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Megan Smith
Phone: 202.741.6346
Email:msmith@americanprogress.org
While conservatives garner public attention with their effort to repeal the Affordable Care Act, other conservative proposals to undermine our nation's health care system are receiving less attention. Most notably, Rep. Paul Ryan (R-WI), the chairman of the Budget Committee in the House of Representatives, advocates in his "Roadmap to America's Future" replacing today's Medicare program with a federal voucher that future Medicareeligible seniors could use to purchase health coverage.
While conservatives garner public attention with their effort to repeal the Affordable Care Act, other conservative proposals to undermine our nation's health care system are receiving less attention. Most notably, Rep. Paul Ryan (R-WI), the chairman of the Budget Committee in the House of Representatives, advocates in his "Roadmap to America's Future" replacing today's Medicare program with a federal voucher that future Medicareeligible seniors could use to purchase health coverage. This proposal will force Medicare beneficiaries to spend significantly more than they do today to maintain coverage equivalent to today's Medicare program.
This issue brief estimates the new costs that Americans with Medicare coverage will bear under Ryan's budget proposal--costs that will be largely borne by everyone under the age of 56.
The proposal
Rep. Ryan proposes to give new Medicare enrollees an annual voucher they could use to purchase health insurance beginning in 2021. Individuals who join Medicare in this year-- largely individuals turning age 65--would receive this voucher, which would initially be worth an average of $5,900 (in 2010 dollars). Rep. Ryan further specifies that when all age groups are fully phased-in, the voucher would be worth, on average, $11,000 in 2010 dollars.
The voucher would grow at a slower rate than projected increases in health care costs, and would replace Medicare's current benefits. Medicare would no longer pay for services as enrollees see their doctors, use hospital care, or fill a prescription. Nor would Medicare pay Medicare Advantage plans a monthly premium to finance and arrange care for their Medicare enrollees.
Traditional Medicare would continue for individuals who enrolled in coverage prior to 2021, but would eventually disappear completely as this older generation of Medicare enrollees passes away. That means anyone who today is under 56 years of age will be paying more, perhaps much more, for health coverage when they qualify for Medicare.
What does this mean for tomorrow's seniors?
Ending Medicare as we know it would leave seniors facing significantly higher health care premiums. With a voucher that fails to keep up with increases in health care costs, Medicare beneficiaries would not be able to purchase coverage equivalent to today's Medicare benefit. Their new premium--the amount above the voucher they would have to pay to purchase that coverage--would far exceed their expected Medicare premiums under current law.
Under current law, people with Medicare coverage can expect to pay $2,730 per year ($228 a month) in 2021 for total Part B and Part D premiums, which will provide them with full Medicare benefits. Under Rep. Ryan's proposal, new Medicare enrollees will pay an average of $3,579 for equivalent coverage--a 31 percent increase in their premium for this year. This "Roadmap" premium increase will grow over time, as the voucher's value fails to keep up with increases in health care costs.
Indeed, the Ryan plan will mean that seniors and people with disabilities who receive the "Roadmap" voucher would face an average increase in premiums of almost $850 in 2021, which will grow to nearly $1,060 in 2025, to purchase a benefit package equivalent to today's Medicare program.
Methodology
The Center for American Progress relied on a multistep calculation to compare Medicare beneficiaries' premiums under Rep. Ryan's "Roadmap" proposal and under current law. Here are those calculations.
In his proposal, Rep. Ryan specifies that the initial Medicare voucher would average $5,900 (in 2010 dollars) per beneficiary, and that the average voucher at full implementation would equal $11,000 (in 2010 dollars). In their analysis, the Congressional Budget Office grows this amount by 2.7 percent annually, which represents their estimate of the growth factor specified by Rep. Ryan--the average of the growth of consumer price index for all urban consumers, or CPI-U, and the growth of the price index for medical care, or CPI-M.1 Using this 2.7 percent annual growth rate, we grow the value of the Medicare voucher to the first year of the voucher program and beyond, which gives us initial voucher values of $7,910 in 2021 and $8,800 in 2025 for the first cohort of enrollees.
To develop projections of average per beneficiary spending, we first grew per capita Medicare expenditures on personal health care spending for 65-to-74 year olds from 2004 to 2010 by historical growth rates found in the 2010 Medicare Trustees Report. We adjusted for the addition of the Part D benefit in 2006 and assumed that spending for this cohort grew at the same rate as the general Medicare population.2, 3 For comparison, we applied demographic adjustment factors for Medicare Advantage contracts to average 2010 per beneficiary costs and obtained similar results. We then grew average per beneficiary spending for this cohort to 2019 using the trustees' projections, and used the trustees' projected average annual growth rate for 2010 through 2019 to estimate per beneficiary expenditures through 2025. These calculations yield average per beneficiary spending of $11,488 in 2021 and $12,930 in 2025.
We then calculate the difference between the projected value of the Medicare voucher under the "Roadmap" proposal and projected average per-beneficiary Medicare spending to estimate the average beneficiary premium under the Ryan "Roadmap."
The 2010 Medicare Trustees Report estimates the Part B standard monthly premium and the Part D base beneficiary premium through 2019. Together, these values equal the monthly baseline beneficiary premium, under current law.
Using the trustees' projected average annual growth in Part B and Part D premiums for 2010-2019, we project the monthly baseline beneficiary premium through 2025. This value, multiplied by 12, equals the annual beneficiary premium under current law for individuals who pay the standard Medicare premium.
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"Charging or jailing the killers is not enough," said the national director of the Working Families Party. "Justice is changing the conditions so no one dies during a traffic stop."
This is a developing story… Please check back for possible updates...
Editor's note: The videos at the end of this article contain graphic and violent content.
The city of Memphis, Tennessee on Friday night released four videos of the January 7 arrest of Tyre Nichols, a 29-year-old Black motorist who died after being beaten by five officers who were subsequently fired and charged with murder.
The footage was privately seen by Nichols' family on Monday. Three of the videos are from body-worn cameras issued by the Memphis Police Department (MPD). Another is from a camera mounted on a pole and contains no audio.
Before the videos were released, MPD Chief Cerelyn "C.J." Davis warned that they show "acts that defy humanity."
Nichols was pulled over by Memphis officers for alleged reckless driving that Davis has since said her department has been "unable to substantiate." After three days in the hospital, he died on January 10 from cardiac arrest and kidney failure.
\u201cA young father, son, skateboarder, a photographer. This is who Tyre Nichols was.\n\nHe should still be alive today.\nhttps://t.co/JbsgEMTxMI\u201d— Vera Institute of Justice (@Vera Institute of Justice) 1674862160
"I am disturbed and disgusted by the sheer brutality and lack of humanity on display in the footage released today," said NAACP president and CEO Derrick Johnson in a statement Friday night. "No person should ever be subjected to such violence, to have to call for their mother as they are being brutalized by police."
"This video is a stark reminder that in America, on any day of the week, a Black person can be brutally beaten to death less than a hundred feet from his home by those who are supposedly here to 'serve and protect' our communities," he continued. "Let me be clear—a traffic stop should not result in the brutal death of an unarmed man—period."
\u201cCPC Chair @RepJayapal and CPC Policing, Constitution, Equity Task Force Chair @RepBonnie echo community demands for justice for Tyre Nichols and call for fundamentally reimagining public safety in their statement on the release of the body camera footage of his killing.\u201d— Progressive Caucus (@Progressive Caucus) 1674865377
As Common Dreamsreported Thursday, former MPD cops Tadarrius Bean, Demetrius Haley, Justin Smith, Emmitt Martin III, and Desmond Mills Jr.—who are all Black—were charged with second-degree murder and various other crimes.
In a series of tweets responding to the charges, ColorOfChange president Rashad Robinson said Friday, "Let's be clear, while the mass movement of people demanding some level of accountability has succeeded in this one instance, convictions aren't the goal."
"WE WANT AN END TO POLICE MURDERS OF BLACK PEOPLE. So, this moment isn't about Black vs. white, it's about blue vs. Black. Diversity cannot and does not solve systemic problems," he continued. "If we don't change the structure of policing and safety in our country, Black people will continue to be killed, by police of all races. The evidence is clear—investing in communities will keep us safe, not the police."
\u201cCharging or jailing the killers is not enough. Justice is changing the conditions so no-one dies during a traffic stop.\n\nPolicing is fundamentally broken. Trading white officers for Black ones was never a solution.\n\nIf we're serious about public safety, we'll fund our communities\u201d— Maurice Moe Mitchell \ud83d\udc3a (@Maurice Moe Mitchell \ud83d\udc3a) 1674866194
Damon Hewitt, president and executive director of the Lawyers' Committee for Civil Rights Under Law, said Friday evening that "Tyre's death is a bitter reminder of the Black lives that we've lost due to police brutality. Thirty years ago, we were horrified by the footage of police beating Rodney King. And yet, despite our decades of protest, we're still fighting the same battle."
"The only difference now is more of the horrific incidents are being captured on video, whether it be bodycams or bystanders," he added. "Tinkering at the margins of a violent police state is not enough. It never was. This death must amount to more than just another viral moment or hashtag. It must spark a serious reconsideration and shifting of priorities, deployment, and resources."
Before the footage was released, major cities across the United States were preparing for potential Friday evening protests.
According toThe Associated Press:
As a precaution, Memphis-area schools canceled all after-class activities and postponed an event scheduled for Saturday morning. Other early closures included the city power company’s community offices and the University of Memphis.
Nichols' mother, RowVaughn Wells, warned supporters of the "horrific" nature of the video but pleaded for peace.
"I don't want us burning up our city, tearing up the streets, because that's not what my son stood for," she said Thursday. "If you guys are here for me and Tyre, then you will protest peacefully."
Noting that "there's been a lot of focus on the perceived threat of violence,"MLK50: Justice Through Journalism, a nonprofit Memphis newsroom, on Friday published a collection of stories and columns "to add context to this tragedy" for those who may be unfamiliar with "the antagonistic relationship police have cultivated with the community, dating back decades."
The coalition Decarerate Memphis shared on Twitter demands from Nichols' family and the community, including reforms to reduce the chances of similar future events.
\u201c\ud83d\udea8\ud83d\udea8\ud83d\udea8 Save and share everywhere. We demand #JusticeforTyreNichols\u201d— Decarcerate Memphis (@Decarcerate Memphis) 1674851240
The Movement for Black Lives tweeted advice on "how to limit viewing sensitive content" on social media platforms, for those who do not want to be traumatized by the footage.
\u201cToday a video of Tyre Nichols\u2019 murder will be released. Do not share it. Do not traumatize our people further by putting it in front of us. We feel the overwhelming rage and grief without subjecting ourselves to a video of his life being taken.\nTo protect yourself online: \u2b07\ufe0f\u201d— Movement 4 Black Lives (@Movement 4 Black Lives) 1674850469
"We grieve with Tyre's family, friends, and the entire Memphis community," the movement said in a statement. "Had those officers not pulled Tyre over, he would be here right now with his four-year-old son, taking photos of sunsets and skateboarding. Yet, even as we try to grieve and stand in solidarity with Tyre's family, we know the police are ramping up to criminalize our actions—meeting our calls for justice and accountability with more state violence and suppression."
Editor's note: The videos below contain graphic and violent content.
"These lobbyists are not getting hired to advocate for American energy consumers—they will push an agenda that benefits the new majority's donors no matter what it costs taxpayers."
An analysis published Friday by the nonpartisan watchdog Accountable.US revealed that numerous former fossil fuel lobbyists are being hired to work for the Republican-controlled 118th Congress, including in high-level positions on the House Natural Resources Committee.
"As the Republicans majority begins the new Congress, former oil industry lobbyists will have new and growing influence as top staffers for congressmen on key committees," the analysis states.
Accountable.US detailed the close ties between Nancy Peele—chief of staff to House Natural Resources Committee Chair Bruce Westerman (R-Ark.)—and fossil fuel interests.
"It's no surprise that Big Oil is infiltrating the halls of Congress after spending millions to elect some of the most extreme legislators in American history."
Peele's history includes:
Majority Leader Steve Scalise's [R-La.] Chief of Staff Megan Bel Miller came to Scalise's office straight out of working as an oil and gas lobbyist... Miller lobbied Congress on behalf of National Oceans Industry Association, a group representing the offshore oil and gas industry. Bel Miller advocated for polluting industry interests on numerous conservation issues, including the Endangered Species Act, National Environmental Policy Act, and offshore leasing. Majority Whip Tom Emmer's [R-Minn.] new Policy Director Ian Foley is an energy and mining lobbyist. In 2022, Foley lobbied Congress on behalf of the uranium mining industry and public utilities with oil and gas portfolios.
These are but a handful of the many examples of the revolving door between Big Oil and Congress highlighted in the analysis.
"It's no surprise that Big Oil is infiltrating the halls of Congress after spending millions to elect some of the most extreme legislators in American history," Accountable.US energy and environment director Jordan Schreiber said in a statement. "These lobbyists are not getting hired to advocate for American energy consumers—they will push an agenda that benefits the new majority's donors no matter what it costs taxpayers."
Underscoring the analysis' findings, the U.S. House of Representatives on Friday passed legislation that would require the federal government to lease a portion of public lands and waters for fossil fuel extraction for each non-emergency drawdown of the U.S. Strategic Petroleum Reserve. The bill was introduced by Rep. Cathy McMorris Rodgers (R-Wash.), who chairs the House Energy and Commerce Committee and was the top recipient of oil and gas PAC money in the House Republican caucus during the last election cycle.
\u201cNEW: MAGA Republicans in Congress just passed a bill that would obstruct one of @POTUS\u2019 only powers to protect consumers from Big Oil\u2019s price gouging\u2014letting oil companies get rich at Americans\u2019 expense. https://t.co/pcwPGdVkIs\u201d— Accountable.US (@Accountable.US) 1674844979
"We grieve for all this unthinkable loss. And with our grief, we also rage," said Jewish Voice for Peace. "The Israeli government's domination and oppression of Palestinians is the root cause of each of these senseless, tragic deaths."
Human rights defenders condemned a Friday attack outside a synagogue in an illegal Israeli settlement by a Palestinian gunman who murdered at least seven people—a massacre that followed the killing of 10 Palestinians by Israeli forces during a raid in the occupied West Bank Thursday.
TheTimes of Israelreports the unidentified gunman shot and killed seven people and wounded three others during the Friday evening attack in Neve Yaakov in East Jerusalem. Friday is International Holocaust Remembrance Day. The attacker was shot dead during a gunfight with police as he attempted to flee into the Palestinian neighborhood of Beit Hanina. An ambulance service said the deceased ranged in age from 20 to 70.
In a statement, Stéphane Dujarric, spokesperson for United Nations Secretary-General António Guterres, said the U.N. chief "strongly condemns today's terrorist attack by a Palestinian perpetrator outside a synagogue in Jerusalem, which claimed the lives of at least seven Israelis and injured several others."
"It is particularly abhorrent that the attack occurred at a place of worship, and on the very day we commemorated International Holocaust Remembrance Day," Dujarric added. "There is never any excuse for acts of terrorism. They must be clearly condemned and rejected by all."
\u201c\ud83d\udea85 #Israelis killed & 5 wounded in a shooting attack near a synagogue in the Neve Yaakov settlements in occupied East Jerusalem.\n\nViolence begets violence begets violence....\n\nPeople don't understand how close the occupied territories are to a full disastrous explosion!\u201d— Muhammad Shehada (@Muhammad Shehada) 1674846498
Tom Nides, the U.S. ambassador to Israel, tweeted that he is "shocked and disgusted at this heinous terrorist attack on innocent people, including children. Praying for all of the victims and their loved ones."
The synagogue massacre came one day after Israeli occupation forces killed 10 Palestinians including an elderly woman and wounded around 20 others during an early morning raid on the Jenin refugee camp. Israeli forces then bombed Gaza early on Friday morning after Palestinian resistance fighters fired two rockets at Israel.
The Jenin raid was part of Operation Breakwater, a nine-month campaign targeting Palestinian resistance in the camp and nearby Nablus. Human rights groups say 30 Palestinians, both fighters and civilians, have been killed so far by Israeli forces in 2023. Last year was the deadliest year for West Bank Palestinians since the second intifada—or general uprising—a generation ago, with 150 people including 33 children killed. Another 53 Palestinians were killed by Israeli forces in Gaza in 2022.
\u201cInstead of linking today's terrible attack in Jerusalem to Holocaust Remembrance Day, which it has nothing to do with, you might connect it instead to the 30 Palestinians that have been killed by Israel just this month. This is a cycle of violence borne of Israeli apartheid.\u201d— Arielle Angel (@Arielle Angel) 1674851482
In a statement following the synagogue murders, the U.S.-based group Jewish Voice for Peace (JVP) called the attack "the inevitable, horrifying outcome of decades of Israeli apartheid"
"We grieve for all this unthinkable loss. And with our grief, we also rage. The Israeli government's domination and oppression of Palestinians is the root cause of each of these senseless, tragic deaths," JVP contended.
"The violent, racist speech coming from the Israeli government makes it clear that the Israeli military will continue to escalate its violent attacks on Palestinians. Already the Israeli army has invaded Palestinian neighborhoods in occupied East Jerusalem," the group said.
\u201c10 killed in #Jenin and now 5 dead, 5 wounded in Jerusalem shooting attack: these are the ENTIRELY PREDICTABLE RESULTS of a vicious extremist #Israeli government that leaves no room for hope, no room for peace, more to come. https://t.co/kQt5NgIMw3\u201d— Sarah Leah Whitson (@Sarah Leah Whitson) 1674845638
JVP continued:
What we are witnessing is not a "conflict," a "clash," or a "war" between two equal parties. There is no mistaking the massive disparity of power between the Israeli government and the Palestinians it targets. Backed by $3.8 billion in annual military funding from the U.S. government, the Israeli government controls, dominates, and dispossesses Palestinian lives and lands.
"We are on the side of unconditional commitment to justice, equality, freedom, and dignity for all people, no exceptions," JVP added. "To achieve a future where all are safe and free, we must end the Israeli government's settler-colonial apartheid regime."