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breaking news

Bill Kadereit, pres

(click here for previous FORUM articles )

Medicare Advantage Plans Speeding Us Toward Privatization

As I reported in the fall 2018 NRLN Focus newsletter, when reviewing the House Budget Committee 2018 budget, I became disturbed by House Budget Committee’s desire to privatize Medicare. This resulted in my researching and writing the NRLN whitepaper entitled, Medicare Advantage Plans – Privatization’s Trojan Horse: Is “Premium Support” a Better Deal for Our Country? I just completed major revisions of the first whitepaper. I have titled it, Medicare Advantage Plans – Speeding Toward Privatization: $350 Billion Wasted on Subsidies to Private Insurers.

Health insurers begged and bought their way into the Medicare business over 40 years but have NEVER, TO THIS DAY, PROVEN THEY CAN COMPETE WITH ORIGINAL MEDICARE and its Fee-For-Service cost management approach. The only market share gained has been driven by risk-adjusted government-subsidized rebates and “star quality” award bonus programs that are mismanaged.

The story is that these incentive rewards are used to buy extra benefits such as: lower or no premiums and deductibles, eye and dental protection plans and silver sneakers memberships prior to 2019. In November of 2018 a New England Journal of Medicine article referenced two sources and quoted that, “Studies suggest that the current rebate-based method may not be an economically efficient away of providing extra benefits to beneficiaries because plans are retaining a fairly large share of rebates for administrative costs and profit, passing on only 54% of rebates, on average”.

The “Bi-Partisan Budget Act of 2018” (BPBA), declared Congresses’ and the White House’s intentions to privatize Medicare. The BPBA created benefits and the Center for Medicare Services (CMS) authorized MA plans to spend $16.5 billion more in 2019 and 2020 for MA plan benefits available to 34% (20 million) enrolled in MA plans but NOT for 66% (38.8 million) enrolled in original Medicare Parts A and B plans. This two-year cumulative $16.5 billion is a 10-year authorization or $165 billion (for trips to fitness centers, doctors, pharmacies, over-the counter meds; eyedrops; vitamins; compression stockings; house calls by doctors & other help providers; home assistance – dressing, eating, chores and light housekeeping; shower grab bars; home delivered meals, wheelchair ramps & A/C units and carpet shampooing for asthma sufferers).


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DESPERATION HAS SET IN, CONGRESS KNOWS IT FAILED TO PROPERLY FUND MEDICARE AND THAT AT THIS POINT ONLY PRIVATIZATION CAN SAVE THEM! However, Congress, other than for Rx drugs, has done little or nothing to reduce healthcare costs. This latest farce discriminates against the 38.8 million original Medicare beneficiaries. New benefits are gifts designed to fuel privatization through MA plans.

MedPAC, the independent Congressional agency created by members of Congress to advise them on issues affecting Medicare, reported on March 15, 2019… “We project the base benchmarks (that is, excluding quality bonuses) will average 103 percent of original Medicare Fee for Service (Medicare Parts A and B) spending.”

An analysis of Medicare privatization (aka Premium Support) by the Congressional Budget Office (CBO) showed that privatization will NOT lower the cost of health care, instead it will shift 18% of the federal tax burden and health care costs to seniors while protecting the health care provider and pharmaceutical industries.

MA private insurer plans carry about 12-15% overhead and profit burdens and have failed to compete without federal subsidies. Original Medicare has a much lower 3% overhead burden. Kaiser Health News on November 9, 2018 quoted a MedPAC report that MA plan insurers made a 5% margin in 2016, twice the average of Medicare plans overall. That’s 25% better than the healthcare industry’s 4% margin reported by Standard and Poor’s.

The Kaiser Family Foundation (KFF) study in 2017 found that payments for MA plans enrollees were 9.9% higher than payments made for original Medicare enrollees.

So, why not fix Medicare, by stripping out the cost of subsidies to private insurers for MA plans? Health and Human Services (HHS) has wasted a total of $350 billion of taxpayer’s money and short-changed Americans in original Medicare. It is time to derail Medicare privatization. The reward for competitive bids and acceptable quality in our country is that you get a chance to prove it or lose it – why should insurers get subsidies?

Currently, there are a little over 50 million Americans age 65 and older. The population of this age group will be 75 million by 2035 and 100 million by 2060. Our federal government must take action now to preserve original Medicare before the costs of providing health care for seniors is beyond a solution.

The revised whitepaper has retained what the NRLN has been calling on Congress and the Executive Branch to do:

  • Grandfather and protect the 20 million seniors (34%), who have purchased MA plans in good faith, from future reductions in benefits and guarantee the protection of baked in subsidies as of December 31, 2019 and all future MA subsidies, rebates, rewards, bonuses and non-traditional Medicare plan benefits combined.
  • Direct Government Accountability Office (GAO), CBO and the HHS Inspector General to investigate and report on MA and Original Medicare Part A and Part B independent financials and assess and publicly disclose the cost effectiveness of MA, with and without taxpayer subsidies (rebates, risk adjustments and star bonuses).
  • Retract the 2019 and 2020 subsidies for home air filters and carpet shampooing for asthma patients, pay for heart healthy meals for those with heart disease and other services that represent a shift from services that prevented, improved or cured a patient’s conditions, to services determined by what a chronically ill patient needs, or make them available to the original Medicare A & B, FFS enrollees who have the same health conditions and needs.
  • Reduce the $140 billion annual wrong and improper payments generated by all federal agencies (particularly the $85 billion attributable to Medicare and Medicaid). Sequester savings and use them to eliminate the 75-year deficits of Medicare Part A and Part B, then Part D. Payroll tax increases are an option.

Whether you are enrolled in original Medicare or MA plans, I hope you conclude the NRLN is being fair in its assessments and proposals. Click here to read the newly revised Medicare privatization whitepaper. .

Bill Kadereit, President
National Retiree Legislative Network


Urge Congress to Pass Improving HOPE for Alzheimer’s Act

Click here to TAKE ACTION to email the NRLN’s sample letter to your U.S. Senators and Representative to urge them to support passage of Improving Health Outcomes, Planning, and Education (HOPE) Act.

The bill requires the Centers for Medicare and Medicaid Services (CMS) to conduct outreach to make more health care providers aware that comprehensive care planning services are available under Medicare for individuals with Alzheimer's disease and related dementias. Passage of the bill will ensure that more families are able to take advantage of this benefit so that they can better prepare for the challenges that an Alzheimer’s diagnosis brings.


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NRLN members are saving big with the Free Health Savings Rx Card℠

The NRLN has arranged to offer you a Health Savings Rx Card™, at NO COST, that offers you and your family savings on prescription drugs, plus vision and hearing services and products.Click here to access the Rx Savings Card℠ website.


amazon smile AmazonSmile Program to Benefit the American Retirees Education Program (AREF)

The NRLN board created the American Retiree Education Foundation (AREF) in 2014 as a 501(c)(3) tax-deductible, nonprofit education foundation to expand the research and educational reach of the NRLN and to enable NRLN to sharpen its focus as an organization lobbying for the passage of federal legislation and regulations that benefit retirees.

For example, the white paper on Protecting Pension Assets which is used to educate members of Congress on the need for legislation to prevent pension plan sponsors from using plan assets for non-pension expenses was funded by AREF.. Access the white paper here.

You can help fund the AREF without costing you anything extra when you make a purchase online from Amazon through its AmazonSmile program. Click here to learn more about AmazonSmile.


report card

NRLN Provides New “Report Card” Feature on Members of Congress

Do your Senators or Representative support bills that help retirees? Check it out here!





The articles and opinion pieces below are for information and are not necessarily a reflection of the NRLN’s position on issues. The NRLN is nonpartisan and its positions on retirement issues are presented in its Legislative Agenda and white papers that can be accessed from the Legislative Agenda tab.

Lawmakers map out path forward on Medicare Part D
By Julia Manchester; The Hill ~ Jun 25, 2019

Trump’s Executive Order To Increase Transparency For Health Care Costs May Seem Intuitive, But Research Suggests It Could Backfire
Via KHN Morning Briefing; Kaiser Health News ~ Jun 25, 2019

Social Security Is Mailing Out Incorrect Benefit Statements
From Laurence Kotlikoff; Forbes ~ Jun 25, 2019

Trump aims at health cost transparency with executive order
By Rachel Roubein; Politico ~ Jun 24, 2019

Thanks to Trump, the healthcare choice is yours
From David Balat; The Hill ~ Jun 24, 2019

The U.S. Gets Hundreds of Millions From Big Pharma in Co-Pay Settlements
By Bill Alpert; Barron’s ~ Jun 24, 2019

Setting the record straight on 5 Social Security myths
From Liz Weston; MarketWatch ~ Jun 24, 2019

Big Pharma' is the big winner of the USMCA
From Veronika J. Wirtz, Warren A. Kaplan & Kevin Gallagher; The Hill ~ Jun 23, 2019

The swamp strikes back — health-care edition
From Katy Talento; The Hill ~ Jun 22, 2019

What's the Difference Between Original Medicare and Medicare Advantage Plans?
By Kailey Fralick; The Motley Fool ~ Jun 22, 2019

America is selling its seniors short
From Constantine Katsoris; The Hill ~ Jun 21, 2019

Key Trump proposal to lower drug prices takes step forward
By Peter Sullivan; The Hill ~ Jun 21, 2019

Cancer patients left in the lurch when some drugmakers stop clinical trials
From Mikkael A. Sekeres, ; The Hill ~ Jun 21, 2019

Getting Social Security Fixed May Be the Best Thing You Can Do for Your Finances
By Jeff Sommer; The New York Times ~ Jun 21, 2019

Why So Many People (Mistakenly) Believe Social Security Adds To The Deficit
From Teresa Ghilarducci; Forbes ~ Jun 20, 2019

Opinion: Patent settlements, not lawsuits, are lowering drug costs
From Michael Busler; The Hill ~ Jun 20, 2019

Senators’ Decision To Go With ‘Benchmark Payment’ Strategy To Address Surprise Bills Deals Blow To Hospital Groups
Via KHN Morning Briefing; Kaiser Health News ~ Jun 20, 2019

Senators Agree Surprise Medical Bills Must Go. But How?
By Rachel Bluth; Kaiser Health News ~ Jun 18, 2019

Opinion: HHS's ideas for rearranging Medicare would raise costs for seniors
From Peter Pitts; The Hill ~ Jun 18, 2019

Trump's health care focus puts GOP on edge
By Alexander Bolton; The Hill ~ Jun 18, 2019

A Trio of Trump Rules Will Remake U.S. Health Insurance Markets
By John Tozzi; Bloomberg ~ Jun 18, 2019

Trump says he will roll out new health care plan in next couple of months
By Rebecca Klar; The Hill ~ Jun 17, 2019

Pelosi: Dems will 'fight relentlessly' against Trump's ObamaCare repeal attempts
By Peter Sullivan; The Hill ~ Jun 17, 2019

A New Bipartisan Bill Could Transform The Way We Pay For Hospital Care
By Avik Roy; Forbes ~ Jun 17, 2019

Drug Prices Are a Populist Campaign Issue. Here Are the Latest Proposals to Lower Costs.
By Katie Thomas; The New York Times ~ Jun 16, 2019

Out-of-pockets costs: Medicine's biggest problem and government and industry's biggest opportunity
From Justin McCarthy; The Hill ~ Jun 15, 2019

1 in 10 Americans skipping doses as prescription drug prices rise
By Jonathan LaPook; CBS News ~ Jun 15, 2019

Here's How the FCC's Aggressive New Plan to Combat Robocalls Will Work
By Bernhard Warner; Fortune ~ Jun 14, 2019

Drugmakers sue over Trump administration TV price disclosure rule
By Nathaniel Weixel; The Hill ~ Jun 14, 2019

It's time to let Medicare to negotiate drug prices
From Max Richtman; The Hill ~ Jun 14, 2019

Healthcare breaches reported in May exposed data on 2 million people
By Jessica Kim Cohen; Modern Healthcare ~ Jun 14, 2019

A Trio of Trump Rules Will Remake U.S. Health Insurance Markets
By John Tozzi; Bloomberg ~ Jun 14, 2019

No, Multi-Employer Pension Woes Have Not Been Fixed
From Elizabeth Bauer; Forbes ~ Jun 14, 2019

Why So Many Older Americans Rate Their Health As Good Or Even Excellent
By Judith Graham; Kaiser Health News ~ Jun 13, 2019

Taxpayers, businesses will also lose if pensions go bust
From Bradley A. Blakeman; The Hill ~ Jun 13, 2019

Insurers must do more to prevent surprise medical bills
From Carter Johnson; The Hill ~ Jun 13, 2019

Retirees Might Run Out of Money 10 Years Before They Die
By Ben Steverman; Bloomberg ~ Jun 13, 2019

Capping Seniors' Out-Of-Pocket Prescription Drug Costs Could Increase Medicare Prices -- And Premiums
By Avik Roy; Forbes ~ Jun 11, 2019

Senate Judiciary Committee plans markup of drug pricing bill this month
By Peter Sullivan; The Hill ~ Jun 12, 2019

Social Security Is Staring at Its First Real Shortfall in Decades. Big Cuts Could Follow.
By Jeff Sommer; The New York Times ~ Jun 12, 2019

4 Key Lessons from Latest Social Security Trustees’ Report
From Charles Blahous; CNS News ~ Jun 11, 2019

Let's Get Congress Off Social Security's Back
From Nancy Altman; Forbes ~ Jun 11, 2019

Help Is Almost Here for Retirement Savers
From Steven Rattner; The New York Times ~ Jun 11, 2019

Multiemployer pension reform bill approved by House Education and Labor Committee
By Hazel Bradford; Pensions & Investments ~ Jun 11, 2019

Breaking Down the Alexander-Murray Senate Health Reform Plan
From Sally Pipes; Forbes ~ Jun 10, 2019

Considering basic Medicare with no backup insurance? That could be a costly mistake, experts say
By Sarah O’Brien; CNBC ~ Jun 09, 2019

What The New 'Best Interest' Rule To Protect Investors Will Do
From Pam Krueger, NA; Forbes ~ Jun 10, 2019

Pension Problems Come With Raytheon, United Technologies Deal
By Kevin Curran; Real Money ~ Jun 10, 2019

Noise can adversely affect human health and quality of life
From Dr. Jonathan Fielding; The Hill ~ Jun 07, 2019

Opinion: 10,000 steps a day: Is it necessary for better health?
From Dr. William S. Yancy Jr. & Jared Rosenberg; The Hill ~ Jun 08, 2019

Liberals fight their own party over drug prices
By Adam Cancryn; Politico ~ Jun 06, 2019

Opinion: CVS And Walgreens Are On Different Paths To In-Store Healthcare
From Bruce Japsen; Forbes ~ Jun 07, 2019

FCC votes to allow phone carriers to block robocalls by default
By Harper Neidig; The Hill ~ Jun 06, 2019

Blowback Over Secret Nursing Home List Prompts Government To Announce Report Will Be Posted Publicly
Via KHN Morning Briefing; Kaiser Health News ~ Jun 06, 2019

Opinion: How Congress can make solid strides in drug pricing reform
From Amy Kapczynski; The Hill ~ Jun 06, 2019

Social Security Error Jeopardizes Medicare Coverage For 250,000 Seniors
By Susan Jaffe; Kaiser Health News ~ Jun 06, 2019

Pfizer had clues its blockbuster drug could prevent Alzheimer’s. Why didn’t it tell the world?
By Christopher Rowland, Washington Post – June 4, 2019

Democratic senators seek answers from Quest Diagnostics after data breach
By Maggie Miller; The Hill ~ Jun 05, 2019

Dropped From Health Insurance Without Warning: Was It Legal?
By Julie Appleby; Kaiser Health News ~ Jun 05, 2019

Are The Days Of Eye-Popping Rate Hikes Over? Health Law Premium Increases Fairly Moderate For 2020
Via KHN Morning Briefing; Kaiser Health News ~ Jun 04, 2019

Through ‘Expanded Access’ Program, FDA Wants To Remove Hurdles For Doctors Seeking Experimental Cancer Drugs
Via KHN Morning Briefing; Kaiser Health News ~ Jun 04, 2019

Long list of troubled nursing homes revealed by senators
By Ricardo Alonso-Zaldivar; The Associated Press ~ Jun 03, 2019

Supreme Court rules against Obama-era provision on Medicare reimbursements
By Jacqueline Thomsen & Peter Sullivan; The Hill ~ Jun 03, 2019

U.S. Supreme Court to hear IBM retirement fund dispute
By Lawrence Hurley; Reuters ~ Jun 03, 2019

Retired coal miners seek Congress's help to preserve their pensions
By Tracie Mauriello; Pittsburgh Post-Gazette ~ Jun 02, 2019

Consumers agree: Greater transparency among pharmacy benefit managers is needed
From Liam Sigaud; The Hill ~ Jun 01, 2019

Dem Rep’s Good Idea to Shield Workers’ Pensions
From Charles Blahous; CNS News ~ Jun 01, 2019

This bill could extend Social Security’s solvency for the rest of this century. Here’s what stands in its way
By Lorie Konish; CNBC ~ Jun 01, 2019

No end in sight to rising drug prices, study finds
By Shamard Charles, M.D. ; NBC News ~ May 31, 2019

CDC changes to pneumonia vaccine could hurt older Americans
From Karyne Jones; The Hill ~ May 31, 2019

How Far Will Congress Go on Retirement?
From Diane Oakley; Forbes ~ May 31, 2019

Clearing Up Misconceptions About Social Security
By Joe Elsasser, CFP®; Forbes ~ May 30, 2019

What Happens When Social Security Goes Broke?
By Michael Douglass; The Motley Fool ~ May 27, 2019

Drug pricing legislation may not affect a new $2.1 million gene therapy drug
By Lauren Clason & Andrew Siddons; Roll Call ~ May 29, 2019

The House passed a bill that would allow more annuities in 401(k) plans — is that actually a good thing?
By Alessandra Malito; MarketWatch ~ May 29, 2019

Check Out Coverage Rules Before Buying A Medicare Advantage Plan
From Diane Omdahl; Forbes ~ May 28, 2019

New Bill Would Conduct the Largest Investigation of Private Pensions in 40 Years
By Elijah Owens; Chief Investment Officer ~ May 28, 2019

Opinion: Social Security Needs More Revenue, Not Cuts
From Teresa Ghilarducci; Forbes ~ May 27, 2019

Opinion: Can You Sue Social Security for Swindling You Out of Lifetime Benefits?
From Laurence Kotlikoff; Forbes ~ May 28, 2019

Opinion: Trump Ready To Force Transparency In Healthcare Pricing With An Executive Order
From Joshua Cohen; Forbes ~ May 27, 2019

8 Major Ways The SECURE Act Could Impact Your Retirement Plan
From Jamie Hopkins; Forbes ~ May 25, 2019

White House, Hill leaders unable to reach spending deal Tuesday. “Deals like this take time,” House Minority Leader Kevin McCarthy says
By Jennifer Shutt & Paul M. Krawzak : Roll Call ~ May 22, 2019

Vision loss linked with anxiety, depression - and vice versa
By Will Boggs MD; Reuters ~ May 24, 2019

FDA approves world's most expensive drug at $2.1M
By Peter Sullivan; The Hill ~ May 24, 2019

How The Latest Report On Social Security's Solvency Changes Your Retirement Plan
From Bob Carlson; Forbes ~ May 24, 2019

House leaders propose restructuring Medicare Part D
By Susannah Luthi; Modern Healthcare ~ May 23, 2019

Bipartisan senators reveal sweeping health care package
By Nathaniel Weixel; The Hill ~ May 23, 2019

Opinion: Congress Poised To Advance Retirement Security For Millions With Saver's Credit Fix
From Cindy Hounsell; Forbes ~ May 23, 2019

Let's work to make sure older Americans have greater financial security in retirement
From Deborah Carr; The Hill ~ May 21, 2019

Private insurance accounted for 42% of drug spend in 2017: KFF
By Jacqueline Renfrow; FierceHealthcare ~ May 21, 2019

Senate chairman says bipartisan health care package coming Thursday
By Peter Sullivan; The Hill ~ May 21, 2019

Are Social Security Benefits Really Protected Against Inflation?
By Maurie Backman; The Motley Fool ~ May 18, 2019

Opinion: Price Transparency: Why Are Drug Prices Such A Bitter Pill to Swallow?
From Joe Harpaz; Forbes ~ May 17, 2019

Opinion: How Social Security's Declining Trust Fund Affects Your Retirement Plans
From Bob Carlson; Forbes ~ May 17, 2019

House Passes Legislation Aiming to Shore Up Health Law and Lower Drug Costs
By Abby Goodnough, New York Times – May 16, 2019

Dems push bill on Obamacare, drug prices toward House OK

How To Find And Use New Federal Ratings For Rehab Services At Nursing Homes
By Judith Graham; Kaiser Health News ~ May 16, 2019

Trump administration backs off Medicare drug pricing rule
By Nathaniel Weixel; The Hill ~ May 16, 2019

House health care bill puts generic drug industry in bind
By Andrew Siddons; Roll Call ~ May 15, 2019

AP FACT CHECK: Trump cites drug-price drop that isn’t
By Ricardo Alonso-Zaldivar & Hope Yen; The Associated Press ~ May 14, 2019