There are troubled times ahead for seniors, and yet Congress is doing nothing. Both Social Security and Medicare are facing the reality of rising costs, but too little revenue to cover them.
Seniors need to take action now, in this election year, when members of Congress are worried about being re-elected, and tell members of the House and Senate they need to work together to fix the problems we are facing. We explain these issues below.
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Social Security Crisis Heading Our Way Unless Congress Acts Starting Now
TSCL has long warned about the impending financial crisis involving Social Security. The most recent official estimates say the crisis is only about 7 years away, most likely in 2033.
Yet when we visited Congressional offices recently, we learned that nothing serious is being done to avert the crisis because members of Congress are not hearing from seniors about the issue.
That means we are moving toward a point where Congress will have to choose between higher payroll taxes on current workers, lower benefits for Social Security recipients, or a combination of both.
Both the Social Security Administration (SSA) and the Congressional Budget Office (CBO) say that without Congressional action soon, we will face automatic Social Security payment cuts of 20% to 25%. In addition, the policy window for orderly reform is the mid-to-late 2020’s.
In short, Congress needs to take action now, or both taxpayers and seniors will face very unpleasant consequences.
That means you and every senior you know should be calling your Senators and Representative and telling them it’s time to stop kicking the Social Security can down the road and start working now in a bipartisan way to fix the problem.
We at TSCL go to Congressional offices and warn them of the urgency, but it is the people in their states or districts that can make the difference. In short, it’s the people who vote for them who have the greatest impact on them.
We urge every TSCL supporter to call your Senators and your own Representative in Washington, D.C., and tell them that action is needed now.
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Millions of Seniors Could Lose Their Medicare Advantage Plans
While many millions of seniors have switched to Medicare Advantage (MA) health care plans, millions of those same seniors are unexpectedly losing their MA plans or finding their health care providers no longer accept their MA coverage.
Since Medicare Advantage has seemed like such a good option for so many seniors, what’s going on?
It turns out that hospitals and physician groups are growing increasingly exasperated with insurance companies that block medical care through preauthorization requirements and other red tape. At the same time, some insurers are canceling their agreements with plans, hospital systems, and doctors.
According to one report, so far this year, dozens of hospital systems have quit MA plans, and as a result, 1 in 10 MA enrollees, which could be as many as 2.9 million seniors, have been forced out of enrollment in their MA plans.
For those seniors, it means that if their health care provider no longer has an agreement with their MA plan, they have to pay their medical bills out of pocket or find a new provider.
When that sort of thing happens, the Centers for Medicare and Medicaid Services (CMS) gives seniors a special enrollment period to change plans or enroll in traditional Medicare in the middle of the coverage year. But that process has been unclear and confusing.
Last fall, CMS proposed a new rule to make the process clearer and easier, but unfortunately, it has decided to drop the proposal.
So, if you find that the insurer has canceled your MA plan, they will move you to another plan of the same type in your county, if one is offered. However, you should immediately check whether your health care providers will be in the new one you’re being enrolled in.
If you do nothing when you receive the notice, you’ll automatically be enrolled in a replacement plan, if one is available. But if the insurance company is exiting your local market altogether, you will either have to find a new MA plan or switch to traditional Medicare next year.
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More Bad News for Some Medicare Advantage Customers
In addition to some seniors losing their Medicare Advantage (MA) plans as described above, Reuters News Service has reported that seniors who are enrolled in Medicare Advantage (MA) health plans should expect to see fewer extra benefits like gym memberships and vision and dental coverage next year, according to investors and industry experts.
That’s because the insurers who manage MA plans say the 2027 government payments to them will not be high enough.
In addition to cutting some benefits, some regions or states could also lose the option to enroll in MA plans.
If the benefits are not cut, some MA customers may be surprised by the increase in out-of-pocket spending, or, in the worst case, they could see both benefit cuts and increased out-of-pocket spending.
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In the months ahead, these issues will continue to evolve, with important implications for current and future retirees. Staying informed and reviewing your benefits and coverage options will be increasingly important as changes unfold. TSCL will continue to monitor developments in Washington and provide updates on policies that may affect seniors nationwide.