SOCIAL SECURITY
Social Security Paycheck to Increase More than 3 Percent
In 2012, about 55 million Social Security recipients will get an average of 3.6% cost of living adjustment (COLA) after no such increases in 2010 and 2011. The Social Security Administration announced the pay increase on October 19, 2011. In 2009, the COLA was 5.8%, largest in 27 years, due mainly to escalating energy prices in the preceding year (2008). Federal law requires government to compare Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W)for the three months of the third quarters (July, August and September) with that of the preceding year. Starting in January 2012, 55 million Social Security recipients will receive a boost of $39 per month, while an additional 8 million Americans will get $18 monthly raise in Supplemental Security Income, the disability program for the poor.
Social Security Disabilities Fund to Run out of Money in 2016
The trustees of Social Security and Medicare program on July 22, 2015 issued an ominous prognosis on Social Security Disabilities Fund that gives, on an average, $1,017 a month to 11 million Americans as disability benefit. According to the report, the disability trust fund will run out of money by the end of 2016, triggering an automatic 19 percent benefit reduction, or $193 per month. However, the larger Social Security Trust Fund has enough money to pay full benefit until 2035, with 75% of benefit to be given after that year. Social Security steps into 80th year in August 2015. President Franklin Roosevelt signed the Social Security Act on August 14, 1935.
No Increase in Social Security Benefit for 2016
Obama administration on October 15, 2015 said that there won't be any cost of living adjustment (COLA) for 2016 given low inflation environment. As a result, next year will mark the third time in the entitlement's lifespan without any annual increase after 2010 and 2011. COLA affects 60 million retirees, disabled workers, spouses and children who receive social security benefits, averaging a monthly check of $1,224. In addition to social security beneficiaries, COLA also affects the paycheck of 4 million disabled veterans, 2.5 million federal retirees and their survivors, and more than 8 million people who get Supplemental Security Income, the disability program for the poor.
2.8 Percent Increase in Social Security Pay for 2019 Announced
Trump administration on October 11, 2018 announced a 2.8 percent cost of living adjustment, or COLA, for millions of beneficiaries.
Social Security Funds in a Shaky State
Government overseers of the Social Security Trust Fund issued an ominous warning on April 22, 2019 that gave another 16 years of lease of life to the entitlement program, with Social Security estimated to be broke in 2035. Social Security is the federal government's costliest program, and in 2018, it disbursed an estimated $853 billion to the elderlies and an additional $147 billion in disabilities benefit.
Social Security Paycheck to Increase More than 3 Percent
In 2012, about 55 million Social Security recipients will get an average of 3.6% cost of living adjustment (COLA) after no such increases in 2010 and 2011. The Social Security Administration announced the pay increase on October 19, 2011. In 2009, the COLA was 5.8%, largest in 27 years, due mainly to escalating energy prices in the preceding year (2008). Federal law requires government to compare Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W)for the three months of the third quarters (July, August and September) with that of the preceding year. Starting in January 2012, 55 million Social Security recipients will receive a boost of $39 per month, while an additional 8 million Americans will get $18 monthly raise in Supplemental Security Income, the disability program for the poor.
Social Security Disabilities Fund to Run out of Money in 2016
The trustees of Social Security and Medicare program on July 22, 2015 issued an ominous prognosis on Social Security Disabilities Fund that gives, on an average, $1,017 a month to 11 million Americans as disability benefit. According to the report, the disability trust fund will run out of money by the end of 2016, triggering an automatic 19 percent benefit reduction, or $193 per month. However, the larger Social Security Trust Fund has enough money to pay full benefit until 2035, with 75% of benefit to be given after that year. Social Security steps into 80th year in August 2015. President Franklin Roosevelt signed the Social Security Act on August 14, 1935.
No Increase in Social Security Benefit for 2016
Obama administration on October 15, 2015 said that there won't be any cost of living adjustment (COLA) for 2016 given low inflation environment. As a result, next year will mark the third time in the entitlement's lifespan without any annual increase after 2010 and 2011. COLA affects 60 million retirees, disabled workers, spouses and children who receive social security benefits, averaging a monthly check of $1,224. In addition to social security beneficiaries, COLA also affects the paycheck of 4 million disabled veterans, 2.5 million federal retirees and their survivors, and more than 8 million people who get Supplemental Security Income, the disability program for the poor.
2.8 Percent Increase in Social Security Pay for 2019 Announced
Trump administration on October 11, 2018 announced a 2.8 percent cost of living adjustment, or COLA, for millions of beneficiaries.
Social Security Funds in a Shaky State
Government overseers of the Social Security Trust Fund issued an ominous warning on April 22, 2019 that gave another 16 years of lease of life to the entitlement program, with Social Security estimated to be broke in 2035. Social Security is the federal government's costliest program, and in 2018, it disbursed an estimated $853 billion to the elderlies and an additional $147 billion in disabilities benefit.
Social Security Benefit to Pay Less a Year Earlier
In a sobering assessment, the trustees for Social Security and Medicare program has released their annual report on August 31, 2021, and for the first time in 39 years, the cost of paying social security benefit will exceed the take-in from payments, interest incomes and other earnings this year. According to the new projection issued August 31, 2021, the benefits will fall below the pledged value beginning 2034, a year earlier than last year's estimate of 2035 when Social Security Trust Fund will stop paying full benefit.
Social Security Payment to Get the Highest Bump in 39 Years
As the inflation is leaping forward due to supply chain woes and other factors, Social Security Administration on October 13, 2021 announced that an average retiree would receive an additional $92 per month in 2022, amounting to about 5.9% raise. The COLA of 5.9% is the highest in 39 years. The COLA was averaging about 1.65% per year over the last decade. After the increase, the average Social Security recipient will get $1,657 per month and a couple $2,753 per month, an increase of $154. COLA affects 1 in 5 people in the U.S., including disabled people, Social Security recipients and federal retirees, totaling about 70 million people.
Social Security Trust Fund to Pay Less than Full Benefit Beginning 2033
Social Security Trustees on March 31, 2023 issued the health report on the Social Security Trust Fund, and it's ominous. According to the trustee report, the Social Security Trust Fund will pay 77% of the full benefit starting 2033, a year earlier than last year's estimate. Driving the shortfall are inflation and lackluster economic growth as well as subpar wage growth for the workers in the lower rung of the wage scale. Reflecting the 23% automatic benefit cut that's to take place in a decade if nothing is done, Social Security Acting Commissioner Kilolo Kijakaji said that Congress should "address the projected shortfall".
Biden Names Former Maryland Governor SSA Administrator
On July 26, 2023, President Joe Biden named Former Maryland Governor Martin O'Malley to lead the Social Security Administration. The president said that O'Malley, a two-term governor (2007-2015) and two-term Baltimore mayor, "is a life-long public servant" who would strive for keeping the government services accessible to citizens.
COLA to Lead Social Security Pay Bump by 3.2%
Social Security Administration on October 12, 2023 announced next year's social security pay increase for the nation's 71 million recipients, including elderly people, people with disabilities and children. Although less than half of this year's increase, a 3.2% pay bump in 2024 will still provide some degree of relief to the recipients, according to the Acting Commissioner Kilolo Kijakaji.
However, the bump is going to consume the expected raise in Medicare premiums.
The maximum earnings subjected to Social Security tax are set to increase to $168,600 in 2024 compared to $160,200 now.
MEDICARE
Efficiency Measures for Medicare Re-imbursements
MEDICARE
Efficiency Measures for Medicare Re-imbursements
The Obama administration is planning to introduce "Efficiency Measures", including "Medicare Spending Per Beneficiary", to score hospitals just like the government does now for mortality rates for heart attack patients and infection rates for surgery patients. The initiative, known as Value Based Purchasing, includes benchmarks for scoring and financially rewarding more than 3,100 hospitals:
* Medicare Spending Per Beneficiary during hospital stay, three days prior to it and 90 days afterward.
* This measure, combined with the measure of quality care, will be used to compute performance score of a hospital.
* Based on this performance score, Medicare will re-imburse higher or lower percentage of the claims.
Medicare will start tracking the spending from July 2011, and start rewarding hospitals beginning October 2012. Since 2004, Medicare started to reward hospitals based on quality care, but this is the first time administration is introducing "Efficiency Measures" for paying hospitals.
Source: The Dallas Morning News (May 31, 2011)
* Medicare Spending Per Beneficiary during hospital stay, three days prior to it and 90 days afterward.
* This measure, combined with the measure of quality care, will be used to compute performance score of a hospital.
* Based on this performance score, Medicare will re-imburse higher or lower percentage of the claims.
Medicare will start tracking the spending from July 2011, and start rewarding hospitals beginning October 2012. Since 2004, Medicare started to reward hospitals based on quality care, but this is the first time administration is introducing "Efficiency Measures" for paying hospitals.
Source: The Dallas Morning News (May 31, 2011)
Outgoing CMS Chief Laments Waste in Entitlement Programs
The outgoing administrator of the Center for Medicare and Medicaid Services, Dr. Donald Berwick, lamented waste in Medicare and Medicaid spending on his last day (December 1, 2011) in office. Dr. Berwick identified five causes that contribute to "extremely high level of waste": (1) Overtreatment of patients; (2) Failure to coordinate care; (3) Administrative complexity of health care system; (4) Burdensome rules; and (5)Fraud. President Obama nominated Dr. Berwick in April 2010. But because of Congressional delay, President Obama made him the administrator through recess appointment.
Medicare Hospital Trust Fund to Last until 2030
The trustees of Social Security and Medicare program on July 22, 2015 said in a report that Medicare's Hospital Fund had enough money to provide desired benefit until 2030.
Medicare to be Depleted in 2026
Medicare and Social Security programs' trustees on June 5, 2018 issued twin ominous reports, giving prognosis of health of:
Medicare Hospital Trust Fund: Estimated year of depletion 2026 compared to 2029 estimated last year
Social Security Trust Fund: Estimated year of depletion 2034
Medicare to Exhaust in 2026
Overseers of Medicare on April 22, 2019 estimated that the program would go broke in 2026. In 2018, Medicare's hospital, outpatient care and prescription drug benefits had a price tag of $740 billion.
Two Ways of Getting Drug Benefits under Medicare (Source: The Dallas Morning News November 27, 2019)
1. Original Medicare Plus Medigap and Medicare Part D
Original Medicare has two elements. Medicare Part A covers the hospital care and limited skilled nursing care. There is no typical monthly premium, but there is an average of $1,364 (based on the figures in 2019) deductibles and co-insurance costs for hospitalization more than 60 days.
Part B covers the doctors' visits, lab procedures, tests and equipment. The standard monthly premium is $135.50. The premiums are taken typically off the monthly social security check. Typically out-of-pocket costs are about 20% of the total bill.
To pay for the out-of-pocket costs for both Part A and Part B, consumers rely on a supplemental policy offered by former employer or a private insurer. It's called Medigap. Medicare Part D provides coverage for prescription drugs.
2. Medicare Advantage
This is all-in-all coverage offered by private insurers that cover Medicare Part A and Medicare Part B as well as drug benefits. On the top, it may offer coverage for vision and dental.
Drug Prices Decline for the First Time
A CMS (Center for Medicare and Medicaid Services) study published on December 5, 2019 shows that drug prices have declined in 2018 for the first time by 1%, mostly due to patients' increasing use of generics and drop in retail prices for some brand names. However, the study, carried out by The Washington Post on December 5, 2019, also shows that total spending on prescriptions has grown by 2.5% to $335 billion.
Total healthcare cost stood at a record high of $3.6 trillion at the end of 2018, a 4.6 percent increase compared with 2017 that has gobbled up about $11,172 per person, or 18% of the U.S. economy
Medicare Depletion Date Remains Unchanged
The Social Security and Medicare Trustees on August 31, 2021 issued the latest annual projection, saying that Medicare fund would be depleted in 2026, unchanged from the last year.
The outgoing administrator of the Center for Medicare and Medicaid Services, Dr. Donald Berwick, lamented waste in Medicare and Medicaid spending on his last day (December 1, 2011) in office. Dr. Berwick identified five causes that contribute to "extremely high level of waste": (1) Overtreatment of patients; (2) Failure to coordinate care; (3) Administrative complexity of health care system; (4) Burdensome rules; and (5)Fraud. President Obama nominated Dr. Berwick in April 2010. But because of Congressional delay, President Obama made him the administrator through recess appointment.
Medicare Hospital Trust Fund to Last until 2030
The trustees of Social Security and Medicare program on July 22, 2015 said in a report that Medicare's Hospital Fund had enough money to provide desired benefit until 2030.
Medicare to be Depleted in 2026
Medicare and Social Security programs' trustees on June 5, 2018 issued twin ominous reports, giving prognosis of health of:
Medicare Hospital Trust Fund: Estimated year of depletion 2026 compared to 2029 estimated last year
Social Security Trust Fund: Estimated year of depletion 2034
Medicare to Exhaust in 2026
Overseers of Medicare on April 22, 2019 estimated that the program would go broke in 2026. In 2018, Medicare's hospital, outpatient care and prescription drug benefits had a price tag of $740 billion.
Two Ways of Getting Drug Benefits under Medicare (Source: The Dallas Morning News November 27, 2019)
1. Original Medicare Plus Medigap and Medicare Part D
Original Medicare has two elements. Medicare Part A covers the hospital care and limited skilled nursing care. There is no typical monthly premium, but there is an average of $1,364 (based on the figures in 2019) deductibles and co-insurance costs for hospitalization more than 60 days.
Part B covers the doctors' visits, lab procedures, tests and equipment. The standard monthly premium is $135.50. The premiums are taken typically off the monthly social security check. Typically out-of-pocket costs are about 20% of the total bill.
To pay for the out-of-pocket costs for both Part A and Part B, consumers rely on a supplemental policy offered by former employer or a private insurer. It's called Medigap. Medicare Part D provides coverage for prescription drugs.
2. Medicare Advantage
This is all-in-all coverage offered by private insurers that cover Medicare Part A and Medicare Part B as well as drug benefits. On the top, it may offer coverage for vision and dental.
Drug Prices Decline for the First Time
A CMS (Center for Medicare and Medicaid Services) study published on December 5, 2019 shows that drug prices have declined in 2018 for the first time by 1%, mostly due to patients' increasing use of generics and drop in retail prices for some brand names. However, the study, carried out by The Washington Post on December 5, 2019, also shows that total spending on prescriptions has grown by 2.5% to $335 billion.
Total healthcare cost stood at a record high of $3.6 trillion at the end of 2018, a 4.6 percent increase compared with 2017 that has gobbled up about $11,172 per person, or 18% of the U.S. economy
Medicare Depletion Date Remains Unchanged
The Social Security and Medicare Trustees on August 31, 2021 issued the latest annual projection, saying that Medicare fund would be depleted in 2026, unchanged from the last year.
Medicare Premium to Drop Next Year
Medicare premium is to drop about 3% next year, according to an estimate released by the CMS on September 27, 2022. The premium covers the Part B plan for outpatient and regular doctor visits. This year, Medicare Part B premium jumped by $21.60, partly due to astronomical price of the new intravenously administered Alzheimer's drug Aduhelm. Next year, the Part B premium will fall to $164.90, a decrease of $5.20. With the reduction in Medicare Part B plan's monthly premium along with a significantly high 9% to 10% potential increase in Social Security benefit, country's elderly people will have hundreds of additional dollars in pockets.
Medicare to Pay Reduced Benefit in Eight Years
Medicare trustees on March 31, 2023 forecasted that Medicare would begin paying 89% of the in-patient hospital procedures, nursing home stays and other Medicare benefits beginning 2031, pushing out the benefit depletion date by three years compared to the last year's projection. The relative good news came as many of the fragile elderly people had lost their lives because of COVID-19 and several in-patient hospital procedures were skipped in favor of less expensive outpatient procedures.
MEDICAID
Trump Administration Proposes Medicaid Rules Overhaul
The head of CMS, Seema Verma, on January 11, 2018 made public the Trump administration's proposed changes to Medicaid benefit rules, requiring the able-bodied beneficiaries to do job or volunteering work.
Indiana Receives Federal Approval for Medicaid Work Requirement
After Kentucky, Indianan received the approval from the federal government on February 2, 2018 for the work requirement to guarantee continuing Medicaid benefit.
Arkansas', Kentucky's Work Requirement Rules Blocked
U.S. District Judge James Boasberg of the Washington D.C. on March 27, 2019 blocked the "work requirements" for Medicaid beneficiaries in Arkansas and Kentucky on the ground that those rules were capricious and might have potential to hurt the recipients of the federal-state program. The judge didn't outright block the "work requirements" per se. Instead, he took aim at how the work requirements were formulated and their adverse impact.
Biden Administration Rescinds the Trump-era Medicaid Waiver
Biden Administration on April 16, 2021 rescinded the last-minute waiver granted by Trump administration for Medicaid funding, leading to a cloud of uncertainty over more than $100 billion Medicaid funding over the next decade. As the rulesets guiding the state's Medicaid program is set to expire in 2022, the then-CMS Administrator Dr. Seema Verma issued the waiver, known as Medicaid 1115 Waiver, on January 15, 2021, just five days before the change in administration. Ms. Verma at that time justified the pandemic to forego the regular public notice-and comment process. The waiver allows Texas to explore an alternative way of getting Medicaid funding other than going through the expansion of Medicaid under the Affordable Care Act. Texas is among the dozen states that has not expanded Medicaid to cover more uninsured under the ACA. The acting administrator of CMS, Liz Richter, wrote to Texas officials on April 16, 2021 that CMS under Dr. Verma "materially erred in granting Texas' request for the exemption from the public notice process". Governor Gregg Abbott criticized the Biden administration's rescinding of the Medicaid 1115 Waiver as the action would put state's $11 billion per year funding in Medicaid at jeopardy and betray "Texans who depend on resources made possible by the waiver".
CMS Sends Letter to States Take Action on Kids' Coverage Loss due to System Glitch
The Medicaid coverage during the pandemic soared because of the pause in eligibility requirements. The Medicaid roll increased one-third from 71 million in February 2020 to 94 million in April 2023. After the pandemic-era rules lapsed in the Spring of 2023, states began the cumbersome process of the eligibility review. As part of the eligibility review, 5 million people already lost the Medicaid coverage.
As part of the eligibility review, states are encouraged to automatically check the income thresholds of the families, using income and other data. When that's not enough, state agencies send notices to affected families to verify incomes. When the families fail to respond, "procedural termination" happens. Under normal circumstances, adults may be dropped off the Medicaid roll, but often kids stay back in the Medicaid roll. Because of a "system glitch" the automated renewal mechanism is not working for many of the enrollees in various states and entire families are getting notices for the eligibility proof. When the responses are not forthcoming, the entire families are getting booted out, throwing out millions of children from the Medicaid coverage. CMS sent a letter on August 30, 2023 to the states to assess the automated renewal system. If the states find faults with the automated renewal system, CMS letter advises, they should pause future "procedural termination" and restore the parties affected by the system glitch. Usually children have a lower threshold to meet to retain the Medicaid coverage.
812K Texas Kids Lose Medicaid Coverage
The Dallas Morning News reported in a front-page article on November 24, 2023 that 1.4 million Texans had lost Medicaid coverage after Pandemic-era automatic enrollment had ended. Out of those 1.4 million disenrollment, about 812,000, or about 58%, are children. Texas has a checkered record of maximum number of uninsured people in the nation. In terms of Medicaid disenrollment numbers, Texas ranked number one in both the total number of people booted out of Medicaid or Children Health Insurance Program and the percentage of children among the total disenrollment.
There are two types of disenrollment: (A) Procedural disenrollment and (B) Ineligibility-related disenrollment. Procedural disenrollment happens when the beneficiaries fail to carry out appropriate actions to renew the coverage such as failing to return the renewal packets to the state Department of Health and Human Services. During pandemic, auto-enrollment took care of millions of beneficiaries, but auto-enrollment had been phased out after March 31, 2023 in Texas and other states. The percentage of procedural disenrollment varies by states, ranging from 96% in New Mexico, to 68% in Texas, to 7% in Oregon.
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