The Better Care Reconciliation Act (BCRA) now under consideration in the Senate would drastically alter the Medicaid program. The proposed Senate bill would change the way the federal government currently funds Medicaid by limiting federal funding and shifting cost over time to both states and Medicaid enrollees. BCRA would subject older adults, adults with disabilities, and children to mandatory per enrollee caps beginning in 2020. State Medicaid programs would have the option to choose between block grants and per enrollee caps for non-elderly non-disabled non-expansion adults.
The Senate bill would start out using the medical care component of the Consumer Price Index (M-CPI)—a measure of the average out-of-pocket cost of medical care services used by an average consumer—as the growth rate for per enrollee caps. However, beginning in 2025, it would slash the growth rate to the Consumer Price Index for all urban consumers (CPI-U)—a measure of general inflation that examines out-of-pocket household spending on goods and services used for everyday living. CPI-U does not tie closely to medical costs and will not reflect population growth or the impact of aging. To be clear, none of the proposed growth factors—M-CPI, M-CPI+1, and CPI-U— keep pace with the growth in Medicaid spending.
Although studies have examined the impact of Medicaid spending cuts in the House-passed healthcare bill over a 10 year period (e.g. [CBO] [CMS] [Urban Institute]) we know of none that examine the impacts over a longer time horizon. To fill this gap, the AARP Public Policy Institute has developed a model that looks out an additional decade to capture impacts on Medicaid spending between 2027 and 2036.
By dramatically reducing the per capita cap growth factor beginning in 2025, we project that the Senate bill would cut between $2.0 and $3.8 trillion from total (federal and state) Medicaid spending over the 20-year period between 2017 and 2036 for the four non-expansion Medicaid enrollment groups: older adults, adults with disabilities, children, and non-expansion adults (children with disabilities are excluded because BCRA does not subject them to capped funding). A cut of this magnitude threatens the viability of the program in unprecedented ways and will increase the number of people who no longer have access to essential healthcare services and critical supports. The projections do not include the proposed cuts to the adult expansion population, which would also be considerable.
Previous analysis by the AARP Public Policy Institute discusses why capping Medicaid is flawed and would leave states and the poorest and sickest Americans holding the bag for the shortfalls that will most certainly occur.
Table 1 shows the cumulative 20-year cuts to Medicaid by eligibility group under the Senate health reform bill for three growth rate projections. The bill would cap per enrollee cost growth using two measures of inflation (M-CPI and CPI-U), which are highly variable and uncertain, though well short of what is needed to maintain the integrity of the Medicaid program. It is difficult to plan for such uncertain growth rates, and reasonable projections are far apart.
We present the high, middle, and low case for M-CPI/CPI-U growth rates based on the following:
- Low Case. Based on historical growth rates. Over the last five years (2012-2016), the M-CPI growth rate has averaged 3.0% per year, and the CPI-U growth rate has averaged 1.32% per year.
- Middle Case. Based on projections from the Congressional Budget Office. CBO projects M-CPI to grow by 3.7% per year, and CPI-U by 2.4% per year.
- High Case. Based on projections from 2016 CMS Medicaid Actuarial Report. From 2019 onward, this report projects M-CPI to grow by 4.2% per year, and CPI-U by 2.6% per year.
In short, the lower the cap growth rate, the more severe the Medicaid cuts will be.
The charts below demonstrate that for any projection of the bill’s cap growth rates, BCRA will lead to significant funding shortfalls for older adults, adults with disabilities, and non-disabled low-income children and adults. The end result is that states and beneficiaries will be left with severe funding shortages, and states will be forced to cut eligibility, provider rates, or covered services—or very likely all three.
Susan Reinhard is a senior vice president at AARP, directing its Public Policy Institute, the focal point for AARP’s public policy research and analysis. She also serves as the chief strategist for the Center to Champion Nursing in America, a resource center to ensure the nation has the nurses it needs.
Jean Accius is vice president of livable communities and long-term services and supports for the AARP Public Policy Institute. He works on Medicaid and long-term care issues.
Lynda Flowers is a Senior Strategic Policy Adviser with the AARP Public Policy Institute, specializing in Medicaid issues, health disparities and public health.
Ari Houser is a Senior Methods Adviser at AARP Public Policy Institute. His work focuses on demographics, disability, family caregiving, and long-term services and supports (LTSS).
Have you ever asked yourself these questions, “What’s the best mobile app to use or the best device to purchase for achieving your everyday goals?” “How can I use technology to stay connected to family and friends, search for jobs,manage my homes, care for loved ones and learn a new skill?” Most of us have. To help with answers, AARP is hosting a free Online Technology Fair, Thursday, June 8 from 1PM to 6PM EST. You can register now to learn about the latest technologies for your daily life without feeling overwhelmed.
The fair will focus on utilizing technology to prioritize and simplify your life, finding work and connecting caregivers to loved ones, fellow caregivers and find local resources. You will find interactive videos and games, plus live webinars and video chats featuring industry experts. You can get your questions answered by representatives from about two dozen non-profit organizations and government agencies that include American Institute for Cancer Research, Consumer Technology Association, Federal Emergency Management Agency (FEMA), the Federal Trade Commission (FTC), Volunteer Match and Next Avenue, to name a few.
By now, we probably all use technology to achieve and engage in most of our life activities. Through the use of our smart phones, computers, and now smart cars and smart homes, there is always something new being created to make our lives simpler. To hear more about this and others, representatives from AARP Driver Safety will discuss the latest in smart vehicle technologies, and AARP Fraud Watch Network will discuss how to stay safe online. In addition, Dean Reistad of HelloTech will talk about how to simplify your life by using smart home automation, and author Jason Rich will discuss how companion robots, technology-controlled pill boxes, and other gadgets can enhance your life.
Using technology to find a job is now common practice. If you are job hunting you are probably using one or more online job boards. For this event, AARP work & jobs expert Kerry Hannon, Tom Ogletree of General Assembly, and other knowledgeable staff will talk about how to better use technology to boost your skills, stand out in your field or transition into a new career. You will also learn about how the AARP Job Board and the AARP’s Employer Pledge Program can help you find relevant jobs for your skills and experiences. They will share information about AARP’s job seeking resources that range from how to prepare your resume to preparing for the interview. You’ll even learn more about teleworking – from how to find a job that allows you to work from home, to how you can stay connected as you work from home.
Now that caregiving has now stepped into the world of technology, apps and gadgets can help you stay connected to your loved one as well as a network of other caregivers. We know caregiving takes a village to provide relief, moral support and help with identifying needed resources. Attend to hear about AARP’s Caregiving Resource Center and Caregivers in the Community (CINC) app that will help you prepare to care and connect to local resources and fellow caregivers.
Register now for the AARP’s free Online Technology Fair and participate from the comfort of your home or office. Take advantage of the myriad of tools and resources offered and discover surprising tricks and shortcuts that can help you from dawn to dusk. Can’t make the live event? Register and you can view the event on demand.
AARP helps people turn their goals and dreams into real possibilities, strengthens communities and fights for and equips Americans 50 and older to live their best lives. Discover all the ways AARP can help you, your family and your community at AARP.
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David Louie, rookie reporter in 1972 (Courtesy of David Louie)
David Louie, a familiar face to TV viewers in San Francisco, turns 67 next month. On May 29 — Memorial Day — he will celebrate another personal milestone: 45 years with ABC as a reporter, spending most of his career at KGO ABC7 Bay Area.
Louie began his career at KGO in 1972, then left for a management position at an ABC station in Detroit in 1977. He missed the Bay Area and returned in ’79 and has stayed ever since. He covered the burgeoning technology scene out of Silicon Valley, and is now a general assignment reporter based in San Jose.
When Louie was hired at KGO, he was one of the first Asian Americans in broadcasting. “We were among the pioneers,” he recalls. “Stations were heavily pushed by the community, ‘Where are Asians? We see no one like us.’”
“The Bay Area was the perfect breakthrough ground,” he adds, because of the large Asian American and Pacific Islander (AAPI) population in San Francisco and surrounding cities.
On camera today (Courtesy of David Louie)
In his long career, Louie’s survived the evolution of broadcast news from film and video to the Internet and digital media.
There are more AAPI faces as reporters today, but outside of the big cities on the west and east coasts, there are still few AAPI anchors. Richard Lui on NBC News and MSNBC, AARP’s Caregiving Champion, is one of the few national exceptions.
Louie has thought about sitting in the anchor chair, but notes he is happy as a reporter. “We all have that desire or to explore every opportunity in our careers,” he says. He’s been a substitute anchor in the mornings and weekends. But believes his place is in the field, not the studio.
David Louie interviewing Yahoo co-founder Jerry Yang on the floor of the Internet startup’s office in 1985 (Courtesy of David Louie)
His decision has led to a fruitful career doing what he loves. “I have people coming up to me, and say,”‘How do you stay so positive?”‘” he says. “You gotta be flexible, go in to work every day no matter what they throw at you, and do the best job. Change is the only constant.”
Change has driven the news industry — especially change brought on by the rise of the Internet. “Technology has changed, and the platforms we push our content out on has changed. We can’t be rigid.” TV reporters these days have to produce their on-air reports, but also write their web stories and post on social media. It’s a constant stream of new information.
It’s like going to school, he adds: “I like to think I’m doing a term paper every day. I learn as much as I can about a topic and produce a term paper that day.”
Louie was born in Ohio and grew up in a suburb of Cleveland before earning his journalism degree from Northwestern in Chicago. Until he was hired by KGO, he had never visited San Francisco. When he arrived in the Bay Area, his family’s Toisanese language was useful to communicate with older shopkeepers in Chinatown. But today, the main language in the community is Mandarin, he says.
Over the years, he embraced his AAPI identity, joining the Asian American Journalists Association and other AAPI organizations. “In my soul I’m very Chinese, but I’m thoroughly American,” he says. “Being immersed in an Asian American community gave me a better sense of who I was, and learned to respect my culture.”
But he was also wary of becoming known for only Asian community assignments. “Initially I wanted those kinds of stories. But the station recognized — and I also pushed — to cover everything. I didn’t want to be pigeonholed as an ‘Asian American reporter.’”
He’s probably best-known today for his role covering the area’s tech scene. He remembers interviewing Jerry Yang, the founder of Yahoo, early on in the company’s sparsely furnished offices. Still, the story he thinks was the biggest of his career was the 9/11 terror attacks.
Transportation Secretary Norman Mineta gave David Louie an exclusive interview at the DOT just days after the terror attacks of 9/11. (Courtesy of David Louie)
Louie was in Nashville attending a news industry conference on September 11, 2001. Because air travel was banned by Transportation Secretary Norman Mineta, Louie offered to drive to Washington D.C. to cover the story for KGO. He filed nightly stories from the damaged Pentagon. During one press briefing, he was told by an aide that Secretary Mineta had asked to speak with him — alone. He got an exclusive interview with Mineta, a San Jose native who was a Congressman before he served as Commerce and Transportation Secretary under President Clinton, then asked to stay on as Transportation Secretary under President Bush. Louie considers that a high point in his career.
As he marks his 45th anniversary in television news, Louie is also proud of the merging of two of of his non-journalism passions: photography and food. He’s an avid cook and foodie, someone who appreciates fine — and funky — dining. He’s also an avid photographer, chronicling his travels with quality equipment. The two combine and result in his shots of food at his favorite restaurants.
“It’s part of our heritage, our culture,” he explains with a laugh. “Food has always been at the center of every culture in the world, and it’s at the very heart of Chinese culture. You greet people with ‘Have you eaten yet’?
“I started taking pictures many many years ago. For me, it helps me remember good times and good experiences. We can’t remember the sensory but we can capture the emotional response.”
As a journalist, Louie has been capturing the emotional responses to local and world events for 45 years. And viewers’ lives have been enriched by the stories he’s served up.
We can hardly wait for his next course.
Last year, AARP had its first-ever AAPI Heroes Contest and awarded three winners as well as their nonprofit organizations $1,000 each. We’re now accepting nominations for the 2017 AARP AAPI Heroes Awards!
You can read about our inaugural winners here!
Once again, we’re looking for those hardworking individuals who might be volunteers or employees for a 501(c)3 organization that serves Asian Americans and Pacific Islanders (AAPIs) who are 50-plus, and exemplify the mission of their organizations yet seldom receive the accolades that they deserve!
You can nominate your 2017 AARP AAPI Heroes here!
We’re not looking for founders, executives or board members, necessarily; we want to shine the spotlight on someone who can be described as the heart of an organization but too often toils in obscurity. They’re treasured members of the organization’s team and are loved by the people the organization serves … but aren’t known outside of the organization. Until now, that is!
We’ve asked people within the AAPI nationwide for their recommendations. They’re not limited to only one nomination, and nominees don’t have to be AAPI.
A panel of judges will choose the top 10 finalists, and their photos and bios, along with a description of their organizations, will be posted on a Facebook photo gallery. Winners will be chosen by highest scores: One point for a “like” on the nominee’s post, two points for a “share” and three points for a comment. Email votes will be accepted, but only one per email, and the vote will count as one point.
Watch our AARP AAPI Community Facebook Page as the contest progresses — nominate your heroes, and then vote for the best!
Have you thought about turning your passion and something that serves others into an opportunity that could pay the bills? Perhaps you sold lemonade, made homemade desserts or sold candy when you were a kid. At that time, you were probably nurturing your entrepreneurial spirit. Many small-business owners will agree that when you’re passionate about what you do, it does not feel like work; you’re just doing what you were placed on this earth to do.
On Tuesday, April 18, at 7 p.m. ET, AARP will host From Passion to Profit, which will explore the journeys of three inspiring owners of Alan Michaels Design, Woofies, and the NailSaloon. All three took a leap of faith and left the corporate world to pursue their passions, ultimately reaping a nice profit. This panel of entrepreneurs will be moderated by renowned musician, Marcus Johnson, owner of FLO Wine and a U.S. Small Business Administration (SBA) award winner. The SBA will also discuss available resources for entreprenuers. REGISTER NOW to hear these inspiring stories from the entrepreneurs who created these businesses:
Alan Michaels Design. After returning from a trip to Kowloon, China, where he was introduced to clothing and tailoring, and eventually leaving his day job of overseeing a minority business program with the NFL, fashion aficionado Michael Humphrey decided to “chase” his passion to become a full-time men’s custom clothier and shoe designer. In 2005, he launched Alan Michaels Designs, located in Ashburn, VA, to not only sell menswear but educate men on identifying their personal sartorial style. Humphrey, who’s always had a desire to “stand-out and be seen,” helps men, through his fashion passion, build their self-confidence. Working in an industry that’s largely underrepresented by minorities, particularly African Americans, he networks through Custom Tailors and Designers Association (CTDA) to influence men of color who have an appetite and interest in the industry.
Woofies. Inspired by their passion and love for dogs, business owners Amy Reed and Leslie Barron left their corporate careers to establish a pet-sitting and dog-walking service. Being pet owners themselves, they knew firsthand the need to make sure their pets were in the best hands at all times when they were away from home or while traveling. As a result, Reed and Barron were frequently called upon to help care for others pets while the owners were away. Due to a high volume of demand, in 2004 they made the leap, and the business grew in a short seven years. Woofies, now includes Pet Taxi, Overnight Care, Bed and Biscuit and mobile grooming services.
NailSaloon. Rated one of the best nail salons on this side of the Mississippi and located in the Georgetown section of Washington, DC, two friends ditched their corporate jobs to open a nail salon. After discussions over a cocktail and writing down ideas on napkins and envelopes, the NailSaloon was born. They envisioned what the shop would look like and the customer experience. They knew they wanted a place where friends, new and old, could talk and relax. They also donate 3% of their daily profit to charity. Andrea Vieira and Claudia Diamante are having a great time helping their customers feel special.
Want to hear more about how each of these owners got started? REGISTER NOW! Can’t attend this webinar? Register and a link will be sent to you when the webinar is complete.
Thinking of starting a business? Check out www.aarp.org/startabusiness to see if starting a business is right for you.
AARP helps people turn their goals and dreams into real possibilities, strengthens communities and fights for and equips Americans 50 and older to live their best lives. Discover all the ways AARP can help you, your family and your community and connect with us on Facebook and Twitter.
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As the April 18 filing deadline looms, a new wave of tax scams is heating up. Whether you’ve already filed your 2016 return – and especially if not – here’s how to protect yourself from these “last-minute” schemes currently making the rounds:
Don’t trust “update” requests. One popular phishing ploy this time of year involves emails supposedly from tax software providers such as TurboTax or TaxACT. They request users to “update” their information. “These ruses generally urge taxpayers to give up sensitive data such as passwords, Social Security numbers and bank account or credit card numbers,” warns the IRS. In addition to emails, beware of similar “update” requests by phone or text supposedly from tax software providers, banks and credit card companies.
Step lightly on TAP requests. Another info-phishing con: Emails that promise a refund that supposedly come from the Taxpayer Advocacy Panel. While TAP is an authentic volunteer board that advises the IRS on taxpayer issues, it doesn’t deal with refunds, or even have access to any taxpayer’s personal and financial information, notes the agency. There emails are from scammers phishing for SSNs and financial account information.
Know the drill. Tax-related correspondence is mailed; the IRS and other tax agencies do not initiate contact by phone, text or email. In the 2016 season, the IRS saw a 400 percent uptick in phishing and malware attempts, most commonly scam emails claiming information or a problem related to refunds, filing status, confirming personal information, ordering transcripts and verifying PIN information. These fakes include an attached link, which can harbor malware, that leads to an IRS-mirroring website run by scammer. Note the tinkered address such as “irsgov” (without the dot between “IRS” and “gov”), irs.net, or a similar variation.
Meanwhile, the IRS imposter phone scam is alive and well, preying on taxpayers including recent immigrants. In addition to the usual ploy – threats of arrest, deportation or property seizure over an allege debt – a new spin has IRS imposters promising a refund, a move to trick targets into sharing private information. If the phone isn’t answered, the scammers often leave an “urgent” callback request. Ignore it, instead calling the IRS at 800-829-1040.
Choose preparers to not lose. Good luck finding a preparer this late in the game, but if you’re still looking, some tips to finding one who’s reputable (if only for next year): Check this IRS directory for credential preparers, and here for organizations provided free help. The AARP Foundation’s Tax-Aide program offers free, individualized tax preparation for low-to moderate-income taxpayers at more than 5,000 locations nationwide. If your adjusted gross income was less than $64,000 last year, you qualify for the IRS Free File program. Beware of preparers (especially with temporary storefronts or conduct business at your home) who promise overly generous refunds, want you to sign a blank return, say that fees are based on the size of your refund claim “secrets” loopholes.
Accountants under attack. Let your numbers-cruncher know of these schemes against them: In a new scam, the IRS reports that fraudsters pose as a client (namely, you), asking tax preparers to make a last-minute change to their refund destination, often to a prepaid debit card. Tax preparers are urged to verbally reconfirm information with clients should they receive last-minute email request to change an address or direct deposit account for refunds.
Another scheme: Emails to tax preparers that warn they need to update or access to their own tax preparation software via a bogus “unlock” link that leads to a fake web page, asking for their user name and password so cybercrooks can access client information. Ruses also include other tax prep provider-posing ploys and attempts to steal data such as PTINs, EFINs or e-Service passwords.
For information about other scams, sign up for the Fraud Watch Network. You’ll receive free email alerts with tips and resources to help you spot and avoid identity theft and fraud, and keep tabs of scams and law enforcement alerts in your area at our Scam-Tracking Map.