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Fiscal responsibility

Progress Illinois cites Ezra Klein’s reassurances that next week’s “fiscal responsibility summit” is not about Social Security, it’s about health care — and even if Social Security ends up on the table, don’t worry because Peter Orszag is head of OMB.

“Any fixes would look more along the lines of…the Orszag-Diamond proposal — which most liberal[s] embraced as the responsible alternative in 2005,” writes Klein, who penned a rather odd paean to Orszag in a recent issue of American Prospect.

But as Mathew Rothschild pointed out in the Progressive (posted on Alternet), while that proposal did come out strongly against privatizing Social Security, it also called for significant benefit reductions.

In contrast, advocates for retirees and consumers — as well as economists like Paul Krugman and Dean Baker — argue that Social Security is sound for decades to come, and any future problems can be dealt with by raising the cap on income subject to the Social Security tax.

Indeed, President Obama took the same position during last year’s campaign.  Klein is simply wrong about any kind of consensus for the Orszag plan.

Hopefully he’s right that the summit will focus on the issue of rising health costs — and the need for health reform — as a solution to Medicare’s growing costs.  But Orszag’s presence is not a great reassurance.

Elders Living ‘Close to the Edge’

Social Security has dramatically reduced official poverty rates among the elderly, but many retired people still struggle to get by, living in the gap between the poverty level and what it really takes to pay daily bills.

A new statewide initiative to improve economic security for the elderly will be launched Monday, with the unveiling of an Elder Economic Security Index which measures the actual costs of basic expenses for each county in the state. Advocates hope it can be used to allign eligibility for public benefits with a more realistic measure of income adequacy.

The federal poverty level, developed in the 1960s, is based on three times a moderate food budget. But other expenses have skyrocketed in intervening years — especially housing and health care, according to Martha Holstein of the Health and Medicine Policy Research Group, who is coordinating the initiative in Illinois.

The new index, developed by Washington, D.C.-based Wider Opportunities for Women and the Gerontology Institute of the University of Massachusetts Boston, includes housing, food, transportation and health costs and measures them by local conditions, county by county.

It turns out that a retiree relying mainly on Social Security for expenses falls far short of what’s needed for a barebones budget, Holstein said.

The gap is greater for women living alone, whose Social Security is less due to segregation in lower-paying jobs and time out to raise families — and it’s greater yet for women of color, she said..

According to WOW, average Social Security earnings for single elderly women were just above the poverty level of $10,210 a year — and for blacks and Hispanics, they’re below that level.

An older woman living at the poverty level who receives all the public benefits for which she qualifies still falls significantly short of an adequate income, Holstein said.

For a third of the nation’s elderly, Social Security accounts for 90 percent or more of their income.

“People are living very close to the edge,” she said. “At the end of the month they’re running out of food.”

Dr. Claudia Fegan of the Woodlawn Health Center said that many of her elderly patients have trouble paying for their medications, even with the new Medicare drug plans. When they get to the plan’s “donut hole,” they have to pay out of pocket. “Medication for things like Alzheimer’s or seizures is very expensive — it can run $100 a month for each medication.”

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Medicare Drug Plan: More Trouble

With a new round of difficulties expected when the new Medicare Part D drug program’s transitional period ends April 1, consumer advocates have launched a “Campaign to Fix the Part D Disaster” and released a study showing that Illinois seniors and taxpayers could save billions of dollars if Medicare was allowed to negotiate prices with drug companies.

Meanwhile, service providers in the Make Medicare Work Coalition, consisting of hundreds of public and nonprofit agencies which have been counseling seniors and people with disabilities regarding drug plan options, will hold a summit meeting March 31 in Oak Brook.

On April 1 the plan’s transitional period ends and insurance companies will stop paying for drugs not on their formularies. “We expect to see a spike in issues when people realize their plans don’t cover all the drugs they take,” said John Coburn of Health and Disability Advocates, one of the conveners of the Make Medicare Work Coalition.

Many will have to undertake the effort of filing for appeals and exceptions, and some of these will end up in federal court, said Lynda DeLaforgue of Citizen Action/Illinois, which is spearheading the Fix Part D coalition.

“So we’re back in an HMO-type situation, with insurance companies overruling doctors’ prescriptions and making medical decisions for patients,” DeLaforgue said.

Also in April, thousands of seniors who qualify for Medicare’s “extra help” program will be automatically enrolled in drug plans, potentially repeating the chaos that ensued from automatic enrollment of low-income seniors in January.

DeLaforgue said many seniors are now experiencing “sticker shock” and finding themselves in the plan’s “donut hole” — where they pay for 100 percent of drug costs — much sooner than they expected.

Us. Representatives Jan Schakowsky (9), Danny Davis (7), and Dan Lipinski (3) joined groups representing consumers, seniors, and labor at the launch of the Campaign to Fix Part D on March 27. They released a report by the Institute for America’s Future which says Congress’s failure to provide a Medicare-administered drug plan option and its prohibition on negotiating drug prices will cost Medicare beneficiaries and taxpayers in Illinois $32 billion over the next decade.

Most of that amount comes from higher drug prices, said Jeff Cruz, co-author of the report. The current program “does nothing to keep prices down, in fact it encourages them to raise prices,” Cruz said, noting that the Congressional Budget Office has projected drug price increases of 8 percent a year, more than double the rate of inflation. Negotiated prices would keep increases closer to the rate of inflation, he said.

Cruz cited a Consumer’s Union report projecting that by next year, the average Part D participant who had no previous drug coverage will be paying more out-of-pocket for drugs than they did in 2003 without the plan.

The Campaign to Fix Part D is calling on Congress to require Medicare to negotiate drug prices, establish a Medicare-administered plan as an alternative to private plans, and prohibit insurers from dropping medications from their formularies during enrollment terms. The group is calling for extending the deadline for enrollment and closing the “donut hole” in Part D coverage.

DeLaforgue notes bipartisan concerns about Part D raised in the recent congressional budget debate, with resolutions passed by the Senate advocating extending enrollment and negotiating prices. She said President Bush has opposed extending the deadline and House leadership has “dug in their heels” on any changes in the plan.

“We will be working in Illinois congressional districts this summer,” she said, listing Mark Kirk(10), Jerry Weller (11), and Speaker Dennis Hastert (14) as “members of congress who especially need to hear from us.”

Meanwhile, hundreds of service providers are signed up for the Make Medicare Work Coalition’s 2006 summit, 9 a.m. to 3:30 p.m. on Friday, March 31 at the Doubletree Hotel in Oak Brook. The coalition is a collaborative project of Health and Disability Advocates, Progress Center for Independent Living and the Suburban Area Agency on Aging.

So far Part D is a good deal for people who didn’t have coverage previously, said HDA’s Coburn. “It’s better than paying 100 percent yourself,” he said. For people who had coverage, especially low-income people and people who are sick or have disabilities, “the transition is extremely rough,” he said. “It’s the most vulnerable who have been impacted most negatively.”

For Coburn, one “untold story” is the role of social service agencies who have been consumed with counseling seniors and people with disabilities. While Medicare has provided some agencies with funding for counseling, many nonprofits have taken on the task without funding.

“We all had full workloads before this,” he said. “At one point we were doing more than just counseling people on drug plans.”

Confusion Grows Over Medicare Drug Plans

The rollout of Medicare drug plans starting October 1 — with enrollment beginning October 15 — is “shaping up to be a big mess of a train wreck,” said Steve Pittman of the Illinois Alliance for Retired Americans.

Seniors in Illinois will have up to ten national companies and perhaps a dozen Illinois companies to choose from, many offering multiple levels of cost and coverage, and all covering a different range of drugs and pharmacies. There may be fifty plans in total, he said.

In addition, low-income seniors will have to determine if drug plans coordinate with state and federal assistance programs. “If a plan requires you to pay $75 upfront and then bill [a government program] for reimbursement, that could create real hardships,” Pittman said.

But the Social Security Administration is far behind schedule in determining eligibility for federal low-income assistance, Pittman said. “They planned to scan the applications electronically” but it turns out that “some seniors’ handwriting is not real good,” he said.

“One common response” at presentations about the new program “is people throwing up their hands and saying they’re not going to deal with it,” Pittman said. Indeed, seniors who aren’t on medication will be tempted to forgo the whole process, points out Syd Bild of Metro Seniors in Action. And seniors covered by retirement packages could lose their existing coverage by enrolling in the new plan.

But with a March 15, 2006 deadline for enrollment, those who miss it will be subject to a late-enrollment penalty on their premium of 1 percent for each late month when they do enroll. “That just scares and frustrates people even more,” Pittman said.

Pittman and Bild agree that most of the state’s 1.5 million seniors will need individual benefits counseling to help choose a drug plan. Area aging agencies are providing orientations and individual counseling.

Pittman recalled that Medicare’s “helpline” for the temporary drug discount card which preceded the new program was often busy and often gave out inaccurate information.

In order to “give seniors some breathing room,” Pittman said, IARA is supporting the Medicare Informed Choice Act (H.R. 3861), sponsored by U.S. Representative Jan Schakowsky (D-IL, 9th), which would delay penalties by extending the enrollment period to December 31, 2006. The bill would also allow seniors to make a one-time change in plan enrollment anytime during 2006.

Another bill sponsored by Schakowsky in the House and Sen. Richard Durbin (D-IL) in the Senate (H.R. 752 and S. 873) would go further, providing for Medicare to offer its own drug plan and rescinding the prohibition on negotiating with drug companies for better prices. Bild and Pittman point out that the Veterans Administration negotiates price reductions of 40 percent or more on drug purchases, and with 40 million recipients, Medicare could do even better.

The administration’s Medicare drug plan is a “giveaway” to drug and industry companies, Bild said. He points out that participants must enroll for a year, but drug plan companies can raise drug prices or change drugs covered with 50 days notice. Premiums will be indexed to drug cost inflation.

The 85 percent of seniors he estimates are ineligible for low-income assistance will pay the full costs of medications between $2250 and $5100, Bild said, and very few people will be able to afford to reach the level above $5100 where plans will cover 95 percent of costs. “And most of those who do will get there in November or December, and in January they’ll have to start paying all over again,” he said.

The drug program as established will be a “huge drain on the Medicare fund,” Bild said, and measures to increase Medicare HMOs and establish health savings accounts will further drain the fund. A dozen local HMOs dropped out of the Medicare HMO program established in the 1990s, but Congress has now increased its funding. Health savings account deposits will come out of employee contributions to the Medicare fund. Bild points out that someone who saved $100,000 in a health savings account could use it all in ten days in an intensive care unit, at today’s prices.

Bild adds that consumers should be aware that they will be the ones paying for the deluge of advertising expected from Medicare drug plans after October 1.

Social Security Coalition Targets Brokerage

A new coalition to defend Social Security will rally on Valentine’s Day outside the offices of the Charles Schwab brokerage, denouncing its support of Social Security privatization as a “conflict of interest.”

Hannah Lehman of the Save Our Security Coalition compared Schwab’s support of privatization with recent Wall Street scandals where “brokers put their own interests over those of their customers.”

Schwab CEO Charles R. Schwab is a longtime supporter of diverting Social Security funds into private accounts, and the company has helped finance the “Alliance for Worker Retirement Security,” a business-backed group supporting privatization.

The world’s largest discount broker, Schwab has recently seen a sharp drop in its profits, and privatization could bring the company millions of new customers, Lehman said.

The new Save Our Security Coalition includes a growing number of labor, consumer, elderly and civic groups. The rally is 12 p.m. on Monday, February 14 at Charles Schwab, 150 S. LaSalle.

Seniors to Discuss Medicare Drug Plan

The interim drug discount card system rolled out by Medicare in May and June is “still a big mess,” said Steve Pittman of the Illinois Alliance for Retired Americans. And it’s reinforcing uneasiness among seniors about the prescription drug plan passed last year, he said.

With that plan set to be implemented in 2006, employers are expected to cancel or scale back drug coverage for millions of retirees; state programs for low-income seniors could be eliminated; and a huge gap in coverage could effect half of all Medicare recipients, Pittman said.

IARE and Metro Seniors in Action are holding a town hall meeting on the Medicare drug plan on Tuesday, August 10, at 11 a.m. in the auditorium of Harold Washington Library, 600 S. State. Congressional representatives are being invited along with state and city officials, and seniors will testify about their experiences and concerns.

One point of interest will be the Medicare Prescription Drug Savings and Choice Act (HR 3767) sponsored by U.S. Rep. Jan Schakowski. The bill would lift the ban on negotiating lower prices from drug companies in the 2003 legislation; require Medicare to offer its own drug plan as an alternative to the HMOs and private plans authorized last year; and establish supplemental coverage to help plug the coverage gap in the existing plan

Medicare Drug Plan Could Hurt Low-Income Seniors

Under legislation establishing the new Medicare prescription drug benefit, low-income seniors in Illinios could end up paying significantly more for drugs.

A provision banning state use of Medicaid funds for drug coverage for low-income seniors (“dual-eligibles” who qualify for both Medicare and Medicaid) would end federal funding for Illinois SeniorCare, said Steve Pittman of the Illinois Alliance for Retired Americans.

The state program provides drug coverage to 170,000 low-income seniors, said Mike Claffey of the Illinois Department of Public Aid. Compared to the spotty coverage offered by the new Medicare plan, Illinois SeniorCare “is a far superior program,” he said, covering 100 percent of prescription drugs up to $1,750 and 80 percent after that.

The IARA, a statewide network of senior clubs, is joining the Committee for New Priorities and other groups to sponsor a forum on the new Medicare plan with U.S. Rep. Jan Schakowsky and William McNary of Citizen Action Illinois, Thursday, February 19, 1 p.m. at Grace Place, 637 S. Dearborn.

Seniors Celebrate Homecare Expansion

Jane Addams Senior Caucus members will gather with supporters Wednesday to celebrate the expansion of the state’s homecare program.

As of January 1, the assets limit for eligibility for the state’s homecare program was raised from $10,000 to $12,500 a year — allowing an estimated 1,000 seniors to stay out of nursing homes. The eligibility adjustment, the first in over 20 years, followed a three-year campaign on its behalf by the caucus.

Nursing home care costs the state seven times as much per person as homecare assistance, according to the caucus. “No senior wants to go into a nursing home, and no taxpayer should want us there,” said JASC activist Pearline Atkins.

State Reps. Sara Feigenholtz and Harry Osterman will join Jane Addams Senior Caucus members for a short program and party at the Ruth Shriman House, 4040 N. Sheridan, on Wednesday, January 7 at 1 p.m.



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