Social Security Fairness Act Signed into Law
At the end of December, the U.S. Senate finally passed the bipartisan Social Security Fairness Act, which had passed the House earlier in the month. In early January, President Biden signed the bill, making it the law of the land.
TSCL is proud to have been a leader in support of this legislation and getting it passed into law.
The legislation boosts Social Security payments for current and former public employees, affecting nearly 3 million people who receive pensions from their time as teachers, firefighters, police officers, and other public service employees in state or local governments.
The bill repeals two provisions — the Windfall Elimination Provision and the Government Pension Offset.
That means workers who previously received reduced payments will soon receive full benefits. The changes are estimated to affect roughly 2.8 million beneficiaries.
When they were passed 40 years ago, the two provisions were intended to prevent beneficiaries who collect state or local pensions from being able to "double-dip" into retirement benefits. However, unions representing public service workers and senior groups like TSCL say that those provisions unfairly penalized them.
Those interested in a more detailed explanation of the WEP can go to
https://www.ssa.gov/policy/docs/program-explainers/windfall-elimination-provision.html for more details.
Recipients who were affected by the Windfall Elimination Provision can expect their monthly benefits to increase by an average of $360 by December, according to an estimate by the Congressional Budget Office (CBO).
Also, according to the CBO, some spouses affected by the Government Pension Offset are anticipated to receive an average monthly increase of $700, and surviving spouses receiving a widow or widower benefit will receive an average monthly benefit of $1,190.
These benefits will also grow over time in line with Social Security's cost-of-living adjustments. Changes will also apply to benefits from January 2024 onward, meaning some recipients will also receive back-dated payments.
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Telemedicine (Telehealth) for Medicare Users Survives – for now
Telemedicine (also known as Telehealth) came into prominence during the COVID-19 epidemic, and many seniors found it to be a very convenient and helpful way to receive medical care. Medicare expanded its telemedicine coverage substantially in 2020, and the expansion has regularly been renewed. That almost ended on Dec. 31, however.
Supporters of telemedicine endured some nail-biting days as Congress considered a continuing resolution to fund the government past year’s end. Included in the 1,500-page bill that originally seemed headed for passage was a two-year extension for expanded Medicare coverage for telemedicine.
However, House Republicans, who had agreed to the overall resolution, changed their minds after Elon Musk and Donald Trump condemned it. “That killed the bill,” said Kyle Zebley, senior vice president for public policy at the American Telemedicine Association.
At first, it seemed the death of the resolution meant the end of expanded telemedicine coverage. Finally, however, both the House and the Senate approved a narrower version, a three-month extension.
On December 21, President Biden signed into law the 2025 American Relief Act, a stopgap funding bill passed by Congress on December 20 that funds the federal government through March 14, 2025.
The bill extends certain Medicare telehealth flexibilities through March 31, 2025, including the six-month in-person requirement for mental health services, the expanded originating sites, and coverage of audio-only services.
The bill also extends funding for several expiring healthcare programs through March 31, including the National Health Service Corps and the Teaching Health Center Graduate Medical Education Program.
It is estimated that 20 to 30 percent of medical encounters could eventually occur virtually, and this is a bipartisan issue. For that reason, many believe it is likely to receive further renewal.
2020 almost half of Medicare beneficiaries had at least one such visit. By late last year, that proportion had receded to about 13 percent.
According to one doctor, though telehealth works better for some services than others, some patients have come to rely on it.
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Telemedicine Survives, but Other Key Health Care Provisions Dropped from Final Bill
As reported above, while telemedicine survived last-minute negotiations in Congress, bigger policies, like reforms to the pharmacy benefit manager (PBM) industry, did not.
The bill that finally passed did not reauthorize the opioid-fighting SUPPORT Act or the Pandemic and All Hazards Preparedness Act. The pandemic legislation had historically been bipartisan, but its inclusion in the spending bill sparked a wave of online misinformation amplified by Elon Musk.
The Republican Majority in the House of Representatives also jettisoned a Medicare physician payment boost and a hospital billing transparency measure included in the original health package.
The PBM reform was to be part of a Congressional effort to lower the cost of drugs. The original bill had called for a series of changes to the operations of pharmacy benefit managers, middlemen in the medicine business who negotiate drug prices with pharmaceutical companies and help determine what medications are covered by insurance firms.
The bill would have ended the practice of “spread pricing,” where PBMs charge a health plan more for a drug than what they pay to the pharmacies that dispense it, pocketing the difference, which occurs in Medicaid plans. For Medicare plans that cover seniors, the bill required PBMs to pass along all rebates and fees that are based on a percentage of a drug price to their health plan clients, a reform commonly called “delinking” designed to eliminate incentives to promote expensive drugs over cheaper ones.
Most, if not all, of those measures are expected to be on the agenda of the new Congress this year.
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Law Limiting Out-of-Pocket Drug Costs Comes into Effect
In 2022, Congress passed the Inflation Reduction Act at President Biden's urging. The bill was, and still is, controversial because all Republicans in Congress voted against it.
Certain provisions of the law are just now taking effect. As of January 1, seniors with a Medicare prescription drug plan now have out-of-pocket prescription drug costs capped at $2,000 yearly. It means millions of seniors will pay significantly less for their prescription drugs this year.
The new out-of-pocket spending cap is estimated to benefit more than 4.5 million older Americans enrolled in Part D.
Approximately 1.4 million Part D enrollees who reach the new out-of-pocket cap between 2025 and 2029 will see annual savings of $1,000 or more, and just over 420,000 will see savings of more than $3,000.
The $2,000 annual cap on prescription drug costs for Medicare Part D beneficiaries is just one of the many actions included in the Inflation Reduction Act. Most notably, the law capped the cost of insulin for Medicare beneficiaries at $35/month—which went into effect January 1, 2023—and empowered Medicare to negotiate lower prescription drug prices for the first time ever.
In August, the Centers for Medicare & Medicaid Services (CMS) announced negotiated drug prices for ten commonly used drugs in the first cycle of negotiations—the new, lower negotiated prices will go into effect on January 1, 2026, and will lower the prices people pay for some of the most common and expensive prescription drugs that treat heart disease, cancer, diabetes, blood clots, and more. Allowing Medicare to negotiate prescription drug costs is expected to save American taxpayers $6 billion, with people enrolled in Medicare expected to save $1.5 billion in out-of-pocket expenses in 2026 alone. Thanks to the Inflation Reduction Act, 15 to 20 more drugs will be added to the negotiating table every year.
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