• Medicare Advantage Cuts, Broad Reforms Expected in 2009
• U.S. House Recovery Package Includes Provisions for Seniors
• AFT Launches 'Fight for America's Future' Campaign
• House Democrats Eliminate Medicare Trigger
• House Passes Important Children's Health Insurance Bill
• New Law Aids Grandparents Raising Grandchildren
• Deadline for Union Plus Scholarship Program Jan. 31
• Union Members Save Passengers, Help Obama Make History
• Quote of Note
• Web Site of the Week: www.medicare.gov

MEDICARE ADVANTAGE CUTS, BROAD REFORMS EXPECTED IN 2009
As in past years, Medicare legislation again is expected to be front and center in Congress in 2009 even if lawmakers do not take steps to reform the U.S. healthcare system. Healthcare reform could dominate the congressional healthcare agenda in 2009, and if it does, Medicare will be integral to reform legislation, including many long-standing AFT legislative priorities. But even without reform legislation, lawmakers are expected to tackle bills reducing Medicare reimbursement to managed care plans and a bill canceling a 20 percent physician payment cut due in 2010. President Barack Obama told ABC's "This Week" in a Jan. 11 interview that he remains committed to the elimination of Medicare Advantage plans. He added that cutting overpayments to these plans combined with other cost-cutting measures could provide as much as $200 billion to spend on expanding healthcare. The Medicare Payment Advisory Commission has estimated that MA plans are paid 13 percent more than the amount Medicare would pay if the same beneficiaries were enrolled in fee-for-service coverage. About 10 million Medicare beneficiaries are enrolled in such managed care plans. Congressional Democrats have tried the last two years to reduce MA spending, but have been rebuffed by Senate Republicans and President Bush, who had threatened to veto any bill containing MA spending reductions. 

Lawmakers also may address Medicare payment reforms, such as linking payments to increasing care quality. Comparative effectiveness research and healthcare information technology provisions also could be approved, either as part of a larger healthcare reform effort or as separate pieces of legislation, and those bills likely would have an effect on Medicare. Changes also could be made to the Medicare prescription drug program, such as requiring HHS to negotiate with manufacturers for the best prescription drug prices. Democrats also may move to incorporate a drug formulary into Medicare similar to that used by the Veterans Health Administration. They also are likely to push legislation creating a federally run Medicare prescription drug plan that would compete with private drug plans.

U.S. HOUSE RECOVERY PACKAGE INCLUDES PROVISIONS FOR SENIORS
The House of Representatives' $825 billion economic recovery package includes an additional Supplemental Security Income payment for low-income older and disabled recipients, as well as healthcare assistance through COBRA and Medicaid for older workers who have become temporarily unemployed. The outline includes plans to provide temporary subsidies through COBRA for health insurance coverage to those who have lost their jobs, and to extend the availability of unsubsidized COBRA coverage for older and tenured workers beyond the 18 months provided under current law. Additional agencies and programs including the Social Security Administration, Low-Income Energy Assistance, and Meals on Wheels will receive increased funding as well. 

AFT LAUNCHES "FIGHT FOR AMERICA'S FUTURE" CAMPAIGN
The AFT on Jan. 14 announced a national campaign to fight for America's future by strongly supporting a national economic recovery plan and other efforts that make smart investments and mitigate the need for any further draconian cuts in education, healthcare and other essential services. "A well-crafted federal economic stimulus package is absolutely necessary to stem the economic tidal wave spreading across America," says AFT president Randi Weingarten, who launched the campaign at a press conference in Washington, D.C. "The solution isn't just about dollars but about the kind of smart investments that will help slow the economic free-fall and strengthen education, healthcare and public services in order to preserve opportunity in this country." The campaign is called "Fight for America's Future: It's Dollars and Sense." Among the states particularly hard hit is Florida, where Weingarten met Jan. 13 with Gov. Charlie Crist to discuss the state's economic challenges and explore ways to ensure quality education. In addition to being the governor of a hard-hit state, Crist also has been designated by the National Governors' Association to be the point person on the economic recovery plan for Republican governors.

HOUSE DEMOCRATS ELIMINATE MEDICARE TRIGGER
On Jan. 13, House Democrats used a rules package to turn off the Medicare "trigger" that each year forces a debate on the program's costs. The provision was included in HR 5, a package of operating rules that govern the House in the 111th Congress. The one-line item simply stated that the Medicare trigger "shall not apply." The package was adopted, 242-181. House Majority Leader Steny Hoyer (D-Md.) called the trigger "an ideologically driven target based on a misleading measure of Medicare's financial health." The trigger is part of the 2003 Medicare overhaul law that also created the prescription drug benefit. According to the law, if 45 percent or more of Medicare's funding comes from general tax revenues for two years in a row, the president must submit-and Congress debate-legislation to slow spending over a seven-year period and in order to restore fiscal stability. The trigger went into effect for the first time last year. The change is temporary, pending additional legislation. The AFL-CIO and AFT have long supported such a move.

HOUSE PASSES IMPORTANT CHILDREN'S HEALTH INSURANCE BILL

The AFT commended the U.S. House of Representatives for its Jan. 14 passage of the State Children's Health Insurance Program Act (SCHIP). The bill reauthorizes the SCHIP program, which will provide continued healthcare coverage for 6.5 million low-income children and expand eligibility for another 4 million poor children. Under the expansion, similar to one that was vetoed by President Bush in 2007, children in families with incomes of up to three times the federal poverty level would qualify for the program. The bill would almost be completely funded by a 61-cent-per-pack increase in the federal cigarette tax. "With millions of additional families being pushed into poverty by the economic downturn, this bill is an absolute necessity," says AFT president Randi Weingarten. "Access to healthcare not only improves a child's physical well-being, but also the likelihood of success in school. Children's health and education are inextricably linked, and expansion of SCHIP is essential, especially in these difficult economic times." The House bill, which passed 289 to 139, also allows states flexibility to expand coverage to children of legal immigrants. President Bush twice vetoed earlier versions of the bill, but President Obama has expressed strong support for the legislation. The U.S. Senate is expected to take up the bill shortly.

NEW LAW AIDS GRANDPARENTS RAISING GRANDCHILDREN
In December, at the end of his administration, President Bush signed into law the "Fostering Connections to Success and Increasing Adoptions Act" (HR 6893). Under the law, the federal government will offer support for states to assist with subsidized guardianship payments to grandparents and other relatives who have children placed with them and will allow states to choose to continue benefits until the child reaches age 21. This program will also ensure relatives receive notice when children are removed from their parents' care and allow states to waive non-safety-related standards for relatives who want to care for these children. The law also guarantees that funding for Kinship Navigator programs, which help caregivers access community assistance and support services. For more information, visit www.grandparentsforchildren.org or call 866/624-9900.

DEADLINE FOR UNION PLUS SCHOLARSHIP PROGRAM JAN. 31
Time is running out to apply for Union Plus Scholarships. If you have a dependent grandchild or child in your household planning to go to college in the fall, he/she can apply for one of these $500 to $4,000 scholarships. You or your spouse can too if you're planning to further your education. The program is open to members, spouses and dependent children of unions participating in any of the Union Plus programs. Members are not required to purchase any Union Plus products or participate in any Union Plus program to apply. Sponsored by the Union Plus Education Foundation, the Union Plus Scholarship Program is open to students attending or planning to attend a four-year college or university, a community college or a technical college or trade school. Winners are chosen based on academic achievement and potential, character, leadership, social awareness, career goals and financial need. Applications are judged by a committee of impartial post-secondary educators. Since 1992, the program has awarded more than $1.8 million to students of working families who want to begin or continue their secondary education. For more information, visit www.aft.org/aftplus/scholarships/unionplus.htm.

UNION MEMBERS SAVE PASSENGERS, HELP OBAMA MAKE HISTORY
The quick thinking, bravery, experience and extensive training of US Airways Flight 1549 pilot, Capt. Chesley Sullenberger, co-pilot Jeffrey Skiles, the crew of flight attendants, the air traffic controllers guiding the flight low over Manhattan and the rescuers were the key factors in Jan. 16's "Miracle on the Hudson," where 155 people survived an emergency landing in the river. Just about every single one of these heroes is a union member who got that extensive safety and job training thanks to their union contracts. Sullenberger, with 40 years of flight experience, served as instructor and safety committee chairman for the Air Line Pilots Association. The crew of three flight attendants who shepherded the passengers safely out the emergency exits are members of the Flight Attendants-CWA. The air traffic controllers, who helped route the Airbus A320 around Manhattan, after Sullenberger reported that a bird strike had shut down both engines, are members of the National Air Traffic Controllers Association. The ferry crews who immediately responded when they saw the plane in the river are Seafarers members. Marine Engineers members pilot many of the ferries and fireboats that responded. Those police and fireboats crews who arrived to pull passengers to safety are members of the Fire Fighters and Patrolmen's Benevolent Association. 

Workers helped Barack Obama make history Jan. 20 and helped ensure that the inauguration of the nation's first African-American President went smoothly. Many of those workers carried union cards, from the construction workers and stagehands who built and ran the reviewing stands and stages to the police, firefighters and emergency medical technicians working to keep people safe. Hotel workers made visitors' stays comfortable. Teamsters kept things moving, and communications workers handled the huge load of millions of people trying call each other-or friends back home—as they watched history unfold. There were many unions and workers who played a role in Tuesday's historic moment, but perhaps none were more visible than the transit workers who carried the massive crowds who flocked to the nation's capital and set new Metro ridership records on Jan. 18, 19 and 20. Long after everyone had returned safely home, sanitation workers and city workers were on the job cleaning up Washington as a new era began.

QUOTE OF NOTE

"Our challenges may be new. The instruments with which we meet them may be new. But those values upon which our success depends - hard work and honesty, courage and fair play, tolerance and curiosity, loyalty and patriotism - these things are old. These things are true. They have been the quiet force of progress throughout our history."

President Barack Obama
Inaugural Address
Jan. 20, 2009

Web Site of the Week: www.medicare.gov
Nursing Home Compare is a new quality rating system developed by the Centers for Medicare & Medicaid Services. The site rates each of the nation's 15,800 nursing homes participating in Medicare or Medicaid from a low of one star to a high of five stars. Ratings are based on health inspection surveys, staffing information and quality of care measures.

Contributors and sources: Bill Cunningham, New York Times, BNA Healthcare Daily Report, CQ Today, CQ Politics, Centers for Medicare & Medicaid Services, National Association of Area Agencies on Aging, Inside AFT, Union City, AFL-CIO Now, Alliance for Retired Americans Friday Alert, Kaiser Health Policy Report. Frank Stella, editor; Mary Boyd, copyeditor; Paula Dutko, design