With the number of Americans over age 65 set to nearly double over the next 40 years, we must preserve and enhance the health care and retirement programs our seniors depend on while also helping families prepare for the caregiving demands of an aging population.
For generations, Social Security has been a stable and secure retirement guarantee for all Americans. We must ensure this program both fulfills its purpose of offering stability to seniors and remains solvent for generations to come.
We also need to protect seniors’ access to high-quality health care—everything from preventative care to affordable prescription drugs—through the Medicare program. In 2022, key provisions based on legislation I led for years,–the Empowering Medicare Seniors to Negotiate Lower Drug Prices Act –were signed into law, lifting the 20-year ban that stopped Medicare from negotiating prices with drug companies on behalf of 50 million seniors. As a result of this new law, Medicare has started the negotiation process for ten of the most costly drugs to Medicare, and people will start seeing savings in a few years. Medicare will continue to lower prescription drug costs for seniors by negotiating the price of additional prescription drugs every year. The negotiated cost savings from these initial ten blockbuster drugs alone will be significant–up to 9 million seniors paid $3.4 billion in 2022 just in out-of-pocket costs for these drugs.
The law will also cap the amount seniors with Medicare Part D can pay for prescription drugs to $2,000 a year. In addition, the out-of-pocket cost of insulin for Medicare patients living with diabetes is now capped at $35 per month and recommended vaccines for shingles and pneumonia are now free with no out-of-pocket cost.
I will also keep fighting to expand Medicare coverage of hearing, vision, and dental care.
In addition, as the population of seniors increases, the need for elder care will also grow. Over 70 percent of adults who survive to age 65 will develop substantial long term care service needs as they grow older. With this, a new generation of family members will assume the role of caregivers for their parents by tending to increasingly complicated health and long-term care needs. Seniors and their adult children must have the resources they need to prepare for this care, including education about the types of services available, how to access these programs, and safeguards to prevent and address abuse or exploitation.
I will continue to work to preserve and enhance the programs, services, and protections that are vital for our seniors, their families, and caregivers.
As Minnesota’s U.S. senator, I will continue to focus on these priorities:
- Protecting and strengthening Social Security. Since President Franklin Roosevelt signed the Social Security Act into law in 1935, Social Security has touched the lives of almost every American. The program serves as a foundation for millions of retired Americans and provides vital support for Americans living with disabilities and the surviving spouses and children of deceased workers. American seniors depend on Social Security as a safety net. Social Security is credited with keeping nearly 38 percent of senior citizens in America out of poverty. More than one-fifth of all seniors rely on Social Security for at least 90 percent of their income. For roughly half of seniors, Social Security makes up at least 50 percent of their income. I will continue to fight against risky schemes that would privatize Social Security and turn it from a guarantee of a secure retirement into a gamble where only the big financial companies on Wall Street would be the sure winners. If these schemes had been in place during previous years, millions of Americans would have lost their Social Security in the stock market. I will also continue to push for sensible reforms that would extend the solvency of Social Security for future generations.
- Protecting and Strengthening Medicare and Medicaid. Medicare and Medicaid are critically important programs for providing health insurance coverage and access to care for seniors in Minnesota and across our country, and I will work to protect and expand these programs to help keep people well. Medicare serves as a health insurance program for nearly 66 million seniors and helps ensure this population has access to hospital and physician visits as needed as well as prescription drugs and other care services. Medicaid provides health coverage to over 7 million low-income seniors and continues to serve as the most important source of funding for nursing home and long-term care.
- Lowering prescription drug prices.
As mentioned above, in August 2022, provisions based on legislation I led for years, the Empowering Medicare Seniors to Negotiate Lower Drug Prices Act, were signed into law, lifting the 20-year ban that stopped Medicare from negotiating prices with drug companies on behalf of 50 million seniors. As a result of this new law, Medicare has started the negotiation process for ten of the most costly drugs to Medicare, and people will start seeing savings in a few years. Medicare will continue to lower prescription drug costs for seniors by negotiating the price of additional prescription drugs every year.
The first drugs that will have lower prices negotiated on behalf of consumers are: Eliquis, Xarelto, Jardiance, Januvia, Farxiga, Entresto, Enbrel, Imbruvica, Stelara, and Fiasp and NovoLog insulin products.
Importantly, this law also stops companies from raising drug prices faster than the rate of inflation. Additionally, the law will cap the total amount seniors with Medicare Part D must pay out-of-pocket for all their prescription drugs to no more than $2,000 a year. Once this $2,000 limit on seniors’ total out-of-pocket costs takes effect, it is projected to save 234,000 Minnesota seniors an average of $480 per year. In addition, the out-of-pocket cost of insulin for Medicare patients living with diabetes is now capped at $35 per month. Finally, vaccines like shingles and pneumonia will be available for free, with no out-of-pocket costs.
Because I believe that increasing competition is another critical way to reduce drug prices, I joined a bipartisan group of senators in introducing the CREATES Act, which became law in 2019, to end tactics that many brand name companies used to prevent generic manufacturers from seeking approval for their products—such as denying access to brand drug samples.
- I will continue fighting for lower drug prices. In addition to allowing Medicare to negotiate drug prices, we must strengthen efforts to stop pharmaceutical companies from blocking competition on the market that would drive down prices and increase innovation. My bipartisan bills would stop anti-competitive tactics used by powerful drug companies to block cost-saving generics and other alternatives and allow personal importation of safe drugs from Canada. I also introduced the Strengthening Medicare and Reducing Taxpayer (SMART) Prices Act which would increase the negotiated savings to American families and taxpayers and double the number of drugs and biologics that HHS must negotiate each year.
- Assisting families in providing care for seniors.
More than half of older Americans are projected to need long-term care, services and supports at some point in their lives. Seniors want to stay in their own homes and live independently as long as possible. Family caregiving support is essential to making that option available. While nursing homes and paid care providers serve our elderly in some situations, the vast majority of elder care comes from informal caregivers – such as spouses, or adult children taking care of their parents. Additionally, informal caregiving does not end when a person transitions from the community to residential care. Millions of families already find themselves members of the “sandwich generation,” coping with the challenges and costs of caring for elderly parents at the same time they are caring for their own children. As the Baby Boomer generation ages, both their needs for and roles as spousal caregivers grow. My bill, the Americans Giving Care to Elders (AGE) Act, would provide caregivers with a tax credit for up to $6,000 for the eldercare expenses incurred for their aging relative. I also introduced the bipartisan Alzheimer’s Caregiver Support Act with Senator Collins, which would expand training and support services for families and caregivers of patients with Alzheimer’s and related dementias.
I continue to oppose efforts to cap Medicaid spending that would jeopardize long-term care for all seniors. We must also ensure that seniors are protected from fraud and abuse in nursing homes and assisted living facilities.
- Helping Americans save for retirement. Hardworking families in America often don’t have enough money in their savings account for an emergency—let alone retirement down the road. Estimates have shown that four in ten adults do not have enough liquid savings to meet a $400 emergency expense. At the same time, nearly half of American workers lack access to workplace retirement plans. The lack of retirement savings particularly affects Americans in the sole proprietor and “gig economy,” about five in six of whom do not have access to a workplace retirement plan. That’s why I supported the bipartisan SECURE Act which became law in 2019 and the bipartisan SECURE 2.0 Act which became law in 2022. These laws encourage small businesses to set up retirement plans for workers, allow many part-time workers to participate in employer-based retirement plans, extend the age for required minimum distributions from 70 ½ to 73 (and 75 in 2033), increase allowable catch-up contributions, allow employers to match student loan payments with retirement contributions, encourage emergency savings, and make other changes in the tax code to make saving for retirement easier. I also introduced the Saving for the Future Act with Senator Chris Coons, which would create innovative, portable personal savings accounts called Up Accounts that can be used for retirement and emergencies by establishing a minimum employer contribution to a savings plan. We need to close the wealth gap, allow families more room to save in case of an emergency, and set workers up for a successful retirement. By doing so, we can help guarantee that all Americans – even those working part-time or as freelancers – have some savings put away for retirement and emergency situations.
- Strengthening oversight of people who work with seniors and court-appointed guardians. As the population of seniors continues to grow in Minnesota, the need for strong protection from abuse for our elders becomes more critical each year. Vulnerable seniors can be victimized, even by the people who are supposed to be caring for them. Most people who work or care for seniors adhere to ethical standards that ensure the safety and well-being of their loved ones or clients. Unfortunately, this is not always the case, leaving older adults abused and financially exploited by court-appointed guardians and conservators – the very individuals charged with protecting their well-being. That’s why I authored the Court-Appointed Guardian Accountability and Senior Protection Act, which was signed into law as part of the Elder Abuse Prevention and Prosecution Act in 2017. My legislation strengthened oversight and accountability for court-appointed guardians and conservators to crack down on elder abuse. We owe it to our seniors to ensure that they are not endangered – physically, emotionally, or financially – by those responsible for their care.
- Protecting seniors from identity theft and other financial scams. Identity thieves often target seniors, invading their privacy and exploiting them financially. In 2020, more than 1 in 4 older adults, age 55 and older, reported being a victim of identity theft. Today, perpetrators of fraud have found new ways to alter their identities to steal the personal and financial information of innocent victims. These crimes have become more profitable in recent years and telemarketing fraud has grown to a $40 billion industry. As Hennepin County Attorney, I made a priority of prosecuting cases of financial fraud against seniors. More recently, my bipartisan bill with Senator Susan Collins of Maines, the Seniors Fraud Prevention Act, was signed into law in 2022. The new law provides protection to seniors from fraud schemes by ensuring complaints of fraud are quickly forwarded to the appropriate law enforcement agencies. Now, the Federal Trade Commission is required to distribute informational materials to seniors, and their families and caregivers, that explain the process for contacting law enforcement authorities in the event that a senior is targeted in a fraud scheme.
As Minnesota’s U.S. senator, I have been standing up for older Americans:
- Preserving and strengthening Medicare and Medicaid.
I have long fought to protect Medicare against attempts to cut benefits or undermine the security of the program. Likewise, I have opposed efforts to privatize or cap Medicaid spending, which would jeopardize long-term care for all seniors.
Minnesota has always led the way in providing low-cost, high-quality health care. I co-authored legislation creating a “value index” for Medicare reimbursement rates that was included in the Affordable Care Act. Since 2015, the value index has helped control costs by rewarding high-value care instead of volume. This value index has helped ensure that Minnesota and other states that deliver high-quality, efficient care are rewarded, not punished. It has also contributed to preserving the solvency of Medicare so we can continue to care for our seniors.
- Closing the Medicare Part D donut hole. The Affordable Care Act included provisions to reduce prescription drug costs for seniors through rebates and close the “donut hole” gap in Medicare Part D drug coverage over time. No longer do the 50 million seniors enrolled in Medicare Part D prescription drug coverage face the prospect of paying higher out-of-pocket costs for the same drugs they paid less for earlier in the year.
- Boosting competition to drive down prescription drug prices. I have fought to make sure competition, not unfair conduct, determines the price of prescription drugs. With Senator Chuck Grassley of Iowa, I have introduced bipartisan legislation, the Preserve Access to Affordable Generics and Biosimilars to end the so-called “pay-for-delay” practice of brand-name drug manufacturers paying off their less expensive generic competitors to stay out of the market. Additionally, my bill with Senator Grassley, the Stop STALLING Act, would go after sham citizens petitions that prevent competing medicines from entering the market. Additionally, legislation that I introduced with a bipartisan group of senators, the CREATES Act, to end tactics some brand-name drug companies use to prevent generic manufacturers from being able to receive approval for their products, like denying access to samples, became law in 2019.
- Allowing the importation of legally prescribed prescription medicines from Canada. For years I have led the Safe and Affordable Drugs from Canada Act with Senator Chuck Grassley of Iowa to allow people to import certain prescription drugs for personal use from certified Canadian pharmacies. I also introduced a bill with Senator Mike Lee of Utah that would allow temporary importation of drugs from countries with strong safety standards—like Australia and those in the European Union—when there is limited competition or a drug shortage in the United States. In 2017, I put forward an amendment with Senator Bernie Sanders of Vermont to allow for the importation of prescription drugs from Canada during the consideration of a budget resolution.
- Reducing drug waste that costs taxpayers millions of dollars. When I asked the U.S. Department of Health and Human Services Office of Inspector General to investigate the waste generated by the size of single-use medicine vials, the Inspector General found that Medicare was wasting hundreds of millions of dollars on medicine that get thrown out because the single-use vial sizes were often bigger than the dose a patient needed. To stop this wasteful spending, I introduced bipartisan legislation with Senator Chuck Grassley of Iowa to prevent paying for left-over medicine amounts that could not be used. Our Reducing Drug Waste Act was signed into law in 2018, requiring a Joint Action Plan to reduce drug waste and better manage costs with respect to single-use drug vials and other drug delivery systems like eye drops. Drugmakers are now required to pay quarterly rebates to Medicare based on the amount of discarded volume or waste from single-use drug vials.
- Improving access to vital drugs, treatments, and medical equipment.
In 2012 I authored and Congress passed into law the first bill to prevent and mitigate drug shortages, my bipartisan Preserving Access to Life-Saving Medications Act that requires prescription drug manufacturers to give early notification to the Food and Drug Administration (FDA) of any supply situation or manufacturing incident that would likely result in a shortage. Early notification helped the FDA prevent 222 drug shortages in 2022. Although the number of new drug shortages has declined over the last ten years in part as a result of my 2012 law, shortages continue to pose a real challenge to health providers and patients.
That’s why I worked across the aisle again to author and pass out of committee with strong bipartisan support this past July 2023, a new bill, the Drug Shortage Prevention Act, that would require drugmakers to report to the FDA any circumstances, including projected increases in demand, that may lead to a shortage of prescription or over-the-counter medications. My bill also requires drugmakers to report to the FDA the suppliers of their active ingredients in order to build more resilience into the supply chain for our medications.
- Increasing research funding to seek new cures for diseases and tackle Alzheimer’s and ALS.
I have consistently fought for strong funding for research at our federal research agencies, including the National Institutes of Health (NIH). With my support, the NIH received a $2.5 billion increase in funding for 2023, which was the eighth straight annual funding increase. I supported the 21st Century CURES Act—and was there when President Obama signed it into law in 2016—which funded nearly $5 billion for NIH research into cures for Alzheimer’s, cancer, and other diseases. Over the past seven years, Congress has increased funding for the NIH by 51 percent. During that time we have also quintupled funding for Alzheimer’s and related dementia research from $631 million to $3.5 billion. I’m also proud that I supported the 2022 launch of the Advanced Research Projects for Health (ARPA-H) to provide a pathway for creating transformative health breakthroughs for diseases like ALS (Lou Gehrig’s Disease) that cannot readily be accomplished through traditional research or commercial activity.
Additionally, in 2021 I was proud to support the Accelerating Access to Critical Therapies (ACT) for ALS Act that was signed into law. This bill creates grant programs to expand investigational treatment options for ALS (Lou Gehrig’s disease) patients. This followed the successful enactment in 2020 of a bill I supported, the ALS Disability Insurance Access Act that eliminated the five-month waiting period before ALS patients could access Social Security Disability Insurance (SSDI) benefits.
I also introduced the bipartisan Steve Gleason Act of 2017—which was signed into law as part of the Bipartisan Budget Act in 2018—to ensure Medicare pays for speech-generating devices for people with ALS, Parkinson’s, and other degenerative diseases. Speech-generating devices are a lifeline for these patients, but a Medicare policy change had put coverage at risk.
- Providing support for seniors who want to stay in their homes and communities. When elderly Americans choose to remain in their own homes and communities, it is not only often better for their health and peace of mind but is also a more cost-effective option. I have introduced and cosponsored multiple bipartisan bills to improve the quality of life for seniors and encourage the use of remote monitoring technology and telehealth services in Medicare and other programs. These bills include the CHRONIC Care Act—which expanded the use of telehealth and was signed into law in 2018—the Fostering Independence Through Technology (FITT) Act, the Independence at Home Act, and the CONNECT for Health Act. I have also cosponsored several bills to preserve and expand access to telehealth and care in rural areas, like the Rural Emergency Acute Care Hospital (REACH) Act, the Critical Access Hospital Relief Act, the Protecting Access to Rural Therapy Services Act, and the Rural Health Connectivity Act. My bipartisan bill with Senator Shelley Moore Capito of West Virginia, the Improving Access to Cardiac and Pulmonary Rehabilitation Act, was signed into law in 2018 and is expanding access to care by allowing physician assistants, nurse practitioners, and clinical nurse specialists to supervise cardiac, intensive cardiac, and pulmonary rehabilitation programs. More recently, I introduced the Americans Giving Care to Elders Act, which would establish a tax credit to assist with the costs of caring for an aging family member.
- Protecting access to pensions. A stable and secure retirement depends on protecting the hard-earned benefits of workers throughout their careers. That’s why I strongly supported the Butch Lewis Act to address the pension crisis threatening the retirement of workers and retirees nationwide by putting pension plans back on solid footing and ensuring that the plans can meet their obligations to retirees and workers for years to come. This important fix was signed into law in 2021 and protects hard-earned pensions for thousands of Minnesotans.
- Providing support for seniors and their families. I introduced the Americans Giving Care to Elders Act, which would establish a federal tax credit to assist with the costs of caring for an aging family member. I also introduced the Alzheimer’s Caregiver Support Act with Senator Susan Collins from Maine, which would expand training and support services for families and caregivers of patients with Alzheimer’s and related dementias. In addition, I introduced a bipartisan bill with Senator Chuck Grassley of Iowa that was signed into law in 2018 called Kevin and Avonte’s Law, to help families locate missing loved ones with developmental disabilities, Alzheimer’s or other forms of dementia, and to provide training and technology to first responders and law enforcement to help them find these vulnerable family members. Our bill reauthorizing Kevin and Avonte’s Law was passed in 2022. I also introduced the Alzheimer’s Caregiver Support Act, a bipartisan bill to expand training and support services for families and caregivers of patients with Alzheimer’s to help keep loved ones with Alzheimer’s and related dementias in their homes longer.
- Protecting seniors from abuse, neglect, and exploitation. I authored the Court-Appointed Guardian Accountability and Senior Protection Act, which was signed into law as part of the Elder Abuse Prevention and Prosecution Act in 2017. My legislation strengthens oversight and accountability for court-appointed guardians and conservators to crack down on elder abuse. I supported the Elder Justice Act, passed in 2010, which established the Elder Justice Program to prevent the abuse, neglect, and exploitation of the elderly by providing grants to states to properly train and certify employees at long-term care facilities. I also supported the Patient Safety and Abuse Prevention Act to improve authorities' ability to conduct criminal background checks on long-term care workers. In addition, I have led efforts pressing for actions by the Department of Health and Human Services and the Government Accountability Office to prevent and more effectively respond to elder abuse in nursing homes and assisted-living facilities, including by keeping families and guardians better informed about incidents and investigations.
- Protecting seniors from fraud. I introduced the Seniors Fraud Prevention Act with Senator Susan Collins of Maine, which was signed into law in 2022. The new law provides protection to seniors from fraud schemes by establishing an effective complaint system that ensures complaints of fraud are quickly forwarded to the appropriate law enforcement agencies. It also will help the Federal Trade Commission monitor the market for mail, TV, internet, and robocall fraud targeting seniors. Now the FTC is required to distribute informational materials to seniors, their families, and caregivers, that explain the process for contacting law enforcement authorities in the event that a senior is targeted in a fraud scheme. In addition, when there was an increase in scams related to the pandemic, I joined with Senator Jerry Moran of Kansas and 32 of our colleagues in urging the FTC to take action to help educate and inform seniors about avoiding scams and those trying to financially exploit.
- Protecting Low-Income Seniors From High Home Energy Costs. I will continue fighting to ensure that no one has to choose between heating or cooling their home and other basic necessities. The Low Income Home Energy Assistance Program (LIHEAP) is an extremely important program in a state like Minnesota that experiences bitterly cold temperatures and lengthy winters. That’s why I worked to include additional funding for LIHEAP in two bills which became law in 2022.