Most Changes Under a Trump Administration Will Require Public Debate
~ By Eileen Doherty, MS ~
DENVER, CO – While the United States has elected a new president and the Colorado legislature has started a new session with some new faces and some returning veterans, many seniors and their families are calling to ask how these changes may affect their lives. The short answer. We don’t know.
The current efforts are to change federal programs either through the budget reconciliation process or through executive order. Many of the programs affecting seniors will require legislative changes.
But many of the programs and services that are available will most likely continue to be available. For example, the cost of living adjustment for Social Security is federal law and would take an act of Congress to change. At the same time, some programs that might become victims of a federal tax overhaul program are such programs as the Older Americans Act and food stamps.
A major concern is changes to the Medicare. Medicare is not only federal law, but there are hundreds of thousands of pages of rules that regulate the amount of money that is paid, who is authorized to deliver care and where to receive care. Although change can happen quickly, significant changes to the Medicare program will require a lot of public debate and even more time to write new rules so that care and services can be delivered. At this time, according to a Harvard T. H. Chan School of Public Health study only 28% of Trump supporters want to change Medicare. That number drops to 15% in the overall population.
Medicare Part D will most likely be a target. Experts are suggesting that drug prices could be reduced if they were imported, but that would only reduce prices in the short term. Most experts agree for drug prices to be reduced, drug companies would have to provide more information to the public about pricing and the value the price provides to patients. This would require a legislative action that most likely will not happen. Meanwhile, some consumer advocacy groups are predicting that the cost of drugs may increase under a Trump administration.
One of the areas of changes is in the area of Medicaid. While many seniors only receive Medicare, hundreds receive Medicaid as well. Medicaid services allow many people to receive care in their home, in an assisted living, or in a nursing home. There is a lot of federal talk about reducing the role of the federal government in the Medicaid program and turning it into a block grant. States would receive fewer federal dollars, but most likely have more control over the program. The pressing question in this debate is Òwould the federal government provide enough money to states without the federal oversight to still meet the needs of low income individuals who need care?Ó The role of the state will be key to these discussions.
The health program that is receiving the most discussion is the Affordable Care Act or Obamacare. The first order of business is to eliminate much of the funding for the Affordable Care Act. For Medicare beneficiaries, there could be serious impact. Individuals between the ages of 55-64 would most likely find it difficult to purchase insurance, with the cost of premiums even higher than under Obamacare. Medicare beneficiaries may find their preventive health benefits are no longer free or might not even be available. Another possible impact might be higher costs for premiums, deductibles, and co-payments for Medicare Advantage beneficiaries.
One of the areas of most concern if Obamacare is repealed is possible changes to Medicare Part D or the cost of prescription drug. Repeal may change the out-of-pocket costs, especially when individuals reach the coverage gap and are being charged higher co-pays in the donut hole.
While some changes can be approved without much debate in Congress, the people still have a voice and an opportunity to make their views known. Very few, if any, changes affecting seniors directly will be subject to executive orders. Much work is being done by advocacy groups to keep the public informed. There are many opportunities for public involvement at the state and local level to make your voice heard.
If you are looking for ways to become involved in the discussions, you can call your Congress person or 303-333-3482. We will be happy to work with you.
Eileen Doherty, MS is the Executive Director of the Colorado Gerontological Society. Her areas of expertise include management and administration of nonprofit organizations, education and training on issues related to older adults, advocacy and policy development on senior issues, and clinical practice in working with seniors and families to manage their lives in the later years. She has been the Director of the Society since 1982. She teaches Nonprofit Management for Fort Hays State University.
Colorado Gerontological Society
1330 Leyden St., Ste. 148, Denver CO 80220, 303-333-3482 or 303-333-9112, www.senioranwers.org