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dontmeantobepoliticalbut · 9 months

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On Thursday, the Social Security Administration announced its largest cost of living adjustment for beneficiaries in four decades, an inflation-driven raise of 8.7% that will take effect in January 2023. That increase matches the average annual COLA from 1975 through 1982, an era of recessions and high inflation. Annual Social Security raises declined after that year. From 1996 through 2021, they averaged 2.3%, and were zero in some years. The 2021 raise was substantially higher: 5.9%.

The new increase in benefits will be pricey. On the other hand, the cost to taxpayers of the entire Social Security program pales in comparison with the cost of federal subsidies for rich Americans enrolled in private or supplemental retirement plans, such as individual retirement accounts (IRAs). According to Federal Reserve data from 2019, only 31% of households from the poorest half of the wealth spectrum contributed to such a plan, while 91% of households in the top wealth decile did.

This suggests that low-wealth retirees rely heavily or exclusively on Social Security, but all US workers get to collect benefits starting at age 62. As of last month, nearly 66 million Americans, rich and poor alike, were getting monthly checks. Most are retirees, but there are also spouses, disabled workers, survivors of deceased workers, and dependent children. The largest and best-compensated group, the retired workers, averaged $1,674 a month, or about $20,000 per year.

The SSA now pays out about $1.2 trillion a year in benefits all told, but those outlays are largely funded by payroll taxes paid by workers who will later reap the benefits. In 2021, the price tag of the entire program—benefits plus administrative costs—totaled $1.14 trillion, of which $1.09 trillion was covered by payroll taxes, income taxes on benefits, and interest. In other words, the federal Social Security subsidy was only about $50 billion.

Compare that with subsidies for private plans and IRAs, which cost the government nearly eight times as much—about $380 billion a year, according to the Joint Committee on Taxation. And unlike Social Security subsidies, these subsidies skew heavily toward the highest earners.

There’s a reason I noted the year 1996 above. Before then, as I point out in this earlier exposé about America’s retirement system, private retirement accounts were strictly regulated and not heavily subsidized. Starting that year, federal lawmakers—led by then Reps. Rob Portman (R-Ohio) and Ben Cardin (D-Md.), began introducing bipartisan retirement “reform” packages that pumped more and more federal dollars into bolstering private retirement savings, mainly to the benefit of high-income workers and Wall Street.

University of Virginia law professor Michael Doran, who dug deep into the subject for a January 2022 paper titled, “The Great American Retirement Fraud,” suggested that lawmakers, rather than helping rich Americans shuffle even more of their money into tax-deferred or tax-exempt retirement funds, could instead pass laws to benefit Americans who actually need help in retirement. That might include simply beefing up Social Security, he wrote.

Instead, yet another bill that benefits wealthy savers sailed through Congress. And Republican Rick Scott released a set of aspirations for his own party—an 11-point “Plan for America,” of which one provision would let all federal laws “sunset” every five years—including laws governing Social Security and Medicare.

#us politics #news #mother jones #social security administration #social security cuts #social security #social security works #individual retirement accounts #federal reserve #cost of living adjustment #Joint Committee on Taxation #Rep. Rob Portman #rep. Ben Cardin #Michael Doran #The Great American Retirement Fraud #sen. rick scott #Plan for America #2022

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dreaminginthedeepsouth · 6 days

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Signe Wilkinson

* * * *

LETTERS FROM AN AMERICAN

April 20, 2024

HEATHER COX RICHARDSON

APR 21, 2024

Cheering broke out in the gallery and among Democrats on the floor of the House of Representatives this afternoon when the House passed the $60.8 billion aid bill for Ukraine. The vote was 311–112, with all Democrats and 101 Republicans voting in favor and 112 Republicans voting against. One Republican voted present.

The House also voted on the three other bills that will be packaged with the Ukraine bill as a single measure to go in front of the Senate. The House voted in favor of providing $8.1 billion in support for Taiwan and the Indo-Pacific by a vote of 385–34. It approved more than $26 billion for Israel, including $9.2 billion in humanitarian aid not specifically for Gaza but for populations in crisis, by a vote of 366–58. And it voted 360–58 to place additional sanctions on Iran, seize Russian assets, and require the Chinese owners of TikTok to sell the company within nine months if they want it to continue to be available on U.S. app stores.

The total price tag of the measures is about $95.3 billion. About $50 billion of it will be used here in the U.S. to replenish the supplies that will go abroad.

Senate majority leader Chuck Schumer (D-NY) says the Senate will take up the measure on Tuesday. Senators had gone home for recess but will come back to vote. The Department of Defense says it is ready to rush crucial supplies as soon as it gets the go-ahead. "We have a very robust logistics network that enables us to move material very quickly; as we've done in the past, we can move within days," Pentagon press secretary Air Force Major General Pat Ryder said Thursday.

Aid to Ukraine has been stalled since Biden first asked for it in October 2023. First, MAGA Republicans said they would never pass such a national security supplemental bill until the U.S. addressed the need for better security at the country’s southern border. Senators, including Republican James Lankford (R-OK) took them at their word and hammered out a strong border security measure, only to have Republicans reject it when Trump demanded they preserve border security as a campaign issue. The Senate then passed the national security supplemental bill without a border measure, but that was back in February. Although it was clear the measure would pass the House, Speaker Mike Johnson (R-LA) has steadfastly refused to take it up.

Meanwhile, countries around the globe have been stepping into the breach, providing funds and weapons for Ukraine as Ukraine’s war effort has faltered without U.S. war matériel.

Suddenly, the dam has broken.

The MAGA extremists who oppose aid to Ukraine expressed anger over the measure’s passage, but outside of that group, there was bipartisan relief and mutual congratulations. The chair of the Foreign Affairs Committee, Representative Michael McCaul (R-TX), who has been vocal in his belief that Republicans have fallen prey to Russian propaganda, compared today’s vote to the period before World War II, when British prime minister Neville Chamberlain tried to appease dictator Adolf Hitler in 1938 by agreeing to Germany’s annexation of the Sudetenland. To Chamberlain’s successor, Winston Churchill, fell the task of fighting World War II.

“Our adversaries are watching us here today, and history will judge us on our actions here today,” McCaul said. “So as we deliberate on this vote, you have to ask yourself: Am I Chamberlain or am I Churchill?”

House minority leader Hakeem Jeffries (D-NY) said: “For months, the national security priorities of the American people have been obstructed by pro-Putin extremists determined to let Russia win. A bipartisan coalition of Democrats and Republicans has risen up to work together and ensure that we are getting the national security legislation important to the American people over the finish line.”

Secretary of Defense Lloyd Austin also released a statement welcoming the passage of the measure. “This bipartisan legislation will allow the Department to surge lifesaving security assistance to help Ukraine defend itself from Russia’s aggression, support Israel’s defense from Iran and its proxies, and increase the flow of urgently needed humanitarian aid to suffering Palestinians in Gaza.” It is also, he wrote, “an important investment in America's future.”

President Joe Biden said that “members of both parties in the House voted to advance our national security interests and send a clear message about the power of American leadership on the world stage. At this critical inflection point, they came together to answer history’s call, passing urgently-needed national security legislation that I have fought for months to secure.”

The reiteration of the bipartisan nature of the vote suggests support for the idea that the breaking dam refers not just to the national security supplemental bill but also to the power of MAGA Republicans more generally. Representative Tom Cole (R-OK) suggested this interpretation in an interview today with Ryan Lizza of Politico.

MAGAs are Trump loyalists, counting on his return to power, and Trump is visibly diminished. For the last week, he has been sitting in a courtroom with no choice but to do as he is told by the judge while potential jurors have expressed their dislike of him to his face. This is novel for him, and it is clearly taking a toll.

Trump’s financial troubles have not gone away, either. Yesterday, New York attorney general Letitia James asked a judge to void the $175 million appeals bond Trump posted to secure the $454 million judgment against him in the business fraud case. She says that the defendants have failed to show that there is enough collateral behind the bond to secure it. She has asked for a replacement bond within a week. Without a bond, James can begin to seize Trump’s property.

Since Republicans took control of the House, Republican leaders have had to turn to Democrats to find the votes to pass crucial legislation like the national security supplemental bill, preventing a U.S. default, and funding the government. Republicans interested in governing and eager to protect the institutions of democracy appear to be getting fed up with the attention-seeking and bomb-throwing MAGA faction that refuses to do the work of governing.

That frustration might have been on display when the House also voted on a fifth measure: a border bill the extremist Republicans demanded. Because it was considered under a suspension of the rules, it needed a two-thirds majority to pass. The measure failed with a vote of 215–211. Aaron Reichlin-Melnick, a lawyer with the American Immigration Council advocacy group, noted that the last time the House voted on a similar measure, it got 219 votes. This time it got fewer votes, even with an added $9.5 billion for Texas, Florida, and other states that are restricting immigrants’ rights.

In The Atlantic today, David Frum noted the changing U.S. political dynamic and, referring to the Ukraine vote, wrote: “On something that mattered intensely to [Trump]—that had become a badge of pro-Trump identity—Trump’s own party worked with Democrats in the House and Senate to hand him a stinging defeat. This example could become contagious.” In other words, he said: “Ukraine won. Trump lost.”

For his part, leading Russian politician Dmitry Medvedev had his own reaction to the House’s passage of the national security supplemental bill with aid for Ukraine. He vowed that Russia would win the war anyway and added: “[C]onsidering the russophobic decision that took place I can't help but wish the USA with all sincerity to dive into a new civil war themselves as quickly as possible. Which, I hope, will be very different from the war between North and South in the 19th century and will be waged using aircraft, tanks, artillery, MLRS, all types of missiles and other weapons. And which will finally lead to the inglorious collapse of the vile evil empire of the 21st century—the United States of America.”

LETTERS FROM AN AMERICAN

HEATHER COX RICHARDSON

#Letters From An American #Heather Cox Richardson #War in Ukraine #the Putin Caucus #Moscow Marge #MAGA Extremists #bi-partisan coalition #do your job #aid to ukraine #defending democracy

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theworldoffostering · 7 days

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Raising kids is not for the weak.

The good:

DS took his road test and passed it! It felt so nice to do a normal kid/parent thing and see him be successful.

The anniversary of his adoption day was this month. It’s been 15 years.

Ms. 6 was accepted into a university.

Ms. 6 is going to graduate high school next month!

We are progressing in attachment therapy with Baby.

School is almost done for the year.

The mediocre:

DD broke up with her fiancé and is already seeing someone else. I did not care for her fiancé, but already seeing someone else is a red flag.

I talked with the students with disabilities center on Ms. 6’s campus this week to try to get her some services. In turn, I had to request her IEP. Her IEP from fall was a train wreck so I reconvened the team this week and told them to rewrite it appropriately. Apparently the guidance counselor quit in the fall and no one has taken his place. For real, without a parent, most kids are completely lost.

I signed Ms. 6 up for college registration and orientation. Students have to bring a parent. I offered but she wants her mom to go which is fine. However, we don’t know if her mom will go. She was too hungover to take Ms. 6 to the hospital when she had knee surgery scheduled a couple of months back. Last week she didn’t get out of bed to take Ms. 6 to a somewhat major dental appointment. I told her I would go, but her mom insisted that she was going so I could not attend. I stood down and then she didn’t show up. Same thing happened with the knee surgery.

The challenging:

So much drama with Ms. 6’s family of origin. Ms. 6 lives over three hours away from us but is enrolled in a high school near us and her graduation will be where we live. I offered to throw her a graduation party and invite her mom. Ms. 6 was thrilled. Her mom told her to cut DH and I off and that she could no longer talk to us or receive mail from us. Now her mom is threatening to take away Ms. 6 attending her own graduation altogether.

Ms. 6 insisted she completed her FASFA. She did, but it was for the 23-24 year, not the 24-25 year. I straightened it out two weeks ago and filled it out for her (she’s an independent so parent income doesn’t count). Financial aid packagers don’t go out until next month so I’m hoping she will still get enough to be able to go to school.

Ms. 6 told me this week that she never obtained a new birth certificate or social security card despite me directing her in how to do both things multiple times in the fall after she left here unexpectedly. I finally just ordered (and paid) for a new birth certificate for her this week.

I feel incredibly burned out. Like maybe I need meds? My endocrin called and told me I need to start doing B12 injections because after taking oral supplements for three months, my b12 levels actually went down. I don’t know if it’s that, or wading through all of the drama, or both. Some days, I don’t feel like I can even put one foot in front of the other. It’s too much. How do you ever get a break from everything?

Tomorrow we are meeting with DD to try to work out getting her a $4k car from a friend of mine. It’s a 2006 Odyssey with almost 200k miles on it. The insurance (collision only) would be $2k for the year. She’s bouncing from one hourly job to another and not saving anything. She desperately needs a vehicle to get to and from work. Currently she’s relying on her fiancé and her vehicle, but now that they’re no longer together, it seems more important that she have her own. She has zero money saved, but I have a college fund set aside for her with about $10k in it. Clearly she’s not going to college right now so I think we are going to pivot with that money and pay for the car and the insurance for a year.

I was planning to drive 6.5 hours this weekend to meet up with Ms. 6 and her BF who she met online. Ms. 6 has really been pushing for this. I asked for his address so I could locate a nearby hotel. She said he didn’t want me to have it. Then I asked for his name. He apparently did not want to disclose that to me either. I did tell her that was super sketch, and now I do think he’s like a really scary person who no one has vetted. Ms. 6 has already stayed with him several times so maybe not a serial killer, but anything else is possible in my brain. He’s definitely older because he has his own apartment.

It’s so much, you guys.

#parenting teens #parenting is hard #adoption #parenting adult children

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fr0ggs · 3 months

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reposting and editing my ceasefire call script because it got taken down. don't lose traction now, none of this is over.

"Hello, *my name is [your name]. I am a constituent of [congressperson], and I am calling to inform you about the numerous genocides happening worldwide. At this point in time, you are likely already aware of the genocide of Palestinian and Ukranian people, but there are many more genocides happening in the world, and the overlooking of such happenings, while innocents continue to suffer, must end.

Currently, Congolese, Armenian, Tigrayan, Yemeni, Guatemalan, Rohingya, Haitian, Native American, Kashmiri, Kurd, Sudanese, Ukrainian, Palestinian, Argentinian, Afghan, Moroccan, Libyan, Syrian, Lebanese, West Papuan, Cameroonian, Burmese, Uyghurs, Iraqi, Somali, Hawai’ian, Puerto Rican, Senegalese, Kenyan, Ethiopian, Cuban and many more people are experiencing genocide (or close risk of it, according to genocidewatch.com), along with ethnic cleansing, displacement, restrictions on living necessities, and the like. Also currently, the United States government continues to be not only complicit, but supportive of these attacks out of ignorance and selfish benefit.

In order to maintain current support, it is dire that you take action on the side of the people. Please do research on each and take a look into doing whatever possible to save the innocent people around the world from living a life of constant abuse and murder.

Some things you can do, for example, include:

- Calling for (or implementing):

The appointment of special envoys

A reversal of the funding cuts to UNRWA

An increase in funding to and the development of NGOs providing humanitarian aid

A permanent and immediate ceasefire for relevant locations (such as Gaza)

- Voting NO on the supplemental funding package to send more weapons to Israel (if you are in the position to do so)

Thank you for your time. I trust that you will do what you would want other countries to do for us."

*before adding your name, check to see if your congressperson requires it. if not, dont give more information than required.

im going off of whats required in email forms for my congresspeople, but im not entirely sure if thats a good way to do it, so feel free to add if you have a better way, mainly for being able to know without having to ask directly, since i and others are calling while out of hours.

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mostlysignssomeportents · 1 year

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Here are just two of the corporate giveaways hidden in the rushed, must-pass, end-of-year budget bill

Yesterday, Congress finally voted through the must-pass, end-of-year budget bill. As has become routine, this bill was stalled right until the final moment, so that Congressjerks could cram the 4,000-page, $1.7 trillion package with special favors for their donors, at the expense of the rest of the country.

This year’s budget package included a couple of especially egregious doozies, which were reported out for The American Prospect by Lee Harris (who covered a grotesque retirement giveaway for the ultra-rich) and Doraj Facundo (who covered a safety giveaway to Boeing and its lethal fleet of 737 Max airplanes).

Let’s start with the retirement scam. The budget bill includes Rep Richie Neal’s [DINO-MA] SECURE Act 2.0, which gives savers with retirement funds until age 75 to cash out their retirement savings — netting an extra three years of tax-free growth for the lucky, tiny minority with substantial retirement savings. This follows on Neal’s SECURE Act 1.0 of 2019, when the age was raised from 70.5 to 72.

The tax-exempt retirement savings account is a Carter-era bargain that replaced real pensions — ones that guaranteed that you wouldn’t starve or freeze to death when you retired — with accounts that let people gamble on the stock market, to be the suckers at Wall Street’s poker table:

https://pluralistic.net/2020/07/25/derechos-humanos/#are-there-no-poorhouses

The market-based gambler’s pension is a catastrophic failure. Half of Americans have no retirement savings. Of the half that have any savings, the vast majority have almost nothing saved:

https://www.federalreserve.gov/econres/scf/dataviz/scf/chart/#series:Retirement_Accounts;demographic:all;population:all;units:have

All in all, America has a $7 trillion retirement savings shortfall:

https://crr.bc.edu/wp-content/uploads/2019/10/IB_19-16.pdf

But for a tiny minority of the ultra-rich, tax-free savings accounts like ROTH IRAs are a means of avoiding even the paltry capital gains tax that you have to pay if you own things for a living, rather than doing things for a living. Propublica’s IRS Files revealed how ghouls like Peter Thiel avoided tax on billions in “passive income” by abusing tax-free savings accounts that were supposed to benefit the “middle class”:

https://pluralistic.net/2021/06/26/wax-rothful/#thiels-gambit

Meanwhile, Social Security is crumbling, thanks to a sustained attack on it by the business lobby and its friends in both parties. Progressive Dems had sought to amend SECURE Act 2.0 by inserting some clauses to shore up Social Security, and none of these were included in the final bill.

One of the fixes that died was the Savings Penalty Elimination Act, introduced by Senators Sherrod Brown [D-OH] and Rob Portman [R-OH]. This act would have tweaked the means-testing for Supplemental Security Income, which supports 8m low-income disabled adults and kids. Right now, you can’t collect SSI if you have $2k in the bank, a limit that hasn’t been adjusted for inflation since the 1980s (adjusted for inflation, $2k in 1980 is $7226.00 in 2022).

The $2k savings cap means that you have to be substantially below the poverty level to receive $585/month in SSI assistance — this being the only source of income for the majority of SSI recipients. Means-testing is a self-immolating fetish for corporate Dems and in retrospect, this betrayal seems inevitable:

https://pluralistic.net/2022/05/03/utopia-of-rules/#in-triplicate

(Notice how no one proposes means-testing billionaires when they get PPP loans or hundreds of millions in IRS “refunds” — like Trump, who paid substantially less tax than you did:)

https://www.cnbc.com/2022/12/21/trump-income-tax-returns-detailed-in-new-report-.html

And it was a betrayal: progressive Dems bargained with Neal and co not to publicly condemn SECURE Act 2.0 if they could get some concessions for the 8 million poorest disabled people in America. In the end, Neal rug-pulled them. Of course he did! This is Richie Fucking Neal, the best friend the Trump tax giveaway ever had:

https://pluralistic.net/2020/07/13/youre-still-the-product/#richie-neal

As with everything Neal touches, this screws poor people in multiple ways. First, it leaves the SSI cap intact. But it also creates a giant unfunded liability in the federal budget. Technically, there’s no reason this should lead to cuts. The US Treasury can’t run out of dollars, and giveaways to the rich are only mildly inflationary, since rich people put their money in the bank and mostly spend it on buying politicians, not goods.

But because of the delusion that currency producers like the US Treasury have the same constraints as currency users like you and me, Congress will need to come up with “Pay Fors” in future budgets to “make up for” the money they’re giving to rich people with SECURE Act 2.0. Dollars to toenail clippings, they’ll do that by hacking away at the tattered remains of the US social safety net.

Fear not, you don’t need to be a desperately poor disabled person or child to get fucked over by late additions to a 4,000 page must-pass bill! If you can afford to get on an airplane, Congress has something for you, too!

Remember when Boeing (the monopoly US airplane manufacturer that squandered $43b on stock buybacks and had to borrow $14b from the US public to survive the pandemic) told the FAA that it could self-certify its 737 Max airplanes, and then killed hundreds and hundreds of people with its defective planes?

https://pluralistic.net/2020/03/12/boeing-crashes/#boeing

The 737 Max was unsafe for many reasons, but one glaring factor was the fact that Boeing sold some of its core safety as “extras” — like they were downloadable content for your Fortnite character — leading to multiple crashes in which all lives were lost:

https://apnews.com/article/ethiopia-indonesia-accidents-ap-top-news-international-news-140576a8e9d4449eae646c8c479fdc3a

Boeing was forced to take the 737 Max out of service, but it eventually brought the plane back, “fixing” the problems by renaming the “737 Max” to the “737 8”:

https://pluralistic.net/2020/08/20/dubious-quantitative-residue/#737-8

Supposedly, Boeing has been diligently working on fixing the problems with its defective jets that can’t be addressed by a rebranding campaign. This wasn’t voluntary: the 2020 Aircraft Certification, Safety, and Accountability Act required Boeing — and every other manufacturer whose aircraft were certified by the FAA — to meet new minimum safety standards by December 27, 2022.

Every manufacturer met that deadline, except Boeing, and someone amended the budget bill to give the company three more years to meet these security standards. Critically, the new security measures, when they come, will be certified by an FAA that Republicans will control, thanks to the House changing hands.

https://prospect.org/infrastructure/transportation/government-spending-bill-waives-aircraft-safety-deadline/

Boeing is slated to ship 1,000 new 737 Maxes, which will fetch $50b for the company. Many of these planes will fly directly over my house, which is on the approach path for Burbank airport. Southwest Air flies dozens of 737 Maxes right over my roof every single day.

As Facundo points out, the FAA can ill afford any more hits to its credibility. It was once the case that if the FAA certified an aircraft, every other country in the world would waive any further certification, so trusting were they of the FAA’s judgment. That is no longer the case: today, the European Aviation Safety Agency does its own aircraft testing, holding jets that enter EU airspace to a higher standard than the FAA does for US planes.

It’s just another reminder that the US doesn’t have “corporate criminals” because the US doesn’t have any meaningful enforcement for corporate crimes. In America, we love our companies like we love our billionaires: too big to fail and too big to jail:

https://pluralistic.net/2021/10/12/no-criminals-no-crimes/#get-out-of-jail-free-card

Image: Ryan Lee (modified) https://www.flickr.com/photos/190784293@N05/50862532686

CC BY 2.0 https://creativecommons.org/licenses/by/2.0/

Henry Wadey (modified) https://commons.wikimedia.org/wiki/File:Flames_%2858765896%29.jpeg

CC BY 3.0 https://creativecommons.org/licenses/by/3.0/deed.en

[Image ID: A living room scene, featuring a sofa in the background and a sofa in the foreground. A man's hand reaches into the frame to lift up the corner of the sofa. A broom enters the frame to sweep a pile of dirt under the rug. Mixed in with the dirt are a crashed WWI biplane with Southwest Airlines livery, and an old lady in a rocking chair.]

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zvaigzdelasas · 7 months

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The Israeli government has asked the Pentagon for missile interceptors, precision-guided weapons and artillery rounds following the deadly attacks by Hamas militants on Saturday, according to a U.S. official. The Pentagon is working with defense contractors to expedite some of the orders, according to the official who was not authorized to speak about the issue. Israeli defense forces do not seem to have a shortage of weapons, but attacks on Israel are continuing and an Israeli offensive into Gaza is expected in coming days.

Continued military support for Israel could be combined with aid packages for Ukraine, Taiwan and funding for domestic natural disasters, the official said. The White House has about $100 million remaining in Presidential Drawdown Authority, the fund that has been regularly tapped for the more than $40 billion in military aid for Ukraine. The anticipated request from the White House for supplemental funding faces uncertainty in Congress, where the House does not have a speaker after Kevin McCarthy was deposed last week.[...]

The Pentagon also stockpiles ammuniton in Israel for conflicts in the Middle East and Europe, including Ukraine's defense against Russian invaders. Israel, with permission from the United States, can tap that arsenal if needed.

9 Oct 23

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kp777 · 7 months

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By Jake Johnson

Common Dreams

Oct. 4, 2023

"Medicare Advantage is just another example of the endless greed of the insurance industry poisoning American healthcare," says a new report from Physicians for a National Health Program.

A report published Wednesday estimates that privately run, government-funded Medicare Advantage plans are overcharging U.S. taxpayers by up to $140 billion per year, a sum that could be used to completely eliminate Medicare Part B premiums or fully fund Medicare's prescription drug program.

Physicians for a National Health Program (PNHP), an advocacy group that supports transitioning to a single-payer health insurance system, found that Medicare Advantage (MA) overbills the federal government by at least $88 billion per year, based on 2022 spending.

That lower-end estimate accounts for common MA practices such as upcoding, whereby diagnoses are piled onto a patient's risk assessment to make them appear sicker than they actually are, resulting in a larger payment from the federal government.

But when accounting for induced utilization—"the idea that people with supplemental coverage are likely to use more health care because their insurance pays for more of their cost"—PNHP estimated that the annual overbilling total could be as high as $140 billion.

"This is unconscionable, unsustainable, and in our current healthcare system, unremarkable," says the new report. "Medicare Advantage is just another example of the endless greed of the insurance industry poisoning American healthcare, siphoning money from vulnerable patients while delaying and denying necessary and often lifesaving treatment."

Even if the more conservative figure is accurate, PNHP noted, the excess funding that MA plans are receiving each year would be more than enough to expand traditional Medicare to cover dental, hearing, and vision. Traditional Medicare does not currently cover those benefits, which often leads patients to seek out supplemental coverage—or switch to an MA plan.

The Congressional Budget Office has estimated that adding dental, vision, and hearing to Medicare and Medicaid would cost just under $84 billion in the most costly year of the expansion.

"While there is obvious reason to fix these issues in MA and to expand traditional Medicare for the sake of all beneficiaries," the new report states, "the deep structural problems with our healthcare system will only be fixed when we achieve improved Medicare for All."

Bolstered by taxpayer subsidies, Medicare Advantage has seen explosive growth since its creation in 2003 even as it has come under fire for fraud, denying necessary care, and other abuses. Today, nearly 32 million people are enrolled in MA plans—more than half of all eligible Medicare beneficiaries.

Earlier this year, the Biden administration took steps to crack down on MA overbilling, prompting howls of protest and a furious lobbying campaign by the industry's major players, including UnitedHealth Group and Humana. Relenting to industry pressure, the Biden administration ultimately agreed to phase in its rule changes over a three-year period.

Leading MA providers have also faced backlash from lawmakers for handing their top executives massive pay packages while cutting corners on patient care and fighting reforms aimed at rooting out overbilling.

As PNHP's new report explains, MA plans are paid by the federal government as if "their enrollees have the same health needs and require the same levels of spending as their traditional Medicare counterparts," even though people who enroll in MA plans tend to be healthier—and thus have less expensive medical needs.

"There are several factors that potentially contribute to this phenomenon," PNHP's report notes. "Patients who are sicker and thus have more complicated care needs may be turned off by limited networks, the use of prior authorizations, and other care denial strategies in MA plans. By contrast, healthier patients may feel less concerned about restrictions on care and more attracted to common features of MA plans like $0 premiums and additional benefits (e.g. dental and vision coverage, gym memberships, etc.). Insurers can also use strategies such as targeted advertising to reach the patients most favorable to their profit margins."

A KFF investigation published last month found that television ads for Medicare Advantage "comprised more than 85% of all airings for the open enrollment period for 2023."

"TV ads for Medicare Advantage often showed images of a government-issued Medicare card or urged viewers to call a 'Medicare' hotline other than the official 1-800-Medicare hotline," KFF noted, a practice that has previously drawn scrutiny from the U.S. Senate and federal regulators.

PNHP's report comes days after Cigna, a major MA provider, agreed to pay $172 million to settle allegations that it submitted false patient diagnosis data to the federal government in an attempt to receive a larger payment.

Dr. Ed Weisbart, PNHP's national board secretary, toldThe Lever on Wednesday that such overpayments are "going directly into the profit lines of the Medicare Advantage companies without any additional health value."

"If seniors understood that the $165 coming out of their monthly Social Security checks was going essentially dollar for dollar into profiteering of Medicare Advantage, they would and should be angry about that," said Weisbart. "We think that we pay premiums to fund Medicare. The only reason we have to do that is because we're letting Medicare Advantage take that money from us."

#medicare advantage #health care #medicare #physicians for a national health program

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mariacallous · 5 months

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It was supposed to be a clarion call to re-energize flagging U.S. support for Ukraine. Ukrainian President Volodymyr Zelensky was meant to dial into a classified briefing to the entire U.S. Senate on Tuesday, alongside top Biden administration officials, urging the Senate to support the swift passage of a massive national security supplemental bill to keep the taps of U.S. military aid flowing to Ukraine.

In the end, those best-laid plans devolved into yet another partisan fight on Capitol Hill.

Zelensky didn’t attend, according to congressional aides and former officials familiar with the matter, due to a last-minute scheduling conflict, and Senate Republicans walked out of the briefing early, fuming that the administration officials slated to brief them would only talk about Ukraine and Israel, and not the U.S. southern border—which was their top policy priority. While several top administration officials attended the briefing, Homeland Security Secretary Alejandro Mayorkas, who oversees U.S. border policy, did not, the aides and former officials said, incensing Republicans.

The drama around this classified briefing encapsulates the political quagmire the Biden administration now faces, with massive implications for U.S. foreign policy and, in particular, Ukraine’s war against Russia. The Biden administration stitched together a major package of $111 billion to support Ukraine, Israel, Taiwan, and fund U.S. southern border security in a bid to get as many members of Congress as possible to support the measure. Instead, it’s devolved into a political headache, leaving continued aid for Ukraine hanging in the balance during a crucial phase in its war in Ukraine, all because of a partisan feud over U.S.-Mexico border policies. In a speech on Wednesday urging members of Congress to support further funding for Ukraine, President Joe Biden accused “extreme Republicans” of “playing chicken” with U.S. national security.

“These are all political games,” said Luke Coffey, a national security expert at the Hudson Institute think tank. “Meanwhile, Ukrainians are dying, and funding is running dry.”

As of mid-November, the Pentagon had spent 97 percent of the $62 billion already earmarked for Ukraine, according to a starkly worded letter sent from the White House to congressional leaders on Monday. Military experts paint a bleak picture of what could happen next if the spigot of U.S. military aid is cut off.

“We support Ukraine or Ukraine loses the war,” said Fred Kagan, director of the Critical Threats Project at the American Enterprise Institute. “It really is that stark,” he said.

In the first months of this renewed war, Russia seized 20 percent of Ukrainian territory, reaching the outskirts of the capital, Kyiv. Ukrainian forces have since waged a grinding battle to claw back towns and cities from Russian control. A collapse in U.S. support could unwind many of those hard-won gains. “If we cut Ukraine off and abandon Ukraine the way we abandoned Afghanistan, ultimately the same thing will happen,” Kagan said.

The war has been characterized by pitched artillery battles. Feeding the Ukrainian military’s rapacious need for artillery shells has been a central component of U.S. support. If that funding is stopped, it would be quickly felt on the battlefield. “People cannot fight with their bare hands,” said Andriy Zagorodnyuk, the former Ukrainian minister of defense.

Another pillar of U.S. support has been air defense systems, which have protected Ukrainian cities from Russian missile and drone attacks. Late last month, Russia unleashed a swarm of 75 drones on Kyiv in the single-biggest drone attack of the war to date. All but one were shot down by the city’s air defense systems. A dwindling in air defense munitions could leave Ukraine’s troops, urban areas, and critical infrastructure exposed to a Russian onslaught from the skies.

Russia watchers have long cautioned that, despite his forces’ underwhelming military performance, President Vladimir Putin believes he can bide his time and wait out Ukraine’s Western backers. The Russian leader has previously stated that Ukraine would not survive beyond “a week” if Western support were to dry up.

In a call with the media on Tuesday, Biden’s national security advisor, Jake Sullivan, cautioned that Putin’s military objectives in Ukraine remain unchanged. “Russia is still intending to continue to advance,” Sullivan said. “Its objectives in Ukraine are the full subjugation of that country, not just the taking of some territory in the south and the east,” he said.

U.S. military aid to Ukraine far outstrips that provided by any other nation, and other Western states would be unable to fulfill the shortfall in the event that it is cut off. “I’ll be dialing for dollars and howitzers on a daily basis, but the bottom line is there is no substitute for the United States and what we can provide,” Sullivan said.

The U.S. has also played an important leadership role in organizing some 50 countries to provide aid to Kyiv through the Ukraine Defense Contact Group. As Washington has given increasingly powerful weapons to Ukraine, including Abrams battle tanks, it has given cover for European nations to follow suit. “The alliance is unlikely simply to trundle forward under its own steam as if we hadn’t been there,” Kagan said. “This will, of course, also be a massive betrayal of the allies who have also leaned forward in incurring Putin’s wrath,” he said.

Foreign Policy interviewed 12 current and former officials, congressional aides, and experts on the ongoing political battles in Washington over the future of Ukraine aid and how the administration has linked it to funding for other national security priorities. One conclusion stands out above all others: There’s a palpable sense of dread among Ukraine’s biggest supporters in Washington and Europe.

Without continued U.S. military and economic aid for Kyiv, those supporters argue, Ukraine may not lose the war tomorrow, but it will undoubtedly tip the scale of the war in Russia’s favor. Biden administration officials and many members of Congress argue that Ukraine’s war is an existential struggle for peace in Europe: If Russia achieves a victory in Ukraine, it won’t stop there, and could invade U.S. allies on NATO’s eastern flank next.

A small group of cautious Ukraine optimists inside the administration and Congress see the political battle over this funding package—around $111 billion in total—as a nasty procedural hurdle that congressional leaders will eventually sort out. The Democrats narrowly control the Senate, while Republicans narrowly control the House, so the politics was always going to be tricky, they argue, but Congress has overcome thorny political impasses before.

House Speaker Mike Johnson has said that House Republicans won’t greenlight Ukraine aid without a Republican-backed immigration bill, H.R. 2, included in the supplemental package. Democrats have resoundingly rejected H.R. 2, which would mirror Trump-era immigration policies, including border wall construction and curbing humanitarian parole programs for asylum-seekers. On the Senate side, even Republicans who are reliably pro-Ukraine have been unwilling to pass the supplemental until the Biden administration puts more security on the border.

“The mayors of our major cities have clearly indicated they do not have the capacity to take care of the refugees,” said Sen. Roger Wicker, the top Republican on the Senate Armed Services Committee, speaking about those who arrive over the U.S. southern border. “This ought to be a no-brainer for the president in terms of the large, hugely Democratic big cities as well as the heartland.”

These cautiously optimistic officials and experts argue that Ukraine has one thing going in its favor: Nearly every senator and a vast majority of the members of the House on both sides of the aisle still support continuing U.S. military aid to Ukraine—as do a majority of American voters, according to some of the latest opinion polls.

Still, there’s a much larger contingent of pessimists, who view the partisan skirmishes in the Senate, and the impasse over the funding package, as an omen of how U.S. support for Ukraine could waver in the coming months and years. They point to the small flank of anti-Ukraine voices in the Republican Party that has been growing louder and more influential outside Washington; the fumbling by the Biden administration on rolling out the national security supplemental tying Ukraine aid to border security; and, above all, to the question of what will happen in the 2024 presidential election.

“It is causing this gloom to descend across Europe and European capitals,” said Jim Townsend, a former top NATO policy official at the Pentagon. “They see this not as some tempest in a teapot or standard political fight in Congress, but as representative of where the U.S. is really going on foreign policy in the future.”

In a bid to marshal more support for Ukraine, Zelensky dispatched some of his top aides to Washington this week to pitch how critical U.S. support is to staving off a Russian victory.

Andriy Yermak, head of Zelensky’s presidential office, said that a postponement in U.S. aid would severely undermine Ukrainian efforts to liberate Russian-occupied territory and would create a “big risk” of Kyiv losing the war. “It will be difficult to keep in [the] same positions and for the people to really survive,” Yermak said in a speech at the U.S. Institute of Peace in Washington on Tuesday. Top Biden administration officials bluntly warned Congress that their ability to keep supplying Ukraine with weapons would dry up unless the emergency supplemental is passed.

“I want to be clear: without congressional action, by the end of the year we will run out of resources to procure more weapons and equipment for Ukraine and to provide equipment from U.S. military stocks,” Shalanda Young, director of the White House Office of Management and Budget (OMB), wrote in a letter to congressional leaders this week. “There is no magical pot of funding available to meet this moment. We are out of money—and nearly out of time.”

There’s another growing fear about how this political battle could affect aid to Ukraine in the future, playing out in the background of the drama on Capitol Hill that many officials point to: the U.S. defense industrial base.

A significant portion of the funds being held up are allocated to the U.S. defense industry to expand the production of U.S. munitions that can be sent to Ukraine to keep up the fight against Russia. The war has bogged down into what some analysts consider a stalemate, and both sides need immense supplies of artillery munitions in particular to keep up the fight. The U.S. Defense Department is now producing about 28,000 rounds of 155 mm artillery ammunition a month, according to the U.S. Army’s October numbers, the most-used across NATO countries. Though that’s double the amount of artillery that the United States was producing before Russia’s full-scale invasion, it’s far less than what Ukraine needs (Troops are firing about 7,000 rounds per day into Russian lines.). Without more money, U.S. officials say even that supply will dry up.

“Do we have the money to do 100,000 [rounds of 155 mm artillery ammo per month]? The answer is yes, if they passed a supplemental,” Pentagon acquisition chief William LaPlante told reporters on the sidelines of the Reagan National Defense Forum this weekend in Simi Valley, California.

Across the pond, European Union officials have also said that they are far short of the 27-nation bloc’s target to produce 1 million 155 mm rounds by early 2024. Any break in the deliveries of U.S. weapons and ammo might give Russia more opportunity to reconstitute its devastated ground forces in Ukraine, meaning the political battles on Capitol Hill could have very stark consequences for the real battles in Ukraine.

“There will be huge implications on the front lines,” Coffey said. “They probably wouldn’t be felt immediately as aid is still moving in the pipeline, but as Ukraine weathers this cold winter, and as it prepares for what it wants to do on the battlefield next year, this [U.S.] funding is crucial.”

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