Entitled to Know

by Barbara B. Kennelly, President/CEO

Not surprisingly, the insurance industry’s million dollar ad and lobbying campaign is paying off on Capitol Hill and it appears a Congressional compromise to re-authorize SCHIP won’t include needed reforms to Medicare.

Congress Daily summarizes the closed-door negotiations and Speaker Pelosi’s comments afterwards:

House Speaker Pelosi said “We are working on agreements between [the] House and Senate to take two proposals to our respective caucuses in order to see where we go from here." House leadership sources speculated she was referring to breaking the House measure into separate Medicare and SCHIP bills to avoid confronting the Senate with the House Medicare funding language, which Senate negotiators have called a poison pill.

Of course, the President promises a veto of anything other than his proposal anyway so that’s no small part of the political calculations here.

Both the Medicare overpayments to private plans and the doctor’s fix appear destined for “to be determined later” status. The Health Care Policy and Marketplace Review’s latest posts on this can be found here and here.

According to a new GAO report, that’s the estimated price tag for the President’s failed Social Security Privatization Road Show two years ago. Most of those taxpayer dollars... $437,887...were spent for Air Force One and Air Force Two to shuttle the promoters in chief to 40 cities nationwide with another $370,000 in travel costs for Executive Office staffers. The kicker here is the GAO acknowledges these numbers probably aren’t complete...

“We could not test the validity of some of those costs because (the Executive Office of the President) withheld certain key information and Treasurydid not have supporting documentation for amounts it reimbursed EOP,’’ Comptroller David Walker wrote in the letter summarizing the review. “ We are, therefore, unable to provide reasonable assurance that the costs reported to us are complete and fully supported.’’

We can only imagine what the finally price tag would have been had the American people not made it abundantly clear that the more the President talked about his Social Security privatization scheme...the less they liked it. Too bad he didn’t figure that out a million dollars or so earlier.

The Swamp also has a good discussion of the GAO report.

The differences between Senate and House members trying to negotiate a compromise in their legislation to reauthorize and improve access to healthcare for children, SCHIP, remain. That, in our opinion, is a good thing. Not because we like gridlock but because this legislation is too important to seniors and children alike to take the easy way...which is to ignore the difficult issues tackled in the House bill but absent in the Senate version.

The House bill, called CHAMP, includes desperately needed reforms to private Medicare Advantage plans and is by far the better piece of legislation. Money currently being used to overpay insurers would go to improve health insurance access to children. More than a fair trade. Thankfully, House leaders are sticking to their guns...so far. Congress Daily describes yesterday’s closed door meeting this way:

"Senate Majority Leader Reid, House Majority Leader Hoyer, Senate Finance Chairman Baucus, and House Energy and Commerce Chairman Dingell attended the meeting in House Speaker Pelosi's office to discuss how to approach a conference report that would merge the bills. They made no decisions. 'We've got to find out how close are we. We know how far apart we are just without talking,' Rangel said. 'They cannot make commitments on their side, and we damn sure can't on ours, to say that we're compromising when we don't even know where we are.' From Rangel's perspective, ripping apart the House package might threaten its majority support. 'We put the baby together, and we made the baby with [Energy and] Commerce Committee and the Ways and Means committee, our caucuses, liberals, Democrats, pro-tax, anti-tax, cigarette people. We put this child together. And to split the child in half is very, very difficult to sell it to the parents,' he said."

While every major seniors and health advocacy organization (including the AMA and AARP) supports cutting millions in outrageous overpayments to private MA insurance companies and using that savings to improve insurance access for children...you can see just how much influence the insurance lobby still has on Capitol Hill...

“Before the meeting, Baucus said it would be very difficult to get the needed 60 votes for a conference report in the Senate if any Medicare provisions are added. Several Republican supporters of the Senate bill say they will not tolerate cuts to private Medicare Advantage programs that are part of the House bill.” Congress Daily AM, Sept 7, 2007

So in short, some in the Senate just "won’t tolerate" cuts to private plans which pay private insurers about $1,000 more than Medicare receives for the same beneficiary. They "won’t tolerate" cutting industry subsidies which will cost taxpayers $149 billion dollars over the next decade and cuts two years from Medicare’s solvency. And let’s not forget the extra $24 a year every Medicare beneficiary is paying to cover these subsidies...whether they’re in a private plan or not.

Clearly, the insurance industry does not want to lose the MA gravy train and it's lobbying hard to protect the sweetheart deal it wrote and passed through Congress in the 2002 Medicare Privatization...oops, we mean Modernization...Act.

That’s why we say in this instance...differences are a good thing. And we urge Senate to find the same courage their colleagues showed in the House and support SCHIP legislation that considers what’s best for children and seniors alike.

No doubt, you’ve seen AHIP’s (America’s Health Insurance Plans) television ads designed to scare seniors into believing that cutting millions in industry subsidies is somehow the same as cutting Medicare. This weekend, their president penned a letter to the Washington Post continuing the intergenerational war refrain, which has become a popular marketing ploy used by the Bush administration whenever it wants to scare one age group or the other.

If you want to get beyond the rhetoric, check out Robert Laszewski’s post today at the Healthcare Policy and Marketplace Review blog. He contrasts AHIP’s main points with the truth, such as:

“The Congressional Budget Office predicts that 3 million seniors—mostly rural Americans—will lose their Medicare Advantage coverage altogether if the House bill becomes law.” I am sure that is right. But the CBO is right more because the plans that have been gaming the Private Fee For Service payment system won’t any longer be able to do it and will leave those markets.

And then the big one: “There’s no justification for pitting children against seniors.” Damn right. So, why are you making this into a kids versus seniors issue?

While we don’t agree with all of Laszewski’s conclusions, it is refreshing to see someone looking past the PR to the actual truth of the matter. The post's discussion also provides more thoughtful insight into this "seniors versus children" propaganda.

The real question is...Can those who actually care about sensible healthcare options for seniors and children cut through this million dollar industry marketing blitz to persuade the Senate to take the House’s lead on SCHIP and MA reform?

Here’s a letter we’ve sent to the Senate urging they consider legislation that improves children’s healthcare access through SCHIP while also making desperately needed reforms to private Medicare Advantage plans.

Ask Mary Jane, NCPSSM Contributor: Mary Jane Yarrington, Senior Policy Analyst

“My wife heard that she won't be able to collect her own SS at retirement age because she will collect from a school retirement plan. Can that be true?”

or

“When I went to the Social Security office I was devastated to learn that I would never receive any social security benefits (even though I have a minimum of 40 credits). I never knew such a thing as the Windfall Elimination Provision existed”

In short, if you hear “you can’t collect any of your Social Security” because of the WEP then you have been misinformed. Any citizen or legal resident who earns 40 quarters of Social Security coverage is entitled to a retirement benefit at retirement age. There are no exceptions.

Ask Mary Jane, NCPSSM Contributor: Mary Jane Yarrington, Senior Policy Analyst

Anyone who tells you Social Security is a Ponzi scheme either doesn't understand what a Ponzi scheme is or their mother’s didn’t teach them not to fib. This myth is a favorite of conservatives who just hate the idea of social insurance in general. The Social Security Administration has a good history describing why this is nonsense. But here’s my take on this myth.

A Ponzi scheme is that e-mail you receive inviting you to send a fancy guest towel to the top three names on a list and instructing you to cross off the first name, add your name and send the same e-mail to three others. Whoever starts the list likely will receive the towels, but ultimately, there is no one left to continue the chain. The final entrants won’t receive anything. The original Ponzi played the game with dollars but the principle is the same. He borrowed money from his first investors and paid them back with money obtained from subsequent investors. He quickly ran out of sufficient investors to keep his scheme going.

Social Security is not a Ponzi scheme. Social Security is a pay-as-you-go system with the contributions of today’s workers going to today’s retirees or into the reserve to pay benefits to future retirees. The ratio of workers to retirees has changed over time, but unless this nation allows the system to be abolished, there will never be a time of no workers paying into the system. The most recent report of the Social Security Board of Trustees forecasts that even with no changes in the system, reserves will last through 2041 and even after that, 75% of promised benefits could be paid with incoming payroll taxes.

And don’t give any credence to the nonsensical comparison that in 1940 there were 40 workers to each retiree and today it is only three to one. Of course, there were fewer beneficiaries. 1940 was the first year a benefit was paid so millions of then-retired workers didn’t have the opportunity to contribute payroll taxes and earn benefits. Many of those ineligible for benefits in 1940 then relied on public assistance or their children to survive their retirement years. Hardly the “good old days” those who hate Social Security should be so eager for us to return to.

Do you have questions about Social Security? If so, feel free to drop me an email at Ask Mary Jane.

Ask Mary Jane, NCPSSM Contributor: Mary Jane Yarrington, Senior Policy Analyst

Apparently the Centers for Medicare and Medicaid Services has.
A new GAO report investigates CMS audits of private insurance providers offering Medicare Advantage plans. These private MA plans will collect billions in government subsidies while also charging $1000 more per beneficiary to provide the same coverage already provided by Medicare.

This latest GAO report finds:

“CMS has not met the statutory requirement to audit the financial records of at least one-third of the participating MA organizations for contract years 2001-2005, nor has it done so yet for the contract year 2006 bid submissions.”

Even worse, the audits that CMS has performed turned up $34 million dollars which Medicare beneficiaries should have received in additional benefits, lower co-payments or lower premiums. Good news for seniors, right? Think again.

“However, in late May 2007,CMS officials told us they were planning to close out the audits without pursuing financial recoveries because legal counsel had determined that the agency does not have the legal authority to recover funds from MA organizations based on ACR audit results.“

In other words, private MA insurers get to keep another $34 million of our taxpayer dollars, because CMS won’t enforce its own contracts with the insurance industry.

Welcome to the world of privatized Medicare.

Only in Washington could a 14% increase in prescription drug premiums for seniors be "spun" to sound like good news. That’s CMS’s strategy in announcing next year’s Part D premium hike. The administration’s logic goes something like this: since Part D isn’t costing as much as we first predicted seniors shouldn’t really mind double-digit premium hikes.

Here are the basics on the 2008 Part D premium: starting January 1 seniors’ average Part D premium for basic coverage will increase from about $22 this year to $25 next year. What CMS doesn't tell you is that in addition to this premium hike, beneficiaries will also face higher deductibles and a growing “doughnut hole” which will remain unchecked as long as healthcare costs continue to skyrocket.

By 2014, the Medicare's Trustees expect monthly Part D premiums to increase to $64.26 , the deductible to rise 75% to $457, and the $2,850 “doughnut hole” to become a yawning gap of almost $4,983.75.

CMS is also quick to remind everyone that if seniors don’t want to pay more they can just go shopping for another plan. As if choosing a drug plan for each of the first two years hasn’t been confusing enough!

72 years ago today President Franklin D. Roosevelt signed the Social Security Act. Today, nearly 50 million seniors, the disabled, and survivors receive Social Security benefits and for many it will make the difference between living independently or in poverty.

No other government program in American history can claim the successes achieved by Social Security. Period. Attacks and misleading predictions about sustainability have been leveled against the program since its creation and still, Social Security checks go out on time and as promised. Whether you’re 72 or 22, it appears Social Security is poised to play an even larger role in your life.

A new report by the Center for American Progress details the decline in pensions, personal savings and median incomes, which increase the importance of the only, guaranteed retirement income…Social Security. These are especially important facts for our younger workers who have been told repeatedly that “Social Security won’t be there for you”.

What nonsense.

Here’s a great source for some historical perspective. “The Battle for Social Security—From FDR’s Vision to Bush’s Gamble”. Author Nancy Altman says Social Security’s most important champion has always been the American people.

“Through its many challenges, Social Security has always emerged victorious,because Americans have remained committed to this essential program. The large majority of Americans have supported Social Security because it embodies the best of American values, including reward for work, compassion, fairness, foresight, and prudent, conservative management. This unflagging support has permitted Social Security to eradicate much of the economic insecurity of the past and to transform society.”

Ultimately, it will be the next generation of workers who will have to see through the political hype and the privatization schemes, and come to the same conclusion generations before them have...Social Security can and must be strengthened for generations to come.

Kudos to Sen. Hillary Clinton for being the first presidential candidate to remind everyone about the continuing privatization threat to Social Security. Here is her answer to a pension question posed at the August 7th Democratic Candidates Forum in Chicago:

Clinton: “The pension system is broken. We’ve got to stop companies going into bankruptcy in order to get rid of theirpension responsibilities(Cheers, applause.) We have to have defined benefits pension plans again. We’ve got to make sure that nobody ever tries to privatize Social Security, something that
I’ve fought tooth and nail with many of you to prevent.”

While the Iraq war, healthcare and the economy have dominated presidential talking points so far, we certainly hope more candidates will remember that it wasn’t that long ago when Social Security was literally under attack by those who’ve never believed in the value of social insurance.

The privatization Social Security and Medicare is a core values debate which we hope more presidential candidates will take on in their campaigns.

MSNBC has video of the Chicago forum and the New York Times has the full transcript.

There were a lot of cheers in our office last night and celebrations today as families nationwide get the news of last night's House vote in support of the Children’s Health and Medicare Protection (CHAMP) Act. Incredibly is was still a largely partisan vote with most Republicans and a few conservative Democrats voting against it. Here's a link to the roll call vote and last night's reaction from our President/CEO, Barbara Kennelly.

“While everyone in Washington claims to care about seniors and children, tonight’s vote in the House forced members of Congress to prove it. A majority has chosen to return America’s healthcare priorities where they belong…on American families.

Government subsidies to private insurers providing Medicare Advantage have created a gaping hole that is draining the Medicare trust fund and imposing unfair costs on millions of beneficiaries across the nation. These outrageous overpayments were proposed by the insurance industry and passed into law by their allies in Congress, 4 years ago. That mistake was corrected in the House tonight.

By eliminating these government subsidies, private Medicare plans will have to compete on a level playing field with traditional Medicare. We’ve been told for decades industry can provide seniors cheaper and more efficient healthcare…this House bill gives insurers the chance to prove it.”

But the battle is far from over. The Senate's SCHIP legislation is still being debated on the floor and it does not include any of the House provisions to eliminate billions in government subsidies to private insurers. The Conference on these two very different bills will be very interesting indeed.

There has been a lot of activity in the SCHIP/Medicare debate in the House last week and today in the full Senate. Kaiser Daily Health Report has a nice editorial roundup of the debate.

But we’ve also seen a number of blog discussions in which it’s clear even those who are paying attention to this debate are still confused about the players. So, here it is in a nutshell.

Virtually every major health and senior’s advocacy group (NCPSSM, AMA, Medicare Rights Center, AARP, Families USA, etc.) supports the House SCHIP/Medicare act called the Children’s Health and Medicare Protection Act or “CHAMP”.These organizations are supporting cuts in industry subsidies…not cuts to seniors. For advocates committed to senior and health issues this is a no-brainer. Here is the AMA/AARP ad.

The only "seniors group" fighting against CHAMP is an organization created by the insurance industry. Here’s their ad.

So, it’s easy to see how people are confused. But CHAMP does not take away seniors’ Medicare. It does require Medicare Advantage private insurers to be paid at the same rate as traditional Medicare, ending the industry gravy train, which has meant hefty profits to insurance companies collecting billions in taxpayer supported subsidies at the same time.

The New York Times’ Paul Krugman, sums up the debate this way:

“The House plan, which would cover more children, is more expensive, but it offsets Schip costs by reducing subsidies to Medicare Advantage -- a privatization scheme that pays insurance companies to provide coverage, and costs taxpayers 12 percent more per beneficiary than traditional Medicare. Strange to say, however, the administration, although determined to prevent any expansion of children's health care, is also dead set against any cut in Medicare Advantage payments. So what kind of philosophy says that it's O.K. to subsidize insurance companies, but not to provide health care to children?”

Industry subsidies or children’s healthcare…it should be an easy choice.

Two key House Committees are debating important "CHAMP" legislation which reauthorizes and improves the State Children’s Health Insurance program while also making desperately needed reforms to the Medicare Modernization Act of 2003, including the elimination of Medicare Advantage subsidies to private insurers.

This is very important legislation for seniors and children alike. You can watch the House Energy and Commerce Committtee hearing mark-up of this bill live at 11:30am and the House Ways & Means Committee at 1:00pm.

The House Ways & Means Committee has also created two wonderful "Truth Squad" reports which provide the facts about this legislation which you won't hear from tobacco companies afraid a tax might limit their sales and insurers worried about losing billions in subsidies. Here's the Tobacco Tax Truth Report and the Rural Care Truth Report on what this legislation really means for rural beneficiaries currently being targeted by an industry scare campaign which is threatening a loss of healthcare in rural America.

This is a critical debate for the future of healthcare of young and old alike. If Congress can't manage to do the right thing for seniors and children...one can't help but wonder how urgent system-wide reform will be possible.

Tomorrow the House Energy and Commerce Committee will consider legislation that would reauthorize and expand SCHIP and make revisions to Medicare. The House Ways and Means Committee is expected to take up the legislation on Thursday.

While the Senate SCHIP bill does not include Medicare provisions, Congress Daily reports that the House bill would increase SCHIP funding by $50 billion over five years while also tackling many of the Medicare reforms sought by healthcare and seniors’ advocates, including the National Committee. Congress daily reports:

“The bill would also: reverse a scheduled cut in Medicare payments to physicians and provide a modest increase in fees for each of the next two years,abolish a provision of the 2003 Medicare law that mandates the president propose changes in Medicare to limit the program's reliance on general revenue, give state insurance commissioners more power to regulate the marketing of private MA plans by agents and brokers, reduce payments to private MA plans, which are estimated to be 12% higher than payments to the traditional program for equivalent benefits, increase reimbursement rates for rural health providers in 2008 and provide larger subsidies to lower-income beneficiaries.”

Kaiser Daily Health Report provides a good roundup of the latest SCHIP/Medicare coverage today.

The Senate and House leadership say they want to pass SCHIP legislation before the August recess.

Thanks to the Center for Budget and Policy Priorities for "Informing the Debate About Curbing Medicare Advantage Overpayments".

Not only are insurers receiving billions in government subsidies to operate private Medicare plans but new profit numbers out this week show business is very good if you’re an insurance company with a piece of the Medicare privatization pie.

“UnitedHealth Group Inc., the largest U.S. health insurer, said profit rose 22 percent on gains from government-sponsored medical programs.”… United Health Profit Rises on Government Medical Plans , Bloomberg 7/19/07

“Health insurer Humana Inc. on Wednesday reported higher-than-expected second-quarter profit, mainly because of improving cost trends, and its shares rose as much as 10.4 percent to a record high. The company,one of the largest providers of Medicare health plans for the elderly, also rasied its full-year earnings forecast, which easily topped Wall Street's forecasts.” … Humana Profit Beats Outlook, Reuters, 07/18/07

Remember that while private insurers collect these record high profits the government is also paying them $1,000 on average more per beneficiary to provide health care coverage already provided by traditional Medicare. And, a married couple on Medicare is now paying $48 more in annual premiums to help cover billions in overpayments to insurers. These overpayments have cut two years from Medicare’s solvency according to the independent Medicare Payment Advisory Commission (MedPAC). MedPAC also estimates that in the case of Private Fee-for-Service plans only half of the excess payments to insurers are being used for extra benefits to seniors. It’s easy to see where the rest may be going…

“Humana has now raised its full-year forecast twice in the past two
months. However, the company's bullish outlook may not play well with U.S.lawmakers as they weigh whether Medicare Advantage reimbursements are too rich,CIBC's McDonald said. ‘If Congress is arguing already that they overpay you, and then you come out and you beat numbers and raise guidance on better Medicare margins, you wonder if that just gives Congress more ammunition to cut rates,’ McDonald said.”…Reuters

We can only hope.

We've been talking and writing and writing and talking about the privatization of Medicare. While a lot of our outreach has been with our National Committee members, seniors nationwide and grassroots work, today we went straight to Congressional staff. Today's briefing focused on those policy influencers who need to understand what Medicare Advantage overpayments are all about and their effect on the Medicare program. Three of the nation’s leading healthcare advocacy organizations were joined by Health Subcommittee Chairman Rep. Frank Pallone (D-NJ) who stated:

“The over-payments made to Medicare Advantage are a gaping hole that is draining the Medicare trust fund and imposing unfair costs on millions of beneficiaries across the nation. The time has come for Congress to put an end to end these subsidies to ensure that Medicare remains a reliable source of health care for the elderly and disabled for many years to come."

Thousands of letters from National Committee members calling on Congress to pass legislation, which would repeal billions in insurance industry overpayments, are being sorted for delivery to Capitol Hill later this month. The President of the National Committee and former Congresswoman, Barbara Kennelly told the audience:

“At a time when our nation is struggling with how to create affordable health care coverage for all Americans, it is simply incomprehensible to me why we would destroy the one affordable, universal health care system that already exists in Medicare. The vast majority of Medicare beneficiaries remain in the traditional program. But their voices are not as loud as the insurance industry’s”.

According to the Congressional Budget Office, private insurers offering Medicare Advantage plans will collect $75 billion dollars this year alone and $1.31 trillion over the next decade. That’s funding which could have gone to Medicare but is now going to the insurance industry instead. Judith Stein, Executive Director, Center for Medicare Advocacy, Inc. says:

“Medicare wasn't broken. But because of the ever-increasing private Medicare options, it is. The solution for the Medicare crisis is not to increase the eligibility age or decrease benefits, but to stop privatizing the program at the expense of older people and taxpayers."

Rev. Sandra Butler-Truesdale, President of the Campbell Heights Resident’s Association, described how D.C. seniors became victims of a private insurer’s marketing pitch that puts sales ahead of seniors’ care. Campbell Heights seniors were promised the private plan wouldn’t replace Medicare, there were no co-pays and they could stay with their own doctors. None of that is true.

“We are now in limbo, waiting 45 days to be placed back in Medicare.What do we do if we need care within those 45 days? Most hospitals are in trouble financially and don’t want to admit patients without medical insurance. What do we do?”

Richard Deem, Senior Vice President of Advocacy with the American Medical Association says

“Congress can stop Medicare cuts to doctors and preserve seniors’ access to care by eliminating overpayments to private health insurers providing Medicare Advantage plans. These subsidies are making Medicare less sustainable as the baby-boom generation reaches Medicare eligibility”

If Medicare continues to fund large subsidies to private plans, the program will face even more pressure to cut benefits and increase out-of-pocket costs for beneficiaries. Traditional Medicare will be eroded while private plans continue to collect billions in subsidies and beneficiaries pay more of the high costs of healthcare.

It’s time to stop disadvantaging Medicare. End these costly subsidies to insurance companies and put that money to work for all of the 43 million Americans enrolled in Medicare not just the few enrolled in private plans.

Breaking down President’s Bush words is always a mind-boggling task, in fact some would argue it could probably be a job unto itself. For that reason, we don’t usually go there.

This time however, the President’s view on healthcare reform...delivered before a friendly audience of Cleveland business leaders (the meeting wasn't open to the public) this week...can’t be ignored. You can read the full White House transcript but here's one key quote. He said:

“The immediate goal is to make sure there are more people on private insurance plans. I mean, people have access to health care in America. After all, you just go to an emergency room.”

There you have it folks. Forget skyrocketing health care costs, forget the millions who can’t afford insurance, forget the fact that this administration is unprepared and unwilling to make the investments necessary to prepare for an aging nation. After all, we have emergency rooms, right?

We highly recommend you watch the whole speech to appreciate the President’s single-minded “business-good, government-bad” approach to health care reform.

by Barbara B. Kennelly, NCPSSM President/CEO

Imagine starting a business with a guaranteed 12 percent to 50 percent federal subsidy not available to your competition. The cost of that subsidy is then passed on to your competitor's customers. And finally, let's add restrictions to your competitors that don't apply to your new business. Sounds like a sweetheart deal, right? It is. It's called Medicare Advantage, the privatized Medicare plan created by the insurance industry, passed by Congress in the Medicare Modernization Act of 2003 and now enrolling millions of seniors nationwide.

Private insurers offering Medicare Advantage plans will collect $75 billion this year alone and $1.31 trillion over the next decade, according to the Congressional Budget Office. That's federal funding which could have gone to Medicare but is now going to the insurance industry instead. These private plans are paid $1,000 more a year for each beneficiary than the government pays for seniors enrolled in traditional Medicare. The independent Medicare Payment Advisory Commission estimates that every Medicare beneficiary is paying $24 more per year for their Part B premiums just to subsidize these private plans. So, even though 81 percent of Medicare's beneficiaries have chosen to remain in traditional Medicare, they are now paying extra premiums to cover the 19 percent who've chosen the private plans. These billions of dollars in overpayments have also cut two years from Medicare's solvency.

Insurers and privatization supporters in Washington defend Medicare Advantage plans claiming better service at a lower cost. The overpayment price tag certainly casts doubt on the cost argument. And, as we saw with the Part D prescription drug benefit, there are mixed results with the quality of service. MedPAC reports that in the case of private fee-for-service plans, only half of the excess payments to insurers are being used for extra benefits to seniors. The other half goes directly to insurance companies' bottom lines. And even though private plans are required to cover everything Medicare covers, they often impose higher cost-sharing requirements than traditional Medicare for benefits such as hospitalization, home health care and skilled nursing care. This means more out-of-pocket costs for seniors, many of whom don't even realize it until faced with a serious health crisis.

Congress is now reconsidering the future of these massive subsidies. Not surprisingly, the insurance industry lobby is geared up and launching its full assault to protect the spoils it won with the passage of MMA 2003. The industry's political case was slowed somewhat with recent news reports that seniors from coast to coast have been defrauded by Medicare Advantage salesmen luring them out of traditional Medicare into private plans their own doctors wouldn't accept or the seniors couldn't afford.

A recent survey of state insurance agencies found 39 of 43 states had received complaints about Medicare Advantage misrepresentations. While the industry claims the complaints are from "a few bad eggs" it promises to crack down on; in fact, the marketing abuses are inevitable in a system designed to reward enrollment numbers. And in an effort to persuade Democrats in Congress, the insurance lobby now claims low-income and minority seniors will suffer if these overpayments are stopped. Conveniently, their data ignore the large number of these beneficiaries currently receiving Medicaid.

A recent analysis by the economists at the Center on Budget and Policy Priorities found that low-income and minority beneficiaries are far more likely to receive coverage through Medicaid than Medicare Advantage plans. In fact, only 14 percent of Asian Americans, 13 percent of African Americans, and 25 percent of Hispanics are enrolled in private plans. The lifeline for Medicare Advantage is the insurance lobby and the billions of dollars it has convinced Congress to pump into industry coffers at the expense of seniors. Insurers have threatened to cut their Medicare Advantage plans if Congress halts the flow of excess payments. However, if Medicare continues to fund large subsidies to private plans, the program will face even more pressure to cut benefits and increase out-of-pocket costs for beneficiaries. Traditional Medicare will be eroded while private plans continue to collect billions in subsidies and beneficiaries pay more of the high costs of healthcare.

Advantage ... insurers.

It's time to stop disadvantaging Medicare. End these costly subsidies to insurance companies and put that money to work for all of the 43 million Americans enrolled in Medicare not just the few enrolled in private plans.


This OpEd can also be seen in the July 10th Hartfort Courant.

As the years pass and healthcare costs continue to skyrocket unchecked, it’s become clear we can’t fulfill our goal of preserving Medicare without system wide healthcare reform. So, that brings us to the universal healthcare debate. The Bush administration opposes this idea because, as we’ve seen with the privatization of Medicare and the on-going attempts to privatize Social Security, this administration’s basic philosophy can be summed up this way: Government oversight…bad. Private industry control…good. Economist Dean Baker says:

"The debate is silly, because the level of government involvement is not the issue. The real issue is the extent to which the health care industry – the insurance companies, the drug companies, and the medical equipment companies – will be allowed to rip off the public.

The government does not have to dictate anything. It can just give people a choice that they don’t currently have: specifically the option for every individual and employer to buy into a government-run Medicare type plan. Such a plan would likely offer care at a considerably lower cost than private insurers since it won’t have to pay high CEO salaries, marketing expenses, and dividends to shareholders. That is why the traditional Medicare program always wipes the floor when it competes on a level playing field with private insurers. (This is also the reason the private insurers insist on large subsidies from Medicare – they can’t compete.)"

Dean goes on to talk about the privatization of Medicare, Part D and industry subsidies which are speeding Medicare’s insolvency while pouring billions into insurers coffers. His full post is on TPM Cafe and is a must-read for anyone interested in healthcare reform, Medicare and the price we’re all paying for this administration’s privatization policies.

by Maria Freese, NCPSSM Government Relations
& Policy Director

Senator Tom Harkin has introduced Pension legislation, the Restoring Pension Promises to All Workers Act, which we hope will ultimately become law.

Social Security was never designed to be the only source of a person’s income in retirement – it was always intended to be one income stream out of 3 in retirement – the other two being income from traditional pensions and income from individual savings. This so-called 3-legged retirement stool is coming under increasing pressure.

Unfortunately, we all know that coverage in traditional pension plans is dropping as only about 20% of today’s workers in the private sector are covered by defined benefit plans. And although coverage in 401k plans is growing, the average balance in the 401k plans of workers in the last decade prior to retirement is only about $60,000. If it weren’t for the run-up in housing values – many workers would be facing retirement with few assets available to finance it.

Senator Harkin’s legislation addresses a number of inequities in our pension system. The provisions he includes won’t help everyone but for the people they do affect, his bill could represent the only thing standing between them and living a life of poverty in retirement.

For workers caught in the globalization wars who are pawns in the game of mergers and acquisitions, the Harkin bill could keep them from losing half their pensions as workers caught up in a recent Halliburton re-shuffling did. For widows and divorced spouses of federal workers, the Harkin bill would help take the gamble out of survivor and retirement annuities, closing several longstanding loopholes that wipe out the pension benefits of some spouses of federal employees.

While it seems as though these glitches in the pension system should be easy to fix because they are so egregious, in fact they are not. Getting them passed will take the commitment of someone like Senator Harkin who believes now is the time to finally right these wrongs.

The National Committee commends Senator Harkin for taking on this challenge. And we look forward to working with him to get the Restoring Pension Promises to All Workers Act signed into law.

There's been some some good coverage of Chairman Stark's introduction yesterday of important Medicare Advantage legislation. We're regular readers of the "Medicare Monitor " blog and Larry Lipman describes this legislation, designed to prevent these private Medicare Advantage plans from charging more than traditional Medicare. You can also see coverage from Stark's home district in the Inside Bay Area blog called "Political Blotter".

Also, here's another Medicare privatization primer if you're interested in more details about Medicare Advantage plans and the privatization of Medicare.

House Ways and Means Health subcommittee Chairman, Rep. Pete Stark (D-CA) has introduced an important piece of legislation to prevent Medicare Advantage (MA) plans from charging seniors and people with disabilities more than traditional Medicare.

The Medicare Advantage Truth in Advertising Act would prohibit MA plans from charging higher cost-sharing. Stark says:

“Medicare Advantage plans don’t live up to their name. Though seniors and people with disabilities wouldn’t know it from the never-ending stream of insurance propaganda, Medicare Advantage plans charge more than traditionalMedicare for a large number of services – everything from home health care to hospital stays and chemotherapy drugs to durable medical equipment. The Medicare Advantage Truth in Advertising Act protects beneficiaries by ensuring they won’t face higher out of pocket costs in private plans than they do in Medicare.”

The Chairman's News Release also says:

"The bill would continue to permit flat co-payments – which private plans charge for certain benefits or services in lieu of deductibles or co-insurance in traditional Medicare – but those charges could never exceed Medicare’s charges.”

The National Committee supports this legislation because; as our President/CEO, Barbara Kennelly says, beneficiaries aren't getting what they pay for with this privatized plan:

"Despite receiving substantial overpayments, private MA plans can provide inferior health coverage compared to traditional Medicare. While MA plans are required to cover everything that Medicare covers, they do not have to cover every benefit in the same way. For example, private plans may create financial
barriers to care by imposing higher cost-sharing requirements for benefits that protest the sickest and most vulnerable beneficiaries. Preventing private plans from imposing greater cost-sharing requirements than traditional Medicare would better protect beneficiaries from higher and unexpected out-of-pocket costs."

Here's another link to a Committe Chart detailing sample higher out of pocket costs in Medicare Advantage.

by Barbara B. Kennelly, President/CEO

How wonderful it is to finally hear the truth about what’s really happening with the privatization of Medicare expressed so clearly and persuasively in the halls of Congress. Specifically I’m talking about the House Budget Committee hearing on Medicare Advantage plans held this morning. As I testified to Chairman John Spratt and the rest of the Budget committee members today, our 4 million members and supporters are committed to the preservation of Social Security and Medicare.


At a time when Americans are being told we “can’t afford” Medicare and Social Security it’s ridiculous to continue paying private insurers billions of dollars in subsidies equaling approximately $1,000 more a year for each beneficiary than traditional Medicare currently pays. These insurance industry subsidies will cost taxpayers $149 billion dollars over the next decade and cut two years from Medicare’s solvency. These subsidies must go.

Congressional Budget Office Director Peter Orszag and Mark Miller, the Executive Director of Medicare’s Payment Advisory Commission, offered compelling and indisputable evidence that the insurance industry has reaped the benefits of these massive subsidies yet there’s little evidence of the promised efficiencies and savings for beneficiaries. In fact, Medicare beneficiaries are paying $24 a year in higher Part B premiums just to fund excess payments to private plans.

Since the passage of the Medicare Modernization Act (MMA) of 2003, Medicare has been undergoing a transformation into a privatized program. This legislation is a weapon aimed at the heart of traditional Medicare. It was designed to accomplish the goal expressed by former Speaker Newt Gingrich – to lure seniors voluntarily out of Medicare so that it would eventually wither on the vine. The overpayments to Medicare Advantage plans the committee explored today are just one of the tools in the MMA to achieve this end.

I cannot overstate the damage these Medicare Advantage overpayments will cause to the traditional Medicare program if they are not eliminated. Ultimately, overpaying MA plans will shatter the risk pool that makes Medicare work. Medicare Advantage plans tend to attract healthier seniors because of their benefits. As more of these seniors are lured out of traditional Medicare, they leave behind the frailest and most vulnerable to pay higher and higher premiums. Also, as MA enrollments grow, so do taxpayer subsidies. Over time, this cycle will cause Medicare to become unaffordable – for both taxpayers and beneficiaries.

At a time when our nation is struggling with how to create affordable health care coverage for all Americans, it is simply incomprehensible to me why we would destroy the one affordable, universal health care system that already exists in Medicare.

When the Bush administration first tried to sell the privatization of Social Security, the American people ultimately saw through the political marketing blitz and put a stop to private account plans designed to turn Social Security over to Wall Street. Unfortunately, by the time the President's Social Security privatization road show stalled out two years ago, the privatization of Medicare had already begun quietly and beneath the radar thanks to passage of the 2003 Medicare Modernization Act. Now seniors and taxpayers are paying the price for that privatization legislation.

With billions in subsidies going to the insurance industry, a substantial portion of which comes from premium hikes, and two years lost from Medicare’s solvency; many in Congress, the press, and the public finally understand what the privatization of Medicare really means. The Los Angeles Times has a good overview:

“Healthcare providers contended that the private sector was more efficient, so they could provide more for less. But as it turns out, the private Medicare Advantage plans provide more for more, costing the Medicare system 12% to 15% more than traditional government-run Medicare costs, said Maria Freese, director of government relations at the Committee to Preserve Social Security and Medicare, a Washington advocacy group. Eliminating Medicare Advantage plans, in which about 20% of Medicare recipients have enrolled, would give the system about two additional years of solvency.”

The Senior-Spectrum also highlighted the issue and quoted NCPSSM President/CEO Barbara Kennelly:

“The Administration’s goal is clear … to stack the deck in favor of a Medicare program run by private insurance companies allowing the destruction of the traditional program seniors have depended on for decades,” said Kennelly. “Congress must level the playing field, and it can start by eliminating these corporate giveaways.”

Congressional hearings in the House and Senate continue and we expect there will be legislation on Medicare Advantage overpayments later this year.

The Washington Post continues its love fest for the so-called "Fiscal Wake-Up Tour", Comptroller General David Walker's traveling troupe of the "sky-is-falling-we-must-cut-entitlements" think tankers. Here's an excerpt from Thursday's article:

"The numbers make Joseph Farrell's head swim. Billions and trillions of dollars, numbers too immense to comprehend."

Of course they are. That's the whole point of lumping together Medicare, Medicaid and Social Security in these presentations, even though the challenges facing each program are as different as the solutions. Let's be honest, the numbers just wouldn't be as incomprehensible or scary if we talked about Social Security (a retirement program facing long term issues) and Medicare/Medicaid (healthcare programs facing a more immediate crisis in concert with a national healthcare crisis) on their own terms. This shock and awe approach is clearly not designed to provide solutions. In fact it appears the end result is just the opposite:

"I knew there was a problem, but I didn't realize it was this bad," Farrell,25, marveled after a recent presentation at the University of South Florida, from which he is to graduate in August. "I didn't realize there was no solution in sight. My taxes are going to be huge."

No solutions in sight? You've got to be kidding. Is that really the message being left by these Paul Reveres for reform? There are scores of Social Security reform options out there. Some more politically viable than others. Here's just one example from Robert Ball, Social Security Commissioner under Presidents Kennedy, Johnson and Nixon. A simple Google search will lead you to countless more.

As for Medicare, here's an obvious solution offered yet again by Congressional Budget Office Director Peter Orszag...nationwide health care reform. You can link to video of his testimony Thursday before the Senate Budget Committee and Congressional Quarterly's coverage. He said:

“The rate at which health care costs grow relative to income is the most important determinant of the long-term fiscal balance; it exerts a significantly larger influence on the budget over the long term than other commonly cited factors, such as the aging of the population.”

In other words, the President's claim that aging baby-boomers are sucking the nation dry through sky-rocketing entitlements does not tell the whole tale. But it certainly makes great headlines.

Friday the Centers for Medicare and Medicaid Services and Insurance industry lobbyists had their News Releases written, statements prepared and happy faces ready to announce their great news...7 insurance copanies which sell private Medicare "Advantage" plans have voluntarily agreed to stop marketing them. This is "spin" for we got caught with our hands in the cookie jar so we better propose a fix more to our liking than the one Congress will impose on us.

These insurers, many specifically accused of defrauding and manipulating seniors nationwide into private Medicare plans they can't use or afford, or worse illegally signing seniors up without their knowledge, say they'll now be take a voluntary marketing break until CMS is sure these plans are actually following the law. Shouldn't CMS have been doing this from the beginning? Shouldn't these "controls" have been in place and enforced before coast to coast headlines and Congressional hearings detailing thousands of cases of marketing fraud made this nationwide scandal too much even for the insurance industry to ignore? For seniors who were unwillingly shifted out of Medicare and into these private plans, those controls might have saved them untold grief and expense.

Is this voluntary (and temporary) marketing ban the only price these private companies will pay for this widespread con of American seniors? Here's what CMS said in it's release:

“While we note that most health insurance agents are helpful and responsible in describing and explaining choices to beneficiareis, there are a few bad actors that need to be removed from the system for good," said Leslie V. Norwalk, Esq., Acting Administrator of CMS. "This voluntary agreement demonstrates that CMS and the plans are stepping up to ensure that deceptive marketing practices end immediately, and that beneficiaries understand what they are purchasing."

Not surprisingly, this late awakening to the need for oversight isn't impressing everyone on Capitol Hill. Including Ways & Means Health Subcommitte Chairman Pete Stark who is quoted as saying:

"The administration's response is to allow private companies to determine which crimes they'll plead to and which sentences they'll serve. This will do virtually nothing to protect Medicare beneficiaries and is a pathetic attempt to pre-empt congressional action."

And so, seniors probably won't be sending out any "Thank You" cards to CMS and the insurance industry just yet.

As we've predicted, seniors enrolled in Medicare are feeling the affects of privatization legislation, called the Medicare Modernization Act, passed four years ago. We've released a new analysis today of how private Medicare Advantage plans are eroding traditional Medicare in favor of a privatized system subsidized by billions of federal dollars which go straight to insurers. Entitled: “Attack on Medicare: Private Health Plan Subsidies Windfall for Corporate America” this report finds:

· Even though they promised better benefits at lower costs than traditional Medicare; private insurers are actually being paid about $1,000 more for each beneficiary covered by private plans.

· These government subsidies will cost the federal government $149 billion dollars over the next decade. These overpayments will also cut two years from Medicare’s solvency.

· Not all of these subsidy dollars are being used to improve benefits. A significant portion goes straight to insurers rather than seniors. Meanwhile, every Medicare beneficiary (even those not in private plans) is paying $24 a year in higher premiums to pay for these industry subsidies, and that number will continue to rise.

Our President/CEO, Barbara Kennelly, joined other senior's groups and Medicare advocates on Capitol Hill today urging Congress to repeal these unfair corporate overpayments and rollback the privatization of Medicare before it’s too late. She says:

“Rome is already burning. Our members nationwide are paying higher premiums, facing larger out-of-pocket costs and being aggressively sold private plans which often do not even provide the coverage they need. The administration’s goal is clear…to stack the deck in favor of a Medicare program run by private insurance companies allowing the destruction of the traditional program seniors have depended on for decades. Congress must level the playing field and can start by eliminating these corporate giveaways.”

This methodical destruction of traditional Medicare is happening with so little attention on Capitol Hill it's frightening. For groups like ours the challenge now is to wake up Washington to what seniors all over this country are painfully discovering...the privatization of Medicare is certainly good for business but not for seniors who need inexpensive and dependable healthcare.

...We sit down to write. However, before even getting our post together this morning we found Dean Baker's reaction to the same two articles, one in the Washington Post and the other in USA Today. Dean is an economist with the Center for Economic and Policy Research in Washington.

Today he offers an excellent description of how often the mainstream media repeats this administration's spoon-fed assertions on Social Security as if they're incontrovertible facts. These articles perpetuate the phony crisis mantra first started (and rejected)in the privatization push two years ago and the "greedy geezer" myth used to fuel inter-generational warfare as part of a build-up to benefit cuts.

We know that writing about Social Security can be pretty dry stuff; however, this program is too important to the millions of Americans and their families who depend on it to live, to have reporters merely repeating political pablum rather than reporting the facts.

Jaw-dropping accounts of predatory and disgraceful tactics being used by some insurers selling Medicare Advantage (privatized and federally subsidized insurance) plans to unknowing seniors were center stage on Capitol Hill today.

The Senate Select Committee on Aging heard story after story from State insurance commissioners from Oklahoma, Georgia and Wisconsin detailing the cons being perpetrated nationwide to shift seniors away from traditional Medicare into privatized for-profit plans. Their offices have received thousands of complaints from seniors being preyed upon by insurers selling Medicare Advantage plans and these are not just the garden variety “hard-sell” tactics you might expect from salesmen. This is appalling, especially when you consider these companies are working under the auspices of our federal government and being paid handsomely to do so.

Here are a few examples: in Georgia, salesmen haved claimed to be from Medicare (they're not), they've promised free eye care and free dental care (which of course doesn’t exist), some seniors were told Medicare was “going broke” and they must sign up for an MA plan to continue coverage (not true), one salesmen falsified MA applications using information collected previously from seniors he’d sold Part D coverage to and one company targeted clients at a center serving mentally disabled and low-income seniors for MA coverage the seniors couldn’t afford.

Albert Sochor sells insurance in Oklahoma. He’s taken the training to sell Medicare Advantage plans and sums up the situation this way:

“I’ve found if agents do tell the senior everything, the customer won’t signup for the plan…it doesn’t fit their needs. Many salesmen are moremotivated by commissions than care.”

So we’ve got salesmen who work for marketing sub-contractors hired by private insurance companies, which are overpaid (111% more than traditional Medicare) by the federal government and taxpayer dollars to sell medical insurance which might not even fit a senior's healthcare needs. And all of this to lure seniors away from the existing Medicare program. As Mr. Sochor told the Senate Aging Committee:

“We can’t keep saying things are going well when they’re actually getting worse….these are our parents, our moms and dads. Is this how we want to treat them?”

We say that’s more than a fair question.

by Barbara B. Kennelly, President/CEO

More than one hundred congressional staffers and reporters joined us yesterday to talk about a wonderful new report prepared by the National Academy of Social Insurance (NASI)on Social Security and the pocketbook realities facing retirees, now and in the future.

I think this report, "Social Security and Retirement Income Adequacy", is incredibly important as the debate over "entitlement reform" moves from conservative think tanks thru the Bush administration to Congressional committees and soon presidential politics. For the past six years, the future of Social Security has been continuously framed as a crisis in the making. Dire macroeconomic projections make great headlines but ignore the dollars and cents truth facing retirees. This NASI analysis correctly shines light on retirement savings, Social Security's role for American seniors and how massive benefit cuts like those proposed by some in Washington could harm millions of current and future retirees, and their families.

Virginia Reno, VP for Income Security with NASI, told the audience yesterday that while private pensions wane and 401K's are still largely being utilized by higher-wage earners, Social Security continues to meet the description of what a successful retirement program should provide. This is from the report's conclusion:

"Social Security has many features of an ideal pension system. It delivers retirement income progressively, effectively, and efficiently. But its replacement rates are modest. To maintain Social Security replacement rates at levels experienced in the past two or three decades would require some increase in benefits. At the same time, steps are needed to bring the Social Security program into financial balance (Reno and Lavery 2005). As private pensions shift from defined benefits to individual savings accounts, a strong defined benefit in Social Security gains added importance. Policymakers who are concerned about securing adequate retirement income in the future – for boomers, their children, and grandchildren – will face choices. They will need to decide how much to build on the strength of the Social Security system, how much to expect from employer-sponsored pension plans, and how much to expect individuals to save for themselves."

Another panelist at yesterday's briefing was Nancy Altman, Social Security expert and author of “The Battle for Social Security: From FDR’s Vision to Bush’s Gamble”. She offered several suggestions to meet Social Security's long range shorftfall that don't involve large benefit cuts or private accounts. Those suggestions are detailed by former SSA Commissioner, Robert Ball, in his proposal "Meeting Social Security's Long-Range Shortfall".

The bottom line is there are more than enough options to preserve and strengthen the monthly benefit. Options which are currently being ignored by this administration's supporters in favor of crisis predictions and dire warnings... all part of a buildup to benefit cuts.

What a day it has been for private insurers reaping the profits of the Medicare Privatization…oops, we mean…Modernization Act. A new GAO report released to the Senate Finance Committee today confirms what many had already suspected. The privatization of Medicare might be good for business but it’s not serving seniors' needs. CMS got an earful from Senators on the Senate Finance Committee today, including Chairman Max Baucus:

I don’t get the feeling that CMS is looking out for seniors. I don’t get that feeling at all. These are basically renegade plans…my personal view is more needs to be done.

The GAO reports that, not only are taxpayers overpaying private insurers (at 111%) to do what Medicare already does, it’s now clear that millions of dollars paid to insurers to cover Medicare’s poorest beneficiaries was never even offered to the people these funds were earmarked for. Medicare paid insurers $100 million last year to provide retroactive coverage for poor seniors who qualify as “dual-eligibles”. However, the GAO says more than 400,000 beneficiaries who qualify for this money weren’t told it exists until after CMS saw a draft copy of this GAO report just over a month ago. $100 million to insurers…$0 to seniors.

Acting CMS administrator, Leslie Norwalk, objects to the “overwhelmingly negative tone” of the GAO report. We’re not quite sure what the positive side of this news would be.

Now, to the scamming seniors part of today’s news. The New York Times has followed up on Robert Pear’s excellent article on marketing scams being perpetrated nationwide by agents sellingMedicare Advantage plans to seniors. Today’s editorial focuses on the abusive sales tactics being used to push these privatized plans on beneficiaries who don’t want to leave their Medicare plans. Only to find out, after the fact, their doctors or treatment might not be covered under the new MA plan.

At some point don’t we all have to ask…why is our government pushing a privatized Medicare system designed to profit private industry, cost taxpayers more than what already exists and inflicts harm on the same beneficiaries the program was originally designed to serve?

Ask Mary Jane. NCPSSM Contributor: Mary Jane Yarrington, Senior Policy Analyst

It seems like such a simple question but a quick Google search this morning gave me 17 million links with answers to this single question. It’s a complicated topic to deal with -- even for the experts.

Generally, I don’t suggest applying for Social Security early in order to maximize lifetime benefits because that is betting against your own longevity. For some, that might be the right course but all too often taking benefits early will cost retirees who live longer than “average”.

The Motley Fool just posted an interesting discussion on this topic. Although the reference, “Its (Social Security) payouts are not guaranteed” was certainly arbitrary. As current retirees can attest, 401K and pension payouts these days are also far from “guaranteed.” In fact, I would argue benefits backed by the US government are far more reliable and predictable than struggling pension plans and the volatile Stock Market. I also think the number of years used in this discussion was too short. The starting point of benefits is only half the equation. The ending point (life expectancy) is equally important.

“Average” life expectancy from age 65 is about 19 years for women and 17 for men. The question is, where will you fall on a longevity continuum that runs from 62 or 65 to 100+? Live longer than “average” and you are on the losing side of that bet.

Applying early also bets against the longevity of your surviving spouse if you are the major wage earner. A surviving spouse inherits (or retains) whichever of their two Social Security benefit checks is the greater amount. You retire early and your widow(er)’s benefit is capped regardless of the age at which he or she begins a survivor benefit.

Early benefits might not look like such a great idea to a 90 year old widow struggling to get by on reduced Social Security benefits and, at best, half of your pension -- a pension that likely has not been cost-of-living adjusted since the day you retired.

The Social Security Administration lets you check the “break even” point for your own benefit. My best advice is do your homework and be skeptical of anyone who tells you taking benefits early is always the best way to go.

Got a question? Link to my Ask Mary Jane form, submit your question and I’ll be glad to help.