We need to defend Social Security, Medicare, Medicaid
In Washington, they're talking about cutting Medicaid, Medicare and Social Security for the first time in generations.
Some people say it will never happen.
Others fear that it will.
We'll just have to wait and see.
But here are a few things to consider.
A study last year found that Kentucky and West Virginia were the unhealthiest states in the union.
Kentucky, it said, has the highest percentage of adults with no physical leisure-time activities — 34.77%.
Other things we rank high in are obesity (40.3%), getting less than seven hours of sleep (39.3%) and smoking (27.09%).
The study says that 32.7% of us have high cholesterol and 7.9% have heart disease.
So, we're not exactly a healthy place to live.
The U.S. Census Bureau says the poorest states in the country are Louisiana, Mississippi, New Mexico, West Virginia and Kentucky.
So, we need help.
According to the Cabinet for Health and Family Services, 31,426 Daviess Countians are on Medicaid this month — up from 31,379 last month.
That's roughly one-third of the county's population.
Medicare doesn't break it down by counties.
But last August, there were 986,495 of us in Kentucky on Medicare.
That's 17.8% of the population.
And in 2020, there were 1,009,092 of us in Kentucky on Social Security.
Nasdaq.com says Social Security pumps $1.4 billion into Kentucky every year.
Of course, the number of recipients is growing by the day as Baby Boomers continue to age.
In 1954, President Dwight D. 'Ike' Eisenhower wrote,' Should any political party attempt to abolish Social Security unemployment insurance and eliminate labor laws and farm programs, you would not hear of that party again in our political history.'
He wrote, 'There is a tiny splinter group, of course, that believes you can do these things. Among them are a few other Texas oil millionaires and an occasional politician or business man from other areas. Their number is negligible and they are stupid.'
Again, we're a poor, unhealthy state and these programs pump millions into Daviess County each year.
Whether the threat is real or not, we need to defend them.
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3 hours ago
- Yahoo
Twin federal proposals threaten provider taxes, key source of Medicaid funding for states
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For instance, California has netted an estimated $8.8 billion this fiscal year from its tax on managed care plans and took in about $5.9 billion last year from hospitals. California Democrats are already facing a $12 billion deficit, and they have drawn political fire for scaling back some key health care policies, including full Medi-Cal coverage for immigrants without permanent legal status. And a loss of provider tax revenue could add billions to the current deficit, forcing state lawmakers to make even more unpopular cuts to Medi-Cal benefits. 'If Republicans move this extreme MAGA proposal forward, millions will lose coverage, hospitals will close, and safety nets could collapse under the weight,' Gov. Gavin Newsom, a Democrat, said in a statement, referring to President Donald Trump's 'Make America Great Again' movement. The proposals are also a threat to Proposition 35, a ballot initiative California voters approved last November to make permanent the tax on managed care organizations, or MCOs, and dedicate some of its proceeds to raise the pay of doctors and other providers who treat Medi-Cal patients. All states except Alaska have at least one provider tax on managed care plans, hospitals, nursing homes, emergency ground transportation, or other types of health care businesses. The federal government spends billions of dollars a year matching these taxes, which generally lead to more money for providers, helping them balance lower Medicaid reimbursement rates while allowing states to protect against economic downturns and budget constraints. New York, Massachusetts, and Michigan would also be among the states hit hard by Republicans' drive to scale back provider taxes, which allow states to boost their share of Medicaid spending to receive increased federal Medicaid funds. In a May 12 statement announcing its proposed rule, CMS described a 'loophole' as 'money laundering,' and said California had financed coverage for over 1.6 million 'illegal immigrants' with the proceeds from its MCO tax. CMS said its proposal would save more than $30 billion over five years. 'This proposed rule stops the shell game and ensures federal Medicaid dollars go where they're needed most — to pay for health care for vulnerable Americans who rely on this program, not to plug state budget holes or bankroll benefits for noncitizens,' Mehmet Oz, the CMS administrator, said in the statement. Medicaid allows coverage for noncitizens who are legally present and have been in the country for at least five years. And California uses state money to pay for almost all of the Medi-Cal coverage for immigrants who are not in the country legally. California, New York, Michigan, and Massachusetts together account for more than 95% of the 'federal taxpayer losses' from the loophole in provider taxes, CMS said. But nearly every state would feel some impact, especially under the provisions in the reconciliation bill, which are more restrictive than the CMS proposal. None of it is a done deal. The CMS proposal, published May 15, has not been adopted yet, and the reconciliation bill is likely to be altered significantly in the Senate. But the restrictions being contemplated would be far-reaching. A report by Michigan's Department of Health and Human Services, ordered by Democratic Gov. Gretchen Whitmer, found that a reduction of revenue from the state's hospital tax could 'destabilize hospital finances, particularly in rural and safety-net facilities, and increase the risk of service cuts or closures.' Losing revenue from the state's MCO tax 'would likely require substantial cuts, tax increases, or reductions in coverage and access to care,' it said. CMS declined to respond to questions about its proposed rule. The Republicans' House-passed reconciliation bill, though not the CMS proposal, also prohibits any new provider taxes or increases to existing ones. The American Hospital Association, which represents nearly 5,000 hospitals and health systems nationwide, said the proposed moratorium on new or increased provider taxes could force states 'to make significant cuts to Medicaid to balance their budgets, including reducing eligibility, eliminating or limiting benefits, and reducing already low payment rates for providers.' Because provider taxes draw matching federal dollars, Washington has a say in how they are implemented. And the Republicans who run the federal government are looking to spend far fewer of those dollars. In California, the insurers that pay the MCO tax are reimbursed for the portion levied on their Medi-Cal enrollment. That helps explain why the tax rate on Medi-Cal enrollment is sharply higher than on commercial enrollment. Over 99% of the tax money the insurers pay comes from their Medi-Cal business, which means most of the state's insurers get back almost all the tax they pay. That imbalance, which CMS describes as a loophole, is one of the main things Republicans are trying to change. If either the CMS rule or the corresponding provisions in the House reconciliation bill were enacted, states would be required to levy provider taxes equally on Medicaid and commercial business to draw federal dollars. California would likely be unable to raise the commercial rates to the level of the Medi-Cal ones, because state law constrains the legislature's ability to do so. 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The state's hospital tax is expected to bring in an estimated $9 billion this year, up sharply from last year, according to the Department of Health Care Services, which runs Medi-Cal. Losing a significant slice of that revenue on top of other Medicaid cuts in the House reconciliation bill 'all adds up to be potentially a super serious impact on Medi-Cal and the California state budget overall,' said Kayla Kitson, a senior policy fellow at the California Budget & Policy Center. And it's not only California that will feel the pain. 'All states are going to be hurt by this," Park said. Wolfson writes for KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF — the independent source for health policy research, polling, and journalism. Sign up for our Wide Shot newsletter to get the latest entertainment business news, analysis and insights. This story originally appeared in Los Angeles Times.
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The cost of staying alive could become a lot more expensive for millions of Americans because of Trump drug tariffs
Americans would likely pay more for necessary everyday prescription drugs, such as insulin, painkillers, chemotherapy, or antibiotics, if President Donald Trump were to enact tariffs on pharmaceuticals, experts warn. In an effort to incentivize drug manufacturers to bring production back to the United States, Trump has proposed tariffing pharmaceuticals made overseas – which account for an overwhelming majority of everyday medicine used in the U.S. 'We're going to be doing that,' Trump said of pharmaceutical tariffs in April. 'That's going to be like we have on cars. You know we have a 25 percent tariff on cars, we have a 25 percent tariff on steel and aluminum, and that's what the [pharmaceutical] category fits right now.' 'The higher the tariff, the faster they come,' Trump said. But experts say that's not necessarily true and there would be tangible consequences to such action, from higher brand-name drug prices to generic drug shortages. 'If tariffs were applied to prescription drugs, one of the most immediate consequences could be price increases — on prices that we already pay way in excess of other countries,' Dr. Mariana Socal, an associate professor at the Johns Hopkins Bloomberg School of Public Health, said. The U.S. imports a majority of its branded prescription drugs – or medications that are patented with a brand name such as Viagra, Wegovy, or Zoloft – from high-income countries. Dr. Jeromie Ballreich, an associated research professor at Johns Hopkins Bloomberg School of Public Health, said much of the manufacturing comes from Ireland, Germany, and Switzerland because they have favorable tax policies for companies. As a result, adding a tariff would only make it more expensive for pharmacies and insurance companies to keep them in supply. 'We would expect pharma to pass the costs onto the insurers and we would expect insurers to pass the cost onto the individual patients,' Ballreich said. 'So, if there is a 50 percent tariff on your insulin product because it's coming from Ireland, patients in Mississippi who get insulin – they will either be faced with a higher cost when they go up to the pharmacy to fill their insulin or they're going to face a higher indirect cost because the premiums of the insurance plan are going to go up,' he said. Ballreich said a tariff on countries that produce high quantities of branded drugs would put 'pressure' on public insurers like Medicare or Medicaid and private insurers. However, branded drugs only account for roughly 10 to 15 percent of prescriptions. A majority of Americans, up to 90 percent, use generic drugs, often manufactured in India and China, because they're cheaper. Making branded drugs less accessible through tariffs would only increase reliance on generic drugs, which could exacerbate shortages that already impact millions of Americans. '[Shortages] can have very significant implications in day-to-day clinical practice,' Socal said. 'For example, if you are administering chemotherapy for an oncology patient, that may have significant consequences even for the prognosis of that case moving forward.' In 2024, the U.S. experienced a shortage of more than 300 drugs – 70 percent of which were generic prescriptions. Socal said that when patients are not able to access a more affordable version of their prescription, it means they may put their health at risk by skipping a dosage, taking a lower dosage, or not filling their prescription at all. Otherwise, they're forced to turn to the more expensive branded version. 'Those more expensive drugs are not always the best,' Socal said. 'Very frequently, and we saw this with chemotherapy shortages, the available drugs are second-line drugs.' The president has indicated that any negative impact from tariffs may be temporary and worth it to bring manufacturing and jobs back. 'We're doing it because we want to make our own drugs,' Trump said. But Ballreich and Socal are more skeptical. 'Tariffs are a very blunt instrument to incentivize domestic U.S. manufacturing of the branded drugs we use,' Ballreich said. Given pharmaceutical companies have moved outside of the U.S. for tax purposes, Ballreich says tax policy may be a better way to incentivize them, especially since many of those drugs are more difficult to manufacture. 'It's not just a very simple chemical plant; these tend to be very complex,' he said. Socal suggested a better strategy would be to understand where drugs are being manufactured and which ones would make more sense to bring to the U.S. — since even those manufactured locally often rely on certain imported ingredients and materials. 'Having tariffs on pharmaceutical products coming from abroad can actually also hurt our domestic manufacturers,' he says. While the president has not officially implemented any tariff policy on pharmaceuticals yet, he said, in April, that the plan would take effect in the 'not too distant future.'
Yahoo
3 hours ago
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Ask Kerry: Readers weigh in on Medicare and more
My recent columns drew thousands of questions and comments, largely centered on rising medical debt and Medicare as well as retirement confusion on Social Security and health savings accounts, known as HSAs. The following is an edited sample of those 6,000-plus comments—good and bad!—and my take on them. As always, if you have a personal finance question, you click here to drop me a note. I'll try and answer in a future column. By subscribing, you are agreeing to Yahoo's Terms and Privacy Policy Here we go. Let's start with someone who wasn't too happy with me: While well intentioned, I was disappointed in your article. You neglected to mention that Medigap policies will cover all or most of what Medicare does not. Also: people you mention could likely be eligible for Medicare Savings Plans that will lower beneficiary costs. A Qualified Medicare Beneficiary or QMB is the most generous plan and covers all copayments and deductibles, the Part B premium, and also provides the extra help you noted. Kerry: Guilty. Regular Medicare does not come with built-in caps on a variety of out-of-pocket costs, so you don't want to be enrolled in it if you don't also have supplemental protection. The bills that lead to medical debt typically include routine healthcare services such as lab fees and diagnostic tests, dental care, and visits to the doctor, and long-term care services not covered by Medicare, according to KFF. And Medicare typically requires patients to pay out of pocket around 20% of their doctor bills. Many retirees can't. Now let's talk about Medigap health insurance. Not everyone has this coverage. These policies are sold by private insurance companies and, as you noted, pay part or all of some leftover costs, such as outstanding deductibles, coinsurance, and co-payments, and may also cover healthcare costs that Medicare does not cover at all like most medical care received when traveling out of the US. In most states, however, the guaranteed right to buy a Medigap is limited to the time when you first sign up for Medicare Part B. That's because Medicare does not permit Medigap plans from rejecting you or charging a higher premium because of a preexisting condition during that period. In most states, your premium, however, will vary depending on factors such as your age, gender, and where you live. The Medigap guarantee policy is also good if you joined an Advantage plan during your first year of Medicare but disenrolled within a year and switched to traditional Medicare. After that, though, Medigap plans in most states can flat-out reject you if you have a preexisting condition, such as diabetes. The exceptions are New York, Connecticut, Maine, and Massachusetts. There is help out there as I noted if you have a limited income, you might be eligible for Medicare's Extra Help, which covers Part D premiums and deductibles and caps drug costs. Free one-on-one counseling is available through state Health Insurance Assistance Programs (SHIP). The Medicare Rights Center offers a free consumer helpline: 800-333-4114. You can also contact Medicare directly at 800-633-4227. QMB, that you mentioned, is a Medicaid program that helps low-income Medicare beneficiaries pay for their Medicare costs, such as premiums, deductibles, and copayments. It's a secondary insurance, meaning it pays for Medicare cost-sharing after Medicare has paid its share. I'm 60 and super worried about future long-term care costs. What might these add up to? Kerry: One factor that plays into the rising healthcare debt for older adults is that traditional Medicare and Medicare Advantage do not cover the cost of long-term care in nursing homes and assisted-living facilities. An apartment in an assisted-living facility had an average rate of $74,148 a year in 2024, according to the National Investment Center for Seniors Housing & Care — and costs go up as residents age and need more care. Units for dementia patients can run more than $94,000. About 80% of those ages 65 and over will require some long-term care, with nearly 20% requiring high-intensity care for more than three years, Anqi Chen, co-author of a brief from the Center for Retirement Research at Boston College, told me Can one use the HSA contributions to pay for Medicare Part B & D costs or any other insurance plans they may have (Advantage, MediGap etc)? Kerry: Yes, you can tap your health savings account to pay for Medicare premiums and other qualified medical expenses, including those covered by Medicare Parts A, B, C (Medicare Advantage), and D (prescription drug coverage). But it's a hard no on using HSA funds to pay for Medicare Supplement (Medigap) plan premiums. Learn more: What is a health savings account (HSA)? My husband and I are retired, in our 70s and living in Mexico. My husband has a HSA he set up through his work probably 15 years ago. Can he use it for medical and similar expenses outside the US? Can we continue to contribute to the existing HSA? Kerry: Yes, you can use your HSA to cover medical costs when you live outside the country as long as the expenses are qualified medical expenses under US law. You, however, might be docked a 1%-3% transaction fee if you are accessing your account with a credit card. As for amping your account up, for now, you can't contribute more money to an HSA at your age. Contributions are kaput once you are eligible for Medicare, typically starting on the first of the month you turn 65. A current bill before the Senate right now might tweak this eligibility if it becomes law. I am about to retire and am planning to live in Canada. If I work and receive a salary of about 50K in Canada, am I bound by the Social Security Income limitations Receipt work limitation? Kerry: This is one to take up with a Social Security officer directly. In general, if you live and work in another country, your Social Security income limits usually remain the same as if you were working in the US. Here's how it works: The earnings test applies only to people who are collecting Social Security between age 62 (the earliest age of eligibility) and their full retirement age, which is between 66 and 67, depending on the year you were born. On the face of it, you're allowed to claim Social Security retirement benefits while working, and the withheld benefits are not lost. Social Security recalculates monthly benefits when you reach full retirement age to credit back the withheld benefits. In general, the way the earnings test works is if you're between age 62 and your full retirement age and earn over $23,400 (the limit is adjusted annually) and collecting Social Security, the administration will withhold $1 for every $2 over that limit. For people hitting their full retirement age in 2025, the annual exempt amount is $62,160. This higher exempt amount applies only to earnings made in months prior to the month you hit your retirement age. The good news is that the earnings test goes away at full retirement age. But nothing is simple here. There is another method called the foreign work test. With this method, your income could impact your current benefit. If you are receiving Social Security benefits and are younger than full retirement age, SSA will withhold your benefits for each month you work more than 45 hours outside the United States and you are not subject to US Social Security taxes. It does not matter how much you earned or how many hours you worked each day. Check out How Work Affects Your Benefits (Publication No. 05-10069). I'm 69 years old and plan to work until at least 72 or 73. My Social Security Income (SSI) benefits will be the bulk of my income upon retirement, and I am currently $40,000 in debt with a repayment plan that will eliminate all or most of the debt before I retire. The caveat is that I will need to claim my SSI benefits to support this payment plan. I turn 70 in September 2025 and would like to know when I can apply for my Social Security Income benefits to maintain the 8% increase until I reach 70 years old. Is it on my birthday in September, or do I need to wait until October 1st? Kerry: To receive the maximum 8% increase in your Social Security benefit, you should apply for your benefits the month before your 70th birthday. This will ensure your benefits start the month of your 70th birthday, and you receive the full 8% increase for each year you delayed taking benefits after your full retirement age. It typically takes at least a month, or 30 days, to receive your first Social Security check after your application is processed. It could be 45 days in some cases. The precise timing of your check delivery relies on processing times at the Social Security Administration. Read more: When will I get my social security check? During a recent operations meeting in April at SSA, an official from the agency reported that the field offices 'are struggling right now to keep pace with the timeliness this year.' The fact that they are aware of this is a good thing, and, if they take action, the SSA will have this under control by the time you apply for your benefit. In general, I recommend applying up to four months before you want to start receiving benefits. Kerry Hannon is a Senior Columnist at Yahoo Finance. She is a career and retirement strategist and the author of 14 books, including the forthcoming "Retirement Bites: A Gen X Guide to Securing Your Financial Future," "In Control at 50+: How to Succeed in the New World of Work" and "Never Too Old to Get Rich." Follow her on Bluesky. Sign up for the Mind Your Money newsletter Sign in to access your portfolio
