July30 by RI ARA

“Fighting for the future of our members.” “NOW, more than ever!!!”

July 30, 2017 E-Newsletter

Publication 2017/ Issue 29 Published in house by the RI ARA

House GOP budget partially privatizes Medicare, slashes Medicaid Now that Senate Republicans have failed in their attempt to repeal and replace Obamacare and cut Medicaid, House Republicans are pushing a budget that aims to do all that and then some. Their budget proposal partially privatizes Medicare and deeply cuts social programs such as food stamps. While it is a nonbinding guide for future congressional action, the 125-page budget blueprint reads like a Republican wish list of spending and tax cuts. Advocates for the poor say the spending plan would have a particularly dire effect in poverty-stricken cities such as Buffalo, given that it calls for $4.4 trillion in cuts over 10 years in Medicare, food stamps, unemployment insurance and other such social programs. Included in that are the cuts to Medicaid and other health care

programs that supposedly died with the Republican health reform bill. But they spring back to life in the House budget resolution, and that would cost New York upwards of $7 billion every year. Those cuts would be tied to a Republican tax reform proposal that, in early proposals, eliminates the deduction for state and local taxes — one that's especially beneficial to New Yorkers, given the state's high tax rates. Republicans insist, though, that it's best not to make too much out of the budget plan at this point. They note that the House has no plans to take up Medicare reform this year. Instead, that plan is included in the nonbinding budget resolution mainly so the federal budget will balance in 10 years. The real power behind the budget resolution, they say, is in the legislative magic it would perform. Under the arcane

rules of the U.S. Congress, if lawmakers can pass a budget resolution, they can pass follow-up legislation such as tax reform under the "budget reconciliation" process. That means those bills can pass with a mere majority in the Senate – leaving Democrats without the power of a filibuster to stop it. "I'm open to the budget. It does at least offer us a Plan A for getting to tax reform," said Rep. Tom Reed, a Republican from Corning who sits on the tax-writing Ways and Means Committee. At the same time, Reed is by no means enamored of all the budget's details. Both he and Rep. Chris Collins of Clarence were among of 20 Republicans who signed a letter to House leadership, protesting how deep the proposed cuts are. "There is significant concern with supporting a budget as aggressive as this is," Reed said...Read More

McCain Votes No, Derails ‘Skinny Repeal’ In Marathon Session Sen. John McCain (RAriz.), who interrupted brain cancer treatment to return to Capitol Hill and advance the health law repeal efforts, cast the dramatic and decisive “no” vote in the early morning hours that upended the Republican effort to repeal the Affordable Care Act. The Senate struggled late into the night to craft and then vote on a so-called “skinny repeal” of the health law, but came up empty as the bill was defeated in a 51-49 vote that prompted gasps in the chamber. McCain’s vote was unexpected and ends — for now — the Republican party’s effort to kill Obamacare. Sens. Lisa Murkowski (R-Alaska) and

Susan Collins (R-Maine) cast the two other Republican “no” votes in a cliffhanger drama that ended just before 2:00 a.m. Friday. Earlier, a group of Republican senators trashed the new measure, widely dubbed a “skinny repeal,” saying it would only worsen the health care system, and they demanded unprecedented promises from their House colleagues to change it. “The skinny bill in the Senate doesn’t even come close to honoring our promises of repealing Obamacare,” said Sen. Ron Johnson (R-Wis.). “Virtually nothing we’re doing in any of these bills and proposals are addressing the challenges, the problems, the damage done [by the Affordable Care Act].”

Staff of Senate Majority Leader Mitch McConnell (R-Ky.) crafted the new bill, which was under discussion all afternoon and posted publicly late Thursday evening. The slimmed-down version of the Senate bill — The Health Care Freedom Act, which the White House refers to as the “freedom bill” — included an end to key elements of the health law. Among them were rollbacks of the mandates for individuals and employers to buy health insurance, changes to waivers available under Section 1332 of the ACA that would give states more leeway to alter essential benefits in insurance plans, and a repeal of the medical-device tax. ..Read More

Rhode Island Alliance for Retired Americans, Inc. • 94 Cleveland Street • North Providence, RI • 02904-3525 • 401-722-2770 www.ri-ara.org • riarajap@hotmail.com • http://www.facebook.com/groups/354516807278/

Senate Parliamentarian Upends GOP Hopes For Health Bill The official rules keeper in the Senate Friday tossed a bucket of cold water on the Senate Republican health bill by advising that major parts of the bill cannot be passed with a simple majority, but rather would require 60 votes. Republicans hold only 52 seats in the Senate. Senate Parliamentarian Elizabeth MacDonough said that a super-majority is needed for the temporary defunding of Planned Parenthood, abor tion coverage restrictions to health plans purchased with tax credits and the requirement that people with breaks in coverage wait six months before they can purchase new plans. The Senate is using a budget process called “reconciliation” that allows

Republicans to pass a bill with only 50 votes (and the potential tie to be broken by Vice President Mike Pence). But there are strict rules about what can and cannot be included, and those rules are enforced by the parliamentarian. Those rules can be waived, but that requires 60 votes, and all the chamber’s Democrats have vowed to fight every version of the bill to “repeal and replace” the Affordable Care Act, which is set for a possible vote next week. The list was released by Democrats on the Senate Budget Committee and later confirmed by a spokesman for the committee Republicans. It is the result of what is called the “Byrd Bath,” a process in which the parliamentarian hears arguments from Democrats and Republicans and then advises on which

provisions comply with the Byrd Rule. That rule requires that only matters directly pertaining to the federal budget are included. The rule is named for former Senate Majority Leader Robert Byrd (D-W.Va.), who first wrote it. Senate Republicans were quick to point out that the document is “guidance” that they can use to try to rewrite impermissible language. The guidance “will help inform action on the legislation going forward,” said a spokesman for Senate Budget Committee Chairman Mike Enzi (R-Wyo.). ...Read More

Team Trump Used Obamacare Money to Run PR Effort Against It The Trump administration has spent taxpayer money meant to encourage enrollment in the Affordable Care Act on a public relations campaign aimed at methodically strangling it. The effort, which involves a multipronged social media push as well as video testimonials designed at damaging public opinion of President Obama’s health car e law, is far more robust and sustained than has been publicly revealed or realized. The strategy has caught the eye of legal

experts and Democrats in Congress, who have asked government agencies to investigate whether the administration has misused funds and engaged in covert propaganda in its efforts to damage and overturn the seven-year-old health care law. It’s also roiled Obama administration veterans, who argue that the current White House is not only abdicating its responsibilities to administer the law but sabotaging it in an effort to facilitate its undoing by Congress. “I’m on a daily basis horrified by leaders at the Department of Health and Human Services who seem intent on taking

healthcare away from the constituents they are supposed to serve,” former HHS Secretary Kathleen Sebelius said in an interview with The Daily Beast. “We always believed that delivering health and human services was the mission of the department. That seems to not be the mission of the current leadership.” The Department of Health and Human Services (HHS) declined repeated attempts to discuss its PR efforts. But more than halfa-dozen sources at various agencies and on the Hill outlined the scope of the antiObamacare push in conversations with The Daily Beast. ...Read More

Trump administration pulls Obamacare help in 18 cities President Donald Trump's administration has ended Affordable Care Act contracts that brought assistance into libraries, businesses and urban neighborhoods in 18 cities, meaning shoppers on the insurance exchanges will have fewer places to turn for help signing up for coverage. Community groups say the move, announced to them by contractors last week, will make it even more difficult to enroll the uninsured and help people already covered re-enroll or shop for a new policy. That's already a concern because of consumer confusion stemming from the political wrangling in Washington and a shorter enrollment period. People will have 45 days to shop for 2018 coverage, starting Nov. 1

and ending Dec. 15. In previous years, they had twice that much time. Some see it as another attempt to undermine the health law's marketplaces by a president who has suggested he should let "Obamacare" fail. The administration, earlier this year, pulled paid advertising for the sign-up website HealthCare.gov, prompting an inquiry by a federal inspector general into that decision and whether it hurt sign-ups. Now insurers and advocates are concerned that the administration could further destabilize the marketplaces where people shop for coverage by not promoting them or not enforcing the mandate compelling people to get coverage. The

administration has already threatened to withhold payments to insurers to help people afford care, which would prompt insurers to sharply increase prices. "There's a clear pattern of the administration trying to undermine and sabotage the Affordable Care Act," said Elizabeth Hagan, associate director of coverage initiatives for the liberal advocacy group Families USA. "It's not letting the law fail, it's making the law fail." ...Read More

Medicare Rights Testifies at Congressional Hearing on Medicare Fraud and Abuse On July 20, 2017, Stacy Sanders, federal policy director of the Medicare Rights Center, testified in support of a proposed law that would increase the civil monetary penalties and criminal fines for certain types of Medicare fraud at a hearingheld by the Subcommittee on Health of the U.S. House Committee on Energy and Commerce. The hearing focused on a number of bipartisan bills to improve Medicare, including the Medicare Civil and Criminal Penalties Update Act of

2017 (H.R. 3245). “Medicare fraud is deeply problematic from two key perspectives—both beneficiary and taxpayer,” said Sanders. “For people with Medicare, fraud and abuse can lead to exploitation in the form of increased costs, including overcharging for services received or even paying for care that was never delivered. Fraud and abuse also lead to increased and inappropriate spending of taxpayer dollars.” Medicare Rights’ support for H.R. 3245 is informed by the organization’s experience working with people with

Medicare and their families for nearly 30 years. Medicare Rights answers almost 20,000 questions on its national helpline annually and provides educational tools and resources to nearly three million Americans seeking a trusted, unbiased Medicare source. Medicare fraud is not a victimless crime, making it critically important that Congress prioritize enhanced efforts to prevent and reduce fraud and abuse,” said Sanders. Read Stacy Sanders’ testimony from the hearing.

Follow The Money: Drugmakers Deploy Political Cash As Prices And Anger Mount Two federal investigations — one examining opioid sales, another about a multiple sclerosis drug whose price had soared to $34,000 a vial — were only part of the troubles Mallinckrodt faced as the year began. The stock of the drugmaker, whose United States headquarters are in St. Louis, was tanking. Wall Street worried that Medicare might reduce the halfbillion dollars it was spending yearly on a Mallinckrodt drug with limited evidence of effectiveness. This year, the company left the industry trade group Pharmaceutical Research and Manufacturers of America, or PhRMA, after the group threatened to kick out

companies that did not spend enough on research. Mallinckrodt, however, has been increasing its spending in another area: It has been writing checks to politicians. After making meager donations in 2015, the company’s political action committee began raising its contributions for congressional campaigns last year. Lawmakers in both the House and Senate collected $44,000 from Mallinckrodt in 2017’s first quarter, nearly nine times what they got from the company in the same period two years ago. Mallinckrodt also spent $610,000 lobbying Congress, triple the amount of 2015’s first quarter. The company, which

makes pain-control drugs as well as H.P. Acthar, an injectable gel prescribed for multiple sclerosis and other diseases, has lobbied on issues related to opioids, patents, Medicare and other matters, regulatory filings show. Mallinckrodt is far from unique. This year, a critical and risky one for drug companies, the industry as a whole is ratcheting up campaign donations and its presence on Capitol Hill, a new database compiled by Kaiser Health News shows...Read More

House Committee Approves Sense of Congress Resolution to Reduce Prescription Drug Costs This week, Congresswoman Jan Schakowsky led an amendment “Sense of Congress” r esolution identifying the cost of prescription drugs as a national problem and calling on the U.S. Secretary of Health and Human Services to engage with the House of Representatives and the Senate to take administrative actions and enact legislative changes to lower the cost of prescription drugs for consumers and reduce the burden of that cost on taxpayers in a way that will balance the need to encourage innovation with the need to increase affordability. The senseof-Congress amendment was successfully

adopted during a hearing of the House Committee on Energy & Commerce marking up pending, bipartisan legislation earlier this week. Congress may express formal opinions about subjects of national interest in this type of resolution, known as a “Sense of the House,” “Sense of the Senate” or “Sense of the Congress” resolution. These resolutions express the opinion of a majority of the chamber’s members, but do not create law. They do not require the signature of the President of the United States, and are not enforceable as laws. Instead, they express the congress’s

opinion about a particular topic in general terms, and can be used for political persuasion, to appeal to the Administrative branch of the government to take action, as here, or to express thanks or congratulations. Medicare Rights strongly supports this sense-of-Congress amendment and remains grateful for continued leadership by members of Congress to once and for all bring down the soaring cost of prescription drugs.

5 Technologies Older Americans Have Embraced Older adults are often viewed as being unfamiliar with or unable to use new technologies. But people age 65 and older are embracing many technologies and learning how to incorporate them into their lives, according to a recent Pew Research Center survey of 3,015 adults. "Seniors feel very positive about technology," says Monica Anderson, the lead author of the study and a research associate at Pew Research Center. "Even though they might be less likely to use these forms of technology, they do believe that technology is a quite positive thing for our society." Here are five technologies older Americans have adopted. Smartphones. Young people aren't the only ones attached to their screens. The proportion of people age 65 and older who report owning a smartphone has more than doubled over the past three years from 18 percent in 2013 to 42 percent in 2016, according to the survey. Many seniors are also taking steps to figure out what they can accomplish with these devices. "We hold Intro to Smartphone sessions at several of our retail stores across the nation," says Sanette Chao, a spokesperson for Verizon. "The majority of them are attended by senior citizens." The internet. While they didn't grow up surfing the web, two-thirds of seniors now use the internet, up from just 12 percent in 2000, Pew found. And half of older Americans have broadband at home. "Seniors who are younger have a more robust relationship with technology, so a majority have smartphones and the vast

majority go online," Anderson says. "When you look at people who are 80 plus, the vast majority don't even use the internet." For seniors who can't drive or have difficulties getting around, the internet makes it easy to email friends, Skype with the grandkids and shop without leaving the house. "Once seniors are online, they are doing a lot of things that everyone else does," Anderson says. Tablets. Touch screens make it easier to navigate a computer, so some older people prefer tablets. About a third (32 percent) of those age 65 and older say they own a tablet computer, such as an iPad, Samsung Galaxy Tab, Microsoft Surface Pro or Amazon Fire. And 19 percent of seniors read books on ereaders, such as a Nook or Kindle. The ability to change the font size, quickly look up unfamiliar words and instantly download new books can make these devices an especially good fit for seniors with vision impairment. Direct deposit. Many retirees have been encouraged to use direct deposit by the Social Security Administration. Social Security beneficiaries have been required to receive their payments by direct deposit or another electronic payment method since 2011. Eliminating the printing and postage costs of paper checks saves the federal government money, and retirees get their money faster, with less opportunity for lost or stolen payments. Online banking services could also benefit seniors who find it difficult to get to a bank branch. "Banks offer a lot of online services, and many [seniors] are becoming increasing receptive to those types of services," says Stacy Canan, assistant director of the Office for Older Americans

at the Consumer Financial Protection Bureau. "But some older consumers still want face-to-face banking or a paper statement they can hold in their hand." Some seniors have complained to the CFPB about checks or paper statements no longer being provided for free with checking accounts. "I would urge consumers to make requests of the bank or credit union that they use to ask that they not be charged for those services," Canan says. Social media. People of all ages are now connecting though social media. Some retirees are also using social media sites to find work. LinkedIn r epor ts that nearly half of the people who use its ProFinder service that helps job seekers find project-based work are over 50. "These professionals have likely had long careers and built substantial networks in their industries before retiring from their corporate job to pick up freelancing," says Tatiana De Almeida, a spokesperson for LinkedIn. "Anecdotally, they've said that freelancing enables them to pursue work they're passionate about and enjoy a more flexible schedule." Just over a third of older Americans now use social networking sites like Facebook, Twitter and LinkedIn, up from a quarter in 2013, Pew found. "Older social media users socialize with friends and family more frequently than people who don't use the internet and don't use social media," Anderson says. "Seniors are still less likely to have certain forms of technology, but in many ways they are very much marching toward a more digitally connected life."

How to Detect Scams That Could Ruin Your Retirement No one expects to fall victim to a financial scam, yet they happen with alarming frequency — and retirees are often in the crosshairs. Nearly 1 in 5 Americans over 65 have been victimized by financial rip-offs, according to a 2016 study from the Investor Protection Trust, a nonprofit investor education organization. A 2015 study by True Link Financial, an investment advisory firm, indicates seniors lose $36 billion each year to elder financial abuse.

Investment swindles come in many was running one of the forms, but no matter the methods, largest Ponzi schemes in perpetrators have their eye on one thing: history. your retirement savings. Here are three A sense of urgency signs of a swindle that could rob you A calling card of of your nest egg. suspicious investments is a sense of Guaranteed returns urgency — which often proves to be Investing is an inherently risky false. Perpetrators want to rush investors endeavor, even though many people into a decision so there’s no time for due would have you believe diligence. But any sound investment otherwise. Bernie Madoff’s firm sold that’s here today will be here tomorrow, clients on the investment dream: low risk even if the price is slightly higher. and high returns. He didn’t mention he ….Read More

RI ARA HealthLink Wellness News

Opioid Treatment Funds In Senate Bill Would Fall Far Short Of Needs At a lunch last week, President Trump tried to persuade some reluctant senators to endorse repealing the Affordable Care Act. During the meeting, he mentioned a provision in the Senate Republican proposal that allocates funding for opioid treatment, saying, “We’re committing $45 billion to help combat the opioid epidemic, and some states in particular like that.” But addiction treatment specialists warn that sum of money is far from enough to address a crisis that has escalated across the United States in recent years, killing tens of thousands of people. The federal money would be spent over about a decade, and is part of a bill that also dramatically cuts Medicaid,

which is helping many people get treatment now. Those cuts will hit people in some states especially hard — those living in states that expanded the Medicaid program under the Affordable Act. “You’re going to take a lot of people, take away their health care benefit, and basically do just a small grant to each state. It’s going to be real big problem,” said Richard Edley, executive director of the Rehabilitation and Community Providers Association, which includes hundreds of mental health and substance use disorder providers in Pennsylvania. “You hate to say you’re opposing [$45 billion], but it’s packaged with a rollback of benefits to these same individuals.” In Pennsylvania in 2016, Medicaid expansion helped 124,000 people get treatment for their substance use

disorder. Democratic Gov. Tom Wolf has said his state won’t be able to maintain Medicaid expansion if the federal government cuts back its share of spending. Without the program, many of those people would have limited access to help for their addiction. Edley did some back-of-the-envelope math, and is really concerned at what he found. If $45 billion is distributed to all 50 states by population, Pennsylvania would get about $1.8 billion, spread out over nine years. Depending on other variables, that could range from somewhere between $1,000 to $2,000 per person per year who might need treatment, based on how many people got treatment under expanded Medicaid in Pennsylvania last year...Read More

How To Get Long-Term Care At Home Without Busting The Bank The vast majority of older adults receive long-term care at home, not in nursing homes. But few people plan for this expense. Nor do they see long-term care insurance as a viable option — because it’s expensive and is often seen as protection against the cost of nursing home care. That should change, some experts contend. If the long-term care insurance industry focused more on helping people cover home-based services, they argue, policies would be more affordable, and potentially appealing.

“Long-term care, for most people, is a home care problem,” said Bill Comfort, who owns Comfort Long Term Care, a brokerage based in St. Louis and Durham, N.C. “It makes sense to insure people for the likelihood of where care is going to be needed first — which is at home,” agreed Deb Newman, president of Newman Long Term Care in Richfield, Minn., outside Minneapolis. Genworth, one of the nation’s leading long-term care insurers, acknowledged that this position is supported by industry claims data.

“Primarily, we are seeing people utilizing home care and a smaller and smaller percentage using nursing home care,” said Beth Ludden, Genworth’s senior vice president for longterm care insurance products. “People think, ‘While I might start out needing care at home, eventually I’ll need to be in a facility,’” Ludden continued. “But that’s not something we see in our data. For the most part, people are able to stay at home for the whole time.”...Read More

How food fads and diet trends fare for heart health Every year Americans adopt new diet trends, from the juicing craze to gluten-free diets, and each new fad promises health benefits such as weight loss and higher energy. But, as specific diets become more popular, doctors wanted to assess whether they would help the one part of the body

that carries the most risk for both men and women in the U.S.: the heart. In order to get a better sense of which diets were the most heart healthy, researchers examined more than 25 peerreviewed studies and published their findings today in a new report in the Journal of the American College of Cardiology. "There is sort of mass confusion about

what foods are healthy or not healthy," lead study author Dr. Andrew Freeman, Director of Cardiovascular Prevention and Wellness at National Jewish Health in Denver, Colorado, told ABC News. "When you take the time to weigh through the data and the evidence it becomes clear," he continued. "Human beings haven’t changed all that much in the last many, many years."..Read More

Opioid Abuse Down in Younger Americans, But Up Among Older Adults While opioid abuse has fallen among younger Americans, the same cannot be said for older adults, a new government

abused opioids in the past year, the 2014 National Survey on Drug Use and Health found. "These findings highlight the need for prevention programs for all ages, as well as to establish improved evidence-based treatment, screening and appropriate report shows. referral services," Dr. Kimberly Johnson, Opioid abuse includes either the use of director for the Center for Substance heroin or illegal use of prescription opioid Abuse Treatment, said in a SAMHSA painkillers, such as oxycodone news release. (Oxycontin, Percocet) and hydrocodone "The high rates of [multiple] illnesses in (Vicoprofen). older populations and the potential for Rates of opioid abuse among young drug interactions has profound adults -- aged 18 to 25 -- decreased from implications for the health and well-being 11.5 percent in 2002 to 8 percent in 2014. of older adults who continue to misuse But in adults 50 years and older, opioid opioids," Johnson said. abuse doubled, from 1 percent to 2 What can be done to get these rates percent, according to the U.S. Substance down, particularly among older people? Abuse and Mental Health Services The U.S. Department of Health and Administration (SAMHSA). Human Services has identified five Overall, about 9.5 million adults had strategies to tackle the opioid crisis in the

United States, including: Improving access to treatment and recovery services, including the full range of medication-assisted treatment. Promoting targeted availability and distribution of overdose-reversing drugs. Strengthening understanding of the epidemic through better public health data and reporting. Providing support for cutting edge research on pain and addiction. Advancing better practices for pain management. More information The U.S. Centers for Disease Control and Prevention has more on opioids. SOURCE: U.S. Substance Abuse and Mental Health Services Administration, news release, July 26, 2017

Over-The-Counter Devices Hold Their Own Against Costly Hearing Aids

Hearing aids that can cost more than $2,000 apiece are only slightly more effective than some over-the-counter sound-amplification devices that sell for just a few hundred dollars, according to a recent study. The study bolsters legislation pending in Congress, which would have the Food and Drug Administration set regulations for cheaper over-the-counter products and is designed to make the devices more widely accessible and safer. Consumers with mild to moderate hearing loss would be able to purchase the devices without a

prescription and without a medical exam, knowing they meet federal safety standards. For the study, researchers compared how well 42 older adults with mild to moderate hearing loss repeated sentences spoken in the presence of background noise. The researchers first tested their ability to understand the speaker without any devices. Then they tested the subjects successively with a hearing aid and with five “personal sound amplification products” sold over the counter. The hearing aid used in the study was a

brand commonly dispensed in audiology clinics. The personal sound amplification products (PSAPs) that were selected either had the best electroacoustic properties or were commonly available in retail pharmacies. PSAPs perform like hearing aids but can’t be marketed as hearing aids because they don’t meet standards set by the FDA. ...Read More

Sex beats puzzles, games as way for senior citizens to increase brain power So, you thought doing puzzles, crosswords or adult coloring books were the things to do as a senior to increase your brain power. Read this and you will know that a better way may be to have more sex. More frequent sexual activity has now been linked to improved brain function in older adults, according to a study by the universities of Coventry and Oxford. Researchers found that people who engaged in more regular sexual activity

scored higher on tests that measured their verbal fluency and their ability to visually perceive objects and the spaces between them. The study involved 73 people aged between 50 and 83. It was published recently in the Journals of Gerontology, Series B: Psychological and Social Sciences Participants filled in a questionnaire on how often, on average, they had engaged in sexual activity over the past 12 months - whether that was never, monthly or weekly - as well as

answering questions about their general health and lifestyle. The 28 men and 45 women also took part in a standardized test, which is typically used to measure different patterns of brain function in older adults, focusing on attention, memory, fluency, language and visuospatial ability. This included verbal fluency tests in which participants had 60 seconds to name as many animals as possible, and then to say as many words beginning with F as they could - tests which reflect higher cognitive abilities….Read More