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Low-income "dual-eligibles" - Medicare beneficiaries whose incomes are so low that they are also eligible for Medicaid. Part B premiums are paid on their behalf by state Medicaid programs..Therefore, they are considering using the "reconciliation" process because they would only need 51 votes. But if they do that, legislation passed over ten years ago dictates that they must either raise taxes or cut spending on current programs to pay for the new spending in the President's bill..Legislation to lower prescription drug prices is a top priority of TSCL's this year and we continue to monitor things very closely and work to pass legislation that will lower drug prices in a substantial way..In addition, since 1992 there has been a significant change to the government's bottom line. For the government fiscal year ending September 30, 2000, the Congressional Budget Office reported a surplus of 6 billion- billion of which comes from non Social Security revenues. The CBO estimates the 10-year non-Social Security surplus to be about .1 trillion..Last year, more than one-fourth of participants in TSCL's Senior Survey reported that they had received a "surprise" medical bill in the past 12 months. While surprise medical bills can refer to any number of situations, including a sudden cost increase for prescriptions, recent legislation passed in December of 2020 addresses a certain type. Specifically, medical bills that a patient unexpectedly receives when treated by an out-of-network provider at an in-network facility..TSCL's review of the Totalization Agreement and related documents raises a number of significant questions. For example, no new estimates of the cost of the agreement to the Social Security Trust Fund were released to TSCL..Reduces the costs of your drugs..The CBO estimated that, the American Health Care Act, introduced in March, would cut federal spending on Medicaid by nearly 0 billion over the 2017 2026 period. The CBO estimated that, by 2026, Medicaid spending would be about 25 percent less than projected under current law, yet Medicaid spending growth would exceed the rate of growth of the inflation adjustment. "With costs growing faster than reimbursements, states would have to come up with the money in some other way or be forced to cut services, restrict eligibility for enrollment or otherwise ration care," says Johnson.".[1] Combined Old-Age, Survivors, and Disability Insurance Trust Funds February 2014 Baseline, Congressional Budget Office.