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Showing posts with label Social Security. Show all posts
Showing posts with label Social Security. Show all posts

Wednesday, October 31, 2018

NJ Senate Passes Increase to Supplemental Benefits for Injured Workers

The NJ Senate adopted legislation (S.1967) to increase supplemental benefits to certain injured workers receiving workers' compensation. On October 29, 2018 the NJ Senate voted (26-12) to pass the legislation. The Assembly version A3635 awaits action.

Saturday, February 11, 2017

Chaos in Workers' Compensation - Raising Medicare's Eligibility Age to 67

A new issue for workers' compensation programs is  emerging as  the Republicans push forward on their legislative agenda to reform Medicare. Uncertainty over the impact of raising the eligibility age for Medicare from 65 to 67 may seriously and adversely impact the nation's network of fragile workers' compensation schemes. Furthermore, looming in the background is also the elimination of The Affordable Care Act and the consequence of a large pool of uninsured again seniors.

Friday, February 3, 2017

Declining Earnings Capacity - A Retrogressive Penalty for Ill Workers

The decline of the earning capacity of ill workers prior to stopping work has an impact on both workers' compensation benefits as well as Social Security disability benefits. It is  a retrogressive penalty for chronically ill workers.


The Social Security Administration in a recent report objectively reports this phenomena.

Saturday, June 25, 2016

The Social Security Financial Report: An Insight Into the Future

Change is coming to the Social Security Disability program based upon the The 2016 Trustees Report that was published this week. It projects that the future finances of the Social Security Disability Trust Fund will require additional funding to remain solvent.

Friday, April 24, 2015

CMS Posts Sample Notice To Beneficiaries Regarding Appeal Rights

CMS has posted the following notice regarding MSP Appeal Rights under the SMART Act. Under the process the the Social Security Beneficiary is only a party of notice and the the direct parties become the Insurance Carrier or Workers' Compensation Entity who initiates the appeal. The process has yet to unfold when an injured workers moves for standing to appear and participate in the process.

On February 27, 2015, the Centers for Medicare & Medicaid Services (CMS) issued a final rule implementing certain provisions of the Strengthening Medicare and Repaying Taxpayers Act of 2012 (the SMART ACT). This final rule establishes a formal appeals process for applicable plans (liability insurance (including self-insurance), no-fault insurance, and workers’ compensation laws or plans) in situations where the Secretary seeks Medicare Secondary Payer (MSP) recovery directly from an applicable plan. The rule is effective April 28, 2015, and applies to demand letters issued on or after April 28, 2015.

Beneficiaries will be notified in writing if an item or service they received is the subject of an appeal by the insurer or workers’ compensation entity.

A new document titled Appeals Process for Insurers and Workers’ Compensation Entities and Required Notice to Medicare Beneficiaries has been loaded to the downloads section of the What’s New page on the Beneficiary Services section of CMS.gov. The following link can be used to access the main page http://go.cms.gov/beneficiary. Once on the main page click the “What’s New” link in the left side menu and scroll to the bottom of the page. 

Thursday, June 19, 2014

Social Security Agency Cuts Services as Demand Grows, Senate Report Says

Today's post is shared from nytimes.com

The Social Security Administration is closing field offices and reducing services to the public even as demand for those services surges with the aging of the baby boom generation, according to a bipartisan Senate committee report.

The report, to be issued Wednesday by the Senate Special Committee on Aging, says the agency has closed more than two dozen field offices in the last year, generally without considering the needs of communities and without consulting beneficiaries or field office managers.

In deciding whether to close field offices, the Social Security Administration “excludes both its own managers and the affected public,” and the decisions often appear arbitrary, the report says.

The committee’s chairman, Senator Bill Nelson, Democrat of Florida, said, “Seniors are not being served well when you arbitrarily close offices and reduce access to services.”

He added, “The closure process is neither fair nor transparent and needs to change.”

The field offices served over 43 million people last year. About 10 percent of the visitors filed for benefits, and 30 percent were seeking new or replacement Social Security cards.

In testimony prepared for a committee hearing on the issue on Wednesday, Nancy A. Berryhill, a deputy commissioner at the agency, said its budget and work force had not kept pace with what she described as “a staggering 27 percent increase” in claims for retirement benefits, to 3.3...

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Tuesday, April 15, 2014

U.S. Halts Effort to Collect Old Social Security Debts

Today's post was shared by The New York Times and comes from www.nytimes.com


WASHINGTON — The Social Security Administration said Monday that it would stop trying to collect taxpayers’ debts that were more than 10 years old.
 The statement came after a Washington Post article revealed that the Treasury had started intercepting the federal and state tax refunds of debtors’ children — even if the debts were decades old. The debts stem from overpayments by Social Security that the agency had been trying to recoup even if the original recipients had died.
 “I have directed an immediate halt to further referrals under the Treasury Offset Program to recover debts owed to the agency that are 10 years old and older,” Carolyn W. Colvin, the acting commissioner of Social Security, said in a statement.
 Ms. Colvin said the effort would stop until the agency completed a thorough review of its “responsibility and discretion” to collect any debts to the government.
 A revision to the Farm Bill passed in 2008 lifted the statute of limitations “applicable to collection of debt by administrative offset.” That allowed the authorities to withhold the tax refunds of 400,000 people who had relatives with debts to Social Security, The Post reported.
Some of the debts were incurred as long ago as the mid-20th century, The Post said, and the taxpayers whose refunds were being intercepted did not know that their relatives had been overpaid or owed any money.
 The actions by the Social Security...
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Related Articles:
CMS Takes a New Direction in the Proposed MSP Appeal ...
Jan 06, 2014
The Centers for Medicare and Medicaid services (CMS) has proposed rules for the Medicare Secondary Payer (MSP) appeals process that will target the “applicable plan” as the primary responsible party for recovery.
http://workers-compensation.blogspot.com/
Federal Court Enjoins CMS From MSP Recovery Procedures
May 18, 2011
"IT IS FURTHER ORDERED that the Defendant's demand that attorneys withhold liability proceeds from clients pending payment of amounts claimed by the Defendant as MSP reimbursement exceeds her authority under the ...
http://workers-compensation.blogspot.com/
US Supreme Court Asked to Review MSP Preemption Issue
Aug 22, 2013
Medicare is not required to abide by a stipulated order of allocation of benefits in a liability case when seeking reimbursement under the Medicare Secondary Payer Act (MSP). Also, the New Jersey Collateral Source Statute .
http://workers-compensation.blogspot.com/
Workers' Compensation: CMS Publishes Rules to MSP ...
Sep 23, 2013
CMS Publishes Rules to MSP Payments Under the SMART Act. Medicare has published proposed Rules to governor obtaining information concerning the conditional payments as required by the recently implemented ...
http://workers-compensation.blogspot.com/

Thursday, February 13, 2014

Missouri Further Defines Permanent Total Disability

"The PTD test is whether the worker can compete in the open labor market.
Schussler, 393 S.W.3d at 96. A worker who cannot return to any normal or
reasonable employment is totally disabled; she need not be inert or completely
inactive. Id. “The key question is whether any employer in the ordinary course of
business would reasonably be expected to hire the worker in his or her current
physical condition.” Id. "

 MARLENE STEWART, Respondent vs. CLINT ZWIEFEL, TREASURER OF THE STATE OF MISSOURI AS CUSTODIAN OF THE SECOND INJURY FUND, Appellant
No. SD32827 )  FILED: February 10, 2014 

Thursday, February 6, 2014

No Judges, No Justice

The LHWCA covers claims for longshoremen and shipbuilding and repair workers.
Today's post comes from guest author Jay Causey, from Causey Law Firm.

Some months ago, I reported about a slowdown in the processing of claims under the Longshore and Harbor Workers’ Compensation Act and allied statutes.  The LHWCA was enacted in 1927, and through amendments over the years has been broadened to include injury and disease claims for longshoremen and shipbuilding and repair workers. Expansion of the program in 1941 resulted in the Defense Base Act, covering employees of military contractors working abroad. With our ten-year presence in Afghanistan and Iraq, a large cohort of injured workers has fallen under the DBA in recent years.
Underfunding of ALJ positions within the Department of Labor routinely results in long delays for the hearing and decision making in claims, often meaning claimants are without any coverage for years.
In another segment of its Breathless and Burdened report (subsequent to the one I recently posted about, concerning how black lung victims are routinely having their claims denied as a result of coal company-sponsored evaluations at Johns Hopkins), the Center for Public integrity has now reported on the extreme reduction of the number of administrative law judges within the US Department of Labor who hear and decide claims under the LHWCA and DBA. The center reports that the number of ALJ’s, nationwide, it has fallen to 35, from 41 earlier in 2013 and 53 a decade ago. This has occurred in the context of a 68% rise of new cases before the office of administrative law judges, and 134% increase in pending cases.
Underfunding of ALJ positions within the Department of Labor routinely results in long delays for the hearing and decision making in claims, often meaning claimants are without any coverage for years. Longshore and military contractor employers and their insurance companies, knowing that the adjudicative process in contested claims has become ridiculously long, are emboldened to sit on monies that are clearly owed to injured workers.  In addition to the injustice to entitled injured workers resulting from this administrative chaos, to the extent that an injured workers medical benefits and indemnity payments are pushed to other systems, such as Medicare, Social Security, and state disability systems, the costs of the Longshore system are shifted to the federal tax payer and away from the employers and their carriers who should appropriately bear the burden.
Read about the specifics of particular cases in the Center’s report here.

Photo credit: Markus Brinkmann / Foter.com / CC BY-SA

Tuesday, January 7, 2014

NJ Senate to Vote on S613 - Workers Compensation Cost of Living Benefit Increase

On Thursday, January 9, 2014, the NJ Senate is scheduled to vote on S613, which is proposed legislation to increase workers' compensation benefits by implementing a cost of living allowance for some beneficiaries.
On December 19, 2013 the following amendments were adopted by the NJ Senate:
These Senate amendments provide:
1. That the periodic cost of living supplement that the bill
provides to an individual for total permanent disability or survivor’s
benefits under workers’ compensation will be reduced by the original
amount of that individual’s periodic Social Security survivor’s or
retirement benefits, but not reduced by subsequent cost of living
increases in those Social Security benefits; and
2. That, in the case of an individual who initially received Social
Security disability benefits and later receives Social Security
retirement benefits, or who dies and has dependents who receive
Social Security survivors’ benefits, the workers’ compensation
supplement will then be reduced by the amount of the Social Security
retirement or survivor benefits, exclusive of any cost of living increase
in those Social Security retirement or survivor benefits
S613:
1/9/2014 1:00:00 PM Senate
1000 AM  Committees at the Call of the Senate President
200 PM  Voting Session
Senate Chambers

http://www.njleg.state.nj.us/bills/BillView.asp?BillNumber=S613

Saturday, December 28, 2013

Social Security - Administrative Law Judge Rulings

ALJ Disposition Data
FY 2014 (For Reporting Purposes: 09/28/2013 Through 11/29/2013)
A listing of hearings completion data by name of individual administrative law judges (ALJ) for all ALJs in ODAR. The data includes hearing office name, total dispositions, decisions, allowances, denials and fully favorable or partially favorable decisions.
Click here to down oad the data in PDF format.
Found on
Tembow….

Friday, December 13, 2013

No Legislation is Stiring: Jobless Fear Looming Cutoff of Benefits

The US House of representative has passed a budget excluding the extension of unemployment benefits. Today's post was shared by The New York Times and comes from www.nytimes.com


Mary Helen Gillespie of Londonderry, N.H., is about to lose her last government lifeline. Since being laid off from a large banking firm in April, Ms. Gillespie, 57, has been living on little more than her unemployment insurance payments of $384 a week. She has burned through her savings and moved back in with her parents.
“There are times where I’ll go two, three, four days where I only have five dollars in my wallet and no money in my checking account,” said Ms. Gillespie, who worked as a corporate compliance officer at her previous employer,choking up as she described the difficulty of finding a job, any job, after her second extended period of joblessness since 2007. “I’ve been making decisions such as: Do I buy groceries or do I buy prescriptions?”
Ms. Gillespie’s 26 weeks of state benefits ran out this month, but she remained eligible for the emergency federal unemployment-insurance program, which has provided as many as 73 additional weeks of checks in states with high jobless rates.
Until now. Unless Congress acts — suddenly and unexpectedly — that recession-era initiative will expire at the end of the month. About 1.3 million current beneficiaries will lose aid. Also affected are an estimated 1.9 million more who would have been eligible for the program in the first half of 2014 after their state benefits ran out.
Democrats in Congress are pushing for an extension, which would cost the...
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Monday, November 25, 2013

The Affordable Care Act, brought to you by ……… the Republicans!

Many might now welcome a Nixon ticket.
Today's post comes from guest author Jay Causey, from Causey Law Firm.

     Looking for information in the media that is supportive of the nation’s transition to the Affordable Care Act (ACA), aka “Obamacare?”  At the moment Republican and right wing noise is drowning out much of the lower–decibel cheerleading by the Administration on why this is a good thing.
In 1974, Pres. Richard Nixon proposed what is essentially the 2010 healthcare act – all but the smallest employers would provide medical insurance to their employees or pay a penalty, expansion of Medicaid would insure the poor, and subsidies would be provided to low–income citizens and small employers.
     In a recent op-ed piece, former Secretary of Labor under President Clinton and leading economic expert, now at the University of California, Berkeley, Robert Reich summed up the history of the origin of “Obamacare,” pointing out the irony of the right wing’s fuss over it.
     In 1974, Pres. Richard Nixon proposed what is essentially the 2010 healthcare act – all but the smallest employers would provide medical insurance to their employees or pay a penalty, expansion of Medicaid would insure the poor, and subsidies would be provided to low–income citizens and small employers. While private insurers liked this plan, Democrats favored a system more like Social Security and Medicare, so there was no consensus.
     Fast-forward to 1989, and the right–leaning Heritage Foundation proposed a plan that would mandate all households obtaining adequate insurance. This plan worked its way into several bills introduced by Republicans in 1993, supported by Senators Hatch (R–Utah) and Grassley (R–Iowa), along with subsequent Speaker of the House, Newt Gingrich, all now vocal opponents of the ACA.
     When in 2004 Massachusetts Gov. Mitt Romney made the original Nixon plan the law in his state, with the same mandate to buy private insurance, he said, “we got the idea of an individual mandate from Newt Gingrich, and he got it from the Heritage Foundation.”
     Health insurance companies, now retooling their policies around the individual mandate, are jubilant about the possibilities of long–term membership growth through the insurance exchanges. These giant corporations have traditionally supported conservative and Republican politics.
     So as Reich notes – – why are Republican spending so much energy trying to sabotage the ACA, and act they designed and about which a huge sector of their patrons are wildly enthusiastic? The answer: it is the singular achievement of the Obama Administration, the head of which is still considered by a large segment of the right to Illegitimately occupy the White House.
     Reich goes on to observe that had the Democrats prevailed on the idea of a system built on the Social Security and Medicare model – – cheaper, simpler, and more widely accepted by the citizenry – – Republicans would nevertheless be making the same noise.

Sunday, November 24, 2013

Social Security’s Job

The Social Security system is an "unfair" benefit distribution plan according to some authorities. Compounding this issue is the patchwork of workers' compensation system that all seem to apply different rules for setoff f benefits from lifetime benefits as well as COLA modifications. Choosing the "right" jurisdiction to file a workers' compensation total disability claim can make all the difference in the world for the amount of benefits an injured worker receives during his or her lifetime. Today's post was shared by Steven Greenhouse and comes from economix.blogs.nytimes.com

Ratio of Social Security benefits to Social Security taxes paid, by race or ethnicity and year.
Ratio of Social Security benefits to Social Security taxes paid, by race or ethnicity and year.
Source: The Urban InstituteRatio of Social Security benefits to Social Security taxes paid, by race or ethnicity and year.
Does Social Security need to be fixed?
As Democrats and Republicans grapple over how to reduce the government’s budget deficit in the face of rising costs for pensions and health care, whether Social Security should be touched remains one of the most controversial topics in American budgetary politics.
But something big is missing to the debate over the finances of what is still the largest component of the social safety net: an understanding of how well it does its job.
When you peek under the hood, it doesn’t always look so great. Indeed, this supposedly great redistributive program — which uses a broad tax on all workers to protect the elderly from poverty — exhibits some fairly stark regressive features.
One well-known regressive feature comes from the rule that benefits must be annuitized, paid out over time in monthly installments rather than as a lump sum. This means that richer people who tend to live longer will get a bigger benefit than poorer people with shorter life spans. Survivor benefits redistribute money from the singles — who don’t get the benefit — to the married, who do.
Eugene Steuerle, Karen Smith and Caleb Quakenbush of the Urban Institute in Washington just discovered another unsuspected regressive...
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Friday, November 1, 2013

Aging Activities: Managing someone else’s money

As America's workforce ages new concerns are emerging for the growing aging population. From time to time we will be focussing on Aging Activities and issues, by providing information and commentary. Today's post is shared from consumerfinance.gov

Millions of Americans are managing money or property for a loved one who is unable to pay bills or make financial decisions. This can be very overwhelming. But, it’s also a great opportunity to help someone you care about, and protect them from scams and fraud.
We are releasing four easy-to-understand booklets to help financial caregivers. The Managing Someone Else’s Money guides are for agents under powers of attorney, court-appointed guardians, trustees, and government fiduciaries (Social Security representative payees and VA fiduciaries.)
The guides help you to be a financial caregiver in three ways:
  • They walk you through your duties.
  • They tell you how to watch out for scams and financial exploitation, and what to do if your loved one is a victim.
  • They tell you where you can go for help.
You can also order free print copies (including bulk orders) online soon.
We’re working hard to empower older Americans to have a secure financial future. Sometimes family members, caregivers and others in the community must pitch in. We’re here to help you, too.
4 Comments » | Categories: Featured | Fraud | Older Americans | Scams
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Saturday, October 26, 2013

Most Americans accumulating debt faster than they’re saving for retirement - The Washington Post

Today's post was shared by Steven Greenhouse and comes from m.washingtonpost.com

A majority of Americans with 401(k)-type savings accounts are accumulating debt faster than they are setting aside money for retirement, further undermining the nation’s troubled system for old-age saving, a new report has found.
Three in five workers with defined contribution accounts are “debt savers,” according to the report released Thursday, meaning their increasing mortgages, credit card balances and installment loans are outpacing the amount of money they are able to save for retirement.
The imbalance is expanding even as policymakers are encouraging people to set aside more by offering generous tax breaks and automatically enrolling workers in retirement accounts that in some cases automatically escalate the amount of money over time.
Currently, workers with retirement savings accounts put aside more than 11 percent of their pay for retirement — 5 percent in their own accounts, and 6.2 percent in Social Security.
Despite that — and despite the $2.5 trillion the report says employers have poured into defined contribution accounts from 1992 to 2012 — the retirement readiness of most Americans has been slipping, according to the report by HelloWallet, a D.C. firm that offers technology-based financial advice to workers and conducts research of economic behavior.
Policy has tunnel vision. It tends to tackle problems on a piecemeal basis. The impact of policy on consumer finances is a bit like playing a game of...
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Thursday, October 24, 2013

“Lamestream Media” Enables Right-Wing Talking Points About Social Security Disability

Today's post comes from guest author Jay Causey, from Causey Law Firm.
By Jay Causey from Causey Law Firm
- - Screen Shot from Fair.org
     Just in time for a scheduled meeting of the Senate Committee on Governmental Affairs to discuss the status of the Social Security Disability program (SSDI) on October 7th, on Sunday, October 6, CBS’ popular “news” show, 60 Minutes, aired "Disability USA" - a sensationalized program full of misleading and largely anecdotal information designed to convince viewers the program is riddled with fraud and on the brink of collapse.  If you watched this program, and it is your sole source of information about Social Security Disability, you know essentially nothing about the actual operation of the program.  You heard not a single word from disability recipients, their advocates, or from officials who administer the program, none of whom were invited to participate in the 60 Minutes piece.
...the 60 Minutes segment focused on some fraud in the program in one impoverished area of the country in order to paint disability recipients generally as the undeserving poor, slackers and frauds.
     First, listening to the program you might not have understood that the average monthly benefit of about $1100 is not tax-payer money but earned credits for money paid into the system by the disabled worker.  Then, in terms of the “shocking” growth of the disability rolls you heard CBS’s Steve Kroft and Senator Tom Coburn, R-Oklahoma natter on about, you didn’t hear that the statistical growth of the program is a direct function of the increase in population over the past 30 years, the aging of the baby-boomer population into their higher disability years, the entry of women into the work force in greater numbers, and similar demographic factors.  Finally, you likely came away from the program thinking that qualifying for SSDI is a cakewalk, when the actual standards for disability result in denial of two-thirds of all applications, only 10% of those denials being reversed on appeal, and an overall figure of about 41% of applicants ultimately qualifying.
     Completely ignored in this puff-piece for the right wing (Coburn is the lead Republican on the Senate Subcommittee for Investigations and has a long-standing, well-documented hostility to Social Security) is the shifting of responsibility for disability from workers’ compensation systems, where it properly belongs, to the Social Security Disability program because of the rollbacks in coverage and benefits in states’ workers’ comp programs across the country, all driven by right-wing and corporate interests.  So, while SSDI faces potential exhaustion of its funds in the next few years (although this can be – and in the past has been – remedied by shifting funds from the Social Security old-age program), the liability insurance industry, which includes workers’ compensation carriers, is enjoying record profits over the last two years.
     Similarly unmentioned was the impact of the worst economy in decades, shrinking the ability of disabled workers to find less physically challenging work.
     As is typically the case with these types of “news” pieces, the 60 Minutes segment focused on some fraud in the program in one impoverished area of the country in order to paint disability recipients generally as the undeserving poor, slackers and frauds. CBS could have moderated the potential negative impact of its program by including interviews of SSA program officials or of spokespersons from some two dozen national disability advocacy organizations who asked to be heard on this show.  It shamefully chose to ignore all such requests, and has diminished itself accordingly as a news organization.

Tuesday, October 22, 2013

Let’s get rid of (the term) entitlements

Is Workers' Compensation thought to be an "entltlement?" Today's post was shared by Steven Greenhouse and comes from www.washingtonpost.com

Let’s drop the whole notion of “entitlement.” Just eliminate it. Politicians, pundits and academics who talk about entitlements would then have to name the actual programs and argue their merits and demerits. This would encourage clarity and candor. Of course, that’s why it won’t happen. Generally, Americans don’t want clarity and candor in their fiscal debates. We blame our leaders for budget brawls — this latest was a doozy — but forget that our leaders are largely governed by public opinion, which is awash in contradictions.
So the government is “open” and the immediate threat of default has lifted. Great. But the political stalemate remains. Americans oppose excessive government spending and persistent deficits. Yet they also support the individual benefit programs (a.k.a. “entitlements”), led by Social Security, that drive spending and deficits.
Until the 1980s, entitlement wasn’t part of everyday language. Ronald Reagan was apparently the first president to use the term extensively. He may have “tired of getting beaten up every time he mentioned Social Security, and wanted a broader and more neutral term,” political scientist Norman Ornstein has suggested. Entitlement is a bland label. To say there’s an “entitlement problem” shrewdly avoids connecting it explicitly with popular programs. President Obama evasively speaks of entitlements in this way; so do most...
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Friday, October 18, 2013

Labor puts Dems on notice: Don’t touch Medicare and Social Security benefits

Today's post was shared by Steven Greenhouse and comes from www.washingtonpost.com


With the crisis chatter in Washington now turning to speculation about the coming budget talks and the possibility of a “grand bargain” to replace the sequester, liberals and unions are getting increasingly nervous that Congressional Dems will give up entitlement benefits cuts in exchange for, well, whatever is on offer from Republicans, which isn’t at all clear.

In an interview, Damon Silvers, the policy director of the AFL-CIO, laid down a hard line, putting Dems on notice that any agreement that cuts entitlement benefits — even in a deal that includes GOP concessions on tax hikes — is a nonstarter. Silvers strongly suggested labor would withhold support in 2014 from any Dem lawmaker who supports such a deal.

“We are opposed to Social Security, Medicare, and Medicaid benefits cuts. Period,” Silvers told me. “There will be no cover for members of either party who vote for such a thing.”

Silvers said the AFL-CIO also opposes the entitlements cuts in the President’s budget, such as Chained CPI and a form of Medicare means testing. It’s unclear how, or whether, those will figure in what Dems bring to the table in the budget talks, which are mandated by the deal just reached to end the crisis.

“Chained CPI is like the vampire of American politics,” Silvers said. “It keeps being shot through the heart and it keeps reviving. The reason it keeps coming back is because it has...
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