This month, the U.S. House and Senate voted on different budget resolutions for fiscal year 2014. There are stark differences between the two budgets, especially on Social Security, Medicare and Medicaid!

Check out the differences in FY 2014 proposals here:

[Fact sheet here]
A fight over the debt ceiling will loom large later this year, especially given the stark differences between the Senate and House budgets.  The need to raise the nation’s $16.6 trillion debt ceiling this summer might be seen as an opportunity to forge a grand bargain that both raises tax revenues and cuts Medicare, Medicaid or Social Security benefits.

Alternatively, there could be some sort of smaller agreement or they very well may end up doing yet another continuing resolution to keep the government running.  

The Ryan Republican Budget must be opposed because:

• It unfairly proposes giving seniors vouchers rather the guaranteed benefits of Medicare.  These vouchers would not keep up with costs, and seniors would be out more and more money every year.
• There are reasonable ways to balance our budget and the Ryan Republican Budget is not it.  We can’t ask seniors and the middle class to give more while corporate America continues to thrive and get more handouts.

A better alternative is Murray’s Budget because

• It is a responsible approach to tackling our country’s fiscal priorities over the coming decade while making necessary investments to create jobs immediately.
• This budget reduces our deficit through both new revenue and targeted spending cuts without cutting Medicare, Medicaid or Social Security benefits.  

Please help us continue to keep the pressure on Congress to make sure cuts to Medicare, Social Security and Medicaid do not take place.  Stay tuned for important action alerts about how to get involved. 

If you haven’t signed the petition against the Ryan budget, please do so here

The House of Representatives voted last week to pass Rep. Ryan’s Republican budget for 2014. This guts Medicaid, dismantles the Medicare program, fast-tracks cuts to Social Security – all while giving $5.7 trillion in new tax cuts for the wealthy and corporations. Fortunately, the Senate voted against this budget, so now we are once again at a stalemate.

California seniors would be ill-served by the Ryan budget and are furious that this vote will decimate programs that seniors and the middle class rely on. According to the Center on Budget and Policy priorities, the Ryan Budget gets 66% of its spending cuts from programs like Medicaid and food stamps. This budget breaks America’s promise to seniors and people with disabilities and jeopardizes their health. By replacing Medicare’s guaranteed benefits with premium-support, or vouchers, that do not keep up with inflation, out-of-pocket health care costs would skyrocket. Also, raising the Medicare eligibility age in 2024 will leave 65 and 66 year olds out in the cold, uninsured and at the whim of the private market. Further, means-testing Medicare has the potential to force beneficiaries with incomes as little as $47,000 to pay higher premiums is not fair.

As if all of this weren’t bad enough, the plan will jeopardize nursing home care and other community based services that allow seniors and people with disabilities to live at home, by slashing Medicaid funding by about $800 billion and repeals the Affordable Care Act, thereby eliminating state exchanges, free preventive screenings and drug discounts for Medicare beneficiaries. All told, this budget plan will bring us back to the day of poor houses and senior poverty above 50%

Without a budget, Congress must pass a continuing resolution in order to continue paying its bills. The Republicans want to continue to force the issue of cuts to Social Security, Medicare and Medicaid as their bargaining chip to agree to vote for a continuing resolution.  The President and many Democrats have put the elimination of COLAs in Social Security – and using the Chained CPI as a negotiating ploy.  This is unacceptable.  The Chained CPI is a cut to current and future beneficiaries and will mean immediate cuts to Social Security recipients – cuts that will get bigger over time.  We must demand that Congress and the President take any cuts to these essential programs off of the bargaining table – NOW.  Please call the President, Senators Feinstein and Boxer and  your Congressmember to vote no to any cuts to Social Security, Medicare and Medicaid including the Chained CPI.

Call your U.S. Senators and Congressmember today, toll free at: 877-762-8762

Call the President at (202) 456-1414

Medicare has become one of the most discussed issues in recent days given Rep. Paul Ryan’s budget proposals. Beyond the sound bites, what do we know about Medicare? Read on to find out the basics of the program and watch for more information to come in this multi-part series.
Medicare is our nation’s health care insurance for all people ages 65 and older, regardless of income. It also covers people under the age of 65 who have certain disabilities as well as those with end state renal disease and Lou Gehrig’s disease. Prior to the enactment of the program in 1965, about half of America’s seniors lacked healthcare coverage. Today, nearly all have coverage, with almost 50 million Americans currently benefitting from the program. Medicare has four parts. Parts A and B are considered “traditional” or “original” Medicare. Recent changes to the program are in italics.
 Part A (Hospital Insurance) helps cover inpatient care in hospitals, skilled nursing facilities, home health care and hospice. If you or your spouse worked 40 quarters or more (10 years), you pay no monthly premium for Part A. Deductibles and coinsurance (paying a percentage of the cost of care) apply.
 Part B (Medical Insurance) helps cover doctor and other health care provider services, outpatient care, durable medical equipment, and some home health care not covered under Part A. Part B also covers a number of preventative services. The monthly premium for Part B in 2012 is $99.90. Premium costs go up somewhat for those earning in excess of $85,000 as an individual. Assistance is available for those who are low income. Deductibles and coinsurance apply to Part B services. The Affordable Care Act (also known as “Obamacare”) did away with many deductibles and coinsurance costs for preventative care. Nearly 33 million people have already experienced this benefit.
 Part C (“Medicare Advantage”) was enacted in 1997 so that Medicare beneficiaries could have the option of receiving their benefits through private health insurance plans. Under Part C, also known as “Medicare Advantage,” private insurers run plans that Medicare approves. Costs and restrictions vary by plan. Approximately one quarter of Medicare beneficiaries choose Medicare Advantage plans. Costs from the Medicare accounts to pay for Part C have been outpacing costs for traditional Medicare. The Affordable Care Act will bring the costs back in line and provide incentives for the best-quality and best-value plans.
 Part D (Prescription Drug Coverage) was enacted in 2003 to help cover the cost of prescription drugs. It is run by Medicare-approved private insurance companies. Beneficiaries choose their plan and pay a monthly premium that varies (for those using Medicare Advantage, Part D premiums are part of the overall premium). Deductibles and copayments may apply and vary depending on the plan that is selected. Part D has what is referred to as a “doughnut hole” meaning that after a certain amount is spent on drugs, there is a gap in coverage until a catastrophic level is reached. The Affordable Care Act offered a one-time $250 benefit to those in this coverage gap and phases out the “doughnut hole” by 2020. Approximately 3.6 million seniors have seen costs go down to date.
Sources: Medicare.gov, Kaiser Family Foundation, Healthcare.gov and Whitehouse.gov
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Medicare provides coverage at a time when our healthcare needs are often the greatest – and the most expensive. 

Cost-Effective Coverage
The good news is that Medicare has a long track record of providing coverage more cost-effectively than private insurance.  Since 1979, Medicare’s cost per beneficiary has grown cumulatively 40 percent more slowly than equivalent benefits provided by private insurers.  To put this figure in real  terms consider that the average family insurance plan provided by employers today is roughly $15,000 annually.  If the private sector was as effective in controlling costs as Medicare over the same time period, that same family coverage would cost only $9,100.  Why does it save?  There are fewer administrative costs, no million dollar CEOs to pay, negotiating power that provides significant discounts and a focus on service rather than being profit-driven.

Finances
Medicare is primarily financed by a payroll tax, general revenue and premiums paid by beneficiaries:

• Part A is mainly funded by a payroll tax of 1.45 percent on current employees and employers.  Next year, this rate will increase for higher-income taxpayers (more than $200,000/individual and $250,000/couple) by 0.9 percentage points (from 1.45% to 2.35%).  The revenues are placed in the Hospital Insurance (HI) trust, which, like Social Security is designed to be self-supporting.
• Part B is financed through monthly premiums paid by Medicare enrollees and general revenues. Income from these sources is credited to a Supplementary Medical Insurance (SMI) trust. 
• Part C is paid for by the government making payments to private insurers on the enrollees’ behalf in appropriate parts from the HI and SMI trust funds.
• Part D funding comes from a separate account in the SMI trust fund and is financed by general revenues, state contributions and beneficiary premiums.

Important Information About the Medicare Trust Funds
A board of trustees makes an annual report to Congress on the status of the trust funds, including a projection for the date when the HI fund will be able to cover a portion of costs rather than 100 percent. Since 1970, the dates have ranged from as little as two years out to as many as 28.  The fund has always covered 100 percent of costs, in part due to legislative changes. 

The passage of the Affordable Care Act (“Obamacare”) included a series of improvements and funding changes to Medicare.  According to the 2010 Medicare trustees report, those changes strengthened the HI trust fund a significant number of years to 2024.  Because of the way it is funded, the SMI trust fund does not face exhaustion. 

Sources: Medicare.gov; Economic Policy Institute; Centers for Medicare and Medicaid Services; Congressional Research Service

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(source: www.labor411.org)

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