Weekly Update for Week Ending July 3, 2020

Weekly Update for Week Ending July 3, 2020

Despite the coronavirus emergency, TSCL is continuing its fight for you to protect your Social Security, Medicare, and Medicaid benefits.  We have had to make some adjustments in the way we carry on our work, but we have not, and will not stop our work on your behalf.

The Senate is in recess while the House of Representatives will have no votes on the floor of the House chamber for the next two weeks.  However, House committees will be meeting and voting on various bills in preparation for the resumption of voting on the floor of the House.

Among the many issues facing Congress is the funding of the federal government for fiscal year 2021, which will begin on October 1.  Last week Senate Appropriations Chairman Richard Shelby (R-Ala.) announced there is disagreement in his committee regarding various funding issues.  As a result, it is likely that, once again, the Senate will fail to pass funding legislation in time for the beginning of the new fiscal year.

 If that happens, Congress will have to pass a continuing resolution (CR) – which is a stopgap measure to fund the government at FY 2020 levels until a complete funding bill can be passed into law.  According to Shelby, the CR will likely have to last from September into late November or early December.

If history is any guide, the House will most likely pass its version of the FY 2021 funding legislation prior to October 1 and must wait until the Senate can get its job done.

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House Passes another Bill to Lower Prescription Drug Prices

Last week the House of Representatives passed a bill that would bolster the Affordable Care Act by raising government premium subsidies and providing subsidies to states to expand Medicaid.  The bill, which passed largely along party lines, is highly unlikely to pass in the Senate, where the Republican majority is having a hard time coming up with its own legislation to lower the costs of prescription drugs.

The Trump administration issued a veto threat on Monday criticizing the House bill and threatened to veto it if in some miraculous way it should manage to pass in the Senate. White House officials denounced the drug-price negotiation provision in the bill, which is designed to bring prices for expensive, single-source drugs closer to prices paid in other countries. Republicans argue the drug-pricing measure will stifle innovation by reducing drug makers' research and development budgets during a pandemic.

To offset the cost of the entire bill, Democrats attached the drug-price negotiation provision that the Congressional Budget Office estimated would save $582 billion over 10 years. The Trump administration attacked Democrats for leaving out other components of their signature drug-pricing legislation that had garnered more bipartisan support, such as capping outpatient drug costs for seniors.

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CAUTION: Government Issues Warning about “Contact Tracing” Scams

You’ve probably been hearing a lot about contact tracing. It is the process of identifying people who have come in contact with someone who has tested positive for COVID-19, instructing them to quarantine and monitoring their symptoms daily. 

Contact tracers are usually hired by a state’s department of public health. They work with an infected person to get the names and phone numbers for everyone that infected person came in close contact with when they could have been infected. Those names and phone numbers are often kept in an online system.

People who had contact with someone infected with COVID-19 may first get a text message from the health department, telling them they will get a call from a specific number.

The tracer who calls will not ask for personal information, like a Social Security number. At the end of the call, some states ask if the contact would like to enroll in a text message program, which sends daily health and safety reminders until the 14-day quarantine ends.

But tracers will not ask you for money or information like your Social Security, bank account, or credit card number. Anyone who does is a scammer.

There is no question, contact tracing plays a vital role in helping to stop the spread of COVID-19. However, scammers, pretending to be contact tracers and taking advantage of how the process works, are also sending text messages. But theirs are spam text messages that ask you to click a link.  Unlike a legitimate text message from a health department, which only wants to let you know they will be calling, the phony message includes that link to click.

Do not take the bait. Clicking on the link will download software onto your device, giving scammers access to your personal and financial information. Ignore and delete these scam messages. 

The U.S. Justice Department, Department of Health and Human Services and the Federal Trade Commission encourage anyone who has spotted a contact tracing scam or any fraud connected to COVID-19 to report it to the National Center for Disaster Fraud at 866-720-5721 or online at www.Justice.gov/DisasterComplaintForm or ftc.gov/complaint.

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70-year old Man Gets $1.1 Million Surprise Medical Bill

The Senior Citizens League has had the issue of ending surprise medical billing as one of its key issues this year and we have written about it several times in the past few months.

While the issue is not as much of a problem for seniors as it is for younger people, it is still possible for seniors to get hit with major medical bills they thought they would never face.

A story recently appeared on the WebMD internet site about a 70-year old man in Seattle who had undergone treatment for COVID-19 for several months.  When he finally recovered and went home, he got slammed with a $1.1 million hospital bill.  Luckily for him, the company through which he has Medicare Advantage agreed to wave most of his out-of-pocket costs for his treatment.

However, hundreds or maybe even thousands of people who get the virus may not be nearly as fortunate.

More than 250,000 people have been hospitalized for COVID infection in the United States, according to a new study.  As we know by now, seniors have been hit the hardest by the virus.  So, unless their Medicare supplement plans are willing to waive their out-of-pocket costs as happened for the Seattle man, many seniors could be facing another financial crisis.  And seniors who are still working and either not eligible for Medicare or still using their employer-provided health insurance could also be in real financial trouble.

Congress passed legislation waiving all out-of-pocket expenses for COVID-19 testing, and many private insurance companies have voluntarily extended such cost-sharing waivers to treatment as well.

But about 60% of employer-sponsored health plans are self-funded plans, where the employer provides direct reimbursement for health benefits and assumes all the financial risk of medical care for their employees. Such plans are not obliged to waive cost-sharing for COVID-19 treatment, even if the insurance company operating the plan has said it will.

A study done in March found that respiratory patients put on a ventilator for four days or more ran up hospital bills of $88,000 on average. Pneumonia patients faced average out-of-pocket costs of between $1,300 and $1,464.

In some ways, the COVID-19 pandemic has revealed the pitfalls of using cost-sharing measures like deductibles and co-pays to reduce costs by making patients think twice before seeking medical care, according to Matthew Rae, associate director of the Kaiser Family Foundation's Program on the Health Care Marketplace.

"We have for the last 15 years or so had this theory that we wanted people to have more skin in the game, more exposure to the cost of health care," Rae said. "That is coming up against the fact that sometimes we really want people to get the care they need to get, and they don't have the financial assets to cover the cost. The theories that help us in normal times aren't helping us during a pandemic."

There are a couple of ways that financial disaster could be averted for COVID-19 patients and their families, experts said.  Congress could pass a law that would waive cost-sharing requirements for COVID treatment, just as it has done for COVID testing.  Companies also could step forward and announce that they will waive cost-sharing on their own initiative.  No doubt some companies will do that, but others will not.

In the meantime, TSCL will continue to fight for legislation that will curb or end the practice of surprise medical billing.

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For progress updates or for more information about these and other bills that would strengthen Social Security and Medicare programs, visit the Bill Tracking section of our website or follow TSCL on Twitter.