The Alliance wishes all of our members a healthy, happy and safe new year!

The Alliance Mourns Loss of Retiree Champion Senator Harry Reid

Members of the Alliance were saddened this week by the passing of former Majority Leader and long-time Nevada Senator Harry Reid, a lifelong champion for older Americans.

“Retirees have lost one of the best friends they ever had in Washington,” said Alliance President Robert Roach, Jr. “Senator Reid never wavered in his support for our earned Social Security benefits. Time and again

he was there to beat back

attempts to privatize, cut, or allow Social Security to be used as a pawn during budget standoffs.”

“The Affordable Care Act, which closed the Medicare prescription drug doughnut hole and provided beneficiaries with guaranteed preventive care and wellness checks, would not have become law without Senator Reid’s commitment. We owe him a great debt of gratitude,” President Roach continued.

“Senator Reid was also a great friend of the Alliance,” said Alliance Executive Director Richard Fiesta. “He joined us at our national meetings and conventions, and our Nevada members were always welcome in his offices in Nevada or Washington. He will be greatly missed but never forgotten.”

Biogen Cuts Price for Alzheimer’s Drug Amid Controversy

Facing widespread criticism for the exorbitant cost of its new Alzheimer’s drug, Aduhelm, Biogen announced it would cut the price by half, from $56,000 per year to $28,200 per year.

Biogen had projected that sales of the drug would generate $12 million in revenue, but it has only yielded $300,000 between July and September. Aduhelm has also sparked heated controversy since it was first approved by the Food and Drug Administration in June. At first, FDA researchers said there wasn’t enough evidence of the drug’s effectiveness to merit its approval. Three members of the FDA’s Central Nervous System Advisory Committee resigned in protest.

Although the drug has not received approval for coverage under Medicare Part B, the Centers for Medicare and Medicaid Services (CMS) said that half of the 14.55% increase in Part B premiums for 2022 is due to the cost of Aduhelm.

“This just shows how arbitrary the prices set by pharmaceutical corporations are,” said Executive Director Fiesta. “Congress must take action now to end the pharmaceutical industry’s monopoly to set prices as high as they wish.”

New Protections from Surprise Medical Bills Go into Effect in 2022

Federal agencies have published regulations to implement the No Surprises Act (NSA), establishing new federal protections that will take effect in 2022 against surprise medical bills.

Surprise medical bills arise when insured consumers inadvertently receive care from out-of-network hospitals, doctors, or other providers they did not choose. The federal government estimates the NSA will apply to about 10 million out-of-network surprise medical bills a year.

Surprise billings occur in about 1 in 5 emergency room visits. In-network hospitalizations for non-emergency care include surprise bills from out-of-network providers such as anesthesiologists not chosen by the patient. Surprise medical bills pose financial burdens on consumers when health plans deny claims or apply higher cost-sharing. Consumers also face “balance billing” from out-of-network providers that have not contracted to accept discounted payment rates from the insurer. The NSA will protect consumers from surprise medical bills by:

requiring private health plans to cover these out-of-network claims and apply in-network cost-sharing, and
prohibiting doctors, hospitals, and other covered providers from billing patients more than the in-network cost-sharing amount for surprise medical bills.

“The No Surprises Act is a welcome change to start 2022,” said Fiesta. “It is bad enough to have a health setback without coming home to an astronomical bill when you thought you would be covered.”

Voting Rights Battle to Continue in 2022

After passing 33 laws of restricting voting in 19 states in 2021, Republicans in at least five states — Florida, Tennessee, South Carolina, Oklahoma, and New Hampshire — are working to pass even more voter suppression laws during their 2022 legislative sessions.

Two federal voting rights bills to counter the state-level laws, the For the People Act (H.R. 1) and the Freedom to Vote Act (S. 2747) are stalled in the Senate. Members of Dr. Martin Luther King, Jr.,’s family, backed by dozens of allied organizations, plan to use the upcoming Martin Luther King Holiday to highlight the need for stronger action to protect the right to vote.

They have planned a series of marches beginning January 15 in Phoenix and ending two days later in Washington, D.C., on the official holiday.

“Protection of our voting rights is essential to our democracy,” said President Roach. “We need to make it easier to vote in the 2022 and 2024 elections, not harder.”

The Texas and Florida state Alliances have filed lawsuits to block the voter suppression bills passed in those states in 2021. A federal judge in Florida dismissed the state’s attempt to stop the suit. A trial is scheduled to begin in early 2022.

Seniors are Disproportionately Affected by Breakthrough Covid Hospitalizations

Although vaccines are proven to significantly reduce the risk of severe COVID-19 infection, breakthrough hospitalizations and deaths have been reported among some fully vaccinated people. New research has found that the majority of COVID-19 breakthrough hospitalizations occurred among people ages 65 and older.

The report from the Peterson Center on Healthcare and Kaiser Family Foundation identified the characteristics of fully vaccinated hospitalized patients who have COVID-19 breakthrough infections and compared them to patients who are not fully vaccinated and hospitalized with Covid.

The findings show that from June through September 2021, 69% of breakthrough Covid hospitalizations were of people ages 65 and older, while people under the age of 50 accounted for only 10% of the breakthrough hospitalizations.

The researchers say that the disparity could be because older people are already at a heightened risk of severe Covid infection, or that it could be that older adults were among the first to receive the vaccine, leading to a decline in immunity over time.

Even so, an overwhelming majority of Covid hospital admissions occurred among unvaccinated or partially vaccinated people. While breakthrough cases are possible, health experts still urge vaccination as the best way to protect oneself from severe disease. And with booster shots now available to a majority of the country, the CDC recommends that all adults receive their booster dose to limit the possibility of breakthrough infection.

“Older Americans need to understand the risks over COVID-19,” said Joseph Peters, Jr., Secretary-Treasurer of the Alliance. “We urge all seniors to speak to their physicians about how best to protect themselves from this disease.”

KHN: ‘The Charges Seem Crazy’: Hospitals Impose a ‘Facility Fee’ — For a Video Visit

By Michelle Andrews

When Arielle Harrison’s 9-year-old needed to see a pediatric specialist at Yale New Haven Health System in June, a telehealth visit seemed like a great option. Since her son wasn’t yet eligible to be vaccinated against covid-19, they could connect with the doctor via video and avoid venturing into a germy medical facility.

Days before the appointment, she got a notice from the hospital informing her that she would receive two bills for the visit. One would be for the doctor’s services. The second would be for a hospital facility fee, even though she and her son would be at home in Cheshire, Connecticut, and never set foot in any hospital-affiliated building.

Harrison, 40, who works in nonprofit communications, posted on Twitter about the unwelcome fee, including an image of Marge Simpson of TV’s The Simpsons with a disgusted look on her face, captioned “GROANS.”

She called the billing office the next morning and was told the facility fee is based on where the doctor is located. Since the doctor would be on hospital property, the hospital would charge a facility fee of between $50 and $350, depending on her insurance coverage.