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Efforts are quietly underway to lay the groundwork for a far-reaching fiscal deal that involves Social Security cost-of-living adjustments and Medicare benefits. White House officials and Senate Republicans have met in a series of private sessions in recent months. In his fiscal year 2014 budget, President Obama proposed reducing the growth in COLAs as well as raising Medicare premiums, reducing benefits of higher income seniors and increasing the Medicare eligibility age. Everything is still on the table, the pressure point being the debt limit. The government is expected to hit the debt limit ceiling the statutory borrowing limit - sometime this fall..In addition, the Senate sometimes holds pro-forma sessions during recess periods to prevent the president from making recess appointments. This is apparently why the Senate remains in the pro-forma session since the House is also out of session. The Senate has the Constitutional responsibility to confirm certain appointments of the President but President Trump has made many appointments at other times when the Senate has been in recess and there are many "acting" secretaries, assistant secretaries and other officials of various departments and agencies serving without Senate confirmation..If your mother enters the nursing home, you can ask the nursing home to submit a "demand bill" to Medicare. When that is rejected, then you can appeal and get a shot at overturning the decision..Petition to Congress: No Budget Deal that Sells Out America's Seniors.Seventy-eight percent of participants in TSCL's 2019 Senior Survey think Congress should establish an out-of-pocket spending cap. In December of last year, prescription drug legislation, H.R.3, the Elijah Cummings Lower Drug Costs Now Act was passed by the House. In addition to allowing Medicare to negotiate drug costs, the House bill would cap Part D's annual out - of - pocket costs for prescription drugs, starting at ,000 per year..Recently a journalist, familiar with my estimates of cost-of-living adjustments, contacted me for my thoughts on the topic. Did I think we were staring down rising inflation? I told him that I needed to see more data..Nearly two-thirds of the spending on prescription drugs by older Americans is for out-of-pocket costs that include deductibles, co-pays and co-insurance. Since the start of Medicare Part D in 2006, out-of-pocket costs grew 188% or roughly 16% per year by the end of 2017, far exceeding the growth in Social Security benefits, that averaged just 1.9% per year over the same period..The task for the Administration is to figure out how to ensure patients don't unknowingly sign away their new protections, monitor and punish providers who violate the ban, and establish a process for settling disputes, among other complicated considerations. The ban is due to take effect in January..COLA cuts: The White House proposes switching to the more slowly - growing measure of inflation, the chained consumer price index, to calculate annual COLAs. The proposal has bipartisan support in Congress. According to the Congressional Budget Office, it would cut spending on Social Security about 7 billion over the next ten years and bring in roughly 4 billion in higher taxes. To learn how the proposal would impact your benefits, try TSCL's Chained COLA calculator.