FY 2018 Omnibus Appropriations Bill Letter

March 14, 2018

The Honorable Thad Cochran
Chairman
Committee on Appropriations
United States Senate
Washington, D.C., 20510

The Honorable Rodney Frelinghuysen
Chairman
Committee on Appropriations
U.S. House of Representatives
Washington, D.C., 20515

The Honorable Patrick Leahy
Ranking Member
Committee on Appropriations
United States Senate
Washington, D.C., 20510

The Honorable Nita M. Lowey
Ranking Member
Committee on Appropriations
U.S. House of Representatives
Washington, D.C., 20515

Dear Chairmen Cochran and Frelinghuysen and Ranking Members Leahy and Lowey:

On behalf of the millions of members and supporters of the National Committee to Preserve Social Security and Medicare, I am writing to ask that as you develop legislation that funds the federal government for the remainder of fiscal year (FY) 2018 you prioritize funding for vitally important programs that America’s seniors depend on to meet the needs of their daily lives.

Members of the National Committee come from all walks of life and every political persuasion. What unites them is their passion for protecting and strengthening Social Security, Medicare, Medicaid, and the other programs that are so vitally important to older Americans. What follows are our
recommendations regarding funding for these programs for the remainder of FY 2018.

SOCIAL SECURITY

Adequate administrative funding for the Social Security Administration (SSA) is among our highest priorities for the remainder of FY 2018. Budget cuts since 2010, estimated to equal 11 percent (after adjusting for inflation), have led to long waits on the phone and in field offices for taxpayers and beneficiaries, as well as a record high backlog of 1.1 million disability hearings.

So far, both the President and House of Representatives appear intent on basically flat-lining the agency’s appropriation relative to FY 2017. Unfortunately, the Senate Labor-HHS Appropriations Subcommittee contemplated a $493 million cut in SSA’s funding level. The National Committee strongly urges that funds be made available in the recently-enacted budget agreement to provide SSA with at least an additional $560 million over the FY 2017 appropriated level of $12.482 billion.

This increase will help to restore the cuts made since 2010 and cover annual inflationary increases, which SSA estimates currently are running at about $378 million. I also believe a similar increase should be included in the FY 2019 appropriations bill. Providing continuity of funding in FY 2019 would strengthen the ability of a new Commissioner to address service delivery issues that currently are plaguing SSA.

MEDICARE

State Health Insurance Assistance Program (SHIP)

The National Committee urges you to restore funding for the State Health Insurance Assistance Program (SHIP) to the Fiscal Year 2016 level of $52.1 million. Even this amount does not keep pace with inflation or the growing number of Medicare beneficiaries who need SHIP services.

Medicare is a complex program, and unbiased, personalized counseling is necessary to ensure that Medicare beneficiaries understand their rights and coverage options. SHIPs provide critically important services that go beyond what is available through 1-800-MEDICARE, on-line or written materials or other outreach activities. Currently, a network of more than 3,300 local SHIPs and over 15,000 counselors, 57 percent of whom are highly-trained volunteers, are providing one-on-one, face-to-face counseling to ensure that Medicare beneficiaries make the best choices for their situation, avoid late enrollment penalties and receive assistance when appealing denials of coverage. Investing in SHIP will help ensure that America’s seniors and people with disabilities make wise decisions about their Medicare coverage.

Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act, (S. 1909, H. R. 2575)

The BENES Act is bicameral, bipartisan legislation that would help people avoid costly mistakes due to confusion about when to enroll in Medicare and would eliminate current coverage gaps. I urge that the provisions of this legislation be included in the Fiscal Year 2018 Omnibus Appropriations bill.

While many individuals are automatically enrolled in Medicare because they are receiving Social Security benefits, an increasing share of newly-eligible beneficiaries must actively enroll because they are not yet receiving Social Security. The BENES Act requires that a clear and detailed notice explaining Part B enrollment rules is mailed to all individuals near the Medicare eligibility age and those nearing eligibility because they receive Social Security disability benefits. Knowing whether and when to enroll in Part B requires that a person understand when to sign up, how their current insurance will work with Medicare, and what penalties may result if enrollment is delayed. The BENES Act also aligns and simplifies Part B enrollment periods to eliminate coverage gaps that occur under current law. For example, a person enrolling during the open enrollment period from January through March of each year does not receive coverage until July. The consequences of missteps can be significant and often lead to a lifetime of higher Part B premiums.

MEDICAID

EMPOWER Care Act (S. 2227)

The Money Follows the Person (MFP) rebalancing demonstration program was designed to provide Medicaid recipients needing long-term services and supports (LTSS) more options about where they live and receive care, and to increase state capacity to serve people in community—as opposed to institutional—settings. Federal funding for MFP expired on September 30, 2016. The delay in extending MFP has already caused states to scale back their programs. Without funding, states may be forced to eliminate these programs entirely. Thus far, the program has helped more than 75,000 older adults and people with disabilities to leave institutions and return to the community.

The National Committee urges Congress to extend the program by passing the provisions in the EMPOWER Care Act as part of the FY 2018 Omnibus Appropriations bill.

AFFORDABLE CARE ACT

Under the Affordable Care Act (ACA), marketplace plan enrollees, including “near seniors” age 50 to 64, can be charged no more than three times what a 21-year-old would pay. Proposals being considered as part of market stabilization provisions of the FY 2018 Omnibus Appropriations bill would broaden the age bands to 5 to 1, allowing insurers to charge the oldest consumers five times more than younger ones. When the Congressional Budget Office analyzed this proposal in the past it predicted that by 2026 this provision would substantially raise premiums for older people. For example, premiums would rise 20-25 percent higher for a 64-year-old. The National Committee urges Congress not to increase the ACA marketplace age bands in the Omnibus Appropriations bill.

OLDER AMERICANS ACT

I urge you to ensure the highest possible levels of funding for Older Americans Act (OAA) programs. Current funding has failed to keep pace with inflation or the growing number of people relying on these programs which help make it possible for seniors to remain as independent as possible in their homes and communities. In particular, the National Committee supports the House-passed increase of $14.2 million for Title III B Supportive Services ($364.2 million), and the Senate-proposed levels of funding for the Senior Community Service Employment Program (SCSEP) ($400 million) and Elder Justice programs ($10 million).

CONCLUSION

Automatic spending caps required by the Budget Control Act of 2011 have resulted in significant funding cuts to most federal agencies and programs that serve seniors at the same time their population is growing by 10,000 people a day. The Social Security Administration, Older Americans Act programs and the State Health Insurance Assistance Program cannot keep up with the demands of this growing population unless they receive funding increases in the FY 2018 Omnibus Appropriations bill to make up for several years of budget cuts or flat funding. In addition, harmful proposals like increasing age rating of ACA marketplace plan premiums should be kept out of this legislation and the extension of the Medicare Money Follows the Person program and the BENES Act should be included in the bill. The National Committee urges Congress to make these investments and improvements in the FY 2018 Omnibus Appropriations bill to ensure that America’s seniors can live independent and dignified lives.

Sincerely,

Max Richtman
President and CEO

cc:
The Honorable Mitch McConnell
Majority Leader
United States Senate
Washington, D.C., 20510

The Honorable Charles Schumer
Minority Leader
United States Senate
Washington, D.C., 20510

The Honorable Paul Ryan
Speaker
U.S. House of Representatives
Washington, D.C., 20515

The Honorable Nancy Pelosi
Minority Leader
U.S. House of Representatives
Washington, D.C., 20515