Paul Ryan
U.S. Congressman and House Budget Chair Paul Ryan

Credit: Gage Skidmore on Flickr, under Creative Commons (CC BY-SA 2.0).

(WOMENSNEWS)–Congress returns from its Easter recess April 8 to begin reconciling the competing budgets passed by the GOP-controlled House and Democratic-controlled Senate.

That leaves advocates for older women girding for another round of battles with
House Budget Chair Paul Ryan (Republican of Wisconsin)
over the future of Medicare, the old-age health program upon which women disproportionately depend.

In 2010, 44 percent of female Medicare beneficiaries lived in or near poverty compared to 34 percent of men, according to the Washington-based National Women’s Law Center.

“Our 300,000 supporters will do everything they can to oppose Ryan’s proposal to replace Medicare‘s guarantee of health coverage with a voucher for people under age 55 and raise the eligibility for Medicare from 65 to 67 years,” said Julie Tippens, director of strategic partnerships at the Washington-based National Committee to Preserve Social Security and Medicare.

She added that, “These proposals are even more dangerous than when Ryan unveiled them because the worst downturn in the economy since the Great Depression of 1929 has taken a severe toll on the financial resources of younger workers who will need Medicare to survive during retirement.”

Almost half of the nation’s workers have less than $10,000 in retirement savings, according to the Washington-based Employee Benefit Research Institute. Tippens noted that women in their 40s and 50s will have a harder time building a retirement nest egg than men because women earn less during their working years and are more likely than men to take time out of the paid labor force for caregiving responsibilities.

The health care costs of older women became a flashpoint in 2011 when Ryan unveiled his plan to dramatically overhaul Medicare. This time around, Ryan’s opponents are ready.

Satirizing Proposals

To satirize the ageist impact of the GOP’s Medicare proposals, the New York-based Agenda Project Action Fund re-released “Granny Off the Cliff” on March 11. The video features a man in a dark suit who resembles Ryan. He pushes a screaming elderly woman in a wheelchair down a rocky path and then shoves her over a cliff while “America the Beautiful” plays in the background.

“More than 50 million Americans have seen this video on TV and YouTube since we released it in 2011 when Ryan first unveiled his proposals,” said Erica Payne, founder of the progressive policy group. “We produced the video because we wanted to put a face on Ryan’s proposals and show that we have a moral obligation to support our elders. For too long, the fight over the national debt in Congress has focused on debates about percentages and decimal points, and not the damage these proposals do to the daily lives of Americans.”

The National Committee to Preserve Social Security and Medicare, which helped defeat President George W. Bush‘s plan to privatize Social Security in 2005, will present petitions this spring to Congress emphasizing the economic arguments for supporting traditional Medicare. The nonpartisan Congressional Budget Office predicts that individuals would likely pay higher premiums with private coverage than under Medicare.

“Administrative costs would also be higher under private plans because the plans would have less negotiating leverage than under the federal program,” said Tippens. “Medicare‘s costs per beneficiary have slowed dramatically in the last three years and will become even more efficient as the cost control mechanisms of the Affordable Care Act are put in place.”

Mixed Marks

Her committee gives the Democratic-controlled Senate high marks for rejecting the voucher approach to cutting health care costs in its proposed budget for fiscal year 2014, but is concerned that several prominent Democrats, including President Barack Obama, have suggested that Medicare be means tested.

“Higher income people (individuals who earn $85,000 or more and couples who earn $170,000 a year) are already paying higher payroll taxes for Medicare,” said Tippens.

“Including a means test for benefits is part of the GOP’s divide and conquer tactics to decrease the broad-based political support Medicare has enjoyed for decades.”

The Older Women’s League (known as OWL), a Washington-based membership organization, predicts that the battle over Medicare will continue through July when Obama will be required to ask Congress to raise the national debt limit unless the parties forge a grand bargain to decrease the deficit.

“Our members will remind Congress when we call on them in their local offices that election results in November showed that Americans rejected Ryan’s plan to transform Medicare and that it is wrong for the Republicans to continue to chip away at the program,” said Joan Brodshaug Bernstein, OWL‘s president emeritus and a board member.

Options Under Consideration

Among the options being considered by Republicans is changing Medicare‘s deductible and Medigap coverage. Currently, the two parts of Medicare are financed in different ways. Part A, which covers inpatient hospital care, is financed through payroll taxes contributed by employees and employers. Part B, which covers physicians’ services, is financed by monthly premiums paid by Medicare beneficiaries and by general revenue from the federal government.

Certain services covered under Parts A and B require co-payments or deductibles. Some people pay these costs out of pocket; others have them covered by Medigap policies, supplemental insurance that helps older people pay for the portion of services not covered by Medicare.

Rep. Eric Cantor of Virginia, the House majority leader, has proposed combining the deductibles for Part A, the hospital program, and Part B, the doctors’ services, into one $550 deductible.

Another proposal calls for making the $550 annual deductible ineligible for Medigap coverage. Republicans claim this change would decrease excessive use of health care services.

A third proposal calls for a 10 to 20 percent co-payment for all services until beneficiaries reach a catastrophic limit of $7,500.

Although the Congressional Budget Office estimates that these changes would save the federal government about $93 billion over the next decade, OWL and other groups predict that they would take a heavy toll on the elderly, who now spend 15 percent of their income on out-of-pocket health expenses, three times the amount of non-Medicare individuals.

“Most Medicare beneficiaries live on modest incomes (over half of Medicare beneficiaries had an income of less than $22,500 in 2012) and are not in a position to pay more for health care,” said Bernstein, who authored OWL‘s 2007 Mother’s Day Report on Medicare. “This is especially true of women who live longer than do men and are more apt to have exhausted their financial resources.”

A poll by Kaiser Family Foundation and the Harvard School of Public Health in January 2013 found that 77 percent of Americans reported that Medicare was personally important to their families. Fifty-eight percent opposed Medicare spending cuts.

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