LeadingAge and 41 other organizations are urging Senate leaders to scrap the Republican tax reform bill and start over, expressing “deep concerns” about “drastic cuts” that potentially would occur to Medicare, Medicaid and other programs, as well as increases in out-of-pocket medical expenses for older adults and those with disabilities, should the legislation pass.
“Our organizations share a commitment to promoting access to affordable, high-quality healthcare and long-term services and supports for older adults, people with disabilities and their families, and this tax package will endanger that goal,” the groups wrote Monday in a letter to Senate Majority Leader Mitch McConnell (R-KY) and Minority Leader Chuck Schumer (D-NY).
The Senate Budget Committee voted to advance the Republican bill Tuesday, and the full Senate is expected to take it up this week.
Increases in the national debt and yearly debt caused by the bill, the letter said, potentially could lead to large funding cuts for Medicare, Medicaid, Social Security and other programs on which older adults rely. “Any significant funding cuts to Medicaid would jeopardize health and long-term care for the more than 6 million low-income older adults who rely on Medicaid,” the organizations said. “In addition, significant Medicare cuts would shift costs onto beneficiaries, endangering the more than 57 million older adults and people with disabilities who rely on the program for high-quality care.”
The more than 11 million people who are dual beneficiaries would be “especially devastated,” according to the groups, which added that more cuts to Medicare and other programs would be triggered under sequestration due to the size of the deficit.
The organizations also asked the senators to protect the medical expense tax deduction, which is eliminated in the House Tax Cuts and Jobs Act but not in the Senate’s version. “Out-of-pocket healthcare costs are a significant financial burden for many older adults and people with disabilities, especially those with chronic conditions and those who need long-term services and supports,” the letter said. “Eliminating this deduction would threaten the financial well-being of such individuals and even prematurely force them to turn to Medicaid to cover their long-term care costs.”
The groups also said that they were concerned that the Senate bill’s repeal of the individual mandate of the Affordable Care Act would increase health insurance premiums or limit access to coverage for the more than 3.3 million adults aged 55 or more years who are enrolled in health plans through the marketplace.
All of the potential effects of the legislation cannot be known until the Congressional Budget Office completes a full analysis, the letter said. The organizations noted, however, that the CBO may not have time for a full analysis given Senate Republicans’ desired timeline.
“Historically, the Senate has worked through a bipartisan, transparent process that included public hearings, open comment periods on discussion drafts, multi-stakeholder meetings, and more,” the groups said. “Any changes to the tax code should be thoughtful and deliberative.”
Read the letter here.