Home Delivered Meals

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You probably heard in recent days that President Trump’s proposed budget threatens home delivered meals programs like Meals on Wheels.   It doesn’t eliminate money for the service but the controversy in the media was about the elimination of the Community Development Block Grant (CDBG) program which some municipalities use to supplement funding for home delivered and congregate meal programs.   Most of the funding for meals programs comes to county governments and their aging services through funding from the Administration on Aging and the State Office for the Aging.  There could be more cuts to the program since the Department of Health and Human Services (HHS) is targeted for cuts of 16% and the AoA is part of HHS.   Private funds are also raised through donations from individuals as well as the corporate sector.

In a  TV interview last Friday, I made the point that “Meals on Wheels” programs are the best type of program, combining government and private support with an army of wonderful volunteers who deliver the meals.  The volunteer may be the only person to see the older person receiving the meals.   The volunteer can report back if the person has any urgent health needs or other problems.

This program has broad support so I was dumbfounded listening to Trump’s Budget Director Mick Mulvaney questioning the program and saying we couldn’t keep funding services that don’t have value.  Obviously he doesn’t know what he is talking about.  There is strong bipartisan support for the program and I believe the budget cuts proposed will be greatly resisted and scaled back or defeated but we have to make a stink with our Congress members!

Here is the link to an interview I did last Friday, March 17 about the threat to home delivered meals.

Mike Burgess


This was on Timewarner (Spectrum) News.  If you not a subscriber you can view 10 videos per month free.

Assembly and Senate Restore, Increase Funds for Seniors in Budget Resolutions

The Senate and the Assembly passed their budget resolutions last week to reflect their program priorities.  Both budgets included the restoration of cuts in senior services that were in the Governor’s budget.  Conference committees are meeting this week in various issue areas and will be given a targeted amount of money that can be added to the Governor’s budget. While the Senate and Assembly resolutions add tens of millions of dollars to the aging budget, they are more a listing of priorities.  Those that are most important will be what the chairs of the Aging Committees, Assemblywoman Donna Lupardo and Senator Sue Serino will be advocating for.

The Senate gave priority to funding for elder abuse programs and adding $5 million provided to county offices for the aging for the Community Services for the Elderly Program (CSE).  The Senate also restored $3.35 million for the New York Connects program which the Governor’s budget proposed funding with some federal dollars for the coming year.

The Assembly restored money for a block grant used to fund 65 senior centers in New York City, increased by $2 million funding for the Community Services for the Elderly program and included funding for a new program  for new senior housing and to provide rental assistance for seniors in New York City.  In addition to funding for senior services, both the Assembly and the Senate budget include money for direct care workers.    Both houses rejected the Governor’s changes in the STAR program that would increase income verification requirements.

The Assembly in its press release noted, “As the Baby Boom population has aged, New York State’s older population has grown, and will continue to grow significantly. By the year 2025, it is estimated that the state’s overall older population will comprise nearly a quarter of the state’s total population – making these services and programs increasingly more critical.

“Seniors are living longer than ever and, in turn, our senior communities are growing,” said Speaker Heastie. “We must make sure that they have the resources they need to facilitate their ability to live independently and with dignity so that they can continue to make contributions to their communities.”

“The Assembly continues our strong commitment to New York’s seniors in our budget proposal,” said Assemblywoman Lupardo. “From protecting our senior centers to committing additional funds to address the growing waiting lists for Community Services for the Elderly; the Assembly’s budget reflects the need to ensure older New Yorkers receive the services they need and can age safely in place.”

“For countless seniors in New York, the rising costs of rent have threatened the ability of seniors to stay in their homes,” said Assemblymember Steven Cymbrowitz, chair of the Committee on Housing. “Seniors cannot afford to be put on waiting lists for safe affordable housing to become available. Our budget offers more meaningful solutions to address these critical issues.”

“Older homeowners count on the savings that the enhanced STAR program offers and do not deserve added complications to the renewal process,” said Assemblymember Sandy Galef, chair of the Committee on Real Property Taxation. “It would be unfair and overly burdensome to create more paperwork and confusion for seniors simply trying to receive the savings they need and deserve.”

Senator Serino, who chairs the Senate’s Aging Committee said, “Earlier this year, we asked legislative leaders to step up for seniors and deliver for them directly in this year’s budget. The Senate answered that call and today passed a budget resolution that makes smart, significant investments to ensure that New York is a place where our seniors can age better—at home in our communities—with dignity. Making the growing population of seniors a priority in this year’s budget is good for our families, it’s good for our economy and it will play a critical role in keeping our state ahead of the curve for generations.”

Summary of Assembly Budget Resolution

Housing and Enhanced STAR Renewal Options

The Assembly recognizes that many seniors wish to stay in their homes and communities as long as possible. In support of that, the Assembly budget proposal includes funding for numerous senior housing programs. The spending plan includes a new program that would provide rental assistance to older adults in New York City who are paying more than 30 percent of their monthly income toward rent. To be eligible for the Elder Rental Assistance Program (ERAP), the senior and his or her family would be required to have a total income equal to or less than 80 percent of the area median income. The amount of rental assistance would be calculated as the difference between the senior’s rent payable, or maximum rent set by the agency, and 30 percent of the senior’s monthly income.

The program would be funded by a 2.5 percent transfer tax paid by the buyer on multi-million dollar real estate transactions of condos, co-ops and one to three-family homes. The tax would apply only to the amount of the transaction exceeding $2 million. The plan would help keep vulnerable seniors in their homes and communities by offsetting burdensome rental costs. The Assembly’s budget proposal also includes $1 million for Naturally Occurring Retirement Communities (NORCs) and $1 million for Neighborhood Naturally Occurring Retirement Communities (NNORCs). The plan also includes $125 million for a senior housing program to create new housing opportunities.

In addition to assisting seniors with housing costs, the Assembly’s budget includes a measure that would reject the governor’s proposal to eliminate an option for Enhanced STAR renewal applications. Under the Executive Proposal, seniors would be required to enroll in the STAR Income Verification Program in which the tax department would automatically review income eligibility every year. However, this option may create difficulties for seniors who do not need to file an income tax return. The Assembly’s proposal would allow seniors to continue exercising the option to submit a renewal application every year together with a copy of their income tax form to their local assessor.

Health Care and Aging Programs

The SFY 2017-18 Budget also includes funding to address high health care costs that seniors often face in New York. The proposal includes provisions aimed at reducing the cost of prescription drugs, which can be a large burden for individuals on a fixed income. The proposal includes much needed resources to offset these expenses and preserve access to long-term care. The Assembly restores $23.8 million in long term care reductions, including $11 million for nursing home bed hold payments, which help seniors maintain their spot in nursing homes in the event that they need hospital care, and $10 million to maintain the right of spousal refusal.

The proposal also provides $2 million in additional funding to support the Community Services for the Elderly program, which provides personal care, home delivered meals, transportation, senior centers, and other important services.

The Assembly spending plan also restores Title XX funding of $27 million to its original discretionary purposes for Local Social Service Districts and removes the Executive’s proposal to mandate that such funds be used only for child care. This will prevent the closure of 65 senior centers in New York City.

 Summary of Senate Budget Resolution

The Senate One-House Budget Resolution that was approved includes key provisions that will help significantly improve aging services, actively combat elder abuse and increase access to vital services.  Further, the proposal restores potentially devastating cuts and adds additional funding to ensure that our seniors have the resources they need to enable them to receive critical services and supports. These include:

  • Adding language aimed at combatting the financial exploitation of vulnerable older adults;
  • Adding $5 million for the Community Services for the Elderly Program (CSE) which provides funding directly to communities, enabling them to provide services like home care, meal delivery and transportation;
  • $500,000 for a transportation pilot program in Dutchess and Putnam counties that would allow seniors who no longer wish to drive to trade in their vehicles in exchange for credits for a ride service;
  • Restoring $3.35 million for the New York Connects—a one-stop-shop kind of program that provides free comprehensive services and supports for seniors and caregivers;
  • Providing $10 million to establish a statewide central register of elder abuse and maltreatment so that we have the tools necessary to better protect vulnerable older adults; and
  • Restoring $700,000 to fund the successful multidisciplinary investigative teams that work to investigate and address elder abuse and maltreatment and return monies lost to elder financial exploitation, as well as including legislation that creates those teams

Serino continued, “As budget negotiations continue, I urge my colleagues in the Assembly to continue to make our seniors a priority and ensure that these critical pieces make it into the final enacted budget. The health, safety and security of New York’s seniors depends on it.”

Over 80 Upper-Income New Yorkers Urge Governor Cuomo and Legislature to Extend and Expand the Millionaires’ Tax

The following is a press release from the Fiscal Policy Institute

As New York State braces for proposed federal budget cuts that could have a devastating impact on health care, education and infrastructure investments across the state, more than 80 New York residents with incomes in the top 1% have sent an open letter to Governor Andrew Cuomo and the New York State Legislature urging passage of an expanded and permanent millionaires’ tax.  An expanded and permanent millionaires’ tax would bring in nearly $6 billion in annual revenue, or over $2 billion more than the current tax – set to expire in 2017 – generates.

The Fiscal Policy Institute’s “1% Plan for New York Tax Fairness” calls for expanded top tax rates for the top 1% of New Yorkers. The plan also calls for continuation of the lower rates enacted last year for middle-income New Yorkers. The 1% Plan is similar to the Assembly-passed plan in that it would set new rates and top brackets, and would also generate a significant amount of new revenue.

The signers include Eileen Fisher, David A. Levine, Dal LaMagna, Lewis B. Cullman, Abigail Disney, Agnes Gund, Leo Hindery, Jr., Steven C. Rockefeller, and George Soros. All of the signers are residents with annual incomes of $650,000 or above, putting them in the top 1% of earners in New York State. Many signers are members of the Responsible Wealth project, which initiated the letter.

The letter states in part:

As New Yorkers who have contributed to and benefited from the economic vibrancy of our state, we have both the ability and the responsibility to pay our fair share. We can well afford to pay our current taxes, and we can afford to pay even more. Our state’s long‐term economic prosperity depends on strong investments in our people and our communities.

The Fiscal Policy Institute (FPI) has long supported not only extending the millionaires’ tax, but increasing the number of brackets at the top end and making the new structure permanent as well. The additional $2 billion raised under an expanded millionaires’ tax could be used to invest in our schools and infrastructure, address the state’s record levels of homelessness, hunger and poverty, and better position our state to handle the impact of any forthcoming federal funding cuts.

Contrary to the conservative insistence that progressive taxation will drive away the wealthiest taxpayers, these upper-income New Yorkers are not only staying put, but they actively support making the current millionaires’ tax permanent and more progressive. Since the millionaires’ tax was established in 2009, the number of millionaires has grown by 33 percent in our state.

Attorney Craig Kaplan said, “Since 2009, poverty in New York has increased and many state responsibilities – including education and housing subsidies – have gone underfunded. Our Legislature should strengthen the current millionaire’s tax, make it permanent, and dedicate the additional funds to improve the quality of life of ALL New Yorkers.” Kaplan and his wife, Anne Hess, were among the signers of a letter organized by Responsible Wealth in 2009 that called for a surtax on upper incomes to address New York’s then-$15 billion budget gap. The letter led to the first-ever income surtax in New York State, which was extended in 2011 in the form of the current millionaires’ tax.

David A. Levine of Manhattan, former chief economist for AllianceBernstein (at that time called Sanford C. Bernstein & Co.), stated, “I am among the many New Yorkers in the top 1% whose income is derived entirely from financial investments. It makes perfect sense that I should pay a significantly higher tax rate than working class and middle class people. And I believe I should pay a higher marginal rate than I do under the current millionaires’ tax.”

Eileen Fisher, founder of Eileen Fisher clothing company in Irvington, NY, said, “I believe those of us fortunate enough to find ourselves in the top 1% of income have a particular responsibility to support that public infrastructure. I wholeheartedly support extending and strengthening the current millionaires’ tax in New York.”

Dal LaMagna, Founder of Tweezerman Corporation, and currently President and CEO of IceStoneUSA, said, “Serious businesspeople understand it is essential for New York to make consistent investments in our infrastructure, environment, and workforce if we want economic growth, and this type of government investment helps make business success possible. Ultimately we benefit from paying our fair share of taxes.”

Sophie Robinson, a 28-year old inheritor and documentary filmmaker, said, “New York has the greatest inequality in the nation, yet fails to adequately provide for those most in need. To me, the millionaires’ tax is a simple matter of equity. Paying an additional 2-3% on my New York State income does not affect my standard of living. But having adequate tax revenue to invest in public transportation, infrastructure, parks and social services for those who are struggling makes New York a better place for all of us.”

Responsible Wealth project director Mike Lapham said, “Responsible Wealth members understand that their wealth has been built on government investment, and to remain economically competitive, New York State must invest in education and infrastructure. They are willing to pay taxes at a higher rate to enable the state to make those investments.” Responsible Wealth members lobbied for the original millionaires’ tax in 2009 and the extension in 2011. If the millionaires’ tax were to expire, the top 1% would get a $3.7 billion annual tax windfall, which would put New York State back in the predicament it faced in 2009.

“Far from threatening to leave the state, it’s refreshing to see this many wealthy New Yorkers are willing to expand and make permanent the temporary top income tax rates set to expire at the end of this year,” said Ron Deutsch, Executive Director of the Fiscal Policy Institute. “They support higher taxes on themselves so the state can fund our glaring human and physical infrastructure needs and have adequate revenue in place to handle pending federal cuts.”

Deutsch added, FPI’s “1% Plan for New York Tax Fairness” and the Assembly’s true millionaires’ tax have support from the very people who would be impacted by them, and they are saying they can more than afford an increase in the top marginal rates.”

The question of whether to extend, expand, make permanent, or end the current millionaires’ tax is central to the budget debate currently playing out in Albany. Governor Cuomo has said he supports extension of the millionaires’ tax at current levels; the Assembly-passed plan calls for setting new brackets and higher rates; the Senate majority currently opposes extension of the millionaires’ tax. These wealthy New Yorkers echo the sentiments of the general public who, according to recent public opinion polls, don’t want to see the millionaires’ tax expire.

The Fiscal Policy Institute (www.fiscalpolicy.org) is an independent, nonpartisan, nonprofit research and education organization committed to improving policies and practices to better the economic and social conditions of all New Yorkers. Founded in 1991, FPI works to create a strong economy in which prosperity is broadly shared.

Responsible Wealth (www.responsiblewealth.org) is a project of United for a Fair Economy (UFE). UFE engages in state and federal policy debates, provides trainings and support for economic justice organizers across the nation, and publishes illuminating reports. United for a Fair Economy is a national, independent, nonpartisan, 501(c)(3) nonprofit organization.




Health Votes Will Impact How Many NY Congressional Seats are Competitive for 2018

House Republicans have now started the battle to replace the Affordable Care Act with their bill introduced on Monday.  How they handle it will directly effect Congressional elections in 2018.  With the massive outpouring of activism against the repeal , Democrats are entertaining hopes of winning the 24 seats they need nationally to take over the House of Representatives in 2018.    New York would be a prime location to try to win some of these.  However, right now, even with the intensity of opposition to Trump, that would have to be translated into action in each Congressional district.

Results from the 2016 elections which tend to have higher turnout show that there were only six of the state’s twenty seven Congressional districts in which the winner had less than 60% and three of those six were Democrats:  Thomas Suozzi with 52%, Sean Patrick Maloney at 55% and Louise Slaughter at 56%.    The three Republicans below 60% were John Faso at 55%, Claudia Tenney at 47% in a three way race and Thomas Reed at 58%.  John Katko in central New York got 61% even though Hillary Clinton won his district.

So, it will take a large Democratic turnout to overcome the odds to win some of these districts.   And, Democrats will have to field good candidates with lots of money to face the avalanche of PAC money available to Republicans.  If Trump’s approval continues to be low, the Republican candidates may distance themselves from him more than they have now.

Still, Democrats faced big odds in 2006 when they won 30 seats to take the House that year.  It all depends on who is turning out.  In most non-Presidential years, the turnout is higher among older and whiter constituencies.  That may not be the case in 2018.  Republicans had a strong turnout for Trump in many areas upstate so the Republican incumbents do have to be concerned about maintaining that.  The difference in intensity of the voters could make a difference in some of these districts.

Intensity will be effected by voting records so it will be interesting to watch how Republicans vote on the bill to replace the Affordable Care Act and whether thousands lose coverage in their districts if such a plan passes.  Passage of an alternative is not certain given divisions among Republicans.  Conservatives want to repeal more of the program than the House bill does.  More moderate members think the program should make sure that people don’t lose coverage, especially on Medicaid.

Also, votes to change Medicare and Social Security could have a big impact in upstate districts which tend to be older.  House Speaker Paul Ryan and many conservatives want to push ahead to change these programs but they face long odds in the Senate.  For example, Social Security changes are exempt from the reconciliation budget process so 60 votes are needed to change the program.

With January 1, 2018 Start for State Paid Leave Program, State Releases Regulations, Launches New Website

With the state’s new Paid Family Leave program set to begin in January 2018, the state Workers’ Compensation Board and the Department of Financial Services filed their regulations for implementation of the new Paid Family Leave law. The new regulations will provide guidance for employers, employees and insurance carriers about their responsibilities and rights under the law.

Paid family leave will be available for three major categories:  care for a newborn, care for a family member with a serious medical condition or providing care while a family member is away for military service.

A new website provides information on medical documentation required for taking the leave.


Workers are expected to provide employers 30 days notice with a request for paid family leave unless an unexpected medical situation developed.

The program opens on January 1, 2018 and employees who have worked for at least 26 weeks with their employer on a full time basis or 175 days on a part-time basis.  Employees are able to take up to eight weeks off at 50% of their salary.  The benefit will be phased in over four years when employees are eligible to take up to 12 weeks off in 2021.  In 2019 and 2020, employees can take up to 10 weeks off.

The program was passed last year by the State Legislature and provides some of the most generous benefits of those states which have similar laws.