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Some significant changes affecting seniors on health care issues may have gotten lost in the tumultuous whirlwind changes between the end of the Trump administration and the start of the Biden administration. Amid the increasing intensity of the pandemic, the violent turbulence at the U.S. Capitol, and the slower than expected rollout of the first vaccines, Congress actually got some important things done affecting seniors that went unnoticed, buried in the massive spending package. Congress passed a $900 billion pandemic relief package and...
President-elect Joe Biden will not get a traditional honeymoon from Congressional lawmakers to start off his new administration in January. It will severely limit what he can accomplish on his ambitious health care agenda. With sharp divides in both houses of Congress, where a few votes one way or the other could determine success or failure, Biden may even have trouble getting his Cabinet nominations through. Without a doubt, Biden's two-prong agenda – to solve the coronavirus pandemic and patc...
So far, almost 40 percent of the nation's more than 240,000 COVID-19 deaths are from seniors living in nursing homes and long-term care facilities. As the coronavirus pushes into what incoming-President Joe Biden calls the "very dark winter," efforts are being made to prevent a repeat of this continued death spiral and apply lessons learned so far. So what lessons can be learned and what can be done to inspire a meaningful shift in how the country cares for – and spends on – its elderly peo...
Enormous drug company profits are the primary driver of soaring prescription drug prices in America, according to an investigation that Democrats on the House Oversight Committee released recently. The report, based on an 18-month investigation which produced more than a million documents, was started by former committee chairperson Rep. Elijah Cummings, D-Md.., who died last year. But it was largely overlooked, with the nation focused on COVID-19 and the presidential elections – despite a congressional hearing with verbal fireworks i...
The misleading ads and distorted facts have not quite hit the level of the 2011 classic “granny off the cliff” political ad where an elderly woman was being foisted from her wheelchair over the edge of a cliff, which then-House Speaker Paul Ryan himself credited for sinking his budget proposal targeting Medicare. But the increasing confusion of information over the future of Social Security (SS) and Medicare has reached fever pitch in the current political environment. Both candidates for president are playing games with the facts. Dem...
Major-party presidential candidates Trump and Biden have dramatically different visions for the future on health care issues. So in assessing their policy positions, it's also important to look at actions versus talk. Trump has been president for almost four years; Biden had eight years as vice president under Barack Obama, and before that 36 years in the U.S. Senate. So both have actual records with which we can look at what they've tried to do, versus what they say they plan to do. Here's a...
Amid the sharp political divides over its handling of the coronavirus pandemic and ongoing racial protests, the Trump administration continues its push to invalidate the Affordable Care Act (ACA) through the courts – a move that could prove to be one of the riskiest decisions in President Donald Trump’s reelection efforts and could also severely complicate who controls Congress. The decision to file its brief to undo the ACA at the U.S. Supreme Court before it hears the case for the third time in the fall, reveals a sharp dividing line in the...
As the nation moves into whatever "reopening" the next phase of the COVID-19 challenge means, the pandemic's mark on American health will be a permanent one in good ways and unfortunate ones too. The nation is nowhere close to a vaccine or a cure despite president Donald Trump's hyper-ambitious "plan" to develop, manufacture and distribute a vaccine by the end of 2020. Most scientists suggested that the most "optimistic" potential for a vaccine would be at the end of 2021 and more likely it...
Getting older in America will never be the same, after the astonishing death toll in nursing homes and senior housing facilities has revealed just how flawed the nation’s system of care is. The fallout could completely collapse the nursing home and assisted living industries. No doubt, though, it will certainly change them and how we take care of our elders. The COVID-19 pandemic has revealed a defective system of caring for seniors, including severe understaffing at nearly all facilities, inconsistent regulations, economic challenges p...
With social distancing, depression, isolation and loneliness hitting the nation’s seniors particularly hard as a result of the coronavirus pandemic, the federal government has made big changes to Medicare to help doctors reach patients easier without visiting offices or hospitals. But while it appears well-intentioned, these policy changes also are going to have to be more carefully thought out over time. The COVID-19 pandemic has prompted Medicare to open access to telehealth, connecting patients to health care providers through videoconferenc...
Despite a genuine consensus that something must be done, Congressional efforts to rein in drug prices remain stalled and more than likely dead until after the November elections. Even with rhetoric rising on how important controlling drug prices is and added pressure due to the coronavirus (COVID-19), nothing is likely to get done as lawmakers are split on fundamental issues of how to solve the problem. Even President Donald Trump’s support for bipartisan Senate drug-pricing legislation doesn’t appear to be motivating Senate Majority Lea...
President Donald Trump recently has been making a striking claim – insisting he has ensured that people with preexisting medical conditions continue to have health insurance coverage. In tweets, at campaign rallies and even at his recent State of the Union speech, Trump says: "I was the person who saved pre-existing conditions in your healthcare." He wasn't. This comes at the very same time that his own Justice Department pushes to eliminate the Affordable Care Act (ACA) altogether, including pre-existing conditions for millions of A...
Congressional lawmakers find themselves caught between the unlikely and the impossible as they try and work through complicated issues like drug price controls. With the sharp partisan divide, the ongoing impeachment of President Trump, the upcoming presidential campaign and their own re-election fights on everyone's minds, difficult choices with disappointing results are the most likely scenario for prescription drug and most other major health care legislation affecting seniors – just like i...
While President Trump has not had much success on the drug price reform front, his administration is making modest progress on a different front – announcing two regulatory changes that Trump hopes will provide more easy-to-read price information to patients. The first effort targets hospitals, finalizing a rule that requires them to reveal and display their secret, negotiated rates to patients, beginning in January 2021. This proposal has been resisted for months by a large portion of the health care industry. It would require hospitals for th...
The Trump administration has proposed to overhaul decades-old Medicare rules that were originally meant to counter self-dealing and financial kickbacks among medical providers such as hospitals, clinics and doctors. But the administration says these anti-kickback rules are now serving as a roadblock to coordinating better care for patients. The Centers for Medicare & Medicaid Services (CMS) wants to encourage primary care physicians and other clinicians to spend more time coordinating care for their patients including social issues, patients...
The numbers are simply staggering. People 85 and older – who usually have multiple chronic illnesses or have difficulty performing some daily tasks – will mushroom to 14.6 million in 2040, up from about 6 million now. So who is going to take care of these seniors? Right now, since Medicare does not pay for long-term care services or non-medical services in the home, there are 3.3 million paid personal care and home health aides and more than 34 million unpaid family caregivers doing that job. Already, around the U.S., many caregivers, sen...
Congress is making its end-of-year legislative sprint, with hot-button health care legislation stuck behind critical must-pass spending bills before a government shutdown. But lawmakers often push shutdowns off with temporary all-inclusive spending bills as they are likely to do this time, as they try to get out of town for the late December winter holidays. Even if the spending bills get approved individually or together in one big temporary bill, the must-do list leaves lawmakers roughly 40 days in which both chambers will be in session...
If you think America's college loan crisis – with more than $1.5 trillion worth of debt – is only a young person's problem, think again. The federal government is now garnishing the fixed-income Social Security benefits of seniors in its crackdown to get people to repay student loans. More than three million people over 60 are still paying off college loans. Many of these seniors took out loans to help their children, grandchildren or spouse pay off tuition and are still paying them off. Oth...
The old baseball star Satchel Paige is supposed to have said: Age is a question of mind over matter. If you don’t mind it does not matter. On Capitol Hill, old seems to be the new young. In the House of Representatives, the top three leaders are all seniors. House Speaker Nancy Pelosi, D-Calif., is 79 years old. Majority Leader Steny Hoyer, D-Md., is 80, and Rep. James Clyburn, D-S.C., is also 80. While you can actually start serving in the House at age 25 and age 30 in the Senate, the 2018 elections brought in a much younger group of l...
Congressional Democrats are pushing an ambitious plan to expand Social Security and put it on a sustained long-term footing in an effort to overturn 20 years of attempts by congressional Republicans to scale back entitlement programs like Medicare and Social Security. The New Deal social insurance program had been one of the primary targets of former House Republican Speaker Paul Ryan, R-Wis., since his arrival in Congress in 1999. Ryan always believed Social Security “is an undeserved entitlement,” and lawmakers have often suggested that it...
House Democrats, Senate Republicans and the Trump administration agree on one thing – that drug prices must be lowered. Both parties are working through the ideas to reduce prescription drug costs, but the problem is finding common ground and achieving consensus. No compromise is there yet and it may not emerge as some lawmakers could choose to use the issue for political advantage instead of working out a solution now. But an arms race of sorts is building as Democratic presidential contenders try to make the most noise on the drug pricing i...
When the next Congress begins its work in January, lawmakers from both parties will try to work with the Trump administration to pass vital health care legislation. But getting a political advantage and maneuvering for the 2020 elections will help determine just how much cooperation can be found. Democrats and Republicans have significantly different political agendas they want to advance. The easiest issue on the health care agenda should be making sure people with pre-existing conditions do...
The formidable pharmaceutical industry wants to recoup the $11.8 billion hit it took earlier this year in Congress’s 2018 budget deal. The drugmakers rarely lose, able to use clout and pressure in every House and Senate district to get what they want. Now they are flexing their muscles and you can expect a relentless push to get back that money which essentially comes out of pharmaceutical industry profits. When Congress approved that budget, the final deal required the drugmakers to shift billions of dollars in Medicare drug costs away from s...
Congress managed to pass well-intentioned legislation recently allowing people with life-threatening illnesses to bypass the Food and Drug Administration (FDA) to obtain experimental medications. Unfortunately, it won’t do much to help the people who need the unapproved therapies the most. The “right to try” legislation, pushed by Sen. Ron Johnson (R-Wis.) and Reps. Andy Biggs (R-Ariz.) and Brian Fitzpatrick, R-Pa., which Congress passed and President Donald J. Trump signed into law in May, gives terminally ill patients the right to seek drug...
Drug prices in the United States are too high – nearly everyone agrees. But political consensus stops at how to lower prices and fix the problem. If it were easy, a simple solution would be found. But paying for prescription drugs is a complicated web of prices, incentives, rebates and discounts among the drug companies, insurance companies and the pharmacy benefit managers (PBMs) who are the middlemen who negotiate with the drug companies on behalf of insurance companies. Think of solving the drug prices mess like a complex jigsaw puzzle. J...
