The Retire Advocate < Back to Table of Contents February 2025 Medicare Advantage Gaming the System Diane Archer UnitedHealth now employs or contracts with about 10 percent of the physicians in the US. It’s one way UnitedHealth maximizes Medicare Advantage profits, report Anna Wilde Mathews, Christopher Weaver, and Tom McGinty for the Wall Street Journal. UnitedHealth incentivizes its physicians to include additional diagnoses codes on Medicare Advantage patient records, which enables UnitedHealth to receive higher Medicare payments. UnitedHealth advises its physicians to check their Medicare Advantage patients for certain diagnoses. So, in Eu- gene, Oregon, one physician explained that before he could move from one patient to another, he must enter into a software system whether his patient had any of a list of diagnoses. In many cases, the diagnoses had nothing to do with the patient, such as hyperaldosteronism, which is a hormone condition related to high blood pressure. Rather than ensuring their doctors focus on treating Medicare Advantage patients for the conditions these patients are reporting, UnitedHealth is focused on having its doctors document as many conditions as possible that will increase the company’s Medicare payments. UnitedHealth does nothing to ensure its doctors document additional conditions for their patients in traditional Medicare. That’s not surprising. Because of the way Medicare pays insurers in Medicare Advantage, adding diagnoses codes to traditional Medicare patient records would hurt UnitedHealth financially. The Wall Street Journal found that patients leaving traditional Medicare for Medicare Advantage in the three years ending 2022 had many more diagnoses in their medical records once they were in Medicare Advantage. Their “sickness scores” typically increased 55 percent. To put it succinctly, once in Medicare Advantage, from a sickness perspective, patients effectively had HIV and breast cancer. While UnitedHealth does more than other insurers to raise sickness scores for its Medicare Advantage patients, other insurers raised scores by 30 percent for new patients in Medicare Advantage. There is no evidence what- soever that entering more diagnoses into Medicare Advantage enrollees’ medical records benefits patients in any way. In fact, UnitedHealth doctors do not use the company’s diagnoses software for patients outside of Medicare Advantage. By the Wall Street Journal’s calculations, United’s Medicare Advantage enrollees who saw UnitedHealth physicians had such high sickness scores that UnitedHealth benefited financially to the tune of $4.6 billion over three years. This insurer gaming of the Medicare payment system must end. Among other things, it is gouging taxpayers, depleting the Medicare Trust Fund, and driving up Medicare Part B premiums. This article summarizes an investigative piece first published in the Wall Street Journal. This article appeared in Diane Archer’s January 11 Just Care weekly newsletter. Diane Archer is the founder and President of Just Care USA, and a senior advisor to Social Security Works for Medicare policy. < Back to Table of Contents

In the Advocate July 2025: Tim Wheeler Tim Wheeler Rural Protestors Urge Senate to Kill Trump Medicaid Cuts Tim Wheeler Senior citizens stood near Clallam County’s only full service public hospital, June 7, holding signs proclaiming “85% of OMC Patients on Medicaid, Medicare” and chanting “No Cuts to Medicaid or Medicare.” The vigil, initiated by PSARA, attracted 18 participants who lined First Street a couple of blocks south of the Olympic Medical Center (OMC), a public hospital that serves 111,000 on the isolated, rural Olympic Peninsula. The protesters held up their signs and waved as passing motorists honked and gave thumbs-up salutes. In the crowd were two candidates for the OMC Board of Commissioners constantly struggling with millions of dollars in debt due to the low reimbursement rates for Medicare and Medicaid. The vigil was in protest against President Trump’s “Big Beautiful” budget bill passed by the House and now pending in the US Senate. The bill would inflict $715 billion in cuts to Medicaid and $300 billion in cuts to the SNAP nutrition programs to defray the trillion dollar tax cut for billionaires and millionaires. Laurie Force, a retired nurse and a candidate in the August primary for the OMC Board, was holding a sign as was her husband, Larry, whose hand-lettered message was “Stop the Steal.” Her campaign slogan is “A Force For OMC.” The other candidate for the OMC Board, Dr. Gerry Stephanz, Medical Director of the Olympic Peninsula Community Clinic, pointed out that Trump’s budget bill is a grave risk to rural hospitals across the nation, including the OMC, that are totally dependent on Medicare and Medicaid payments to stay afloat financially. OMC, he said, should file to be designated a “Rural Health” provider, like the hospital in Port Townsend. If recognized as a rural hospital that provides life and death services to more than 100,000 people, OMC would enjoy far higher reimbursement rates for the 85% of its patients now covered by Medicaid and Medicare. The vigil took place one week after a “town hall” meeting, also organized by PSARA at the senior Shipley Center in nearby Sequim. Speaking at the Shipley Center in Sequim on May 24, PSARA leaders Robby Stern and Anne Watanabe urged fightback against President Trump’s so-called budget “reconciliation” bill that will inflict hundreds of billions in cutbacks to Medicaid, the SNAP food stamp program and other human needs benefits while handing trillions in tax cuts to themselves and their billionaire cronies. Said Watanabe, “The GOP ‘big, beautiful bill’ means that by 2034, 8.6 million lose health insurance because of cuts. Another 5.1 million lose health insurance through loss of tax credits….13.7 million total will lose healthcare insurance.” She cited the disastrous impact the cuts would inflict in Clallam County where 20,866 children, 38 percent of youngsters, are protected by Medicaid and 21 percent of those 55 years or older. In neighboring Jefferson County 7,641 people, over 29 percent of children and 27 percent of those 55 years are older are enrolled in Medicaid. Rural hospitals, she said, like the Olympic Medical Center (OMC) in Port Angeles that serves 111,000 people, are at grave risk of closing or losing their public status, being privatized through merger with private for-profit hospitals like Providence, a Catholic hospital chain that bans abortions and other reproductive health care. These hospitals, she charged, are being forced into bankruptcy due to ruinously low reimbursement rates for their Medicaid and Medicare patients. In the past twenty years, 200 rural hospitals across the nation have been forced to close due to this crisis in rural America. OMC is the only full service hospital in an isolated region two hours drive from Silverdale or Tacoma and a long ferry ride from Seattle. Treatment for a heart attack or delivery of a baby is care needed instantly not after a two hour drive. Enactment of the Trump-MAGA budget bill will be a death sentence for tens of thousands of low income people, children, immigrant and native-born alike. Already approved by the House, Stern and Watanabe urged the crowd to bombard the U.S. Senate with mes- sages demanding the Senators vote down the budget scam, the most sweeping attack on federal human needs programs ever. Both Stern and Watanabe addressed the issue of defending traditional Medi- care from privatization by so-called “Medicare Advantage.” Stern described in detail the life-threatening struggles by PSARA member Richard Timmins, of Whidbey Island, who was forced to undergo intense treatment for skin cancer because his so-called Medicare Advantage (MA) provider refused to approve in time treatment by a dermatologist despite his physician’s recommendation. By the time the MA provider reversed course and approved examination, the tumor had metastasized into cancer. Stern told of his own family forced to file multiple appeals against a Medicare Advantage provider to win skilled nursing coverage for a parent/ grandparent in a nursing home. Medicare Advantage was authorized in 1982 said Watanabe. “The intention was to lower the cost of Medicare and improve outcomes for patients. So what happened?” Corporate insurers paid a per patient capitation fee, seek to inflate their profits through massive overcharges, false claims, "upcoding" in which patients are over-diagnosed to allow MA providers to receive higher capitated payments from Centers for Medicare & Medicaid Services. The total overcharges by MA is estimated to be $80 billion to $140 billion annually. Much of this corrupt profiteering has been exposed by the MEDPAC, a commission that oversees Medicare and Medicaid. PSARA is part of a nationwide coalition seeking to preserve Medicare against privatization by “leveling the playing field,” enacting reforms that allow traditional Medicare to offer the same extra benefits offered by MA like dental, vision, and hearing, and capping out-of-pocket costs for traditional Medicare enrollees. PSARA also supports “Medicare For All” or universal publicly paid healthcare for every person in the U.S. native born and immigrant, said Watanabe. Ellen Menshew, a member of PSARA and also Chair of the Clallam County Democratic Party (CCD), and Lisa Dekker, an Outreach Vice President of PSARA from Clallam County, introduced the guest speakers from Seattle. Dekker told the crowd that PSARA members and other volunteers are standing in front of the Federal Building in Port Angeles every Friday at 1 p.m. to protest the Trump-Musk attacks on Social Security, Medicare, and Medicaid focused now on demanding that the U.S. Senate reject the MAGA-Trump budget bill. It was Memorial Day weekend and many in the crowd came directly from a “Hands Off Our Veterans” protest by hundreds at the main intersection in Sequim denouncing cuts by Trump and unelected Elon Musk to the Veterans Administration, and sharp reductions in healthcare and other benefits for war veterans and their families. In the audience were members of PSARA from Sequim, Port Angeles, Port Townsend, Gig Harbor, and Tacoma. US Army vets, and active union members were present. Tim Wheeler is a veteran activist, journalist, and a leader of PSARA's Clal- lam County organizing committee. BACK TO THE ADVOCATE

The Retire Advocate < Back to Table of Contents November 2025 Update on the Fight Against WISeR Anne Watanabe Retiree Advocate readers know that PSARA has been actively pushing back on the upcoming changes to Original Medicare the WISeR pilot program. As reported in previous RA issues, the WISeR model is slated to begin on January 1 in Washington State. As a result, prior authorization (prior approval by Medicare) will then be required for 17 procedures that previously were left up to you and your doctors to decide (although described by CMS as “voluntary,” absent prior authorization, your healthcare provider risks not being reimbursed by Medicare for your treatment). Original Medicare, unlike private Medicare Advantage plans, has in the past rarely required prior authorization. But under WISeR, contractors utilizing artificial intelligence will review doctors’ requests for approval of these procedures. And these contractors will be rewarded with a share of the costs that they “save” for Medicare (i.e., savings from denying or discouraging treatments). CMS introduced WISeR in July with little fanfare or consultation with the public or the medical community. So, few seniors realize this change is coming. This is why the PSARA outreach team has made many presentations during the last few months throughout the Puget Sound area to raise awareness and to push back against WISeR. Many of you have responded with calls and letters to your representatives. Your advocacy is working! PSARA has met with staff of our Congressional leaders, including Rep. DelBene, Senator Patty Murray, and Senator Maria Cantwell. You’ll find an inspiring video about WISeR by Senator Patty Murray on our webpage. We’ve met with staff of the state Office of Insurance Commissioner, Patty Kuderer, and she has now issued a statement critical of WISeR. At press time, Representatives Smith, DelBene, Jayapal, Randall, and Strickland had signed onto the Pocan/Schakowsky House Resolution calling for WISeR to be stopped (see the September issue of the RA for more info on this Resolution). PSARA continues our work to protect Medicare from becoming a privatized system that reaps profits by denying care to seniors and the disabled. Regardless of whether you are in Original Medicare or a Medicare Advantage plan, it benefits all of us to maintain a strong, solvent, publicly-funded Medicare system as a safety net for all seniors and the disabled. Finally, dear Retiree Advocate readers, if you have a personal story you are willing to share about prior authorization and how it affected you or your family’s care, please send it to organizer@psara.org . We know that personal stories show us how real lives are affected, and these can in turn affect public opinion and elected officials. Thank you for joining us in this fight. Anne Watanabe is a member of PSARA's Executive Board and Chair of our Race and Gender Equity (RaGE) Committee < Back to Table of Contents

The Retire Advocate < Back to Table of Contents January 2025 40 Years of the Retiree Advocate Advocate Editorial Board Readers might have noticed that with this January issue, we’ve made the transition to Volume XL of the Retiree Advocate. That’s not “XL” as in extra large – although we like to think PSARA has an extra large impact – it’s XL as in 40. That’s right, we’re beginning the fortieth year of the Retiree Advocate. That’s a remarkable achievement for any independent publication, but even more remarkable for one like the Advocate that relies solely on subscriptions and doesn’t accept advertising of any kind. We owe our success primarily to you, our readers, who have supported us for 40 years. But we also need to acknowledge two outstanding working-class journalists who guided the Advocate through its formative years and shaped it into the publication we know today. Max Roffman (1910-2003) edited the Advocate even before it was the Advocate. He came to Seattle in 1984 from Hawaii, where he’d spent 21 years organizing the United Public Workers Union (UPW), and another 10 working for the Center for Labor Education and Research at the University of Hawaii. When he came to Seattle, Max became a leader of the Puget Sound Council of Senior Citizens (PSCSC) and was the first editor of Senior News – the predecessor of the Retiree Advocate. In 1994, Max retired as editor, although he continued to write for the publication, and Will Parry (1920-2013) took on his editorial responsibilities. Will had been a writer for The New World and People’s World, until 1956, when the McCarthy persecutions deprived him of his ability to make a living as a journalist. Will then went to work for a box-making company and became a leader of Western Pulp and Paper Workers (AWPPW) Local 817. Will went on to edit the AFT-WA newsletter, and when he retired, became involved in the PSCSC and Senior News. When he became editor in 1994, the publication was only a four-pager that came out every other month, and was written mainly by Max and Will. In 1998, the Senior News became a monthly and expanded to six pages. The National Council of Senior Citizens was relaunched as the Alliance for Retired Americans (ARA) in 2001, and Senior News became the Retiree Advocate in 2002. Will retired as editor in February 2013, and died the following May 13, having seen the Advocate through a period of sustained growth. The Advocate hasn’t come this far and had the extra large impact it’s had without the constant support of our as a journalist. Will then went to work for a box-making company and became a leader of Western Pulp and Paper Workers (AWPPW) Local 817. Will went on to edit the AFT-WA newsletter, and when he retired, be- came involved in the PSCSC and Senior News. When he became editor in 1994, the publication was only a four-pager that came out every other month, and was written mainly by Max and Will. In 1998, the Senior News became a monthly and expanded to six pages. The National Council of Senior Citizens was relaunched as the Alliance for Retired Americans (ARA) in 2001, and Senior News became the Retiree Advocate in 2002. Will retired as editor in February 2013, and died the following May 13, having seen the Advocate through a period of sustained growth. The Advocate hasn’t come this far and had the extra large impact it’s had without the constant support of our readers. Many of you have written for the publication, many have volunteered your time to help us mail the Advocate or to distribute it to friends and neighbors, and all of you have contributed dues to help keep us running. Thank you! As we begin 2025 with a second Trump administration in the “other Washington” we’ll need the Retiree Advocate more than ever. We'll keep bringing you hard-hitting analysis of the major issues, let you know what PSARA is doing about them, and how you can help. Together we’ll keep pushing for a positive vision of a future that benefits all of us. And we will resist the temptation to “moderate” our agenda in order to accommodate the Trump regime, or Elon Musk, or whoever. We know we can do it because we've been doing it for 40 years, and we look forward to continuing our run for as long as it takes. Advocate Editorial Board < Back to Table of Contents

The Retire Advocate < Back to Table of Contents May 2025 A Letter to the Editor Kris Melroe I have been lucky enough to be part of a groundbreaking study on diabetes since 1996. But on March 10th, without warning or reason, this research was abruptIly stopped. The so-called reasonable audits and cuts by DOGE are in fact harmful and are just one more lie among many. This arbitrary cut didn’t consider the long- term implications. The Diabetes Prevention Project Outcome Study (DPPOS) has been funded through the National Institutes of Health (NIH) with a grant that was to continue until 2027, at a minimum. The termination had nothing to do with safety issues, procedures, or personnel. In fact, Dr. Kahn, the lead investigator, just received a national award from the American Diabetes Association. This is the longest continuous study in the US, with seven different sites, including one right here in Seattle, at the VA hospital on Beacon Hill. The study has already had major impacts on the diagnosis, medications (i.e., Metformin), and care of diabetes. Long-term studies are valuable because they allow researchers to examine cause-and-effect relationships more effectively than a study that only collects data at one point in time. They provide insights into the long-term consequences of disease and its treatment. Evaluating the long- term effects and characteristics leads to breakthroughs in prevention for people all over the world. I question if this is an extension of cuts related to DEI. Why? Studies indicate that Black adults are nearly twice as likely as white adults to develop type 2 diabetes. When I worked as an educational trainer on the Northern Cheyenne Reservation, 60 percent of the staff had diabetes. For 30 years, all of the participants in the study have spent hundreds of volunteer hours undergoing various tests. Why? Because we were dedicated to creating a healthier world. Does DOGE think our time and efforts were not valuable? It will be another 30-plus years before this information can be replicated. Please call your representative and senators and demand that the staff at least be given the time and money to do a summary wrap-up of the results. THIS STUDY NEEDS TO BE CONTINUED. Sincerely, Kris Melroe Kris Melroe is a longtime member of PSARA and a veteran activist. < Back to Table of Contents

The Retire Advocate < Back to Table of Contents January 2025 History: “Neutralize Elderly Voters” Nancy Altman Social Security is the most popular and effective program in America, and Wall Street has spent decades on a campaign to undermine the people’s faith in the system. Think we’re exaggerating? A right- wing think tank called for a “Leninist Strategy on Social Security” back in 1983. Reading it today, much of that strategy looks just like reality. In 1983, Social Security was in a real crisis. But the system’s popularity protected it from destruction, much to Wall Street’s disappointment. Wall Street sees our Social Security system as a cash cow that they can’t access. They want to get their hands on Social Security’s $2.8 trillion trust fund, which is instead invested in US Treasury Bonds. So Wall Street–funded conservative think tanks got to work, outlining a long-term strategy to chip away at the public’s confidence in Social Security. And it was extraordinarily successful. The right-wing Cato Institute published a plan in 1983 called a Leninist Strategy1, designed to “neutralize” elderly voters while continuing to undermine confidence in Social Security among the young. The strategy had two main prongs: Make younger Americans lose faith that Social Security will keep its promise to them, and create an alternative in the form of private accounts that could be gambled on the stock market, similar to 401(k)s. The strategy took a decade to be mainstreamed by the Republicans. In 1988, a presidential candidate sharing his views about Social Security appeared on the scene. Former Delaware governor Pierre S. “Pete” du Pont IV, an heir to those who had thrown money at any FDR-hater they could find, sought the Republican nomination for president and ran on a platform of privatizing Social Security. But George H. W. Bush won the Republican nomination and the election that year. As president, he showed his understanding of the program when he said, “In my budget plan, I say we’ve got to control the growth of . . . mandatory programs but set Social Security aside. It’s not a welfare program. It’s sacrosanct.” In 1994, the House of Representatives returned to Republican control for the first time in over 40 years, the first time since Eisenhower was president. The Republicans had run in support of the “Contract with America,” drafted and promoted by Congressman Newt Gingrich (R-Ga.). Unfortunately for those opposing Social Security, the Contract with America expressed implicit support for the program by proposing only minor modifications. However, in 1994, as the law had required since 1956, the Secretary of Health and Human Services appointed 14 members to serve on Social Security’s quadrennial advisory council. The trustees had begun to project a long term deficit in Social Security’s financing occurring somewhere more than 35 years in the future. Included in the report was an appendix, entitled “Developments Since 1983,” which addressed the causes of the projected shortfall. The appendix began by debunking the myth that the inexorable tide of aging baby boomers had anything to do with the projected deficit. The report clarified: “the fundamental ratio of beneficiaries to workers was fully taken into account in the 1983 financing provisions and, as a matter of fact, was known and taken into account well before that.” The report then explained that the shortfall resulted from a variety of factors. By the time the advisory council reported, almost 31 million workers participated in 401(k) plans, which contained assets of over $1 trillion. As the stock market went up and up in the 1990s, these arrangements became more and more popular. This was the opportunity the Leninist Strategy envisioned. More and more Americans were becoming used to private accounts for retirement income. The Cato Institute formed the Project on Social Security Privatization on August 14, 1995. A co-chairman of the project was José Pinero, the Pinochet Minister of Labor who had designed the Chilean system of private accounts. Just as supporters of private accounts had been doing since almost the moment Chile had privatized its Social Security program, Cato touted the Chilean system as a model for the United States, despite its decidedly mixed results. The new right-wing project fueled privatization talk with publications and conferences. In less than a decade, the project could proudly boast that it had “published more than forty books, articles, and reports” criticizing Social Security and advocating private accounts. During these years, Social Security produced large surpluses, as it had been projected to do when the 1977 and 1983 amendments had been enacted—but the federal deficit grew to record deficits. On March 7, 1999, the wealthy governor of Texas announced that he was forming a committee to explore a run for the presidency. Despite his limited political experience and his weaknesses as a speaker, he had one huge asset. He happened to be the son of a former president, and the two men shared the same first and last names, George Bush. Well before Bush formed his exploratory committee, he had been thinking about the presidency and had been thinking about Social Security as well. He had a long history of hostility to the program. As a student at the Harvard Business School in the early 1970s, he had railed against Social Security and other New Deal programs. In his losing bid for a congressional seat in 1978, he had ventured that “people [should] be given the chance to invest [Social Security] the way they feel.” The patience of the anti-Social Security forces seemed to have paid off. They finally had a president who seemed to see the world their way. Despite Social Security’s absence from the campaign, President Bush established a presidential commission, on May 2, 2001, to study and make recommendations about Social Security. The members consisted only of people who were dedicated to destroying Social Security’s universal promise, and it resulted in Bush’s privatization scheme. Unlike most presidential commissions, which are given broad guidelines within which to work, this commission was to be tightly constrained. Among the stipulations dictated by Bush was that the commission’s recommendations “must include individually controlled voluntary personal accounts.” It was not a commission to consider what should be done; rather, it was a commission to advise the president how to do what he had already made up his mind to do. At the same time, Bush used the ad- ministration of government to sow distrust in Social Security. Though Trustees Reports between 2001 and 2004 grew slightly more optimistic, with the projected year of exhaustion of the trust funds slightly further into the future, Social Security Administration publications became more alarmist. No longer confirming that Social Security faced “no immediate crisis,” the publications now warned that the program was “unsustainable,” and “under financed.” Most disturbing was the change in the annual statement sent to all of the 125 million workers aged 25 and over who pay into the trust funds. This statement, completely unsolicited, simply arrives in each worker’s mailbox. The 2001 statement proclaimed, “Will Social Security be there when you retire? Of course it will.” This reassurance was gone by 2002. And in 2005, the unsettling remark “Congress has made changes to the law in the past and can do so at any time” was now in the mailing, just in case workers were feeling too secure. The same tactics are being used today. Republicans in Congress are systematically underfunding the Social Security Administration, forcing office closings and longer wait times to receive the world class service Americans are promised. George W. Bush set the agenda for Trump and Elon Musk: Pass a massive tax cut, then try to cut Social Security in the name of fiscal discipline. Of course, Bush’s gamble failed. But privatizers learned a lesson from that. Instead of hashing it out in public, where Social Security’s overwhelm- ing popularity protects it, Wall Street learned to sharpen their axes behind closed doors – just like Elon Musk and Vivek Ramaswamy are doing right now. This isn’t a new fight – it is the same thing we have been fighting for almost a century. With our voices together, we beat Bush’s privatization scheme, we beat the neo-liberal drumbeat of President Obama’s fiscal commissions, and we’re going to beat Trump and Elon Musk. The way we win is to go on the offense. We need to EXPAND Social Security and never cut it. Nancy Altman is President of Social Security Works, Chair of the Board of Directors of the Pension Rights Center, a member of the Boards of Directors of the Alliance for Retired Americans Educational Fund, Latinos for a Secure Retirement, and the Institute for America’s Future. < Back to Table of Contents

I Can't Look Backward, I Can't Look Forward, Part 3 Dina Burstein and Mohamed Ibrahim discuss his immigrant experience. Read

The Retire Advocate < Back to Table of Contents August 2025 Here Is a Guide to Make it Easy to Submit Comments Opposing EPA Revoking the Endangerment Finding on Greenhouse Gases Anne Shields Comments Due by Sept 15. Let’s Overwhelm Their Inbox! rump’s Environmental Protection Agency (EPA) has issued a proposal to revoke the endangerment finding and vehicle emission standards for greenhouse gases (GHG). The proposal relies on fringe science and misinterpretations of the law tojustify a conclusion that the EPA should not regulate GHG. Here is the link to submit your comment to EPA by September 15: https://www.regulations.gov/commen ton/EPA-HQ-OAR-2025-0194-0093 Mom’s Clean Air Force has provided a template and examples that you can use in writing your comments: 1. Introduction & ask: My name is [NAME] and I’m from [STATE]. I urge EPA not to rescind the Endangerment Finding. This rule is crucial to protect our communities and future generations from the impacts of climate-warming pollution. 2. Tell your story: Share how extreme weather and cli- mate change is impacting you and your family, your community, your future, or yourchildren’s future. How have you and your family and community been impacted by wildfires, floods, extreme heat, orother extreme weather? What do those impacts look like? 3. Include a few facts, for example: · Climate change is caused by green- house gases emitted from burning fossil fuels like coal, oil, and gas.These gases trap heat in the atmosphere and warm the planet, supercharging dangerous extreme weather. · More intense and more common extreme weather can lead to worsened asthma, allergies, respiratoryillnesses, adverse birth outcomes, Lyme disease, economic costs, and much more. · In 2024, the US had 27 climate disasters that each caused over $1 billion in damages( Climate.gov ). · Today’s children are expected to face 3 times more extreme weather disasters than their grandparents(Earth. org). 4. Close your comments by restating your opposition: Once again, I strongly oppose this proposal to rescind the Endangerment Finding. The EPA needs to fulfill its mission of protecting human health and the environment. To learn more: See Third Act’s online Action Alert about EPA’s authority and obligation to limit deadly greenhouse gases: https://thirdact.org/act/urgent-tell-the- epa-dont-gut-the-climate-rule-that- protects-our-health-and-safety/ Earth Justice has a brief, straightforward legal analysis describing what revoking the rule would mean: https://earthjustice.org/experts/hana-vizcarra/a-legal-analysis-of-the-trump-epas-plan-to-revoke-the-endangerment-finding Anne Shields is a member of Third Act and an active member of PSARA's Climate and Environmental Justice Committee < Back to Table of Contents

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

The Retire Advocate < Back to Table of Contents October 2025 Trump Tariffs and Stagflation: Why TACO is the Least Bad Option Robert Pollin (reprinted from Left Hook Economics) The first obvious step right now for fighting stagflation is for Trump to dump his tariff policies. Is stagflation—the toxic blend of high unemployment and high inflation—taking hold now in the U.S. economy? The most recent evidence mostly signals “yes.” If stagflation is on the way, we can mainly thank President Donald Trump’s imposition of unprecedented tariffs—that is, taxes on the products we import from more than 90 countries. The latest data from the Bureau of Labor Statistics (BLS) reported that only 106,000 jobs had been added to the U.S. labor market between May and July. This represents a nearly 80% drop in job growth relative to the 474,000 jobs created over the same three-month period last year. Meanwhile, wholesale prices spiked by 0.9% in July, the largest monthly wholesale inflation increase since May 2022. It was in response to the dismal May-July job report that Trump fired BLS Commissioner Erika McEntarfer, after claiming, without evidence, that she had “rigged” the numbers to make him look bad. How could Trump’s tariff polices produce stagflation? According to the Yale Budget Lab, as of July 30, U.S. consumers are facing an average import tax/tariff rate of 17.5%, the highest since 1934. At the same time, imports account for 14% of overall purchases in the U.S. economy. Therefore, if the average 17.5% tariff rate were simply passed on, dollar for dollar, to U.S. consumers, this alone would raise average prices in the United States by 2.5% (that’s 17.5% x 0.14 = 2.5%). But price increases resulting from the tariffs don’t need to be confined to imported products only. This is because higher prices for imports create cover for businesses to raise prices on domestically produced goods and services as well, enabling them to boost their profit margins. Of course, nobody forces businesses that sell imported products to raise their prices. The alternative is for them to pay the tariffs to the U.S. Treasury and then just eat their average 17.5% cost increases by cutting their profits. Obviously, businesses would much rather raise prices before letting their profit margins shrivel. Why should employment conditions also get worse in this situation? This is because businesses worry that the tariffs will cut into their profits. They therefore hold off on plans to expand their operations and hire new people. To date, the Trump program to combat stagflation has two prongs. First, cook the government data to make reality disappear. Second, lambaste Jerome Powell, the chair of the Federal Reserve (which is the US central bank, and commonly referred to as “the Fed”), into cutting interest rates. Trump regularly ridicules Powell as a “stiff,”“numbskull,” or “moron” for not having cut interest rates so far. Most recently, Trump also began attacking and demanding the resignation of Lisa Cook, the first Black woman to serve as a member of the Fed Board of Governors and a Biden appointee. Trump and company claim that Cook committed mortgage fraud in 2021, before she joined the Fed. Cook vehemently denies the charges and insists that she will not resign. Trump’s real purpose here is to replace independent voices at the Fed with loyalists who will toe his policy line, whatever that line happens to be. In fact, by maintaining relatively high interest rates to fight inflation, Powell, Cook, and the other Fed policymakers are only following the standard Fed playbook. The aim with high interest rates is to slow the economy and increase unemployment. The higher unemployment rate then weakens workers’ bargaining power, which lowers labor costs for businesses, enabling businesses to maintain their profit margins without raising prices. Thus, it is baked into the standard Fed inflation control program that working people are the designated sacrificial lambs, even if their wage increases have not caused the inflation in the first place. Trump’s tantrums aside, there are indeed major problems with this standard Fed approach. To begin with, workers gaining excessive bargaining power has never been the driver of stagflation in the United States. In the 1970s and early 1980s, stagflation resulted because global crude oil prices rose roughly tenfold between 1973 and 1980, from $3.56 to $39.50 a barrel. The only other bout of stagflation was after the COVID lockdown was lifted. In this case, stagflation resulted because the production of major items, like new cars, had been cut during the lockdown conditions. Demand for cars then returned quickly when lockdown conditions lifted, but with new cars in short supply, used car prices rose by 40%. From a longer-term perspective, we also have to remember how the U.S. working class has fared, on average, under the 50 years of neoliberalism that preceded Trump. The most central facts are that average wages for nonsupervisory workers are basically where they were 50 years ago, at roughly $50,000 per year (in 2024 dollars), even while average worker productivity has increased by 150%. Meanwhile, over this same 50-year period, average CEO compensation has risen nearly tenfold, from $1.5 million to almost $15 million. In fact, in a major August 22 speech, Powell signaled that, at its next official meeting in September, the Fed is likely to modestly reduce the main interest rate that it controls (the federal funds rate), due to mounting evidence of worsening employment conditions. As Powell knows well, this will accomplish nothing to reduce the inflationary pressures created by Trump’s tariffs. In other words, through deploying the Fed’s main policy tool of manipulating interest rates, you can either reduce inflation through raising unemployment or reduce unemployment at the cost of higher inflation. What you can’t do is combat both sides of stagflation—inflation and unemployment—at the same time. The first obvious step right now for fighting stagflation is for Trump to dump his tariff policies. We shouldn’t rule that option out. Trump didn’t earn the nickname TACO—“Trump Always Chickens Out”—for nothing. But even if Trump does chicken out on the tariffs, we will still be stuck at square one in terms of advancing inflation control policies that also enable U.S. workers to get the long-overdue raises they deserve. Robert Pollin is Distinguished University Professor of Economics and Co-Director of the Political Economy Research Institute (PERI) at the University of Massachusetts-Amherst. < Back to Table of Contents

The Retire Advocate < Back to Table of Contents July 2025 4,000 Attend No Kings Event at People’s Park, Tacoma! John Alessio Our Vote, Our Choice, Our Power, Our Voice!” “Power to the People, We Insist-Billionaires Should Not Exist!” “Say it Once,Say it Twice, We Will Not Put Up With ICE!” These are just a few of the chants heard at People’s Park Saturday, June 14th. PSARA joined Indivisible Tacoma and many other organizations to create an informative, riveting, and festive event on “No Kings Day”. Other participating groups were: 350 Tacoma; AF- SCME Council 28; Evergreen Resistance Tacoma; Black Panther Party, The TSM Shop; Jewish Voice for Peace Tacoma; La Resistencia; Rainbow Center; The Tacoma Urban League; LD27, LD28, and LD29 Democrats; Oscar’s Enemies; Pierce County Central Labor Council, AFL-CIO; Pierce County Immigration Alliance; Tacoma Democratic Socialists of America; Tacoma Fellowship of Reconciliation; Tacoma for All; Tacoma Veterans for Peace; The Conversation 253; Washington Wildlife First; and United Food & Commercial Workers Local 367. Careful planning included meetings and continuous communication between the leaders of many of these organizations to assure a safe and meaningful protest of the Trump administration’s immoral and unconstitutional activities. Preparation included de-escalation training sessions that resulted in a roaming Safety Team during the event. A First Aid Sation was created, with drinking water, snacks, and other relevant supplies. Various groups had their own information booths, plus a booth for sign-making, and even a face painting booth. People’s Park was humming with excitement and enthusiasm. Four thousand people, peacefully demonstrating, were completely rapt for two and a half hours listening to inspiring speeches about what is being done, and what still needs to be done, to stop Trump and his minions from destroying our democracy and inflicting more grievous harm on large segments of our population. The event started and ended with lively protest music, and there were clever chants interspersed throughout. The importance of local elections was emphasized, and people were encouraged to get involved by door-knocking, providing support to progressive candidates, and especially voting in the upcoming 2025 Primary on August 5 and again in the General on November 4th! Action events were announced, such as a June 18th “Door-Knocking for Introverts” to help people become effective doorknockers. On July 9th Indivisible Tacoma endorsed candidates will participate in a Candidate Forum at 6:30PM at Tahoma Unitarian Universalist Church, 1115 So. 56th, Tacoma. La Resistencia and others will continue to strategize and call for united actions against the activities of ICE and the Northwest Detention Center - a critical court hearing is set for September. Some people may want to attend the “Breakfast With the Sheriff” meetings to remind Pierce county Sheriff Keith Swank that Washington state laws protect people from unconstitutional harassment and arrest. The next scheduled breakfast is 7-9AM Saturday, June 21st. We know he would love to see us. A Facebook message to a friend read: “I was at People’s Park with my brother who is blind and paralyzed on his left side. We had the best day. He felt part of society.” That statement captures the mood and inclusive spirit of the Tacoma “No Kings Day”. Let’s keep it going! John Alessio is a member of PSARA and Indivisible Tacoma. < Back to Table of Contents

The Retire Advocate < Back to Table of Contents February 2026 The Fight for Medicare in 2026 Robby Stern The attack by the Trump administration and their Republican sycophants on healthcare coverage will land with tragic consequences on a very large number of people in the US. With compassion for the suffering caused by the Trumpian attacks and determination based on belief in social and economic justice, the movement for Improved Medicare for All will grow and become more and more vocal. Meanwhile, our fight to preserve and expand original public Medicare will continue, as will our educational work exposing the consequences of for-profit Medicare Advantage (MA) and the introduction of the WISeR pilot program. We know the drive for increasing profits leads to abuse and fraud by the insurance companies. Requiring frequent prior authorizations (more than 50 million in 2024), upcoding, cherry picking and lemon dropping (i.e. offloading sicker patients), and offer-ing a limited network of providers are all about profit. The growing trend of large corporations like United Health Group owning subsidiaries like Optum that employ provider networks and/or pharmacy benefit managers create multiple opportunities to extract profit from the Medicare Trust Fund. Their practices will continue until we build a strong enough movement to stop them. The WISeR pilot program began on January 1, 2026 in Washington. That’s bad news. It expands the use of prior authorization in Original Medicare, adding 17 procedures. It also introduces the use of private, for-profit corporations to determine whether these 17 procedures will be covered by Medicare. These corporations are required to use AI to make the determination and will be paid a larger reimbursement for denials. The good news is that our education and advocacy work has been very effective, and our members have made a big difference. Most recently, Sen. Patty Murray introduced S. 3480, a bill prohibiting the Secretary of Health and Human Services from implementing the WISeR pilot program in Medicare. There are 18 Senators co-sponsoring the legislation including Sen. Cantwell. Sen. Murray’s bill is companion legislation to Rep. DelBene’s legislation in the House. HR 5940 also bars the Secretary of Health and Human Services from implementing WISeR. Introduced in November, HR 5940 has 38 co-sponsors, including all the Democratic representatives in Washington, except for Rep. Glusenkamp Perez. We will try to get her support in 2026. It is unlikely these bills will pass in 2026, but they are a good organizing tool. Our work in 2026 will include building momentum to end WISeR before the scheduled six-year termination date. PSARA is a member of the national Reclaim Medicare Coalescence, which includes a number of organizations that have a significant presence in Washington, DC, and wide national outreach. The coalescence has adopted as a goal the introduction of the Level the Play-ing Field legislation, hopefully in 2026. Members of the coalescence also play a major role in researching and exposing the abuses of the Medicare Advantage corporations, and they advocate for regulations and legislation to put an end to these abuses. We are all working to terminate WISeR, and many of the organizations in the Reclaim Medicare Coalescence support Rep. Jayapal’s Improved Medicare for All legislation (HR30069). Here are some things our members can do to help in the coming year: Help us find venues where we can educate and advocate about leveling the playing field, about achieving Improved Medicare for All, and ending the abuses and fraud of Medicare Advantage. If you or someone you know has a personal story of problems related to the healthcare being provided by a Medicare Advantage plan or if you are on Original Medicare and have a personal story related to the use of prior authorization in the WISeR program, please email organizer@psara.org to let us know. Personal stories are powerful. We will not use your name unless you give us permission. When you receive emails urging you to contact elected officials, please continue to respond with action. For example, we will be working to have legislation introduced in Congress to level the playing field related to benefits between Original Medicare and Medicare Advantage. We are educating and advocating for the legislation to set an affordable cap on out-of-pocket costs in Original Medicare, making it unnecessary to purchase Medigap insurance. It will also include hearing, dental, and vision coverage. When the legislation is introduced, we will need assistance in getting co-sponsors from the Washington Congressional delegation. In the state legislature we will be educating and advocating for the passage of SJM 8002, which puts the state legislature on record calling for Congress to stop the fleecing of the Medicare Trust Fund by Medicare Advantage and level the play-ing field between Original Medicare and Medicare Advantage. We want Medicare beneficiaries to have a real financial choice between the public plan and the private for-profit plans. We will also support efforts to restore the cuts to Medicaid. Will Parry, the former inspirational leader of PSARA, would frequently sing the song "Carry It On," made famous by Joan Baez. In 2026, we will resist attacks on Medicare and Medicaid and demonstrate there is a better way. We will carry it on. Robby Stern is President of the PSARA Education Fund and a member of PSARA's Executive Board. < Back to Table of Contents