Social Security COLAs Need to Double and Medicare Part B Increases Cut in Half, to Ensure Benefit Adequacy

Social Security COLAs Need to Double and Medicare Part B Increases Cut in Half, to Ensure Benefit Adequacy

(Washington, DC) – Social Security cost-of-living adjustments (COLA) would need to double their rate of growth and Medicare Part B premium increases would need to slow by half their historic rate to provide greater Social Security benefit adequacy, says a new report  from The Senior Citizens League.  Using the federal government’s economic projections for the Social Security COLA and Medicare Part B premium estimates over the next decade, the study examined how well Social Security benefits would cover Part B premiums increases in coming years.

“Social Security benefits simply are not adequate when people with a Social Security benefit of even as much as $1,288 per month are at risk of having their entire COLA used to cover rising Part B premiums,” says Mary Johnson, Social Security and Medicare policy analyst for The Senior Citizens League.  “That is what happened in 2018, and that left nothing to cover all other rising household costs,” Johnson explains.

The new study takes a closer look at the Social Security “hold harmless” provision.  Typically, Social Security benefits tend to grow slightly each year as COLAs compound over time.  But when the Medicare premium increases more than an individual’s COLA that can trigger this special provision of law.   Hold harmless protects Social Security benefits when the dollar amount of an individual’s annual COLA increase is not sufficient to cover the increase in the Medicare Part B premium increase.  If the increase in Medicare Part B premium would cause an individual’s net Social Security benefit to be less than it was the year before, then the Part B premium is reduced to ensure the individual’s Social Security benefit does not decline.

The hold harmless provision usually affects only a small number of beneficiaries in any given year, which has a relatively minimal impact on Part B financing.  Since 2010, however, the hold harmless provision has been triggered on a nationwide basis an unprecedented four times.  This occurred when inflation was so low that the COLA was zero in 2010, 2011 and 2016 and just 0.3 percent in 2017.

Currently, when hold harmless is triggered on a nationwide scale there is no provision of law to finance the unpaid portion of Medicare Part B premium increases.  Instead, the entire burden of Part B costs is spread over a much smaller number of individuals, which is the 30 percent of Medicare Part B enrollees who are not protected by the hold harmless provision.  This has led to significant spikes in Medicare Part B premiums during the hold harmless years, and in 2018 when a COLA finally became payable, to steep jumps in premiums for those whose Medicare Part B premiums were held lower in 2016 and 2017.

While hold harmless provides valuable protection from reductions in benefits due to rising Part B costs, low inflation and high Medicare costs restrict the growth of net Social Security benefits.  This occurs when Part B increases take the entire COLA.  This leaves less Social Security income to cover all other rising costs such as out-of-pocket medical expenses, food and housing, requiring people to spend more of their retirement savings or to go into debt.

According to the report, the triggering of hold harmless will continue on an individual basis, particularly when inflation is lower than forecast (about 2.4 percent) or if Medicare Part B premium increases are higher than forecast (5%), or both.  The risk for both is high, because over the past 8 years COLAs have averaged just 1.2 percent and since 2000 Medicare Part B premiums have increased on average more than 10 percent per year.  According to the report, individuals with the lowest benefits, $490 or less, are the most likely to be affected by hold harmless on an individual basis over the next decade, even in years when a COLA is payable, particularly if Medicare Part B premium increases are higher than expected.

The most important thing people nearing retirement should consider doing is to delay starting benefits until age 70, the report says.  After reaching full retirement age, benefits will grow 8 percent per year after for each year delayed, until age 70. “The higher your benefit and COLA, the easier it will be to cover Medicare Part B and other healthcare costs in retirement,” Johnson says.

How have you been affected by high Medicare Part B premium increases?  To participate in a survey, visit The Senior Citizens League’s website at


With 1.2 million supporters, The Senior Citizens League is one of the nation’s largest nonpartisan seniors groups. Its mission is to promote and assist members and supporters, to educate and alert senior citizens about their rights and freedoms as U.S. Citizens, and to protect and defend the benefits senior citizens have earned and paid for. The Senior Citizens League is a proud affiliate of The Retired Enlisted Association.  Visit for more information.