Week Ending September 24, 2022

Week Ending September 24, 2022

Congress Races to Avoid Government Shutdown

This is the do-or-die week for Congress as the end of the fiscal year for the federal government arrives this Friday. Because Congress has not passed any funding legislation for FY 2023, they are planning to pass a “continuing resolution (CR) to keep the government from shutting down at midnight on Friday.

The CR is temporary funding legislation that keeps federal spending at the previous fiscal year’s spending levels for a limited period of time. It has become common practice for Congress to resort to a CR in the last several years no matter which party is in control. Congress uses the temporary time extension to put together the legislation that will fully fund the government for the new fiscal year.

It is usually disagreements over what and how much to fund that causes Congress to fail to pass funding legislation on time and create the need for a CR. In 2019, the federal government shut down for 35-days, the longest shut down in history, caused by a dispute between then-President Trump and Congress over the funding amount for an expansion of the U.S.–Mexico border barrier.

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Medicare Open Enrollment Season Almost Here

Medicare Open Enrollment runs from October 15 through December 7 each year.

There are several sources online to get information about the enrollment season, but TSCL recommends you first go to Medicare.gov to get the official Medicare information. Most other sites are put up by insurance-related companies that want you to buy their products. Their information may be accurate but just know that there is a reason they have put up those websites.

(TSCL does not endorse any Medicare supplement or Medicare Advantage product and has no affiliation with any of them.)

As the open enrollment season approaches, there is new information that you may be interested in.

A comparison on Medicare Advantage and traditional Medicare plans by Kaiser Family Foundation shows some nuance in how people feel. For example, Medicare Advantage enrollees were more likely than those in traditional Medicare to report having a usual source of care. They were also more likely to receive preventive care services, such as annual wellness visits and routine check-ups, screenings, and flu or pneumococcal vaccines.

However, traditional Medicare outperformed Medicare Advantage on measures such as receiving care in the highest-rated hospitals for cancer care or in the highest-quality skilled nursing facilities and home health agencies.

Findings on prescription drug use varied depending on a couple of factors. Three studies found that among specific groups – people with a mental illness, diabetes, Alzheimer’s disease, and high-need beneficiaries (each studied separately) – there were no differences in the use of prescription drugs between Medicare Advantage and traditional Medicare beneficiaries.

Two of these studies found that the use of prescription drugs was higher for Medicare Advantage enrollees than traditional Medicare beneficiaries without diabetes and without Alzheimer’s disease.

Most studies found that utilization of home health services and post-acute skilled nursing or inpatient rehabilitation facility care was lower among Medicare Advantage enrollees than traditional Medicare beneficiaries but were inconclusive as to whether that was associated with better or worse outcomes.

Interest in how well Medicare Advantage plans serve their growing and increasingly diverse enrollee population has never been higher, as Medicare Advantage, for the first time, is projected to enroll more than half of all eligible Medicare beneficiaries next year, making it the main way that Medicare beneficiaries get their coverage and care. In comparison, just over a decade ago in 2010, 25% of the eligible population was in a Medicare Advantage plan.

Then there is this new report on StatNews.com.

“Health insurers are misleading on Medicare Advantage savings, experts say. The health insurance industry is continuing its campaign to convince the public that Medicare Advantage saves taxpayers money, but experts say federal data still concludes the exact opposite — and that the program as currently designed is a drain on Medicare’s trust fund.

The industry’s primary lobbying group, America’s Health Insurance Plans (AHIP), funded a new report on the controversial, private alternative to original Medicare. AHIP claims that MA is ‘saving Americans billions of dollars every year.’”

The actuaries who wrote the report, however, never use that language. Nobody involved with the report responded to interview requests, but several independent Medicare policy experts, all of whom said AHIP’s report was incomplete at best and refuted by other studies that analyzed the same data. Analysts also stressed the federal government certainly isn’t reaping any savings from Medicare Advantage.”

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WEP/GPO Repeal Update

This past Friday, the House Ways and Means Committee discussed H.R. 82, the Social Security Fairness Act. They voted to send the bill to the whole House of Representatives with no recommended changes, so that it can be considered and, hopefully, voted on.

The Social Security Fairness Act would repeal the Windfall Elimination Provision (WEP) and the Government Pension Offset (GPO), which unfairly reduce the Social Security benefits for public service workers, including teachers.

The WEP reduces Social Security benefits for workers who receive a pension from an employer who did not pay Social Security taxes, even though the worker might have paid into Social Security from a different employer. This provision can leave retirees receiving a fraction of the pension payment they would otherwise receive.

The GPO reduces spousal benefits for workers who receive a pension from an employer who did not pay Social Security taxes. If they receive such a pension and their spouse dies, the surviving spouse’s benefits will be reduced by two-thirds of the amount of the pension under the GPO.

For progress updates, or for more information about these and other bills that would strengthen Social Security and Medicare programs, visit our website at www.SeniorsLeague.org or follow TSCL Facebook or on Twitter.