A Resource for Seniors, Caregivers, and Advocates

The administration just released their proposed increase for payments to Medicare Advantage (MA), and it was much less than what was expected. This should be of great interest to many seniors since over half of us are enrolled in this type of Medicare plan. They proposed a rate increase of 0.09% for 2027, significantly lower than the 4 to 5% that the administration finalized for 2026. It’s important to put some context around this proposed rate. When you include the complicated risk-adjustment and coding change trends, the expected net increase that the MA plans will see is closer to 2.5% which, based on inflation and medical utilization trends, is still exceptionally low. It’s complicated but the administration has decided to alter their relationship with this popular approach to Medicare, and it might have a significant impact on those of us who have chosen MA to administer our healthcare. It could result in fewer benefits, higher premiums, or both.

Congress is poised to fund some programs that will impact many of us and it’s about time. I say that because we’ve been fighting for many of these programs to be implemented or extended for quite a while and they’ve often had bipartisan support, yet they kept putting them off until they were forced to act by a hard deadline. Not that a hard deadline has always forced them into action – remember the government shutdown. It’s too bad that this seems to be the only way that our lawmakers take action, but more about that later. Let’s get right into the good, the bad and the ugly of this pending legislation.

It’s 2026, which seems to be a year that is very far in the future and then I realize it’s now. How in the world did I get this old and this broken? In my mind I’m 40 years old but if I were 40 and woke up feeling this way, I’d call 911. When you get this old and feel this way most of us search for ways to feel better and stay active. The start of the new year is the usual time for resolutions, time to set goals, which usually require establishing new habits. I’ve noticed that many new year’s resolutions are centered on stopping bad habits like smoking, drinking, and laying immobile for long periods of time. There’s no doubt that stopping any one of these habits will pay huge dividends in terms of your health and even in the length of your life, but resolutions often entail starting a good habit. There’s the tough part of accomplishing your resolution, successfully establishing a good habit . . . because it’s difficult.

As I do each year, I went to the Consumer Electronic Show (CES) last week to see how technology is impacting healthcare and my overall impression was . . . the way we administer healthcare is changing – fast! Technology, which at past shows has shown promise and caused excitement, just didn’t seem quite ready for prime time. This year it seems to be maturing and is beginning to thrust itself into how we administer healthcare, whether we like it or not.

I first want to wish everyone a happy new year! I remember thinking about 2025 60  years ago, wondering if I would even be alive and wondering what life would be like. I had read an article in Popular Mechanics, one of my favorite magazines of my youth, about the possibility of flying cars early in this century, they missed a little on that one. I don’t remember reading anything about what healthcare might be like in 2026 but I’m pretty sure no one could have predicted the scientific breakthroughs and new medicines that would be discovered. I don’t think as a 16-year-old I even understood or cared, for that matter, how healthcare was administered or worried that in 2026 we would find ourselves concerned about how our healthcare is rapidly changing and wondering its future. Well, here we are, at the start of a new year, and it’s a good time to look back at what our concerns were in 2025 and see where we stand as we look forward to 2026.

As I sit down to write the last blog of 2025, I want to take the time to wish everyone a great 2026 and hope you all took the time this holiday season to be with your loved ones and to recharge your batteries for 2026. Here at Seniors Speak Out we will continue to keep you up to date on what’s happening with healthcare for older Americans. I talked about some of the changes that happened last year in my last blog and I’m going to try to look forward and talk about 2026 and what we can expect. Many very smart people have warned me that trying to predict the future of healthcare policy is a fool’s errand, but I think it’s part of my job to make predictions and I’m the perfect fool to give it a try.

Seniors Speak Out is deeply concerned by the recent announcement of the Medicare Part B and D demonstrations. If implemented, these demonstrations would put seniors at a disadvantage by importing a Most Favored Nation pricing model into their Medicare plans, threatening access to their everyday medications and undermining patient choice.

As this year comes to a close, we find ourselves getting ready for the holidays, after hopefully spending time with our families during Thanksgiving. We may even be looking forward to the new year, thinking of resolutions that we need to make. I’m a big fan of looking forward, a wise man once said, “you can’t plow a straight furrow if you’re looking behind you.” I also know that Patrick Henry said, in his “give me liberty or give me death” speech, “I have but one lamp by which my feet are guided, and that is the lamp of experience. I know of no way of judging the future but by the past.” So here I am trying to decide what the end of the year blog(s) should be focused on, and, since I’m a fan of compromise, I decided to stay true to both of these words of wisdom and do two blogs, one looking back to how our healthcare was changed in 2025 and one looking forward to what we might expect in 2026.

Lung Cancer Awareness Month is always in November so I’m a little late in bringing it to your attention, but I hope my tardiness won’t diminish the importance of focusing on this health issue because it’s especially important for older Americans. Lung cancer is the leading cause of cancer death, and it affects older people more than anyone else. 83% of lung cancer cases are diagnosed in people 65 and older with the average age being 70. That should immediately raise our interest level. There are reasons why older people are susceptible to lung cancer.

If you ask anyone about their experiences during the COVID pandemic, you’ll no doubt hear about people they knew who were very sick and even some who lost friends. You’ll hear about the quarantining, the loneliness, the lost chances to see their kids and grandkids. I’m not sure anyone will talk about anything positive that came out of that experience except, maybe one thing – the change in the rules that gave us the gift of expanding the use of telemedicine.

In the 25 years I’ve been involved in some part of healthcare, I’ve always understood that access is the most important part of care delivery. It doesn’t matter how good the medicine is or how good the surgery is or how good a medical device is if you don’t have access to it. Not having access can be because you can’t afford it, or it isn’t covered by your insurance, or it is delayed by administrative policies, or it hasn’t yet been discovered or there is a shortage. Most of my blogs have been dealing with one or more of these reasons for a shortage. We’re all accustomed to some popular items being temporarily “out of stock,” usually because of high demand that outpaced production, but this a fairly new phenomenon with generic drugs. While these shortages have been sporadic, they were a warning of a much more troubling problem that will continue to grow unless we find solutions.

I think that, for most of us, artificial intelligence (AI) has kind of moved into the category occupied by crypto currency, you hear about it all the time, but no one seems able to explain it in simple terms. While all I know about crypto currency is the fact that I should have bought a whole bunch of it 5 years ago, I have learned a little more about artificial intelligence as it applies to healthcare.

‍Last Tuesday Seniors Speak Out had our annual Facebook live event reviewing and discussing the Medicare Part D Satisfaction survey. Healthcare Leadership Council’s Medicare Today has been taking this survey every year since 2007 to gauge America’s senior’s satisfaction with Medicare and specifically Part D, Medicare’s prescription drug program. I was joined this year by Maria Ghazal, Healthcare Leadership Council’s President and CEO and Matt Monday from Morning Consult. You can watch the entire Facebook live event here.

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Each year, Healthcare Leadership Council’s Medicare Today sends a survey to a cross section of seniors to ask them how they feel about Medicare’s Prescription Drug program, Part D. Click here to read more about the 2025 survey. We average a response of over 1,000 seniors who give us their feedback to the basic questions we always ask about how the program is working, and also to some current relevant questions about how the implemented changes have, or the proposed changes will, impact(ed) Part D. For the past five years I’ve reported on the survey’s results and for most of those years we’ve also done a Facebook live event to discuss those results. We will continue that tradition by holding a Facebook live event on Tuesday, November 4th at 1:00 PM ET. You can click hereto take part in this event.

I get inundated with bulletins that talk about “hacks” that will make my life much easier. Secrets that are revealed by restaurant servers, flight attendants or cruise line insiders. They are actually helpful sometimes, if I take the time to wade through the long narrative, but often they’re just schemes to get you to keep clicking through the monologue. My blogs usually take about 4 minutes to read so I hope you’ll decide that it’s worth your time to find out about a Medicare Part D prescription drug “hack” that might make a real difference in your life.