- Medicare Advantage ads will look different this fall Axios
- As Medicare Enrollment Approaches, So Do Misleading Ads AARP
- KFF Research Shows that Medicare Open Enrollment TV Ads Are Dominated by Medicare Advantage Plans Featuring Celebrities, Active and Fit Seniors, and Promises of Savings and Extra Benefits Without Fundamental Plan Information KFF
- Low-income seniors report deceptive Medicare marketing: study FierceHealthcare
- New Medicare Advantage Marketing and Sales Rules Will Help Better Protect Consumers AARP Blogs
- View Full Coverage on Google News
Tag Archives: Medicare
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Trump urges GOP to avoid cuts to Social Security, Medicare
“While we absolutely need to stop Biden’s out-of-control spending, the pain should be borne by Washington bureaucrats, not by hard-working American families and American seniors,” Trump said. “Cut waste, fraud and abuse everywhere that we can find it and there is plenty there’s plenty of it. But do not cut the benefits our seniors worked for and paid for their entire lives. Save Social Security, don’t destroy it.”
Trump also suggested cuts to foreign aid, “left wing gender programs from our military,” and “billions being spent on climate extremism.”
Trump’s message comes as newly emboldened House Republicans are trying to leverage the standoff over the debt limit to extract major spending cuts, insisting that previous Congresses and administrations have spent too much on social programs. Some GOP lawmakers have raised the prospect of seeking changes to popular entitlement programs, including Social Security and Medicare.
Contrary to Trump’s claims, the national deficit grew substantially during his tenure, in part due to tax cuts passed in 2017 at his urging by the Republican-led Congress. In fact, the national debt rose by nearly $7.8 trillion while Trump was in office.
Republicans, including House Speaker Kevin McCarthy (R-Calif.), voted to raise the debt ceiling three times during Trump’s tenure without insisting on spending cuts in return. The GOP demand for cuts — and threats of a debt default — have occurred when a Democrat is in the White House, such as Barack Obama in 2011 and President Biden now.
On Thursday, the administration began “extraordinary measures” to prevent the federal government from breaching its debt limit. Treasury Secretary Janet L. Yellen told lawmakers that officials will alter certain federal investments to preserve the nation’s credit until summer — largely through technical moves that will buy lawmakers time to pass legislation raising the limit.
Last year’s midterm elections underscored the political peril of advocating, or even the appearance of advocating, cuts to popular entitlement programs.
Democrats, including Biden, seized on a plan issued by Sen. Rick Scott (R-Fla.) that called for requiring all legislation to be renewed every five years — or wiped off the books. Democrats stressed that Social Security and Medicare were created by legislation.
Senate Minority Leader Mitch McConnell (R-Ky.) and other leading Republicans rapidly distanced themselves from Scott’s plan.
At event after event, Biden accused Republicans of wanting to put the two programs “on the chopping block,” pointing to Scott’s plan, even though it made no explicit call to cut Medicare or Social Security.
During the 2016 campaign, Trump was critical of then-Rep. Paul D. Ryan (R-Wis.), the 2012 GOP vice-presidential nominee, for pushing for changes to Medicare and Social Security.
In fact, Trump seemed to blame Mitt Romney’s loss in the 2012 presidential election on his running mate. Trump said that Romney was hurt by Ryan’s previous calls to change Social Security and other entitlement programs for the elderly.
“That was the end of that campaign, by the way, when they chose Ryan,” Trump said in February 2016. “And I like him. He’s a nice person, but that was the end of the campaign.”
Shortly after Republican nominee Romney picked Ryan as his running mate, the progressive policy group Agenda Project Action Fund ran an ad attacking Ryan’s stance on Medicare that showed an elderly woman in a wheelchair being thrown off a cliff by a man in a dark suit. The message on the screen: “Mitt Romney made his choice. … Now you have to make yours.”
Jacob Bogage and Jenna Johnson contributed to this report.
Alzheimer’s drug lecanemab receives accelerated FDA approval amid safety concerns
CNN
—
The US Food and Drug Administration granted accelerated approval Friday for the Alzheimer’s disease drug lecanemab, one of the first experimental dementia drugs to appear to slow the progression of cognitive decline.
“Alzheimer’s disease immeasurably incapacitates the lives of those who suffer from it and has devastating effects on their loved ones,” Dr. Billy Dunn, director of the Office of Neuroscience in the FDA’s Center for Drug Evaluation and Research, said in a statement. “This treatment option is the latest therapy to target and affect the underlying disease process of Alzheimer’s, instead of only treating the symptoms of the disease.”
Lecanemab will be marketed as Leqembi, the FDA statement said. It has shown “potential” as an Alzheimer’s disease treatment by appearing to slow progression, according to Phase 3 trial results, but it has raised safety concerns due to its association with certain serious adverse events, including brain swelling and bleeding.
In July, the FDA accepted Eisai’s Biologics License Application for lecanemab under the accelerated approval pathway and granted the drug priority review, according to the company. The accelerated approval program allows for earlier approval of medications that treat serious conditions and “fill an unmet medical need” while the drugs continue to be studied in larger and longer trials.
If those trials confirm that the drug provides a clinical benefit, the FDA could grant traditional approval. But if the confirmatory trial does not show benefit, the FDA has the regulatory procedures that could lead to taking the drug off the market.
Lecanemab, a monoclonal antibody, is not a cure but works by binding to amyloid beta, a hallmark of Alzheimer’s disease. In late November, results from an 18-month Phase 3 clinical trial published in The New England Journal of Medicine showed that lecanemab “reduced markers of amyloid in early Alzheimer’s disease and resulted in moderately less decline on measures of cognition and function than placebo at 18 months but was associated with adverse events.”
The results also showed that about 6.9% of the trial participants given lecanemab, as an intravenous infusion, discontinued the trial due to adverse events, compared with 2.9% of those given a placebo. Overall, there were serious adverse events in 14% of the lecanemab group and 11.3% of the placebo group.
The most common adverse events in the lecanemab group were reactions to the intravenous infusions and abnormalities on their MRIs, such as brain swelling and bleeding called amyloid-related imaging abnormalities, or ARIA, which can become life-threatening.
Some people who get ARIA may not have symptoms, but it can occasionally lead to hospitalization or lasting impairment. And the frequency of ARIA appeared to be higher in people who had a gene called APOE4, which can raise the risk of Alzheimer’s disease or other dementias. ARIA “were numerically less common” among APOE4 noncarriers, the study showed.
The drug’s prescribing information carries a warning about ARIA, the FDA says.
The trial results also showed that about 0.7% of participants in the lecanemab group and 0.8% of those in the placebo group died, corresponding to six deaths in the lecanemab group and seven in the placebo group.
The Alzheimer’s Association welcomed Friday’s decision.
“By slowing progression of the disease when taken in the early stages of Alzheimer’s, individuals will have more time to participate in daily life and live independently,” President and CEO Joanne Pike said. “This could mean more months of recognizing their spouse, children and grandchildren. This could also mean more time for a person to drive safely, accurately and promptly take care of family finances, and participate fully in hobbies and interests.”
More than 6.5 million people in the United States live with Alzheimer’s disease, according to the Alzheimer’s Association, and that number is expected to grow to 13.8 million by 2060.
Lecanemab will carry a wholesale price of $26,500 per patient per year, the drug’s manufacturers announced Friday.
Biogen and Eisai have listed the drug slightly below the reduced price of the Alzheimer’s medication Aduhelm, which now costs an average patient about $28,200. The companies had to lower the cost of Aduhelm – originally set at $56,000 per patient per year – after insurers balked at covering it.
In justifying the cost of Leqembi, the companies said in a news release that based on the estimated quality of life gained by people who take it, the value of the medication to society is around $37,000 a year, but they chose to go lower “aiming to promote broader patient access, reduce overall financial burden, and support health system sustainability.”
The wholesale cost of a drug is akin to a car’s sticker price. It isn’t necessarily what patients will pay after insurance or other discounts are factored in.
Insurance coverage for this medication is not a given, however. Medicare restricted its coverage of lecanemab’s sister drug, Aduhelm, after clinical trials showed questionable benefits to patients. The agency agreed to cover the drug only for people enrolled in registered clinical trials, which limited access to the medication.
Center for Medicare and Medicaid Services Administrator Chiquita Brooks-LaSure said after the FDA’s decision Friday that her office would quickly review Leqembi, but for now, because of its accelerated approval, it will be covered the same way Aduhelm is covered.
“At CMS, we will continue to expeditiously review the data on these products as they become available and are committed to timely access to treatments, including drugs, that improve clinically meaningful outcomes,” Brooks-LaSure said in a statement.
Last month, the Alzheimer’s Association filed a formal request asking CMS to provide “full and unrestricted coverage” Alzheimer’s treatments approved by the FDA.
“What the FDA did today in granting accelerated approval to Leqembi was the right decision. But what CMS is doing by severely restricting coverage for approved treatments is unprecedented and wrong,” Pike said in a statement Friday.
“The FDA carefully reviewed the evidence for Leqembi before granting approval. CMS, in sharp contrast, denied coverage for Leqembi months ago before it had even reviewed this drug’s evidence. CMS has never done this before for any drug, and it is clearly harmful and unfair to those with Alzheimer’s. Without access to and coverage of this treatment and others in its class, people are losing days, weeks, months – memories, skills and independence. They’re losing time.”
CMS told CNN that it will review and respond to the association’s request. The agency also noted that it continues to stay informed about ongoing clinical trials, including the most recent lecanemab results published in the New England Journal of Medicine. Also, it has met with drugmakers to learn about their efforts since CMS’s coverage decision was announced.
The FDA approved Aduhelm for early phases of Alzheimer’s disease in 2021 – but that decision has been shrouded in controversy as a congressional investigation found last week that the FDA’s “atypical collaboration” to approve the high-priced drug was “rife with irregularities.”
Before Aduhelm, the FDA had not approved a novel therapy for the condition since 2003.
Aduhelm’s FDA approval and initial hefty price tag hit Medicare’s Part B premiums, driving up the 2022 standard monthly payments by 14.5% to $170.10.
About $10 of the premium spike – or just under half the amount – was due to Aduhelm, a CMS official told CNN in late 2021.
The premium increase was set before Medicare announced its limited coverage of the drug, but its actuaries had to make sure that the program had sufficient funding in case Aduhelm was covered.
Medicare’s decision, as well as Biogen’s slashing of the drug’s cost, prompted a decline in monthly premiums for 2023 to $164.90.
The FDA’s accelerated approval of lecanemab was expected, said Dr. Richard Isaacson, director of the Alzheimer’s Prevention Clinic in the Center for Brain Health at Florida Atlantic University’s Schmidt College of Medicine.
Isaacson said lecanemab can be “another tool” in his toolbox to fight Alzheimer’s disease.
“I will prescribe this drug in the right person, at the right dose and in a very carefully monitored way, but this drug is not for everyone,” he said.
“I would do genetic testing for APOE4 first. I would have a frank discussion with my patients,” he said. “If someone is having side effects, if someone is on a blood-thinning medication, if someone has a problem, they need to discuss this with the treating physician, and they need to seek medical attention immediately.”
What to know as record 8.7% Social Security COLA goes into effect
Kathrin Ziegler | Digitalvision | Getty Images
As inflation has kept prices high in 2022, Social Security beneficiaries may look forward to a record high cost-of-living adjustment in 2023.
“Your Social Security benefits will increase by 8.7% in 2023 because of a rise in cost of living,” the Social Security Administration states in the annual statements it is currently sending to beneficiaries.
The 8.7% increase will be the highest in 40 years. It is also a significant bump from the 5.9% cost-of-living increase beneficiaries saw in 2022.
The increase is “kind of a double-edged sword,” according to Jim Blair, a former Social Security administrator and co-founder and lead consultant at Premier Social Security Consulting, which educates consumer and financial advisors on the program’s benefits.
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“It’s good for people on Social Security,” Blair said. “It’s not so good for the economy with inflation.”
Social Security benefit checks will reflect the increase starting in January.
The average retiree benefit will go up by $146 per month, to $1,827 in 2023 from $1,681 in 2022, according to the Social Security Administration The average disability benefit will increase by $119 per month, to $1,483 in 2023 from $1,364 in 2022.
What’s more, standard Medicare Part B premiums will go down by about 3% next year to $164.90, a $5.20 decrease from 2022. Medicare Part B covers outpatient medical care including doctors’ visits.
Monthly Part B premium payments are often deducted directly from Social Security checks. Due to the lower 2023 premiums, beneficiaries are poised to see more of the 8.7% increase in their monthly Social Security checks.
“The good news about these letters is people are realizing 100% of the 8.7% lift,” said David Freitag, a financial planning consultant and Social Security expert at MassMutual.
“Of course, the economy is inflated at a frightful rate, but this represents the value of cost-of-living adjusted benefits from Social Security,” Freitag said.
Few other income streams in retirement offer cost-of-living adjustments, he noted.
What to look for in your Social Security statement
Justin Paget | Digitalvision | Getty Images
If you’re wondering how much more you stand to see in your checks, the personalized letter from the Social Security Administration will give you a breakdown of what to expect.
That includes your new 2023 monthly benefit amount before deductions.
It will also tell you your 2023 monthly deduction for premiums for Medicare Part B, as well as Medicare Part D, which covers prescription drugs.
The statement will also show your deduction for voluntary tax withholding.
The good news about these letters is people are realizing 100% of the 8.7% lift.
David Freitag
financial planning consultant and Social Security expert at MassMutual
After those deductions, the statement shows how much will be deposited into your bank account in January.
Of note, you do not necessarily have to be receiving Social Security checks now to benefit from the record 2023 increase, Blair noted.
“The good news is you don’t have to apply for benefits to receive the cost-of-living adjustment,” Blair said. “You just have to be age 62 or older.”
When you may pay Medicare premium surcharges
If your income is above a certain amount, you may pay a surcharge called an income related monthly adjustment amount, or IRMAA, on Medicare Parts B and D.
This year, that will be determined by your 2021 tax returns, including your adjusted gross income and tax-exempt interest income. Those two amounts are added together to get your modified adjusted gross income, or MAGI.
In 2023, those IRMAA premium rates kick in if your modified adjusted gross income is $97,000.01 or higher and you filed your tax return as single, head of household, qualifying widow or widower or married filing separately; or $194,000.01 or higher if you are married and filed jointly.
Notably, just one dollar over could put you in a higher bracket.
“It’s important for everyone to make sure that the amount of adjusted gross income that they’re using for the IRMAA surcharges agrees with what they filed on their tax return two years ago,” Freitag said.
If the information does not match, you “absolutely need to file an appeal,” he said.
Because the IRMAA surcharges can be extremely significant, that is an area to watch for errors, Freitag said.
When to appeal your Medicare surcharges
If your income has gone down since your 2021 tax return, you can appeal your IRMAA.
That goes if you have been affected by a life changing event and your modified adjusted gross income has moved down a bracket or below the lowest amounts in the table.
Qualifying life changing events, according to the Social Security Administration, include marriage; divorce or annulment; death of a spouse; you or your spouse reduced your work hours or stopped working altogether; you or your spouse lost income on from property due to a disaster; you or your spouse experienced cessation, termination or reorganization of an employer’s pension plan; or you or your spouse received a settlement from an employer or former employer due to bankruptcy, closure or reorganization.
To report that change, beneficiaries need to fill out Form SSA-44 with appropriate documentation.
How higher benefits could cost you
Andrew Bret Wallis | The Image Bank | Getty Images
As your Social Security income goes up with the 8.7% COLA, that may also push your into a different IRMAA or tax bracket, Freitag noted.
That calls for careful monitoring of your income, he said.
Keep in mind that two years in the future you may get exposed to IRMAA issues if you’re not careful.
In addition, more of your Social Security benefits may be subject to income taxes. Up to 85% of Social Security income may be taxed based on a unique formula that also factors in other income.
It is a good idea to have taxes withheld from Social Security benefits in order to avoid a tax liability when you file your income tax returns, according to Marc Kiner, a CPA and co-founder of Premier Social Security Consulting.
“Do it as soon as you can,” Kiner said of filling out the voluntary withholding request form.
To better gauge how IRMAA or taxes on benefits may affect you going forward, it may help to consult a tax advisor or CPA who can help identify tax-efficient strategies, Freitag said.
Medicare willing to reevaluate Alzheimer’s drugs coverage
And so, another working week will soon draw to a close. Not a moment too soon, yes? This is, you may recall, our treasured signal to daydream about weekend plans. Our agenda, so far, appears to be rather modest. We plan to promenade extensively with the official mascot, tidy up around the castle, check in on the Pharmalot ancestors, and have a listening party with Mrs. Pharmalot (this will be first up). And what about you? There are some holidays just around the bend, so this may be an opportunity to open those catalogs or visit the nearest temple of consumption. You know what they say — act now, before prices rise still further. There is still time, of course, to plan a holiday getaway. Or you could hit the pause button and take stock of life. Well, whatever you do, have a grand time. But be safe. Enjoy, and see you soon. …
Medicare is willing to reevaluate its coverage of Alzheimer’s drugs in light of a new therapy, called lecanemab, that has shown potentially more promising patient data than its controversial predecessor, Aduhelm, STAT tells us. “I can’t speak to any specifics, but just to say that our door is really open,” Chiquita Brooks-LaSure, the Centers for Medicare and Medicaid Services administrator, said at the Milken Institute Future of Health Summit when asked about how the agency will approach the drug. “We will look at it as new data comes.” Last April, Medicare finalized a coverage policy in which it would only pay for Aduhelm if patients were enrolled in a clinical trial.
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Social Security COLA will be 8.7% in 2023, highest increase in 40 years
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Amid record high inflation, Social Security beneficiaries will get an 8.7% increase to their benefits in 2023, the highest increase in 40 years.
The Social Security Administration announced the change on Thursday. It will result in a benefit increase of more than $140 more per month on average starting in January.
The average Social Security retiree benefit will increase $146 per month, to $1,827 in 2023, from $1,681 in 2022.
The Senior Citizens League, a non-partisan senior group, had estimated last month that the COLA could be 8.7% next year.
The confirmed 8.7% bump to benefits tops the 5.9% increase beneficiaries saw in 2022, which at the time was the highest in four decades.
The last time the cost-of-living adjustment was higher was in 1981, when the increase was 11.2%.
Next year’s record increase comes as beneficiaries have struggled with increasing prices this year.
“The COLAs really are about people treading water; they’re not increases in benefits,” said Dan Adcock, director of government relations and policy at the National Committee to Preserve Social Security and Medicare.
“They’re more trying to provide inflation protection so that people can maintain their standard of living,” Adcock said.
How much your Social Security check may be
Beneficiaries can expect to see the 2023 COLA in their benefit checks starting in January.
But starting in December, you may be able to see notices online from the Social Security Administration that state just how much your checks will be next year.
Two factors — Medicare Part B premiums and taxes — may influence the size of your benefit checks.
The standard Medicare Part B premium will be $5.20 lower next year — to $164.90, down from $170.10. Those payments are often deducted directly from Social Security benefit checks.
“That will mean that beneficiaries will be able to keep pretty much all or most of their COLA increase,” Mary Johnson, Social Security and Medicare policy analyst at The Senior Citizens League, told CNBC.com this week.
That may vary if you have money withheld from your monthly checks for taxes.
To gauge just how much more money you may see next year, take your net Social Security benefit and add in your Medicare premium and multiply that by the 2023 COLA.
“That will give you a good idea what your raise will be,” said Joe Elsasser, an Omaha, Nebraska-based certified financial planner and founder and president of Covisum, a provider of Social Security claiming software.
How the COLA is tied to inflation
The COLA applies to about 70 million Social Security and Supplemental Security Income beneficiaries.
The change is based on the Consumer Price Index for Urban Wage Earners and Clerical Workers, or CPI-W.
The Social Security Administration calculates the annual COLA by measuring the change in the CPI-W from the third quarter of the preceding year to the third quarter of the current year.
Benefits do not necessarily go up every year. While there was a record 5.8% increase in 2009, the following two years had 0% increases.
“For seniors, because they spend so much on health care, those years were difficult,” Adcock said.
A similar pattern may happen if the economy goes into a recession, according to Johnson.
What the COLA means if you haven’t claimed benefits yet
If you decide to claim Social Security benefits, you will get access to the record-high COLA.
But you will also have access to it if you wait to start your benefit checks at a later date, according to Elsasser.
If you’re 62 now and don’t claim, your benefit is adjusted by every COLA until you do.
The amount of the COLA really should not influence claiming.
Joe Elsasser
CFP and president of Covisum
What’s more, delaying benefits can increase the size of your monthly checks. Experts generally recommend most people wait as long as possible, until age 70, due to the fact that benefits increase 8% per year from your full retirement age (typically 66 or 67) to 70. To be sure, whether that strategy is ideal may vary based on other factors, such as your personal health situation and marital status.
“The amount of the COLA really should not influence claiming,” Elsasser said. “It doesn’t hurt you or help you as far as when you claim, because you’re going to get it either way.”
How a record-high increase may impact Social Security’s funds
Social Security’s trust funds can pay full benefits through 2035, the Social Security Board of Trustees said in June.
At that time, the program will be able to pay 80% of benefits, the board projects.
Tetra Images | Tetra Images | Getty Images
The historic high COLA in 2023 could accelerate the depletion of the trust funds to at least one calendar year earlier, according to the Committee for a Responsible Federal Budget.
Higher wages may prompt workers to contribute more payroll taxes into the program, which may help offset that. In 2023, maximum taxable earnings will increase to $160,200, up from $147,000 this year.
What could happen to future benefit increases
While 2023 marks a record high COLA, beneficiaries should be prepared for future years where increases are not as high.
If inflation subsides, the size of COLAs will also go down.
Whether the CPI-W is the best measure for the annual increases is up for debate. Some tout the Consumer Price Index for the Elderly, or CPI-E, as a better measure for the costs seniors pay. Multiple Democratic congressional bills have called for changing the annual increases to that measure.
Congress OKs Dems’ climate, health bill, a Biden triumph
WASHINGTON (AP) — A divided Congress gave final approval Friday to Democrats’ flagship climate and health care bill, handing President Joe Biden a back-from-the-dead triumph on coveted priorities that the party hopes will bolster their prospects for keeping their House and Senate majorities in November’s elections.
The House used a party-line 220-207 vote to pass the legislation, prompting hugs among Democrats on the House floor and cheers by White House staff watching on television. “Today, the American people won. Special interests lost,” tweeted the vacationing Biden, who was shown beaming in a White House photo as he watched the vote on TV from Kiawah Island, South Carolina. He said he would sign the legislation next week.
The measure is but a shadow of the larger, more ambitious plan to supercharge environment and social programs that Biden and his party unveiled early last year. Even so, Democrats happily declared victory on top-tier goals like providing Congress’ largest ever investment in curbing carbon emissions, reining in pharmaceutical costs and taxing large companies, hoping to show they can wring accomplishments from a routinely gridlocked Washington that often disillusions voters.
“Today is a day of celebration, a day we take another giant step in our momentous agenda,” said House Speaker Nancy Pelosi, D-Calif., who minutes later announced the final vote as she presided over the chamber. She said the measure “meets the moment, ensuring that our families thrive and that our planet survives.”
Republicans solidly opposed the legislation, calling it a cornucopia of wasteful liberal daydreams that would raise taxes and families’ living costs. They did the same Sunday but Senate Democrats banded together and used Vice President Kamala Harris’ tiebreaking vote t o power the measure through that 50-50 chamber.
“Democrats, more than any other majority in history, are addicted to spending other people’s money, regardless of what we as a country can afford,” said House Minority Leader Kevin McCarthy, R-Calif. “I can almost see glee in their eyes.”
Biden’s initial 10-year, $3.5 trillion proposal also envisioned free prekindergarten, paid family and medical leave, expanded Medicare benefits and eased immigration restrictions. That crashed after centrist Sen. Joe Manchin, D-W.Va., said it was too costly, using the leverage every Democrat has in the evenly-divided Senate.
Still, the final legislation remained substantive. Its pillar is about $375 billion over 10 years to encourage industry and consumers to shift from carbon-emitting to cleaner forms of energy. That includes $4 billion to cope with the West’s catastrophic drought.
Spending, tax credits and loans would bolster technology like solar panels, consumer efforts to improve home energy efficiency, emission-reducing equipment for coal- and gas-powered power plants and air pollution controls for farms, ports and low-income communities.
Another $64 billion would help 13 million people pay premiums over the next three years for privately bought health insurance. Medicare would gain the power to negotiate its costs for pharmaceuticals, initially in 2026 for only 10 drugs. Medicare beneficiaries’ out-of-pocket prescription costs would be limited to $2,000 starting in 2025, and beginning next year would pay no more than $35 monthly for insulin, the costly diabetes drug.
The bill would raise around $740 billion in revenue over the decade, over a third from government savings from lower drug prices. More would flow from higher taxes on some $1 billion corporations, levies on companies that repurchase their own stock and stronger IRS tax collections. About $300 billion would remain to defray budget deficits, a sliver of the period’s projected $16 trillion total.
Against the backdrop of GOP attacks on the FBI for its court-empowered search of former President Donald Trump’s Florida estate for sensitive documents, Republicans repeatedly savaged the bill’s boost to the IRS budget. That’s aimed at collecting an estimated $120 billion in unpaid taxes over the coming decade, and Republicans have misleadingly claimed that the IRS will hire 87,000 agents to target average families.
Rep. Andrew Clyde, R-Ga., said Democrats would also “weaponize” the IRS with agents, “many of whom will be trained in the use of deadly force, to go after any American citizen.” Sen. Chuck Grassley, R-Iowa, asked Thursday on “Fox and Friends” if there would be an IRS “strike force that goes in with AK-15s already loaded, ready to shoot some small business person.”
Few IRS personnel are armed, and Democrats say the bill’s $80 billion, 10-year budget increase would be to replace waves of retirees, not just agents, and modernize equipment. They have said typical families and small businesses would not be targeted, with Treasury Secretary Janet Yellen directing the IRS this week to not “increase the share of small business or households below the $400,000 threshold” that would be audited.
Republicans say the legislation’s new business taxes will increase prices, worsening the nation’s bout with its worst inflation since 1981. Though Democrats have labeled the measure the Inflation Reduction Act, nonpartisan analysts say it will have a barely perceptible impact on prices.
The GOP also says the bill would raise taxes on lower- and middle-income families. An analysis by Congress’ nonpartisan Joint Committee on Taxation, which didn’t include the bill’s tax breaks for health care and energy, estimated that the corporate tax boosts would marginally affect those taxpayers but indirectly, partly due to lower stock prices and wages.
“House Democrats ensured voters will fire them this fall,” said spokeswoman Torunn Sinclair of the House GOP campaign committee. In an email, she listed dozens of Democrats in competitive reelections who will face Republican attacks for raising taxes and empowering the IRS “to target their constituents.”
Democratic-leaning interest groups had their own warnings. “We’ll ensure that every Republican who voted against this bill is held accountable for prioritizing polluters and corporate special interests over the health and well being of their constituents,” said Tiernan Sittenfeld, a top official of the League of Conservation Voters.
The bill caps three months in which Congress has approved legislation on veterans’ benefits, the semiconductor industry, gun checks for young buyers and Ukraine’s invasion by Russia and adding Sweden and Finland to NATO. All passed with bipartisan support, suggesting Republicans also want to display their productive side.
It’s unclear whether voters will reward Democrats for the legislation after months of painfully high inflation dominating voters’ attention, Biden’s dangerously low popularity ratings and a steady history of midterm elections that batter the party holding the White House.
Biden called his $3.5 trillion plan Build Back Better. Besides social and environment initiatives, it proposed rolling back Trump-era tax breaks for the rich and corporations and $555 billion for climate efforts, well above the money in Friday’s legislation.
With Manchin opposing those amounts, it was sliced to a roughly $2 trillion measure that Democrats moved through the House in November. He unexpectedly sank that bill too, earning scorn from exasperated fellow Democrats from Capitol Hill and the White House.
Last gasp talks between Manchin and Senate Majority Leader Chuck Schumer, D-N.Y., seemed fruitless until the two unexpectedly announced agreement last month on the new package.
Manchin won concessions for the fossil fuel industries he champions, including procedures for more oil drilling on federal lands. So did Centrist Sen. Kyrsten Sinema, D-Ariz., who ended up eliminating planned higher taxes on hedge fund managers and helping win the drought funds.
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Associated Press reporter Seung Min Kim in Kiawah Island and congressional correspondent Lisa Mascaro contributed to this report.
Senate Democrats pass Inflation Reduction Act; House to vote next
WASHINGTON D.C. — Democrats pushed their election-year economic package to Senate passage Sunday, a hard-fought compromise less ambitious than President Joe Biden’s original domestic vision but one that still meets deep-rooted party goals of slowing global warming, moderating pharmaceutical costs and taxing immense corporations.
The estimated $740 billion package heads next to the House, where lawmakers are poised to deliver on Biden’s priorities, a stunning turnaround of what had seemed a lost and doomed effort that suddenly roared back to political life. Democrats held united, 51-50, with Vice President Kamala Harris casting the tie-breaking vote.
“It’s been a long, tough and winding road, but at last, at last we have arrived,” said Senate Majority Leader Chuck Schumer, D-N.Y., ahead of final votes.
“The Senate is making history. I am confident the Inflation Reduction Act will endure as one of the defining legislative measures of the 21st century.”
Senators engaged in a round-the-clock marathon of voting that began Saturday and stretched late into Sunday afternoon. Democrats swatted down some three dozen Republican amendments designed to torpedo the legislation. Confronting unanimous GOP opposition, Democratic unity in the 50-50 chamber held, keeping the party on track for a morale-boosting victory three months from elections when congressional control is at stake.
“I think it’s gonna pass,” Biden told reporters as he left the White House early Sunday to go to Rehoboth Beach, Delaware, ending his COVID-19 isolation. The House seemed likely to provide final congressional approval when it returns briefly from summer recess on Friday.
The bill ran into trouble midday over objections to the new 15% corporate minimum tax that private equity firms and other industries disliked, forcing last-minute changes.
Despite the momentary setback, the “Inflation Reduction Act” gives Democrats a c ampaign-season showcase for action on coveted goals. It includes the largest-ever federal effort on climate change – close to $400 billion – caps out-of-pocket drug costs for seniors on Medicare to $2,000 a year and extends expiring subsidies that help 13 million people afford health insurance. By raising corporate taxes, the whole package is paid for, with some $300 billion extra revenue for deficit reduction.
Barely more than one-tenth the size of Biden’s initial 10-year, $3.5 trillion rainbow of progressive aspirations in his Build Back Better initiative, the new package abandons earlier proposals for universal preschool, paid family leave and expanded child care aid. That plan collapsed after conservative Sen. Joe. Manchin, D-W.Va., opposed it, saying it was too costly and would fuel inflation.
Nonpartisan analysts have said the “Inflation Reduction Act” would have a minor effect on surging consumer prices.
Republicans said the measure would undermine an economy that policymakers are struggling to keep from plummeting into recession. They said the bill’s business taxes would hurt job creation and force prices skyward, making it harder for people to cope with the nation’s worst inflation since the 1980s.
“Democrats have already robbed American families once through inflation, and now their solution is to rob American families a second time,” Senate Minority Leader Mitch McConnell, R-Ky., argued. He said spending and tax increases in the legislation would eliminate jobs while having insignificant impact on inflation and climate change.
In an ordeal imposed on all budget bills like this one, the Senate had to endure an overnight “vote-a-rama” of rapid-fire amendments. Each tested Democrats’ ability to hold together a compromise negotiated by Schumer, progressives, Manchin and the inscrutable centrist Sen. Kyrsten Sinema, D-Ariz.
Progressive Sen. Bernie Sanders, I-Vt., offered amendments to further expand the legislation’s health benefits, and those efforts were defeated. Most votes were forced by Republicans and many were designed to make Democrats look soft on U.S.-Mexico border security and gasoline and energy costs, and like bullies for wanting to strengthen IRS tax law enforcement.
Before debate began Saturday, the bill’s prescription drug price curbs were diluted by the Senate’s nonpartisan parliamentarian. Elizabeth MacDonough, who referees questions about the chamber’s procedures, said a provision should fall that would impose costly penalties on drug makers whose price increases for private insurers exceed inflation.
It was the bill’s chief protection for the 180 million people with private health coverage they get through work or purchase themselves. Under special procedures that will let Democrats pass their bill by simple majority without the usual 60-vote margin, its provisions must be focused more on dollar-and-cents budget numbers than policy changes.
But the thrust of their pharmaceutical price language remained. That included letting Medicare negotiate what it pays for drugs for its 64 million elderly recipients, penalizing manufacturers for exceeding inflation for pharmaceuticals sold to Medicare and limiting beneficiaries out-of-pocket drug costs to $2,000 annually.
The bill also caps Medicare patients’ costs for insulin, the expensive diabetes medication, at $35 monthly. Democrats wanted to extend the $35 cap to private insurers but it ran afoul of Senate rules. Most Republicans voted to strip it from the package, though in a sign of the political potency of health costs seven GOP senators joined Democrats trying to preserve it.
The measure’s final costs were being recalculated to reflect late changes, but overall it would raise more than $700 billion over a decade. The money would come from a 15% minimum tax on a handful of corporations with yearly profits above $1 billion, a 1% tax on companies that repurchase their own stock, bolstered IRS tax collections and government savings from lower drug costs.
Sinema forced Democrats to drop a plan to prevent wealthy hedge fund managers from paying less than individual income tax rates for their earnings. She also joined with other Western senators to win $4 billion to combat the region’s drought.
Several Democratic senators joined the GOP-led effort to exclude some firms from the new corporate minimum tax.
The package keeps to Biden’s pledge not to raise taxes on those earning less than $400,000 a year.
It was on the energy and environment side that compromise was most evident between progressives and Manchin, a champion of fossil fuels and his state’s coal industry.
Clean energy would be fostered with tax credits for buying electric vehicles and manufacturing solar panels and wind turbines. There would be home energy rebates, funds for constructing factories building clean energy technology and money to promote climate-friendly farm practices and reduce pollution in minority communities.
Manchin won billions to help power plants lower carbon emissions plus language requiring more government auctions for oil drilling on federal land and waters. Party leaders also promised to push separate legislation this fall to accelerate permits for energy projects, which Manchin wants to include a nearly completed natural gas pipeline in his state.
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Pharmacies can’t discriminate on reproductive health scripts
The Biden administration is warning pharmacies not to discriminate against women who may seek reproductive health prescriptions, including some that might be involved in ending a pregnancy.
The Department of Health and Human Services said Wednesday that pharmacies receiving federal money from programs such as Medicare and Medicaid cannot discriminate in how they supply medications or advise patients on prescriptions.
The agency noted that discrimination against people based on their pregnancy or related conditions would be a form of sex discrimination.
The announcement comes as the administration seeks to ensure reproductive health services for women following last month’s Supreme Court decision that ended a constitutional right to abortion.
On Monday, the administration told hospitals that they “must” provide abortion services if the life of the mother is at risk. The government said federal law on emergency treatment guidelines preempts state laws in jurisdictions that now ban the procedure without any exceptions. Now, all states provide an exception for the life of the mother.
President Joe Biden also has signed an executive order to try to protect some access to the procedure, but he also has acknowledged that his administration is limited in what it can do. He noted earlier this month that an act of Congress would be required to restore nationwide access to abortion services, and he has urged Americans angered by the Supreme Court’s ruling to vote in November.
Wednesday’s actions, like those outlined Monday, do not reflect new policy. They aim to remind care providers of their existing obligations under federal law.
“We are committed to ensuring that everyone can access health care, free of discrimination,” Health and Human Services Secretary Xavier Becerra said in a statement. “This includes access to prescription medications for reproductive health and other types of care.”
The department’s guidance to pharmacies outlined several hypothetical examples of potential discrimination. They include a pharmacy that refuses to fill a prescription of mifepristone followed by misoprostol to help manage complications from a miscarriage after a pregnancy loss.
That combination of drugs also is commonly used in medication abortions.
A pharmacy that refuses to fill a prescription of misoprostol prescribed to help deal with severe stomach ulcer complications may be discriminating based on disability, HHS said. The agency noted that the pharmacy also may be discriminating if it refuses to stock the drug based on its alternate use.
HHS also cited as another example of potential discrimination: a pharmacy that refuses to fill a prescription for methotrexate to halt an ectopic pregnancy, which grows outside the womb and is not viable.
The federal agency said people who believe their rights have been violated should visit an online portal for the Office for Civil Rights to file a complaint.