Entitlements: Who’s Entitled to What? Social Security Medicare Medicaid Affordable Care Act Older Americans Act

The National Committee to Preserve Social Security and Medicare Laura Feldman Grassroots Manager

3 Fairy Tales There are two kinds of fairy tales Those that begin with…….. “Once Upon a Time” Those that begin with……. “If elected, I Promise”

4 “Entitle” “To furnish with a right or claim to something.” (American Heritage Dictionary) (Legally) Access to benefits by right of law (Psychology) A symptom of narcissism

5 Entitlements Earned Eligible Expected Elective Egocentric

6 American’s have debated since 1776 on the Role of Government How much government is too much? What is the role of government? How many rights should states have? How much power to the President? How many individual rights? Taxation? Regulation? Personal freedom?

7 Social Security An EARNED entitlement

8 Social Security Act of 1935 “It shall be the duty of the Secretary of the Treasury to invest such portions of the amounts credited to the account as is not, in his judgment, required to meet current withdrawals. Such investment shall be made only in interest bearing obligations of the US or in obligations guaranteed as to both principal and interest by the US.”

9 Social Security by the Numbers 2015: Benefits exceed income, excluding interest, when Boomers start drawing Social Security benefits 2020: Surplus grows to $4.2 trillion 2037: Trust Fund Assets exhausted Approximately 75% of benefits will continue to be paid if no changes are made to system. Social Security will not go BROKE

10 Social Security Facts million people received benefits 34 million retired workers and their dependents 6 million survivors of deceased workers 8 million disabled workers and their families 163 million paid Social Security payroll taxes in 2010

11 What is Social Security worth? $450,000 equivalent to a life insurance policy for a family with two children $450,000 equivalent to a disability insurance policy for a family with two children 69% of Social Security benefits go to retired persons 17% of Social Security benefits go to people with disabilities 14% of Social Security benefits go to survivors The average Social Security benefit is $14,100 a year, less for women

12 Social Security & the Deficit Social Security has not contributed one dime to our nation’s debt Annual surpluses in Social Security have been used for years to help mask the true size of the federal debt Social Security currently has accumulated a surplus of 2.6 trillion dollars Social Security is not the trouble; it is the target

13 Reasons to strengthen Social Security Social Security is our safety net against poverty for many Americans Social Security is a guaranteed benefit Social Security provides disability benefits for all eligible workers Social Security benefits provide inflation protection Social Security is an earned benefit

Payroll Tax “Holiday” In 2011 workers will pay 4.2% in to Social Security instead of 6.2% This will cost the SS Trust Fund $120 billion in lost contributions in 2011 Amount to be paid back with borrowed funds from general revenue in 2012 Extending the “holiday” would leave Social Security dependent on general fund revenues rather than workers’ contributions and double Social Security’s 75 year projected shortfall

15 Social Security Messages SS is not responsible for our budget deficit SS is owed 2.6 trillion from the federal government SS is our money not the governments In this recession, SS has been the only source of financial security for many American’s. SS can pay the beneficiaries in full until 2037

16 Common Sense Solutions Raise retirement age-already in place Increase maximum amount of earning subject to FICA to 90% of average wages, SS cap is now $106,800 which is 84% of average wages Slight increase in payroll tax Make program universal by covering newly hired state and local employees

17 What can you do? Contact your Representative & Senator Write a letter to the editor with a personal story Join the National Committee Vote for a candidate who reflects your interests for economic & health security NC Legislative hotline 800/998/0180

18 Health Care Who is ENTITLED to health care?

19 The Affordable Care Act passed in March 2011 On March 23, 2010 President Obama signed the Patient Protection and Affordable Care Act. The new law will extend coverage to over 30 million uninsured Americans Some changes are already taking place and parts of the law will take until 2014 to be fully implemented

20 Health Care Goals To slow the rising cost of health care To end pre-existing conditions clause To end life time caps on health insurance policies To extend the life of the Medicare Trust Fund To cover 30 million uninsured To improve benefits and lower cost

21 Straight Facts on Health Reform The law will improve care for all Americans by: 1. Reduce costs for age and gender rating 2. End pre-existing conditions clause 3. Cover children on their parents policy until age Ban caps on lifetime coverage 5. Ban dropping coverage when sick 6. Help small businesses with tax credits

22 Better Health Coverage for people ages Immediate high risk pool for uninsured Help employers to pay for early retirees health care End annual limits on coverage End pre-existing condition clause Better preventive & chronic care

23 Women and Health Reform Up to 4.5 million women will be eligible for coverage through Medicaid About 11 million women will receive insurance subsidies Ban gender rating Women will have access to obstetrical and gynecological care Reduce age rating

24 Medicare An ELIGIBLE entitlement

25 Medicare and the 2011 Affordable Care Act Medicare, established in 1965 is the federal health care plan for people 65 years and older and those under 65 with certain diseases or disabilities In 2010, 45 million people were covered by Medicare: 38 million age 65 and older and 7 million disabled people

26 Medicare and Health Reform The law will reduce Medicare costs and extend the Medicare Trust Fund by 12 years 1. Slow the rate of payment to providers 2. Reduce fraud and abuse 3. Reduce payments to Medicare Advantage plans & increase benefits 4. Create a new Medicare Advisory Board

27 Medicare Policy Challenges Contain spending growth with the boomer generation reaching 65 Protect the most vulnerable elders Fix physician payment rates The role of private plans The prescription drug benefit costs Improving value with added benefits

28 Original/Private Medicare Original Medicare plans provide the same coverage in all 50 states. Parts C & D are “private” Medicare supplements with over a thousand different plans across the United States provided through state based insurance companies regulated by Medicare.

29 Medicare Maze Part A=Hospital Care Part B=Outpatient, doctor care A & B, together are original Medicare Part C=Medicare Advantage or managed care supplemental Part D=The Prescription Drug Benefit

30 Medicare & Health Reform Savings Reduce Medicare Advantage plans overpayments Reduce prescription drug costs and close the donut hole by 2020 Reduce Medicare fee-for-service payment rates Reduce fraud and abuse costs

31 Health Care Benefits for Seniors in 2011 Free medical check up each year Most preventive screenings are free Prescription drug discounts in the donut hole on brand name and generic drugs Bonuses for primary care providers Better coordination of care and follow up after hospitalization

32 Medicaid An ELIGIBLE entitlement

33 Medicaid Our nations primary insurance program for high-need individuals. A joint federal and state-run program that provides health care coverage for low income people and those who need long-term services or nursing care.

34 Medicaid Eligibility and coverage differ from state to state. Cost is Federal and State. Core benefits are guaranteed. It covers more than 1 in 4 of the nation’s children. 60% of all nursing home residents are covered by Medicaid.

35 The Class Act An ELECTIVE entitlement

36 Community Living Assistance Services & Supports (CLASS) Act The Class Act, created under the Affordable Care Act, is a voluntary, federally administered, consumer- financed insurance plan. CLASS will be administered by the AoA. It will begin in 2013 and begin to pay benefits in 2018 for long term care services at home.

37 CLASS Act Program/Benefits Most working adults will be able to make voluntary premium payments and need to pay for five years before being eligible to receive a daily cash benefit to pay for home care services. The program will be self sustaining and receive no federal funds.

38 The Older Americans Act An ELIGIBLE entitlement

39 Older Americans Act The Older Americans Act established the Administration on Aging and the Aging Services Network, including 632 Area Agencies on Aging; 240 Title VI Native American Programs; and over 30,000 service provider organizations.

40 Older Americans Act Services Supportive Services and Senior Center programs Nutrition Services and Education Disease Prevention and Health Services National Family Caregiver Support Program Elder Rights Protection Grants for Native Americans Community Services Senior Opportunity Act

41 TAXES I EARNED my money the hard way I’m ELIGIBLE for the deductions I take I EXPECT to keep my hard earned $ I ELECT to not pay for others I am not EGOCENTRIC, I’m good for the economy

42 Final Thoughts on Senior’s Health & Retirement Security Health reform is NOT A Government take over of health care The law is a “process” not an event The Affordable Care Act is an “uniquely American” solution to provide quality health care for more American’s at a lower cost Timely and proper implementation will be key to Success or Failure to begin to contain healthcare costs for all Americans

43 Social Security’s Future Is up to all of US Social Security today has 163 million people paying in to the system Social Security’s surplus is 2.6 trillion Social Security is now raising the full retirement age to 67 over 25 years Social Security keeps most seniors out of poverty and in their own homes Social Security is an earned benefit

44 Where you can find the National Committee Entitledtoknow.org Facebook.com/NationalCommittee Youtube.com/nationalcommittee 1/ member services 1/ Legislative Hotline

45 THANK YOU For more information, please view the National Committee website or contact me at To speak with your Senator or Representative, use the NC Legislative Hotline at