Why We Need the Affordable Care Act

Last week the Supreme Court held arguments on the constitutionality of several provisions of the Affordable Care Act (ACA). And earlier this spring, House Budget Chair Paul Ryan released a proposed budget that would repeal the ACA (See Generations United’s response to the Ryan budget). Generations United is very concerned that repealing the ACA will have a serious and detrimental impact on the long-term budget outlook for the national and undo many critical provisions that support America’s most vulnerable populations.

The Government Accountability Office recently released a report entitled “The Federal Government’s Long-Term Fiscal Outlook.” This report concluded that repealing key provisions of the ACA would contribute to a significant increase in the federal debt due to spending on Medicare and Medicaid. According to the GAO, without the ACA in place, spending on Medicare and Medicaid would grow to over eight percent of GDP by 2030.

As a result of the reforms made in the ACA, Medicare is expected to save $418 billion over 10 year. The savings will come from making Medicare more efficient by improving the way health care providers deliver care, modernizing how Medicare pays for those services, and eliminating waste, fraud, and abuse. The GAO report highlights the importance of not recklessly overturning the ACA, or using other means such as the Ryan budget proposal to mandate ACA repeal along with attacks Medicare and Medicaid.

Generations United strongly supports the ACA. The intergenerational provisions within the bill provide vital health care protections and services to children and older adults. However, these benefits are not yet guaranteed. Since the ACA’s provisions are phased in gradually, lawmakers must continue to fund and support the implementation of the ACA for all its provisions to take full effect.

Learn about these benefits and more in Generations United's fact sheet, Health Care Benefits for Children & Older Adults: The Affordable Care Act.

-Eric Masten and Rachel Snell

Response to Ryan’s Budget Plan

Yesterday, Congressman Paul Ryan presented his latest “Pathway to Prosperity” budget. After examining the document, Generations United was deeply troubled by many of the proposals contained in it because they would significantly reduce funding to the critical social safety net for America’s most vulnerable children, youth and older adults. Here is our analysis of the Ryan budget.

Food and Nutrition

If enacted, Ryan’s plan would convert the Supplemental Nutrition Assistance Program (SNAP) into a block grant. In the long term, this would harm tens of millions of children, families, and older adults who rely on this critical safety net program. Hunger, food insecurity, and poverty are significant problems affecting millions of people in the U.S. and are expected to persist at high levels due to the weakened economy.

Higher Education

Additionally, the Ryan budget proposes to restructure Pell grants by “limiting the growth of financial aid and focusing it on low-income students.” Without specific language, it is hard to gauge the full impact of this proposal. When combined with additional budget cuts, this would surely limit access to this critical program that serves nearly 10 million college students.

Health Care

Proposed changes to essential health programs are even more concerning. The Ryan budget calls for repealing the Affordable Care Act (ACA). The act provides critical health benefits to an estimated 19 million children and older adults by 2019 and includes provisions that would save $418 billion in Medicare costs over 10 years. In place of the ACA, the Ryan budget proposes that employers provide a cash supplement for their employees to purchase health care on the open market. That proposal ignores the troubling question of how our nation’s most vulnerable, including the unemployed or underemployed, will access health care.

The budget also proposes to convert Medicaid to a block grant, shifting the costs and risks to states, providers, and beneficiaries. With state budgets already overstretched, that move could jeopardize access to critical health services and put states in the difficult position of choosing between providing health care coverage for children's doctor visits or long-term care for older adults.

While ensuring existing Medicare benefits for those over 55, the Ryan budget would provide an unspecified amount of money directly to younger workers and require them to buy their own coverage in a way that may not guarantee the same coverage seniors have come to trust from Medicare. While Generations United believes the nation must address Medicare spending, this proposal sets up the potential for younger workers to not receive the care they need when they age.

Social Security

While the specifics in Ryan’s plan are unclear, we know his claims that it will “strengthen” Social Security are false. In reality, the provisions he has outlined would result in cuts for beneficiaries, many of whom increasingly rely on Social Security as a safeguard against poverty. Despite knowing first-hand the role Social Security plays in the lives of children and youth, Ryan refers to Social Security solely as a retirement security program. Social Security is more than a retirement program. Nearly seven million children receive part of their family income from Social Security today.

The Federal Budget

To balance the budget and reduce the deficit, the Ryan budget proposes measures that would dramatically slash spending and place children, youth and older adults at risk. These measures include relying on six separate committees to recommend cuts. These cuts would be directed at domestic spending including nutrition, Medicare, and Medicaid. Additionally, the Ryan budget would require caps on both discretionary and mandatory spending, beyond what was agreed to in the final budget agreement reached in fall 2011. Any increases to mandatory spending would require Congress to reduce other spending to pay for the increases and to “review mandatory spending programs” regularly. This sets up a dangerous situation where vital safety net services could be cut to pay for needed increases in mandatory spending. Generations United opposes any deficit reduction plan that puts the burden of cuts on the backs of the most vulnerable Americans. We must ensure that budget reduction is done in a responsible manner that truly reflects shared sacrifice, without disproportionately burdening the most vulnerable.

We at Generations United strongly support investing in our country’s economy and people. These investments include creating opportunities for vulnerable people to overcome hunger and poverty, extending the rights of today’s youth to continue their education through college, and for today’s older adults to receive affordable care on a fixed income. These investments are needed more than ever in today’s economy. If we fail to support them, we fail our commitment to the generations before and after us. The true path to prosperity is through strengthening our safety net and investing in our country; not by cutting critical supports to Americans in need and balancing the budget on the backs of the most vulnerable.

-Eric Masten

Generations United's Reponse to Possible Social Security Cuts

 

Photo: Pete Souza | Official White House Photo



Today, news outlets announced that President Obama plans to propose significant reductions in Medicare spending and for the first time will offer to tackle the rising cost of Social Security.

  

Experts are speculating that the President is considering Social Security cuts to the Cost of Living Adjustment (COLA). This would be done by changing the formula used to calculate the annual COLA to the so-called chained-CPI (Consumer Price Index). This technical change would cut the benefits people have earned – whether they receive Social Security now or in the future. After ten years, average retiree benefits will be cut by about $600 a year, and after 20 years, they will be cut by about $1,000 a year.

Generations United is focused on protecting Social Security and Medicare for the millions of children, families, and retirees that rely on these critical programs. Furthermore, Social Security did not contribute to the deficit, and it should not be cut to reduce a deficit it did not cause. Generations United urges Congress to balance the budget in a responsible way that doesn't do so on the backs of our nation's most vulnerable citizens.



Generations United believes the best way to invest in and protect our nation’s most vulnerable citizens is to strengthen Social Security, not cut it. Social Security plays a critical role in providing economic security and indispensable protections for children, families, and retirees. Social Security provides vital support for children, in addition to older adults, covering 98 percent of all children in the event of the death or disability of a caregiver.



In order to improve Social Security for future generations, Generations United continues to advocate for one low-cost recommendation that would strengthen Social Security for future generations: reinstating the student benefit. Restoring the Social Security student benefit would offer students whose parents are deceased and disabled the support they need to become the educated workforce our country’s economy needs. To read more about our recommendation, download our publication Social Security: What's at Stake for Children, Youth, and Grandfamilies.



To read more about this story, check out today’s Washington Post article.

To read more about the COLA cut, check out the Strengthen Social Security Campaign’s analysis.

Generations United's Response to The President’s Deficit-Reduction Speech

As the President made clear in his speech yesterday, “we are all connected…some things we can only do together.” Generations United applauds the President for recognizing that fiscal policy affects all generations and for advocating for a balanced deficit reduction plan focused on shared sacrifice. As the President stated, programs such as Social Security, Medicare, and Medicaid not only protect aging seniors, poor children, and those with disabilities, but they provide each of us with “some basic measure of security…in hard times or bad luck, [in the event of] a crippling illness, or a layoff [which] may strike any one of us.”

Generations United supports the President’s pledge to invest in and protect our nation’s most vulnerable citizens by strengthening Social Security. Social Security provides vital support for children, in addition to older adults, covering 98 percent of all children in the event of the death or disability of a caregiver.

We also support the President’s effort to reform the tax code to promote balanced economic growth and provide adequate revenues to address the needs of our citizens and to preserve Medicare and Medicaid for future generations. Proposals which would change Medicaid to a block grant would leave states with inadequate funding and ultimately shift the burden of medical costs onto the backs of seniors and poor families.

Generations United strongly opposes proposals which deny low-income individuals, young and old, access to programs vital to their economic security while giving tax breaks to the wealthy, protecting corporate tax subsidies, and shifting the burden to the middle class.

We urge our members and supporters to reject extreme proposals which would weaken these critical federal protections, prolong our economic recession, and endanger the welfare of the young, old, and disabled.

Generational Fiction in Times Op-Ed

Richard Dooling, a successful novelist, tries his hand at health policy in a provocative, though ultimately misguided, op-ed today’s New York Times.

It’s the job of any novelist to make his narrative stimulating and interesting, but the picture Dooling paints of greedy seniors selfishly milking away the earnings of grandchildren while they receive unnecessary medical treatment is farcical. Dooling creates a false choice between funding unnecessary and expensive surgeries for terminal patients and funding preventive care for children:
[…] shouldn’t we instantly cut some of the money spent on exorbitant intensive-care medicine for dying, elderly people and redirect it to pediatricians and obstetricians offering preventive care for children and mothers?

The source of the rising cost doesn’t come from seniors’ desire to rip off their grandchildren, as Dooling suggests, it comes from a poorly structured Medicare reimbursement system that pays for procedures and not health outcomes. Healthcare reform is not about denying care for seniors, it’s about changing the incentives of Medicare payments so that seniors get better outcomes. The Mayo Clinic is able to bill Medicare significantly less than other hospital systems, yet delivers excellent care. Medicare needs to reward healthcare systems like the Mayo Clinic and pay for progress, not process.

Dooling is correct that healthcare reform is also about extending healthcare coverage to the 8 million uninsured and underinsured children in America, but grandchildren don’t want to get healthcare if it means taking away their grandparents’ arthritis medication (especially since about 4.5 million children are being raised by grandparents). Our country has provided healthcare to all seniors; it’s now time to extend that benefit to all children. Threatening generational warfare may not be a novel technique in public policy debates; it is, however, tired and worn. We are not a country of isolated self-interested generations, but of connected and interdependent families and communities.

-Terence Kane
Note: The following is published from The Hill's Pundits Blog.