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“If anyone here tries to cut Social Security or Medicare… I will stop them!”

President Joe Biden, 2024 State of the Union Address,

March 7, 2024

(This is a reprint from PSARA’s April 2024 Advocate)

By Jeff Johnson

Jeff Johnson.jpg

Jeff Johnson and Floyd

Since 2021, PSARA has launched a  full-court press against attacks on Traditional Medicare and now against House Speaker Mike Johnson’s Fiscal Commission to undermine the health and retirement income security of seniors.  


“Over the past several years there has been a gold rush to privatize Medicare…. If we don’t ‘level the playing field’ between Traditional Medicare and privatized Medicare, healthcare decisions for seniors will be completely at the mercy of corporations…by the end of the decade.” (Congresswoman Pramila Jayapal, from the forward to Give Us a Real Choice! Level the Playing Field Between Traditional Medicare and Medicare Advantage, PSARA 2024). 


Congresswoman Jayapal’s warning and President Biden’s declaration could not have come at a more important moment in history for protecting and strengthening the quality of life for seniors.


As the leader of the Democratic party, we need President Biden to do everything he can, and by all means necessary, to provide seniors with a level playing field, a fair choice, in choosing between Traditional Medicare and Medicare Advantage/ACO REACH for their healthcare needs.  


Traditional Medicare is a legacy democratic issue that is being systemically dismantled by private industry.  If Trump and MAGA Republicans prevail at the ballot box in November, Traditional Medicare and Social Security as we know it will end. And so too will an important part of our democratic and social justice legacy.


To level the playing field, President Biden needs to lead the effort to jettison the need for Medigap insurance policies (which were part of a historically racist policy to keep as many Black people out of the doctors’ offices and hospitals that primarily served white people); place a cap on out-of-pocket expenditures; equalize the benefits between Traditional Medicare and Medicare Advantage (e.g., hearing, dental, vision, transportation, home visits, etc.); and put an end to the overpayments to private industry for managing Medicare claims, and the fraudulent practices private industry uses to bilk the Medicare Trust Fund out of tens of billions of dollars a year. Returning this money to the Medicare Trust Fund will pay for leveling the playing field.

How is President Biden supposed to do this?


  • Direct the Centers for Medicare & Medicaid Services to incentivize Traditional Medicare; create pilot programs with cost parity for beneficiaries choosing Traditional Medicare Plans; claw back overpayments to, and fraudulent charges from Medicare Advantage and ACO REACH Programs; and put an end to fraudulent charges going forward.

  • Lead on legislative and budgetary proposals.

  • Use the power of executive orders where possible, in the face of Congressional resistance.

  • Use the courts where necessary (Equal Protection Clause, e.g.).

  • Educate the public through a concerted and strategic communications and organizing campaign.


What can PSARA members and allies do?

PSARA has drafted a letter to President Biden as well as a Resolution that outlines the need for and the consequences of not “Leveling the Playing Field” between Traditional Medicare and privatized Medicare. We are asking leaders and organizations to sign on to the letter with PSARA as well as to pass the resolution, in the case of organizations. We hope to demonstrate to President Biden the need for, and urgency of, creating a fair choice for seniors over their health care and the quality of their lives.


We hope you will sign on to the letter. We hope you will also take the letter and resolution to organizations that you belong to and community leaders that you know for their endorsements. This is a national effort, so please reach out to relatives, friends, and organizations across the country.  


PSARA has also published a Medicare primer on making the case for “Leveling the Playing Field.” The primer, the letter to President Biden, and the Resolution can all be found on the PSARA website at  


In this hyper-political environment we find ourselves in, Democrats need basic issues that will unite the majority of voters. Fulfilling the original promise of Medicare – to provide the health care seniors need when they most need it – is one of those fundamental issues.


Jeff Johnson is Co-President of PSARA and a retired President of the WashingtonState Labor Council.

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