Where Presidential Candidates Stand on Senior Issues

Q. I am having a hard time following where the candidates stand on Social Security, Medicare, and Medicaid. I watched all the debates so far, and typically vote based on the person, not the party. If you know more about their stances on these issues, can you provide an apples-to-apples view on where they all stand, so I can make an informed decision. Thanks very much for your help!

A. When it comes to Social Security, Medicare, and Medicaid, there are clear differences between the Democratic and Republican candidates. Information is all over the place, and I agree with you that it is important to know where candidates stand when it comes to senior programs to help us decide how to vote in the upcoming primaries and the presidential election in the fall. So, let’s examine the positions taken by the leading 2016 presidential candidates on these topics, using the chart below. For Republicans, we will focus on the top 4 candidates, based on the most recent polls, and will focus only on Medicare and Social Security in this part (Part 2 will include details on Medicaid.) Information in the chart is derived from OntheIssues.com, Boston College’s Center for Retirement Research, various articles for which I provided the links, and candidate’s websites.

Candidate
Issue
View
 Democrats

Hillary Clinton
Medicare and the Affordable Care Act (ACA)
Clinton:
supports the ACA and will defend it against efforts to appeal it;
• opposes privatization of Medicare or phasing it out;
• would allow Medicare to negotiate prescription drugs costs to help drive down their costs;
• advocates Medicare delivery reforms to improve value and quality of care.Read more here.

Social Security
Clinton believes that Social Security must remain what it has always been: a rock-solid benefit that seniors can always count on—not subject to the budget whims of Congress or to the fluctuations of the stock market.

She would:

• fight any attempts to gamble seniors’ retirement security on the stock market through privatization;
• oppose reducing annual cost-of-living adjustments;
• oppose Republican efforts to raise the retirement age—an unfair idea that will particularly hurt the seniors who have worked the hardest throughout their lives;
• oppose closing the long-term shortfall on the backs of the middle class, whether through benefit cuts or tax increases.

Bernie Sanders
Medicare and the Affordable Care Act (ACA)
Sanders:
• would allow Medicare to negotiate prescription drug costs and allow drugs to be imported from Canada, in an effort to drive down costs;
• would restore discounts to seniors under Medicare Part D, and would close the Medicare donut hole in 2017, three years earlier than the current schedule.Sanders has been quoted as supporting the ACA and the goal of universal coverage. He’d go a step farther and implement a single-payer system, basically “Medicare for all.”

Social Security
Sanders:
• opposes any reductions to Social Security benefits, opposes increasing the retirement age and opposes privatization;
• would strengthen Social Security funding by raising the system’s taxable wage base to $250,000 (it will be $118,500 in 2016).Watch his video for more details on his views on this issue.
Republicans


 

Donald Trump
Medicare and the Affordable Care Act (ACA)
Trump opposes cuts to Medicare and supports repeal of the ACA. He doesn’t appear to take any position on a potential replacement for the ACA, which would mean a return to the pre-2014 days regarding pre-age 65 retiree health coverage. Notably, Trump is the only republican candidate who vows to expand economic growth enough that cuts in Medicaid will be unnecessary.

Social Security
Trump opposes cuts to Social Security and opposes raising the retirement age.
Ben Carson
Medicare and the Affordable Care Act (ACA)
Carson has previously said he would dismantle the national social insurance program for the elderly (Medicare) and replace it with a private voucher system. He recently changed his mind when asked on Facebook if he wanted to abolish Medicare and said he’ll soon offer a plan to “save money and deliver better service to our nation’s seniors.” He’d use Health Savings Accounts (HSAs) to reduce the need for government assistance programs, such as Medicare and Medicaid. He’s also been quoted as saying Obamacare is the “worst thing since slavery.” While Carson apparently is in favor of repealing the ACA, he does not appear to have suggested specific proposals to replace the ACA and, in particular, provide for universal coverage or prohibit exclusions due to pre-existing conditions.

Social Security
Carson proposes to:
• allow workers to invest a portion of their payroll taxes in a personal account;
• gradually raise the age at which benefits are distributed;
• forbid the government from reallocating any of the money that has been set aside for Social Security.Read more here.
Ted Cruz
Medicare and the Affordable Care Act (ACA)
Cruz would raise Medicare’s eligibility age to save costs. He advocates repeal of the ACA and has actively fought its implementation. He has proposed the Health Care Choice Act as an alternative to ACA, although it’s unclear if it allows universal coverage and prohibition of exclusions due to pre-existing conditions.

Social Security
Cruz proposes:
• allowing workers to invest a portion of their payroll taxes in a personal account;
• gradually increasing the retirement age;
• changing the rate of increase in benefits so that it matches inflation, rather than exceeding inflation.Read more here.
Marco Rubio
Medicare and the Affordable Care Act (ACA)
Rubio would make no changes for those in retirement or near retirement. He would transition Medicare to a premium support system, which would give seniors a fixed amount to purchase health insurance. They could have the option of either Medicare or a private provider. Rubio would repeal the ACA. On his site, he states that he’d provide all Americans with a tax credit that can be used to purchase private insurance, although he has no stated position on whether insurance companies can allow exclusions for pre-existing conditions

Social Security
Rubio proposes that we:
• gradually increase the retirement age for individuals under 55, without changing it for current seniors;
• reduce the growth of benefits for upper income seniors while making the program even stronger for lower-income seniors;
• empower people to save more for retirement.Read more here.

 

I hope you find this to be helpful! Stay tuned as the presidential campaign heats up and the candidates continue to refine their positions about these issues. We will continue to keep our readers updated!

Have you planned for your future and for your loved ones? Regardless of the election outcome or possible changes in the law, the need to plan in advance remains. If you have not done Incapacity Planning, Estate Planning, or Long-Term Care Planning (or had your documents reviewed in the past several years), or if you have a loved one who is nearing the need for long-term care or already receiving long-term care, please don’t hesitate to call us as soon as possible for a no-cost initial consultation:

Fairfax Elder Law: 703-691-1888
Fredericksburg Elder Law: 540-479-1435
Rockville Elder Law: 301-519-8041
DC Elder Law: 202-587-2797

A New Era of Human Longevity

Helping Seniors with Winter Hazards

Dear Baxter,

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Helping Seniors with Winter Hazards

Dear Baxter,

The forecast calls for a huge snowstorm, and my mother lives alone. She is having a tough time with the bitter cold weather as it is, and the snow that they are calling for can be dangerous. Do you have any suggestions to help her deal with the winter hazards?

Thanks for your help,

Warry Duboutter

—-

Dear Warry,

The cold winter weather we are experiencing and the snowstorm we are expecting can present severe challenges and potential hazards for seniors. Luckily, there are strategies that seniors and caregivers can employ to help avoid cold weather hazards:

• Falls on the ice: Slips are a major risk for seniors in winter, so it’s important to wear shoes with traction, such as warm boots with rubber soles.

 Driving: Seniors should avoid driving when road conditions are bad, and if they must drive, they should make sure snow-tires are installed and warm blankets and food are available in the car, should the vehicle become stranded or disabled.

• Hypothermia: According to Center for Disease Control (CDC), more than 50% of hypothermia deaths are among seniors. Older adults who do venture outside in cold weather should make sure to layer their clothing and dress warmly. Seniors should keep their thermostats above 65 degrees, and seek assistance if they lose heating.

• Social Isolation: If your mother has been spending a lot of time alone at home due to inclement weather, try to visit her often and spend time with her in her home. Arrange transportation to the local senior center, your mother’s church or synagogue, or other places where she can socialize.

 Seasonal Affective Disorder (SAD) or “the Wintertime Blues”: Many seniors experience a decrease in happiness and energy during the winter, which is caused by decreased daytime light in winter. This phenomenon is known as “seasonal affective disorder” or “SAD.” During times of year when daytime is shorter, seniors are at highest risk. Open curtains and blinds during winter to let natural lighting in. Seniors experiencing depression should of course talk to their doctors.

 Sundowning: Seniors with Alzheimer’s and other forms of dementia sometimes experience sundowners syndrome, which may include increased memory loss, agitation, confusion, and even anger during the evening hours. Sundowning is often exacerbated during winter, because the season’s low light can disrupt the body’s circadian rhythms. To help seniors experiencing sundowning, establish a routine, let light into the home, and promote a relaxing, quiet environment in the evening.

We send you and your mother warm winter wishes!

Baxter

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Social Security Benefits for Spouses and Children

By Fredrick P. Niemann, Esq. of Hanlon Niemann, a Freehold, NJ Elder Care Law Firm

A little-known feature of the Social Security system is that in addition to paying retirement benefits for the retired worker, it may provide benefits to the worker’s spouse, an ex-spouse if the marriage lasted at least 10 years, and dependent children and grandchildren, depending on the circumstances. Moreover, these benefits can be paid all at the same time.

Spousal Benefits

Your spouse is entitled to an amount equal to one-half of your full primary insurance amount (PIA). In order to receive this benefit, your spouse must be at least 62 years old or caring for your child who is under age 16. Also, you must have filed for Social Security retirement benefits (although you do not need to be receiving benefits) in order for your spouse to receive them as well.

It may be that your spouse could receive more from Social Security based on her own earnings record than through your spousal benefit. If this is the case, the Social Security Administration (SSA) automatically provides your spouse the larger benefit.

If you retire early, your spouse will still receive benefits based on one-half of the PIA you would have received had you waited until full retirement age to retire. But in order to receive a full half of your PIA, your spouse must wait to begin receiving the retirement benefits at her full retirement age. If she opts to receive benefits before that time, she will be penalized according to a formula similar to that used to compute the reduced benefits of workers who retire early. (For an article on how couples can maximize their Social Security benefits, click here.)

Children’s Benefits

Children and even grandchildren who are unmarried and dependent upon you (the retired worker) for their support are eligible for benefits. To be eligible, the child must be under age 18, under age 19 but still in elementary school or high school, or over age 18 but have become mentally or physically disabled prior to age 22.

Children generally receive an amount equal to one-half of your PIA, up to a “family maximum” benefit. The family maximum is calculated when you reach age 62, and is determined by a formula similar to that used to determine the PIA. The family maximum depends on the amount of your benefit and the number of family members who also qualify on your work record. The total varies, but it is generally equal to about 150 to 180 percent of your retirement benefit. Every January 1 the family maximum benefit may be increased to reflect a rise in the cost of living.

Because of the maximum, the more dependents you have, the less each of their individual benefits will be, although your own benefit will not be reduced. For example, let’s say Henry’s PIA is $1,500 and his family maximum is $2,300. Henry would receive his $1,500 a month, and his wife, Beatrice, and their dependent child, Barbara, would split the remaining $800 a month ($2,300 – $1,500). If Henry and Beatrice had two children who qualified for benefits, the remaining $800 after Henry’s benefit would be evenly divided three ways. Upon the worker’s death, dependent children receive 75 percent of the worker’s PIA, up to the family maximum, until they outgrow their eligibility.

Benefits for a Divorced Spouse

If you are the retired worker, your divorced spouse is eligible to receive an amount equal to one-half of your PIA, provided the marriage lasted at least 10 years. The rules are similar to those for spousal benefits described above, with two notable exceptions. First, your divorced spouse can begin receiving benefits even before you have begun receiving benefits yourself. The SSA does require, however, that you be at least 62 years old and that the divorce have been final for at least two years if you have not yet reached full retirement age. Second, your divorced spouse’s benefits are not counted in your “family maximum” benefit described above, and they do not affect that maximum.

Divorced spouses who had more than one marriage that lasted at least 10 years do not receive multiple benefit checks, one for each marriage. But the SSA does automatically choose the former marriage that will yield the largest benefit to the ex-spouse. Divorced spouses generally cannot collect benefits on their former spouse’s record unless their later marriage ends (whether by death, divorce, or annulment).

Survivor’s Benefits

If you die and your spouse has by that time reached full retirement age, your spouse begins receiving your actual benefits. This is true even if you and your spouse have divorced, so long as you had been married for at least 10 years. If your surviving spouse has not yet reached full retirement age but is at least age 60, she receives an actuarially reduced percentage of your benefits. At age 60, for example, she will receive 71.5 percent of your actual benefits. This percentage increases each year until she reaches full retirement age herself, at which point she begins receiving 100 percent of your actual benefits. Spouses younger than 60 may be able to receive benefits in limited circumstances, such as cases of disability or if they are caring for a disabled child.

Finally, the widow (if not divorced) of a deceased worker or his children under age 18 are entitled to a lump sum death benefit of $255.

To discuss your NJ elder care matter, please contact Fredrick P. Niemann, Esq. toll-free at (855) 376-5291 or email him at fniemann@hnlawfirm.com. Please ask us about our video conferencing consultations if you are unable to come to our office.

Sometimes Your Home Can Be Transferred to a Child Without a Medicaid Penalty

By Fredrick P. Niemann, Esq. of Hanlon Niemann, a Freehold, NJ Medicaid Attorney

You are a daughter or son of a sick and aging parent. Assume you have been caring for your mother and/or father for a number of years. You may even live in their home. Mom has severe COPD and dad has dementia. What needs to be done to protect Mom and Dad’s home if one or both of them need to be placed in a nursing home?

There’s good news for you. If structured correctly and properly documented, your parents can transfer the house to you without a penalty under New Jersey Medicaid laws. Generally, a transfer causes up to five years of ineligibility for Medicaid coverage. However, you can qualify for the so-called “caretaker child” exception to Medicaid’s rules governing the transfer of the home. In states like NJ, to qualify for this exception you need documented medical proof and affidavits from a doctor saying that for at least the past two years were it not for the care you provided to your parents, they would have had to move to a nursing home. If you think you qualify, reach out to us to better understand your rights and what must be done to assert your claim.

To discuss your NJ Medicaid matter, please contact Fredrick P. Niemann, Esq. toll-free at (855) 376-5291 or email him at fniemann@hnlawfirm.com. Please ask us about our video conferencing consultations if you are unable to come to our office.

 

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