En español | DES MOINES, IOWA – Affordable health care, the high cost of prescription drugs and how to pay for long-term care services dominated the discussion Monday in Des Moines at the first of five AARP presidential candidate forums across Iowa.
Former Vice President Joe Biden, Sen. Cory Booker (N.J.), former Colorado Gov. John Hickenlooper and Sen. Amy Klobuchar (Minn.) met separately with an audience of hundreds of AARP members to answer questions from the members and moderators from the Des Moines Register and Radio Iowa.
The forum at Drake University began just hours after Biden unveiled a comprehensive health reform proposal that would maintain the current insurance system, including the Affordable Care Act, but would add a public option. Also on Monday, Booker unveiled a policy that would increase the amount of assets Americans could keep and still qualify for federal assistance with long-term care costs. He said he would also expand the earned income tax credit to help cover family caregiving expenses.
“I’d give people the option,” Biden said of his health insurance plan. “If you like your employer-based plan, you can keep it. If you have private insurance, you can keep it.” Biden said creating a public option would be the “quickest and most rational way” to get 99.9 percent of Americans covered.
Coleen Kelleher, 69, a retired nurse from Windsor Heights, Iowa, told Biden her 49-year-old son has had diabetes since age 9. “I know the cost of his insulin has gone up exponentially,” she said. “I also take my own prescriptions, and the last time I picked up my prescription, my pharmacist told me that my cost is going to be much higher the next time I pick up,” even though she has Medicare Part D coverage. Kelleher asked Biden what he would do to reduce the costs of prescription drugs.
“There is no justification for raising the price of a drug once it’s been invented and patented,” Biden said, “no justification for raising the price above inflation.” Biden said under his plan if a pharmaceutical company increased the price of a drug more than the rate of inflation, that drug would not be covered by Medicare or Medicaid.
Kay Marcel, a 66-year-old retired special education teacher from Urbandale, Iowa, said she and her husband, Steve, both in their 60s, are the primary caregivers for their 40-year-old developmentally disabled son, Joel. “More and more parents, like me, are reaching an age where providing daily care for a son or daughter is increasingly difficult,” Marcel said. She asked Booker how he would improve access to quality long-term care.
“We have a system right now that’s unfair,” Booker said, one that “forces you to impoverish yourselves to allow you to qualify for many Medicaid benefits.” Booker said his plan to increase the amount of assets Americans could keep and still qualify for federal assistance would allow more middle-income Americans to afford long-term care at home or in a nursing home.
Several of the candidates also addressed the growing crisis surrounding Alzheimer’s and other dementias.
Ken Gregersen has been a caregiver since 2012, when his wife was diagnosed with Alzheimer’s. “I am one of the 16 million Americans that provide unpaid care for their loved one with Alzheimer’s or other forms of dementias. We incur substantial costs managing this disease,” he said. Gregersen, an 87-year-old retired advertising and public relations official from Ankeny, Iowa, asked Hickenlooper what he would do “to address Alzheimer’s as a public health crisis that will only get exponentially worse if not dealt with now.”
“There’s no clear miracle drug in the offing,” Hickenlooper said, calling the burden Alzheimer’s puts on families “almost unbearable.” One way to help families, he said, would be to create a national paid leave system that helps workers not only when they have a child or a serious illness, but also when an older adult needs help.
Protecting Medicare and Social Security
Cathy Wilkinson Barash, 69, who has multiple sclerosis, told Klobuchar that as a freelance writer and photographer she is heavily dependent on Social Security and Medicare. “I remember what it was like not to have health insurance and it’s very scary, especially with a disease with incredibly high drug costs,” Barash told Klobuchar. “What are you going to do to ensure Social Security and Medicare benefits continue for seniors?”
“Seniors know that Social Security and Medicare are your safety nets,” Klobuchar said. “I am devoted to keeping them strong, to not privatizing Social Security and to making sure we do everything to keep them solvent.” One way Klobuchar said she would attack the high costs of Medicare is by “unleashing the bargaining power” of Medicare and negotiating drug prices with pharmaceutical companies. “There are two PhRMA lobbyists for every member of Congress,” Klobuchar said. “They think they own Washington. Well, they don’t own me.”
All the candidates took on the question of the solvency of Social Security.
Social Security is primarily funded by the payroll taxes Americans pay. In 2019, employers and employees pay taxes on the first $133,000 of a worker’s income.
All four hopefuls said they think the way to maintain and strengthen Social Security is to address the current cap on the taxes Americans pay into the program.
Booker called the current system “a regressive tax that is hurting working-class Americans.” He would raise the tax cap so high-income Americans would pay Social Security taxes on more of their earnings, something he said would preserve the solvency of the program.
Hickenlooper said he would raise the cap but didn’t specify by how much. He also said he would “never support extending the retirement age,” and would support adding an additional retirement account on top of Social Security. Contributions to that account would be made equally by the employee, the employer and the federal government.
Both Klobuchar and Biden said they would leave the $133,000 cap as is but require wealthier Americans to resume paying Social Security taxes once their incomes hit a certain level. Klobuchar would have them start paying once their annual income reached $250,000. Biden would require such payment for people earning over $400,000 a year.
AARP is sponsoring this week’s forums along with the Des Moines Register as part of a voter engagement and education campaign. As AARP CEO Jo Ann Jenkins told the audience: “We do this because we know that voters over the age of 50 are the most reliable and powerful voting bloc in the country.”