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Documents and Presentations on the Privatization of Medicare and Documented Issues with Medicare Advantage and AOC Reach Resources: Don’t Privatize Medicare, Level the playing Field Below are additional resources to help you better understand the issue and hopefully join PSARA in taking action to protect Medicare. PS ARA Webinars/Presentations: Is Medicare Advantage Driving Your Providers to Despair? And Why You Should Care . Insurance companies may be forcing your doctor into a crises of conscience, learn more through this Webinar. "Fear & Loathing on the Way to Levelingthe Playing Field” Five National experts discuss PSARA’s strategy to Level the Medicare Playing field. " Is Medicare Advantage Preying on People of Color ” PSARA’s December 4, 2023 Webinar Featuring Dr. Claudia Fegan " Stop Raiding Medicare" Rally Aug 1, 2023 Highlights video "Pirates of the Medicar ibbean ” Slides presented by PSARA members Rick Timmons and Ellen Menshew "Pulling back the Curtain: Lies, Fraud, and Naked Profiteering in Medicare Privatization Schemes. ” Presented by Wendell Potter, Mr. Potter was previously an executive in the healthcare industry. He brings a unique perspective to the overall healthcare debate and the attempted privatization of Medicare. Mr. Potter is currently the President of the Center for Health and Democracy and also a Co-founder of Business Leaders for Health Care Transformation. Dr. Ed Weisbart is the Chair of the Missouri Physicians for a National Health Program. Dr. Weisbart has done three Webinars for PSARA: "Defending Medicare from ACO Reach" " Don’t Let Naked Profiteering Destroy Our Medicare" "We Can Reclaim Medicare From Greedy Profiteers ” presented September 13, 2023 Testimonials /Letters , personal stories and letters concerning Medicare Advantage delay and denial of care: PSARA member's letter to the Senate Finance Committee (Statementsfortherecord@finance.senate.gov ) Gary: Gary had emergency brain surgery. His doctors had a recovery plan. That plan never happened. Watch the video to learn why. Jacob: Too many families, like Jacob’s, are suffering from the predatory management tactics of Medicare Advantage insurers. PSARA is proud to have the support from the Be A Hero campaign to share these personal stories. We must never stop fighting to end the profiteering from these corporate predators. Please join us in this fight to “LEVEL THE PLAYING FIELD”. Protect and expand Medicare! Rick Timmons: PSARA member Rick Timmons talks about how a slow approval process and delay in being able to schedule a surgery put his life at risk and significantly complicated his recovery from cancer. More information from other organizations: National Public Radio (NPR): Older Americans say they feel trapped in Medicare Advantage plans Bloomberg Law: UnitedHealthcare Accused of AI Use to Wrongfully Deny Claims (1) “UnitedHealth pushed employees to follow an algorithm to cut off Medicare patients’ rehab care” by Casey Ross and Bob Herman (Nov. 14, 2023). Link is a summary by Center for Medicare Advocacy "Level the Playing Field Between Medicare and Medicare Advantage ” talking points "2023 Convention of the Washington State Labor Council, AFL-CIO. Resolutions #2023.01” Washington State Labor Council passed this resolution on July 20, 2023. The resolution calls out the existential threat to Medicare as a public program that is coming from the privatized Medicare Advantage plans and ACO REACH – a threat that has intensified under the Biden Administration. The resolution calls for leveling the playing field between Medicare Advantage and regular Medicare as well as stopping the overpayments to Medicare Advantage companies and recouping the overpayments already made due to fraud by Medicare Advantage insurance companies. This is an excellent resolution for groups to adopt to communicate to their members and representatives their position on this issue. "Hospitals dropping Medicare Advantage because of Concerns with patient care " 8/16/23 by Diane Archer, Just Care "Grand Theft Medicare " 8/21/22 by Dick Conoboy, NW Citizen "The Stealth Plan to Privatize Medicare for All ", 8/24/22 by Rick Staggenborg, Counterpunch Physicians for a National Health Program resources on DCE/ACO REACH: https://pnhp.org/direct-contracting-entities-handing-traditional-medicare-to-wall-street/ 6/7/18: Kip Sullivan article on CMS evaluation of several "medical home" ACO programs: The verdict is in: All three of CMS’s “medical home” demonstrations have failed – The Health Care Blog 1/16/22: For background on the origins of the ACO REACH program, here's a short article on the key Medicare official who for years has promoted corporate interests in federal health policy. 2/24/22: American Journal of Managed Care https://www.ajmc.com/view/cms-redesigns-direct-contracting-into-an-equity-focused-aco-model 5/19/22: Biden’s Little-Publicized Medicare Privatization Scheme Is Starting To Raise Alarm Bells https://portside.org/2022-05-19/bidens-little-publicized-medicare-privatization-scheme-starting-raise-alarm-bells An excellent webinar that addresses the lack of health equity in the ACO REACH proposal. DCEs & REACH: Health Equity or Private Equity? - YouTube Robby Stern, President of the PSARA Education Fund, was interviewed by Richard Eskow about ACO REACH and the privatization of traditional Medicare. Watch the interview on YouTube by clicking this link: https://youtu.be/6FKFsxRs-Rw Robby Stern was interviewed on Twitter Spaces on Jan. 27 about the Medicare Anti Privatization Campaign. Link here: https://twitter.com/i/spaces/1jMKgLrlaOjGL?s=20l Webinar with Rep.Pramila Jayapal and members of PSARA on ACO Reach and privatization of Medicare. Link HERE Read and Download PSARA’s Primer on Leveling the Playing Field

PSARA Signs an Open Letter Rejecting the House Homeland Security Committee’s Unfounded Inquiries into 200+ Nonprofit Organizations In the Advocate August 2025: PSARA Signs an Open Letter Rejecting the House Homeland Security Committee’s Unfounded Inquiries into 200+ Nonprofit Organizations We, the undersigned more than [...] nonprofit and nonpartisan organizations and community leaders, stand united inopposition to the House Homeland Security Committee’s and Senator Josh Hawley’s unfounded demands for information from hundreds of nonprofit organizations. These charities and organizations have done nothing but carry out their work, including what is outlined in the federal grants some of them were awarded, and include religious organizations and groups working on advocacy and services for immigrants, workers, youth, and a vast array of other organizations serving their communities. These letters of inquiry target civic organizations that have provided services under valid federal contracts that were authorized and appropriated by Congress, filling a need the government cannot perform itself. No allegations of wrongdoing, or evidence is provided for these extraordinary and burdensome inquiries. This effort appears to be an attempt to weaponize Congressional power and create the appearance of wrongdoing against those who the signers believe disagree with their political agenda. The process these lawmakers intend to drag these law abiding, community serving organizations through is the punishment. As nonprofit and nonpartisan organizations and community leaders, we work in communities across the country to feed the hungry; house those without shelter; protect our air and water, our rights to vote, worship, and organize; we fight for consumers, workers, and our children; we advocate for civil and human rights at home and abroad; we have made it safer to drive on our roads, easier to start a business, and healthier to live in our cities. We span the full ideological spectrum. And today, we stand together for our democracy and in solidarity with those nonprofit organizations unjustly targeted by these Congressional letters. Let us be clear – this investigation is Congress weaponizing its powers to target and intimidate nonprofit organizations that are fulfilling the guidelines of federal grants, simply because they disagree with the policy those grants advance. This unfounded inquiry is not about protecting Americans, rooting out waste and fraud, or defending the public interest. It is about using un- checked power to chill constitutionally protected activity, community activism, and voices those sending the letters may disagree with. That is un-American and flies in the face of the Constitution. This specific attack on nonprofits is not happening in a vacuum. Rather, this attack exists in the context of a wholesale offensive against organizations and individuals the administration and its allies find objectionable. We are standing in solidarity with the organizations targeted in this unfounded investigation because nonprofits of all types, members of the clergy and religious groups, advocates, and community serving organizations should not be punished for their work – even if those in power find it threatening to their policy agenda. Our government is meant to serve the people, not those in office. Efforts by members of Congress to attack nonprofit groups they disagree with are reprehensible, dangerous, and a violation offundamental American freedoms. Speaking out for the voice- less is, and has always been, our collective mission. As such,we stand with those organizations wrongly targeted, and with one another. BACK TO THE ADVOCATE

For more than a quarter century, Puget Sound Advocates for Retirement Action (PSARA) has been active in fighting for older Americans, their children and their families. Working together for justice, equal rights and dignity for all of us in our retirement years. For more than a quarter century, Puget Sound Advocates for Retirement Action (PSARA) has been active in fighting for older Americans, their children and their families. We engage in a variety of activities and educational work, including the production and distribution of our monthly newsletter, The Retiree Advocate . Our efforts are based on the belief that seniors, our children and grandchildren need and deserve: A lifelong, adequate, dependable income; Comprehensive, affordable health care, including prescription drug coverage; Taxes and utility bills we can handle Access to affordable housing, transportation, and social services; Support for our family care-giving responsibilities, and Quality time to relax and enjoy life with family and friends. This is your cordial invitation to join. If you wish to become a PSARA member, or renew your PSARA membership, you can write in via the U.S. mail, or join on-line with a credit card. For detailed information, please go to the “Membership and Renewal ." PSARA Board Members PSARA Officers Membership & Renewal Donate Contact Us Partner Organizations Social Security Works Strengthen Social Security The Stand - Washington State Labor Council Washington Fair Trade Coalition Just for Fun

She Walks Miles in Other People’s Shoes, Part I Interview With Maureen Bo Angie Bartels interviews PSARA member and labor organizer Maureen Bo on her life experiences and work in organized labor Read

In the Advocate July 2025: Steve Bauck The Long-Term War on Social Security Steve Bauck In last month’s Retiree Advocate, Steve Kofahl described the devastating impact of staffing cuts and rules changes on Social Security beneficiaries. While newly implemented, they are part of long-term attack on Social Security. In 1983 the Cato Institute produced an article titled “Achieving a Leninist Strategy”. It called for “guerrilla warfare against both the current Social Security system and the coalition that supports it.” The long-term goal was to shift the $1.5 trillion we pay into Social Security each year out of Social Security and into IRA or similar private accounts. Their strategy has had considerable success in reducing confidence in the fiscal soundness of Social Security. An April 2025 poll by the AP and University of Chicago found that 52% of those surveyed were not confident that Social Security benefits would be available when they need them. The Social Security staffing cuts have nothing to do with reducing the federal deficit or debt. Social Security is completely self-funded. Administrative costs, including staffing, come from the contributions we make into Social Security. Currently administrative expenses for Social Security amount to a miniscule 0.9%. Were administrative expenses to be raised back to 1.26% where they have historically been, SSA could have the full staffing it needs to adequately serve the public and it wouldn’t impact the federal budget at all. But the cuts do serve the purpose of eroding confidence in Social Security’s ability to deliver benefits to those who have earned them. They are also likely to cut costs by deterring deserving beneficiaries from accessing their benefits. Similarly, the DOGE theft of Social Security personal data in the name of rooting out fraud has nothing to do with saving billions in fraudulent Social Security payments. DOGE has not been able to demonstrate that there is fraud because it is almost nonexistent in Social Security. A recent Social Security oversight report found an “improper payments” rate of 0.3%. They noted that only a sliver of that low rate is due to fraud. The focus on fraud reinforces the idea that Social Security is an entitlement program giving benefits to undeserving beneficiaries who haven’t earned them and that the federal government isn’t competent to administer the program. The data is also being used as a weapon by declaring people to be dead and thus denying them access to employment, banking and virtually all economic activity in the country. When we first start working, we don’t know when we are going to retire, how long we will be retired or what financial resources we will have. We also do not know if we are going to become disabled and unable to work (only a third of workers have disability insurance be- side Social Security Disability) or if we will die young and leave dependents without a source of income. Social Security is not a retirement savings program, it is an insurance program. Our contributions are pooled to ensure that all covered workers have a monthly benefit in all these situations. Although by law Social Security can never go bankrupt, there is a future funding issue. In 1983 the stagflation of the 1970s caused a funding crisis for Social Security. It was solved primarily by benefit cuts. Projections indicated that the changes would take care of all future needs. What was not anticipated at the time was the theft of wages over the past 40 years. Almost none of the gains in productivity have gone to workers. Currently the Social Security Trust Fund surplus built up to provide for the surge of baby boomer retirement is projected to be depleted in 2033. This is not a new issue. It has been known for over 30 years. There will need to be either a 21% cut in benefits or an increase in revenue. Overwhelming majorities of Americans favor increasing revenue over benefit cuts. The most obvious source of additional revenue is to “Scrap the Cap” and make those who have received most of the gain in productivity pay their fare share. Currently wages above $176,100 are not taxed for Social Security. Had the cap been eliminated 30 years ago when the looming funding issue was first identified it would have solved the entire problem. It would still solve a large portion of the problem and is essential to any realistic plan to avert benefit cuts. We need to counter the assault on Social Security by exposing the lies that have eroded confidence in Social Security’s future and insist that the rich pay their fair share by scrapping the cap. Steve Bauck is Co-Chair of PSARA's Social security Task Force and a member of PSARA's Executive Board. BACK TO THE ADVOCATE

Rev. Dr. Robert Jeffrey, Sr. Jayza Duhon Celebrate Juneteenth with PSARA Saturday, June 14, 1:00 p.m. - 3:00 p.m. New Hope Missionary Baptist Church PSARA welcomes all to our annual Juneteenth celebration on Saturday, June 14, from 1–3 p.m. We are honored to hold our event at New Hope Missionary Baptist Church, located at 124 21st Ave, Seattle. The Rev. Dr. Robert Jeffrey, Sr. and his congregation have graciously allowed us to have this celebration at their beautiful historic Black church in the heart of Seattle’s Central District. Our theme this year is “With Hope We Unite, Resist, and Overcome.” The Juneteenth holiday celebrates the historic day of June 19, 1865, when Union troops arrived in Texas to declare the end of slavery, some two years after Lincoln’s signing of the Emancipation Proclamation. Today, as waves of racial hostility and injustice sweep across our country, we gather on this day to stand together and lift each other’s spirits while we renew our commitment to resist and overcome racism and hatred. Our celebration includes presentations by Rev. Jeffrey, Sr., MLK Labor leader Shaunie Wheeler, PSARA leaders Claude Burfect and Larry Gossett, and musical performances by members of the New Hope Choir and soloists Jayza Duhon and Laila West. We will have books on display, curated by Rhonda Gossett, and refreshments for attendees. We are grateful to the Abe Keller Peace Education Fund for a generous donation to help us put on this event. Please join us on June 14 at 1:00 p.m. for this special event! BACK TO THE ADVOCATE

PSARA Talking Points (03/13/25 Update) Lobby Day Training Page Healthcare PSARA believes that comprehensive, affordable, accessible, and culturally appropriate health care is a fundamental human right. Highest Priority: SJM 8002 (Hasagawa), Urge Congress to Level the Playing Field between Original Medicare and Medicare Advantage. Status: Passed Senate 30-19. Hearing House Healthcare and Wellness March 21, 8:00 a.m. Sponsors: Hasagawa, Chapman, Stanford, Trudeau, Valde Medicare is a core part of our health care system, especially for seniors, but is in danger. Investors and private insurance companies are taking advantage of lax rules in the Medicare Advantage part of the program to increase profits and drive up costs – too often by limiting or denying access to needed care. Improving benefits in Original Medicare, the public part of the program, and cracking down on fraud and abuse in private Medicare Advantage programs will save billions in taxpayer money and strengthen our whole healthcare system. 1.5 million Washington residents are Medicare beneficiaries. When first enrolling, people must choose between Original Medicare and Medicare Advantage. Original Medicare has many advantages: beneficiaries can choose almost any doctor or hospital, and rarely experience delays or denials due to prior authorization requirements. However, Original Medicare has a 20% co-pay with no cap, so many purchase supplemental insurance which averages over $200 per month. · Medicare Advantage (MA) is private, usually for-profit insurance that has significantly lower monthly premiums than Original Medicare plus supplemental insurance, making it seem more attractive. But its plans have limited provider networks, often require prior authorization, and can end up being very costly for people needing extensive care. · Many seniors opt for MA plans, especially those with limited incomes, disproportionately people of color. However, when they face a complex problem like cancer or a stroke, many discover the doctor or hospital they want is out of network, and insu rance gatekeepers frequently delay or deny prescribed care, potentially causing serious harm. · Medicare Advantage insurers take significantly more money per beneficiary from the Medicare Trust Fund than Original Medicare, because they do their own risk assessment on each beneficiary and bill the Medicare Trust Fund upfront. Government and academic studies estimate that overpayments through upcoding, fraud and other abuses cost Medicare between $85 billion to $140 billion annually. SB 5291 (Conway): Strengthening WA Cares Act, by implementing the recommendations of the Long-term Services and Supports Trust Commission. Status: Passed Senate 38-31. Sponsors: Senators Conway, Saldaña, Cleveland, Frame, Nobles, Stanford, Valdez, C. Wilson; Reps.(HB 1415) Macri, Tharinger, Reed, Fey, Ormsby, Hill Washington took the lead in creating the first public long term care program in the country to address the growing crisis in elder care. As with any major program, continuing improvements are required. The substitute bill strengthens the program by adjusting provisions for workers who move out of state, providing automatic exemptions for military, and launching a pilot for supplemental insurance. The vast majority of people do not purchase private long term care insurance because it is expensive and too often cannot be relied on at the point when someone needs care. WA voters showed their support of WA Care by voting down the 2024 initiative to undermine the program (I-2124). S JM 8004 (Hasagawa): Requests that the federal government create a universal health care program or allow Washington State to implement one. Status: Passed Senate 30-19. Hearing House Healthcare and Wellness March 21, 8:00 a.m. Sponsors: Senators Hasegawa, Bateman, Lovelett, Nobles, Stanford, Trudeau, Valdez and Wellman. Despite gains in coverage, too many Washingtonians are struggling to both access and afford health care as premiums rise in the commercial health insurance market. Inadequate coverage and medical costs are the largest contributors to bankruptcies. Universal health care coverage will improve the health of our whole community. We must bring everybody in and leave nobody out of this basic right to health care. Workoers Rights PSARA supports legislation that promotes healthy families and workplaces. HB 1213 (Berry): Provides job protection for all workers using Paid Family & Medical Leave benefits. Status: Passed House 55-41. Sponsors: HB 1213 - Representatives Berry, Fosse, Reed, Obras, Fitzgibbon, Alvarado, Mena, Macri, Ryu, Farivar, Doglio, Simmons, Peterson, Street, Wylie, Pollet, Ormsby, Lekanoff, Salahuddin and Hill. SB 5539 - Senators Alvarado, Stanford, Frame, Nobles, Riccelli, Slatter, Trudeau, Valdez and C. Wilson. Washington had the best PFML program in the country when first passed. Since benefits began in 2020, hundreds of thousands of Washington workers and families have benefitted from parental leave, time to heal from surgeries or recover from cancer, and time to be with loved ones during health crises. But only about half of workers are guaranteed their jobs will be protected and health insurance will continue during their leaves. Low wage workers and workers of color are most at risk of being forced back to work too early in order to keep their jobs. Now job protection only covers those in companies with 50+ workers who have been in their jobs at least a year and worked at least 1250 hours in the previous year. This bill changes that to all workers who have been with their employer at least 90 days. Nine of the 13 other states with programs include job protections for most workers. The bill expands the small business grant program to cover health insurance premiums for employees out on PFML in companies with fewer than 50 employees. The bill also reduces the minimum claim from 8 to 4 consecutive hours and incorporates additional employer protections concerning coordination with FMLA requested by the business community. A broad coalition of labor, senior, health, and community groups support the bill. The Association of Washington Business (AWB) and other major business groups are neutral on the substitute bill, although a few business groups oppose. SB 5041 (Riccelli) Extends unemployment benefits to striking workers. Status: Passed Senate 28-21. Hearing House Labor and Workplace Standards 3-18 10:30 a.m. Sponsors: Senators Riccelli, Conway, Hasegawa, Saldaña, Salomon, Stanford, Dhingra, Nobles, Trudeau, Valdez, Bateman, Lovelett, Cleveland, Frame, Orwall, Pedersen, Slatter, Wellman and C. Wilson This bill would allow striking and locked out workers to collected unemployment insurance after 2 weeks out of work. UI provides a vital safety net for working families and their communities, allowing them to cover basic necessities. This bill will help level the balance of power between workers negotiating in good faith for fair working conditions and their better resourced employers, especially for lower wage workers. Most strikes are resolved quickly, within 2 weeks. Only 7 strikes in the past decade would have qualified, so the bill will have minimal impact on the UI trust fund. HB 1214 (Thai)/SB 5768 (Saldana): Expands eligibility for the Working Families' Tax Credit to include people 18 years of age or older. Status: SB 5768 Dead. HB 1214 Sponsors: Representatives Thai, Reed, Shavers, Farivar, Simmons, Pollet, Lekanoff and Scott. SB 5768 Sponsors: Senators Saldaña, Cleveland, Cortes, Dhingra, Frame, Krishnadasan, Nobles, Riccelli, Slatter, Stanford, Trudeau, Valdez and Wilson, C. Background: In 2021, the Legislature established the Working Families Tax Credit (WFTC) Program, based in part on the federal Earned Income Tax Credit (EITC) Program. It provides a refundable credit for retail sales or use tax paid by low-to-moderate income Washington residents who meet certain eligibility requirements. Under current law, to be eligible one must be over 24 years old, but under 65 years of age, or have a qualifying child. How does eligibility change under the proposed legislation? Expands eligibility for the Working Families' Tax Credit to include people 18 years of age or older without regard to filing with a qualifying child. For seniors still working, this is a critically significant benefit. Housing and Homelessness PSARA supports keeping people housed, building more low-income housing, and preventing homelessness in the firs place. HB 1217 (Macri)/ SB 5222 (Trudeau): provides renters and manufactured homeowners with predictability over their housing costs by limiting annual rent increases to no more than 7% a year. Status: HB 1217 Passed House 53-42 Senate Hearing Housing 3-19 1:30 p.m. HB 1217 (Macri) Sponsors: Representatives Macri, Ramel, Peterson, Berry, Mena, Thai, Reed, Obras, Farivar, Parshley, Ortiz-Self, Cortes, Duerr, Street, Berg, Taylor, Fitzgibbon, Doglio, Timmons, Tharinger, Fosse, Gregerson, Simmons, Wylie, Pollet, Kloba, Nance, Davis, Ormsby, Lekanoff, Berquist, Scott, Stonier, Hill SB 5222 (Trudeau) Sponsors: Senators Trudeau, Chapman, Bateman, Conway, Frame, Hasegawa, Lovelett, Nobles, Orwell, Pedersen, Riccelli, Robinson, Saldana, Slatter, Stanford, Valdez, Wilson, C. Why is rent stabilization needed? Washington is already one of the most expensive rental markets in the country, and many tenants receive excessive rent increases even while landlords are not performing basic repairs. Black, Indigenous, and other people of color households in Washington are disproportionately renters. In addition, data from the Census Bureau Pulse Survey in 2024 showed that Black renters in Washington receive higher rent increases than other demographic groups. Advancing tenant protections like rent stabilization is critical to address the housing needs of BIPOC households. Evictions continue to rise on a year-over-year basis, with several parts of our state seeing higher eviction rates than before the pandemic. Rent increases are a key driver of evictions and homelessness. HB 1491 (Reed) promotes transit-oriented housing development. Status: Passed House 58-39. Senate Hearing Housing 3-14 1:30 p.m. Sponsors: Representatives Reed, Richards, Berry, Duerr, Cortes, Doglio, Ryu, Fitzgibbon, Alvarado, Davis, Ramel, Parshley, Mena, Peterson, Nance, Macri, Fosse, Kloba, Ormsby, Scott. HB 1491 Requires cities planning under the Growth Management Act to allow new residential and mixed-use development within a station area at certain transit-oriented development densities. Establishes affordability requirements and authorizes a 20-year property tax exemption for residential and mixed-use buildings constructed within a station area. Why is HB 1491 needed? This bill addresses the urgent need for housing by making it possible to build new and denser housing around the most used transit assets. Transit oriented development will help the state add significantly more homes while reducing sprawl, cutting pollution, and making communities more affordable to a range of incomes. Climate and Environmental Justice PSARA supports the right of all people to live and work in a clean and healthy environment. HB 1150 (Berry) /SB 5284 (Lovelett) improves Washington’s solid waste management program. Status: SB 5284 Passed Senate 27-22. House Hearing Energy 3-17 1:30 p.m. HB 1150 Sponsors: Representatives Berry, Donaghy, Ryu, Ramel, Farivar, Mena, Alvarado, Duerr, Reed, Fitzgibbon, Callan, Macri, Doglio, Fosse, Simmons, Street, Pollet, Kloba, Nance, Davis, Ormsby, Salahuddin and Hill. SB 5284 Sponsors: Senators Lovelett, Shewmake, Nobles, Bateman, Salomon, Saldaña, Stanford, Wilson, C., Frame, Pedersen, Hasegawa, Liias, Orwall, Slatter and Valdez. Background: In 2021, the Legislature established minimum recycled content requirements applicable to three categories of plastic products or products in plastic containers: trash bags, household and personal care product containers, and plastic beverage containers. Producers subject to minimum postconsumer recycling content (PCRC) requirements were required to register with Ecology and pay fees to cover Ecology's administrative costs related to minimum recycled content standards beginning in 2022. What improvements do the bills make? Establishes an extended producer responsibility program for covered packaging and paper products. Requires producers of covered packaging and paper products to join a producer responsibility organization. Specifies requirements related to planning, funding, enforcement, and outcomes for the program. Budget and Fiscal Reform PSARA supports a state budget that is transparent, pays a living wage to state workers, and provides services that help our people, economy, and environment thrive. New progressive sources of revenue are essential to prevent devastating cuts to programs that keep people across Washington housed, fed, and healthy. Please don’t pass a budget that further harms the very people already struggling and undermines our children’s future. We can make our tax system and state stronger now and in the long run by finally asking the very wealthy to pay their fair share of taxes. The legislature must pass a new 2-year for the biennium that starts July 1, 2025, but the state faces a multi-billion dollar shortfall due to inflation, increased caseloads, and slower tax revenue growth. Possible cuts include sharp reductions in health care affordability and access, fewer kids in childcare and preschool, furloughs for state employees, less support for foodbanks and housing, and cuts to almost all state programs, including senior services. The all-cuts budget of 2009 harmed the health and well-being of Washingtonians for years, and made our families and communities less prepared and resilient for the devastation of the COVID pandemic. The influx of federal funds and the strong, forward-looking budgets passed by our legislature during the early stages of the pandemic helped get our people and state through that crisis. Washington’s tax system is highly regressive, with low- and moderate- income Washingtonians paying at far higher rates than the wealthy. Small businesses also pay higher rates than large profitable corporations. Continued growth in economic inequality helps feed the state budget crisis. Possible new revenue sources include: HB 1319 Wealth Tax (Street) Creates a 1% tax on financial assets (stocks and bonds) over $100 million. Sponsors: Reps. Street, Macri, Ormsby (Office of Fiscal Management request legislation, requested by Gov. Inslee) Wealth inequality is skyrocketing, while our state struggles to fund educational opportunity, health care, and basic services. Middle class Washingtonians pay annual property taxes on their most significant asset – their home – while the main financial assets of billionaires and mega-millionaires go untaxed. A modest 1% tax on financial assets such as stocks and bonds would allow for ample funding of public education, childcare and early learning, higher education, and provide the services that will allow all our people to thrive. In previous sessions, the Dept. of Revenue estimated that a similar wealth tax proposed by Sen. Frame and Rep. Thai would raise up to $4.5 billion annually. This new tax would make Washington’s highly regressive tax system more fair. HB 1839 (Reed) Creating equity in high tech tax by removing the cap. Sponsors: Reps Reed, Pollet, Berg, Parshley, Scott, Ormsby and Hill. This bill will help stave off devastating cuts to education and vital public services, and make Washington’s tax system less regressive by asking our biggest and most wealthy corporations to pay a little more. The bill eliminates an arbitrary cap of $9 million for high tech companies with worldwide gross revenues over $25 billion in the advanced computing surcharge. The Dept. of Revenue estimates the bill will add $231 million in the 2025-27 biennium, and $404 million in 2027-29. Revenue from the advanced computing surcharge is dedicated to the Workforce Education Investment Account.

In the Advocate May 2025: Lisa Dekker North Olympic Peninsula 2025: Rural Resistance! Lisa Dekker Like the rest of Washington State, Clallam County and the Peninsula are reeling from the harms happening now – and those yet to come – from this corrupt regime and their flagrant refusal to follow the law. But we are not taking this lying down. Our residents and our leaders are determined to resist. Olympic National Park, just outside Port Angeles, gets thousands of visitors each year and is an economic engine for the region. It was already unable to meet basic maintenance needs, and reduced staffing will make it worse. In addition, although $80 million was al- ready allocated by Congress to replace the Hurricane Ridge Day Lodge that burned down in 2023, delivery of those dollars is now uncertain. For many years Port Angeles has been a gateway for Canadian visitors via the Coho/BlackBall Ferry that connects us to Victoria, B.C., just 12 miles away. But now, the absurd tariffs and territorial threats coming from #47 have resulted in an understandable backlash of Canadians deciding not to spend their tourist dollars here. This will have grave economic consequences for our restaurants, hotels, and small businesses this summer unless the tariffs are undone. Likely the most unconscionable harms to individuals here would be the drastic cuts to Medicaid in the current Republican budget. With 20 percent of our adults and more than 37 percent of our children dependent on Medicaid in Clallam County alone, the devastation would be felt by thousands here on the Peninsula. So how are we fighting back? There have been sizeable rallies in Port Ange- les, Sequim, and Port Townsend (Jefferson County) that have many new faces and an enthusiastic response from the community. Indivisible Sequim, first begun in 2016, has had a surge of new members and has backed several rallies. One of the largest gatherings in Port Angeles, and the one with the most young people, was a raucous and upbeat march supporting the Olympic National Park and Park staffers who had been abruptly laid off. Clallam Democrats have become re-energized. With the leadership of their Chair, PSARA member Ellen Menshew, they have hosted timely forums and promoted many rallies. With a new online newsletter, Clallam Democrats Rising, plus a blog, a presence on Substack and Blue Sky, and an events calendar, the Dems are keeping members informed and involved. Our three County Commissioners even did their bit with a letter to Senators Murray and Cantwell and Congresswoman Emily Randall, reminding them of the impacts being felt here and asking that they “do all that they can to support our community.” We don’t know what’s next, but here in the northwest corner, we saw that despair became righteous anger, then hope, and now resistance. We are determined to fight back. Lisa Dekker is PSARA's Co-VP for Outreach and a leader of PSARA's Clallam County organizing committee. BACK TO THE ADVOCATE

In the Advocate May 2025: Steve Kofahl Social Security Attacks Continue Steve Kofahl It seems that nearly every day we learn about a disturbing new aspect of the Trump administration’s ongoing attacks on Social Security, the Social Security Administration (SSA), and SSA employees. I write this on May 12, with a Washington Post piece (“The hidden ways Trump and DOGE are shutting down parts of the government”) in today’s Seattle Times. The article reveals that some SSA employees are running out of pens, paper, and printer toner because the US DOGE Service, on February 26, placed a $1 spending limit on each government-issue credit card that managers use to make purchases and pay for services. They cannot pay their phone bills, or for translation services, for example. Less than a dozen people at SSA, an agency with 1,300 work locations, are now authorized to make decisions on any purchase requests, causing lengthy backlogs and delays. How’s that for making government more efficient? Less than a week ago, Wall Street billionaire Frank Bisignano was confirmed 53-47 by the Senate to serve until January 2031 as SSA Commissioner. A self- described “DOGE person,” he was called out by the usually mild-mannered Oregon Senator Ron Wyden for lying to the Senate Finance Committee, when he denied having worked with DOGE and Trump’s Acting SSA Commissioner, Leland Dudek, for months before his confirmation. It was during this time that the SSA website crashed 3 times in 10 days, in March. Bisignano, who comes with a reputation for slashing jobs and treating workers disrespect- fully, has said that he intends to replace SSA 800-number agents with Artificial Intelligence (AI). Speaking of AI, SSA has already been utilizing it to some extent in the disability determination process. The National Academy of Social Insurance (NASI) has formed a task force that issued a report last month citing a number of concerns. One is the presence of bias in medical care and in medical record-keeping. How do we identify and mitigate it? NASI believes it imperative that hu- mans make the adjudicative decisions, including whether to obtain additional existing medical evidence or request a consultative exam paid for by SSA. SSA had more than 84,000 employ- ees in 1980, compared to about 50,000 today, with half as many Americans receiving benefits compared with today. Each of 1,200+ field offices had at least one SSA field representative to reach those who lived far from an office and needed a home visit, or to be served at one of the Agency’s hundreds of con- tact stations (sites like courthouses and social service agencies, most at no cost to SSA). They also made presentations to educate people about SSA programs. There are no more contact stations, and no more field representatives. With SSA having largely withdrawn from communities across our nation, it shouldn’t surprise us that lies about Social Security are believed by too many Americans. Why else would anyone agree with Elon Musk that Social Security is a 90-year Ponzi scheme, that benefits are being paid on the records of 150-year-olds, or that undocumented workers are receiving payments (they’re not!)? Incorrect payments, which include underpayments as well as overpayments, are about 1 percent of total benefits paid. Incorrect payments (which could be greatly reduced by restoring staff) and fraudulent payments are not the same thing, and there is, in fact, very little fraud. Reports of changes that affect eligibility or payment amount are received by SSA, but often go unworked for many months due to job cuts. Implementation of the Social Security Fairness Act, which restored benefits for public retirees who had been subject to Government Pension Offset or the Windfall Elimination Provision, is also being slowed by staffing losses. Nearly three mil- lion records require adjustment, but some won’t be processed for a year. Of 182,000 new applications filed by those who hadn’t applied previously because no payments were due before the law was changed, 15 percent have not been processed. The Trump administration intends to strip all civil service and union rights from about 20 percent of the SSA workforce, including the Administrative Law Judges (ALJs) who conduct dis- ability hearings and render decisions. That would make it easy to intimidate or remove ALJs who allegedly approve too many cases. Thankfully, we have been getting some help from the courts and others. In April, a federal judge issued a preliminary injunction to block DOGE from accessing the sensitive personal information in SSA records. On May 7, 15 House Republicans (none from Washington) wrote to Bisignano to express concerns about staff cuts and office closures. Two days later, another judge issued a two-week temporary restraining order blocking implementation of a February 11 executive order directing major “reorganizations” at SSA and 19 other agencies. The Administration appealed to the 9th Circuit within hours. H.R. 2550, the Protecting Ameri- ca’s Workforce Act, which would restore federal employee rights that have been stripped away, already has 220 House co-sponsors. We have a long and difficult fight on our hands, but we can and must win it. We have to pull back the curtain and reveal what’s really going on in the other Washington, reach out wherever possible to tell the story to others, and take action by attending rallies and/or calling members of Congress from both parties. Steve Kofahl is a former President of AFGE 3937, representing Social Security workers, a member of PSARA's Executive Board, and Co-Chair of PSARA's Social Security Task Force. BACK TO THE ADVOCATE

How To Make America Sick The Trump administration’s plan to “Make America Healthy Again” will make Americans’ health worse. Donald M. Berwick In the Advocate August 2025: Donald M. Berwick, MD. How To Make America Sick The Trump administration’s plan to “Make America Healthy Again” will make Americans’ health worse. Donald M. Berwick, MD. Reprinted from the Center for American Progress website. It might seem obvious that the United States, the wealthiest country on earth, would have the best health and health care. But we do not. Not even close. So when President Donald Trump, Secretary of Health and Human Services Robert F. Kennedy Jr., and their allies in Congress propose to “Make America Healthy Again,” it’s easy to get on board. The trouble is that their plan won’t work. In fact, it will make Americans’ health worse. They are currently proposing to cut Medicaid and Medicare, decimate public health structures, withdraw support for food security and other basic needs, and harm the environment all of which is dead wrong from a scientific viewpoint. There is no disputing that America’s health care system needs a dramatic overhaul. U.S. life expectancy ranks 49th globally at more than four years lower than that of the world’s healthiest countries. Our children’s health ranks 36th among the 38 richest nations. Not a single U.S. state has an average life expectancy longer than that of comparably wealthy nations. If the goal is to make America as healthy as other wealthy nations, it would be hard to do worse than we are doing right now. And for that terrible performance, the United States spends twice as much per capita on health care as the average wealthy country—with more than 110 million Americans struggling with medical debt. So, yes, by all means, let’s “make America healthy.” However, unlike how the Trump administration and RFK Jr. are going about it, doing so requires following the science. In 2015, the revered British epidemiologist Michael Marmot wrote “The Health Gap,” arguably the best playbook for making any country healthier. The book summarizes decades of research on why health varies enormously among places with ostensibly similar conditions. The gap in health outcomes can be between nations, between sub- groups within nations, and even across the tracks in a single city. For example, Black Americans had a lifespan six years shorter than that of white Americans in 2021; residents of west Chicago live 14 years less than residents of the Chicago Loop; and across the city of Boston, lifespan varies by more than two decades. Marmot sorts known causes of health gaps into buckets including early childhood experiences, education, workplace conditions, supports to the elderly, and community “resilience”; he also looks at the impact of attributes such as food security, housing security, transportation systems, clean air, compassionate criminal justice systems, and recreational opportunities. Through that lens, a scientifically guided plan for “making America healthy” is simple to devise: Invest in what drives health. This is why what RFK Jr. and the Trump administration are doing makes no sense. Watch the administration, and it would be hard to find a better way to “make America sick.” It’s like “opposite day”: Every single component of the Marmot playbook is being not only neglected but controverted through the administration’s actions. Let’s run the list. Kids Healthy societies tend to place their bets on safe perinatal care, strong supports for the early years—say, from birth to age 3—and school readiness, which means not only helping children but also their parents. Contrast that with the House-passed One Big Beautiful Bill Act that instead cuts food stamps by nearly $300 billion and enacts a historic $793 billion cut to Medic- aid and the Children’s Health Insurance Program, which cover 50 percent of the children in America. Education People in countries and regions with strong educational systems, especially those that include girls and women, tend to live longer. Overall, the U.S. education system ranks 31st in the world, and it varies widely, with many schools performing poorly and many students underachieving. This is neither the teachers’ fault nor the students’. It boils down to ensuring that all children and youth, regardless of where they live or how wealthy their families are, have access to the highest quality education. The proper response would be to pour resources into delivering on that promise. On the contrary, the Trump administration’s plan calls for slashing funding for the Department of Education, cutting support to K-12 programs, and eliminating federal subsidies for student loans. Workers Job security is also foundational to national health. Unionization, which has been backwatered in the United States, is one straight shot to improving worker power. So is raising the federal minimum wage far above its embarrassingly low level of $7.25 per hour, instituting stronger legal protections for workers’ rights, and establishing more equity in tax and compensation policies. The Trump administration, meanwhile, seeks to abolish the Consumer Financial Protection Bureau, hamstring the Department of Labor, reduce bargaining rights for federal workers, weaken worker protections, and cut the essential food assistance and health care programs that the working class relies on, all to give massive tax cuts to the wealthiest Americans. Seniors How a nation supports its aging and elderly population affects not only how long and well its older citizens live, but also the health and well-being of a country’s entire population. The Trump administration claims to want to protect Medicare—a mainstay of security for those age 65 and older in the country—but study the details of what the president and his congressional allies are doing so far, and you will find steadily weakening protections for coverage, reduced access to care, and thousands of dollars more in out-of-pocket costs. For example, Medicaid, which has been torpedoed by the Trump-signed reconciliation bill, is the primary payer for 63 percent of people in nursing homes. Where are the elderly Americans who rely on that care supposed to go? Communities Healthy communities help ensure access to nutrition, housing, safety, mobility, and opportunity for everyone. The Trump administration is already weakening every one of those things and is poised to damage them further. The administration is hurting public transportation systems and rolling back environmental controls for particulate air pollution. It is also publicly in favor of coal and against wind power, against public housing expansion, against mental health supports to help reduce violence, and has backpedaled on criminal justice reform. Conclusion President Trump and Secretary Kennedy can preach all they want about making us healthy again, but their rhetoric is no substitute for facts. The right way to “Make America Healthy Again” is to invest in the infrastructure, programs, and priorities that we know, based on scientific evidence, will actually improve health—the very same ones that the Trump administration seems intent on destroying. Donald M. Berwick, MD, is President Emeritus and Senior Fellow at the Institute for Healthcare Improvement, and a former Administrator of the Centers for Medicare & Medicaid Services (CMS). BACK TO THE ADVOCATE