The vigorous contest of Democrats seeking the 2020 presidential nomination has produced excellent policy proposals to address major issues. This is from the Biden 2020 campaign:
THE BIDEN PLAN FOR OLDER AMERICANS
The moral obligation of our time is rebuilding
the middle class. The middle class isn’t a number, it’s a value set. And, a key
component of that value set is having a steady, secure income as you age so
your kids won’t have to take care of you in retirement. This means not only
protecting and strengthening Social Security, but also helping more
middle-class families grow their savings.
A dignified retirement also means having access to affordable health care and support. Too many Americans – and too many older Americans – cannot afford their prescriptions or their long-term care. Their families are faced with saving for their own retirement or taking care of their aging parents. It’s not right.
Working- and middle-class Americans built this country. And, they deserve to retire with dignity – able to pay for their prescriptions and with access to quality, affordable long-term care.
STAND UP TO THE ABUSE OF POWER BY PRESCRIPTION DRUG CORPORATIONS
Too many Americans cannot afford their prescription drugs, and prescription drug corporations are profiteering off of the pocketbooks of sick individuals. The Biden Plan will put a stop to runaway drug prices and the profiteering of the drug industry by:
- Repealing the outrageous exception allowing drug corporations to avoid negotiating with Medicare over drug prices. Because Medicare covers so many Americans, it has significant leverage to negotiate lower prices for its beneficiaries. And it does so for hospitals and other providers participating in the program but not drug manufacturers. Drug manufacturers not facing any competition, therefore, can charge whatever price they choose to set. There’s no justification for this except the power of prescription drug lobbying. The Biden Plan will repeal the existing law explicitly barring Medicare from negotiating lower prices with drug corporations.
- Limiting launch prices for drugs that face no competition and are being abusively priced by manufacturers. Through his work on the Cancer Moonshot, Biden understands that the future of pharmacological interventions is not traditional chemical drugs, but specialized biotech drugs that will have little to no competition to keep prices in check. Without competition, we need a new approach for keeping the prices of these drugs down. For these cases where new specialty drugs without competition are being launched, under the Biden Plan the Secretary of Health and Human Services will establish an independent review board to assess their value. The board will recommend a reasonable price, based on the average price in other countries (a process called external reference pricing) or, if the drug is entering the U.S. market first, based on an evaluation by the independent board members. This reasonable price will be the rate Medicare and the public option will pay. In addition, the Biden Plan will allow private plans participating in the individual marketplace to access a similar rate.
- Limiting price increases for all brand, biotech and abusively priced generic drugs to inflation. As a condition of participation in the Medicare program and public option, all brand, biotech and abusively priced generic drugs will be prohibited from increasing their prices more than the general inflation rate. The Biden plan will also impose a tax penalty on drug manufacturers that increase the costs of their brand, biotech or abusively priced generic over the general inflation rate.
- Allowing consumers to buy prescription drugs from other countries. To create more competition for U.S. drug corporations, the Biden Plan will allow consumers to import prescription drugs from other countries, as long as the U.S. Department of Health and Human Services has certified that those drugs are safe.
- Terminating pharmaceutical corporations’ tax break for advertisement spending.Drug corporations spent an estimated $6 billion in 2016 alone on prescription drug advertisements to increase their sales, a more than four-fold increase from just $1.3 billion in 1997. The American Medical Association has even expressed “concerns among physicians about the negative impact of commercially driven promotions, and the role that marketing costs play in fueling escalating drug prices.” Currently, drug corporations may count spending on these ads as a deduction to reduce the amount of taxes they owe. But taxpayers should not have to foot the bill for these ads. As president, Biden will end this tax deduction for all prescription drug ads, as proposed by Senator Jeanne Shaheen.
- Improving the supply of quality generics. Generics help reduce health care spending, but brand drug corporations have succeeded in preserving a number of strategies to help them delay the entrance of a generic into the market even after the patent has expired. The Biden Plan supports numerous proposals to accelerate the development of safe generics, such as Senator Patrick Leahy’s proposal to make sure generic manufacturers have access to a sample.
II. PROTECT AND STRENGTHEN MEDICARE AS WE KNOW
IT AND ENSURE QUALITY, AFFORDABLE HEALTH CARE FOR ALL OLDER AMERICANS
On March 23, 2010, President Obama signed the Affordable Care Act into law, with Vice President Biden standing by his side, and made history. It was a victory 100 years in the making. It was the conclusion of a tough fight that required taking on Republicans, special interests, and the status quo to do what’s right. But the Obama-Biden Administration got it done.
Today, the Affordable Care Act is still a big deal – especially for older Americans. Because of Obamacare, over 100 million people no longer have to worry that an insurance company will deny coverage or charge higher premiums just because they have a pre-existing condition – whether cancer or diabetes or heart disease or a mental health challenge. Insurance companies can no longer set annual or lifetime limits on coverage. The law limited the extent to which insurance companies may charge you higher premiums just because of your age. And, the Affordable Care Act strengthened Medicare by extending the life of the Medicare Trust Fund; giving Medicare beneficiaries access to free recommended preventive services, such as an annual wellness visit; and closing the prescription drug coverage gap, often referred to as the “donut hole.”
But, every day over the past nine years, the Affordable Care Act has been under relentless attack.
Immediately after its passage, Congressional Republicans began trying again and again to repeal it. Following the lead of President Trump, Republicans in Congress have only doubled down on this approach since January 2017. And, since repeal through Congress has not been working, President Trump has been unilaterally doing everything he can to sabotage the Affordable Care Act. Now, the Trump Administration is trying to get the entire law – including protections for people with pre-existing conditions – struck down in court.
As president, Biden will protect the Affordable Care Act from these continued attacks. He opposes every effort to get rid of this historic law – including efforts by Republicans, and efforts by Democrats. Instead of starting from scratch and getting rid of private insurance, he has a plan to build on the Affordable Care Act by giving Americans more choice, reducing health care costs, and making our health care system less complex to navigate. You can read Biden’s full health care plan [here]. In addition, to improve older Americans’ access to affordable, quality health care, Biden will:
- Protect Medicare as we know it. Today, Medicare provides health insurance coverage to over 60 million older Americans and people with disabilities. As president, Biden will continue to defend our nation’s commitment to older Americans and people with disabilities through Medicare, and he will keep Medicare as a separate and distinct program, and ensure there is no disruption to the current Medicare system.
- Protect Medicaid and ensure its beneficiaries can access home and community-based long-term care when they want it. Medicaid pays for more long-term care than any other insurer in the country. In fact, roughly 6 in 10 individuals residing in nursing homes are enrolled in Medicaid, including many older Americans. Yet, the Trump Administration is reportedly considering a plan to cut Medicaid funding by turning it into a block grant. And Republican leadership in states like Iowa, where Medicaid has been privatized with devastating results for some of its most vulnerable residents, are not fulfilling their obligations under the program. The Biden Plan will protect Medicaid funding and make sure the program gives those on Medicaid who need long-term care the flexibility to choose home- and community-based care. In addition, the Biden Administration won’t let states skirt their duties under Medicaid and will take enforcement action against any state that allows profiteering to get in the way of Medicaid beneficiaries’ health.
- Provide tax relief to help solve the long-term care challenge. The Biden Plan will also help Americans pay for long-term care by providing relief for Americans needing long-term care by creating a $5,000 tax credit for informal caregivers, modeled off of legislation supported by AARP. These informal caregivers – whether family members or other loved ones – have for too long been doing tireless work without any financial support. In addition, Biden will increase the generosity of tax benefitsfor older Americans who choose to buy long-term care insurance and pay for it using their savings for retirement.
- Care for our caregivers. The physical, emotional, and financial challenges of caring for a loved one is enormous. As president, Biden will work to enact at the federal level the AARP-endorsed Caregiver Advise, Record, Enable (CARE) Act, which has already been passed in 39 states. This legislation will help our caregivers by ensuring hospitals equip them with instructions and information when their loved ones are discharged. Biden also supports additional proposals to support caregivers, such as funding to give them access to respite care.
III. PRESERVE AND STRENGTHEN SOCIAL SECURITY
Social Security is the bedrock of American retirement. Roughly 90% of retirement-age Americans receive Social Security benefits, and one-in-four rely on Social Security for all, or almost all, of their income. The program has not only ensured that middle-class workers can enjoy the sound and secure retirement they worked so hard for, it also lifted over 17 million older Americans out of poverty in 2017 alone.
The Biden Plan will protect Social Security for the millions of Americans who depend on the program. With Social Security’s Trust Fund already in deficit and expected to be exhausted in 2035, we urgently need action to make the program solvent and prevent cuts to American retirees.
But the Biden Plan doesn’t stop there. As president, Joe Biden will strengthen benefits for the most vulnerable older Americans – including widows and widowers, lifelong workers with low monthly benefits, and old-age beneficiaries who may have exhausted their other savings. Specifically, the Biden Plan will:
- Put Social Security on a path to long-run solvency. The impending exhaustion of the Social Security Trust fund imperils American retirement as we know it. Waiting to act only jeopardizes the program further, and will make an eventual solution that much more difficult. The Biden Plan will put the program on a path to long-term solvency by asking Americans with especially high wages to pay the same taxes on those earnings that middle-class families pay.
- Preserve the nature of Social Security. Social Security is one of our nation’s great public policy successes, in large part due to the fact that participation in the program is shared across almost all workers. Efforts to privatize the program – such as an approach suggested under the Bush Administration – will undermine the program’s solvency, while putting at risk individuals’ income in retirement. Similarly, proposals to make the program “means-tested” – so that only low-income retirees workers receive benefits – jeopardizes the program’s universal nature and key role as the bedrock of American retirement. Ultimately, the success of Social Security is largely due to the fact that almost all Americans can rely on the program to make their retirement more secure.
- Provide a higher benefit for the oldest Americans. At advanced ages, Americans become more vulnerable to exhausting their savings, sometimes falling into poverty and living a life of hardship. The Biden Plan will provide the oldest beneficiaries – those who have been receiving retirement benefits for at least 20 years – with a higher monthly check to help protect retirees from the pain of dwindling retirement savings.
- Implement a true minimum benefit for lifelong workers. No one who has worked for decades and paid into Social Security should have to spend their retirement in poverty. The Biden Plan will revolutionize the Social Security’s minimum benefit, which has deteriorated over time to the point of being entirely ineffective. Under the Biden Plan, workers who spent 30 years working will get a benefit of at least 125% of the poverty level.
- Protect widows and widowers from steep cuts in benefits. For many couples, the death of a spouse means that Social Security benefits will be cut in half – putting pressure on the surviving spouse who still needs to make the mortgage payment and handle other bills. The Biden Plan will allow surviving spouse to keep a higher share of the benefits. This will make an appreciable difference in the finances of older Americans, especially women (who live longer on average than men), raising the monthly payment by about 20% for affected beneficiaries.
- Eliminate penalties for teachers and other public-sector workers. Current rules penalize teachers and other public sector workers who either switch jobs or who have earned retirement benefits from various sources. The Biden Plan would eliminate these penalties by ensuring that teachers not eligible for Social Security will begin receiving benefits sooner – rather than the current ten-year period for many teachers. The Biden Plan will also get rid of the benefit cuts for workers and surviving beneficiaries who happen to be covered by both Social Security and another pension. These workers deserve the benefits they earned.
IV. EQUALIZE SAVING INCENTIVES FOR
In the modern retirement landscape, a sound retirement begins with years of diligent saving. While other aspects of the Biden Plan will help raise wages for workers and reduce costs for spending like child care and health insurance, the Biden Plan will also ensure that middle-class families get a leg up as they grow their nest egg.
Under current law, the tax code affords workers over $200 billion each year for various retirement benefits – including saving in 401(k)-type plans or IRAs. While these benefits help workers reach their retirement goals, many are poorly designed to help low- and middle-income savers – about two-thirds of the benefit goes to the wealthiest 20% of families. The Biden Plan will make these savings more equal so that middle class families can enter retirement with enough savings to support a healthy and secure retirement. President Biden will do so by:
- Equalizing the tax benefits of defined contribution plans. The current tax benefits for retirement savings are based on the concept of deferral, whereby savers get to exclude their retirement contributions from tax, see their savings grow tax free, and then pay taxes when they withdraw money from their account. This system provides upper-income families with a much stronger tax break for saving and a limited benefit for middle-class and other workers with lower earnings. The Biden Plan will equalize benefits across the income scale, so that low- and middle-income workers will also get a tax break when they put money away for retirement.
- Removing penalties for caregivers who want to save for retirement. Under current law, people who work as caregivers without receiving wages are ineligible to get tax breaks for retirement saving. The Biden Plan will allow caregivers to make “catch-up” contributions to retirement accounts, even if they’re not earning income in the formal labor market, as has been proposed in bipartisan legislation by Representatives Jackie Walorski and Harley Rouda.
- Giving small businesses a tax break for starting a retirement plan and giving workers the chance to save at work. As proposed by the Obama-Biden Administration, the Biden Plan will call for widespread adoption of workplace savings plans and offer tax credits to small businesses to offset much of the costs. Under Biden’s plan, almost all workers without a pension or 401(k)-type plan will have access to an “automatic 401(k),” which provides the opportunity to easily save for retirement at work – putting millions of middle-class families in the path to a secure retirement.
V. PROVIDE HELP FOR OLDER WORKERS WHO WANT TO
With longer lifespans and the changing nature of work, many Americans are choosing to stay in the workforce longer. Despite their valuable contributions, these workers often face illegal discrimination or steep tax penalties when they try to continue to earn a living. Joe Biden believes that all workers deserve an opportunity to earn a living and will fight to change the laws to allow all people – regardless of their age – to get the pay they deserve. The Biden Plan will:
- Protect older Americans against harmful age discrimination. As president, Biden will back bipartisan legislation protecting older workers from being discriminated against in the workforce. According to an AARP survey, this practice is widespread – with more than 60% of older workers reporting discrimination because of their age. The Biden Plan will put in place workplace safeguards making it easier for older workers to prove that they were treated unfairly at work.
- Expand the Earned Income Tax Credit (EITC) to older workers. The EITC is one of the most effective strategies for helping low-wage workers achieve a living wage. Unfortunately, the EITC is not available to workers once they turn 65, putting them at a distinct disadvantage relative to their younger peers. As president, Joe Biden will allow low-wage older workers to claim the tax credit they deserve.