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The Retire Advocate < Back to Table of Contents December 2025 How the Trump Administration Is Changing Nonprofit Organizations: Chaos to Follow Katie Harris Did you know that, in the Trump regime, up now means down? That’s right; Trump’s administration is issuing guidance and executive orders that turn the nonprofit sector on its head. Existing laws are being reverse engineered to make it discriminatory to reverse discrimination. Organizations working to reverse inequities and injustice are scrambling to understand how they’re affected, and how to position themselves to avoid nuisance complaints and lawsuits. Advocacy and service organizations will have to recast how they represent their work, hiring, and programming. But first, what, exactly, are executive orders and guidance? Executive orders are directives, signed by the president, that have the force of law. They can be nullified by the courts or modified through legislation, but they remain in effect until they are rescinded by a president or expire on a specified date. Trump has issued hundreds. For handy reference, the National Council of Nonprofits has published a chart of executive orders with sizable sector impacts. Organizations centering diversity, equity, and inclusion (DEI); immigrant justice; health care; envirormental justice; LGBTQ+; and civic access are among those hardest hit. Unlike executive orders, official guidance does not have the force of law. However, guidance from Attorney General Pam Bondi has a huge impact on organizations. Guidance for Recipients of Federal Funding Regarding Unlawful Discrimination redefines how the federal government considers DEI. Centering the interests of a specific population is now discrimination on the basis of a protected characteristic. The Guidance maintains that programs that “separate or restrict access based on race, sex, or other protected characteristics…generally violate federal law by creating unequal treatment or reinforcing stereotypes, regardless of the stated goal.” But lest we assume consistency matters, “failing to maintain sex-separated athletic competitions and intimate spaces can also violate federal law.” Therefore, “organizations should affirm sex-based boundaries rooted in biological differences.” The assaults on organizations are mind-boggling in scope and very destabilizing. Among the most impacted: Race-based scholarships and program participation; Preferential hiring or promotion; Access to facilities or resources based on race, ethnicity, income level or census tract. Language to serve as proxies for “preferential treatment” is explicit in Bondi’s Guidance . Cultural competence, lived experience and diversity statements are cited as examples of proxies. Instead, organizations are supposed to be “merit-based.” In other words, the protected class is now those who benefit from the “affirmative action of generational wealth,” as Michelle Obama aptly put it. The Department of Justice, alone, canceled 373 grants, totaling $500 million, affecting 221 organizations. These grants had been approved by Congress, which sets policy through its power of the purse. Eliminating these grants puts the president’s actions at odds with Congressional intent. But, with this administration, that’s the point. The implications are huge. Government grant cycles have been canceled. Foundations have redirected their grants to maintain the operations of vital organizations under sustained assault. Legal service organizations are deluged by preparing legal challenges to fight these orders. Nonprofits must also expect nuisance complaints and lawsuits requiring defense, intended to divert resources away from programming. One tool will be scrutiny of IRS Form 990, the detailed nonprofit tax filing, which anyone may inspect online. (Religious congregations are exempt from public scrutiny). Ongoing foci in the 990 for right-wing trolls include: Using contractors in lieu of staff. Expect increased scrutiny here. The IRS criteria are clearly spelled out; Fundraising costs that appear disproportionately high, relative to the budget; Advocacy activities that might constitute lobbying in excess of thresholds; Lack of conflict of interest and whistleblower policies; Absence of financial policies and procedures. Meeting minutes, annual reports and job announcements will also face scrutiny. One growing vulnerability: agencies record meeting minutes using Zoom instead of taking written minutes. It is very tempting, but don’t do it. People say all sorts of things in meetings that shouldn’t be captured for all time. Expect meeting minutes to be requested with complaints. Referring to a contractor as a deputy director in a recorded board meeting, for example, could leave an organization very vulnerable. We can expect complaints around phrasing of job postings and program eligibility. Any public-facing document is a potential avenue of exposure for an organization. To read the Attorney General’s memo, search for Guidance for Recipients of Federal Funding Regarding Unlawful Discrimination. A tool kit for protecting nonprofits from scurrilous attacks is Nonprofit Toolkit: Resources for Organizations Facing Government Investigations . A New York Times article about what’s coming is "You May Not Be Trump’s Target This Time, but You Could Be Next." Katie Harris is the Retiree Advocate's Copy Editor. < Back to Table of Contents

The Retire Advocate < Back to Table of Contents November 2025 Please Make an End-of-Year Donation to the PSARA Education Fund Robby Stern When you consider End-of-Year donations, we hope you will decide to donate to the PSARA Education Fund, a 501c3 organization. Your financial support will assist the Education Fund with our work in 2026. The Retiree Advocate , a publication of the Education Fund, has continued to provide information and the type of analysis that would be difficult to find elsewhere. Although we are a regional organization and address issues impacting residents of Washington, increasingly the information we are providing is used by organizations in other parts of the country. In 2025, many of us suffered varying levels of shock at the attacks by the Trump administration on democracy, immigrants, the environment, health care, and on programs won by mass activism like Medicare, Medicaid, and Social Security. Republican members of Congress and a few Democrats have collaborated or stood by. While a number of the lower courts are resisting the attack on the rule of law, a majority of the Supreme Court appears to be in the pocket of the autocrats. Fortunately, the resistance to autocracy and fascism is growing. Unfortunately, we can anticipate willful attacks on the resisters by the fascists and their allies. It will take more determination, hope, and bravery to build the movement we need to stop this march to eliminate our democratic rights and the programs we hold dear. The PSARA Education Fund intends to help build our knowledge and spirit to resist, with good information and analysis and even some levity. (Remember the articles about Jello?) Besides the Retiree Advocate , the Education Fund finances presentations, meetings, and webinars, all designed to give our members and the broader community the information they need. We utilize the knowledge of national and state experts. We draw attention to the attacks and what we can do. Besides the fight to preserve and expand Social Security and Medicare in which we play a leading role, we stand with allies in the fight for democracy. We stand with working people in their fights for the right to organize and to be treated with respect and dignity. We join with allies to fight for racial justice and climate justice. We also focus on what we want to build after we defeat this attack on our lives, our families, our neighbors, and our communities. Remember, things were not so great before the MAGAs gained power. We will discuss what we and our allies can build that is better as we resist the horror that is being unleashed. We will, with many others, develop a vision of how things should be. We do not want to go back to the old ways of the wealthy and corporations deciding what is best for all the rest of us. There is so much to do and so much we can do, and your donations help to pave the way for the work this time in history demands of us. We keep plugging away, and your support financially and morally is the wind behind our organization’s sails. Please make a donation to the PSARA Education Fund of any size prior to the end of the year by either writing a check and mailing it to the PSARA office or going to www.psara.org and making an online donation. Together we will resist and carry on. Robby Stern is president of the PSARA Education Fund and a member of PSARA's < Back to Table of Contents

The Retire Advocate < Back to Table of Contents May 2025 Remember-ing Retired House Speaker Frank Chopper Frank was a long-time member of PSARA. He was extraordinarily gracious and generous with his time when PSARA members came to lobby day in Olympia. Below are some remembrances of Frank from PSARA leaders. Jeff Johnson Jeff is the retired president of the Washington State Labor Council, AFL- CIO, and presently serves as the co-president of PSARA: On November 3, 1998, Initiative 688, written and backed by labor, raised Washington’s state minimum wage to the highest in the country and was the first minimum wage to be indexed to inflation. Passing by 66 percent, and bringing out an additional 3 percent of the vote, broke Republican control of the House, creating a 49-49 tie and making Frank Chopp Co-Speaker of the House of Representatives. In March of 2001, labor convinced Tom Campbell (R-Spanaway) to cast his vote for Frank’s budget, passing the first Democratic budget in seven years, essentially giving Frank control of the House. In November, 2001, labor-supported candidate Brian Sullivan won a special election in the 21st LD, giving Frank and the Democrats full control of the state House. Frank liked to tell the story of how his grandparents met on a picket line outside the mines in Roslyn, WA. In 2002 he was able to honor that history by helping to shepherd four collective bargaining bills through the legislature, giving full collective bargaining rights to state employees and giving over 60,000 workers a real voice at the workplace. Frank was a complex man, and not always easy to work with. But he was a champion for the poor and for afford- able housing. His leadership at the Freemont Public Association (Solid Ground) and the Washington State legislature has left an indelible mark on the less fortunate among us. Frank had so much more he wanted to give. He will be missed. Sretan put, voda Frank Chopp! Marily Watkins Marilyn is on the Board of the PSARA Education Fund and on PSARA's Government Relations Committee. She retired as the Policy Director of the Economic Opportunity Institute: Frank was a master of the long game. In 2002, with our state in recession and facing a budget shortfall, he taught me a key lesson for winning new policy. The coalition I worked with was pushing an early version of paid family and medical leave. When we met with Frank, he said there was no way he could pass it that year. But instead of leaving it there, he added, “Come back with something I can pass.” We came back with the Family Care Act, and it did pass. Since then, Washington workers have had the right to use their sick leave or any other employer-provided paid time off to care for a sick family member. It was still a long path to winning comprehensive paid family and medical leave, but along the way, the Washington Work and Family Coalition, partnering with local coalitions, helped win paid sick leave for all workers in Seattle, Spokane, and Tacoma, then statewide. Finally, in 2017, Speaker Chopp presided over passage of our state’s landmark paid family and medical leave program. These advances have served as models for other states, helping mil- lions of workers and families across the country. Pam Crone Pam is the chairperson of PSARA’s Government Relations Committee and a retired lobbyist for PSARA: I lobbied for 20 years in the Washington State Legislature. Seventeen of those years were during Frank’s long tenure as House Speaker. Being summoned to Frank’s office has been likened to getting called to the principal’s office in junior high. The reason for the summons wasn’t always clear beforehand. Perhaps you had done some- thing really great or terribly wrong? Approaching the Speaker’s Office hop-ing for the former, the experience was always significant, and one walked out abundantly clear as to what the expectations were for a future course of action. Frank exuded energy and power. No one worked harder in the Legislature than he did. His legislative successes were legion, and he knew how to communicate those successes to Washingtonians, ensuring healthy majorities session after session. I always respected and admired how he mentored ranks of smart and eager young people, providing them a front-row seat in making policy and navigating politics. I cared for him deeply and the loss is great. Angie Bartels Angie is PSARA’s Membership Vice President: Frank Chopp was a very close friend and colleague of my husband, Tony Lee, deceased. While Frank was Speaker of the House, he recruited Tony to work at Solid Ground and lead the Statewide Poverty Action Network as the director and lead advocate. Together, these two incredibly talented men worked tirelessly (with others of course) over many years drafting legislation and garnering the support of other state legislators to pass laws in support of low-income residents of our state. This included health care, employment, workforce training, union support, early childhood education, equity in education, prisoner’s rights, services and rights for immigrants, and so much more. Occasionally we had large meetings at our house of advocates and supporters. I remember one occasion when Frank was sponsoring legislation to increase and improve mental health services. He gave a very emotional speech about the need for services to ease the suffering of the people affected and their families. As he spoke about his own sister’s mental health condition and how it affected their family, Frank wept. Through his tears, or in spite of them, Frank spoke boldly and valiantly of the work he was preparing in the legislature. I was very moved by this presentation, and it changed how I viewed Frank. His persona, in my eyes, of the mythical hero melded with the sensitive human being that he was. I don’t think I’ve ever met anyone who has fought harder or given more of himself for the people of the state of Washington. Rest in peace Frank. Your legacy lives on. < Back to Table of Contents

The Retire Advocate < Back to Table of Contents March 2026 Kaiser Permanente’s Hand in the Cookie Jar Robby Stern In February 17, 1971, President Nixon’s domestic advisor, John Erlichman, briefed President Nixon on a conversation he had with Edgar Kaiser, the founder of Kaiser Permanente (KP). Erlichman was describing KP to the President as an example of the newly emerging Health Maintenance Organizations (HMO). They were considering whether the HMO model was a possible alternative to the call for nationalized healthcare. Erlichman told the President, “All the incentives are toward less medical care, because…the less care they give them the more money they make.” Nixon responded, “Fine." Flash forward 50-plus years. A New York Times (NYT) article written by Reed Abelson and Margot Sanger-Katz, published on January 14, 2026, revealed that KP had reached a very large settlement with the Department of Justice (DOJ) concerning Medicare fraud claims amounting to an estimated one billion dollars. The settlement was for $556 million to be paid to the federal government and two whistle blowers for overbilling by KP’s Medicare Advantage plan. The lawsuit dated back more than 12 years and asserted that KP affiliates in California and Colorado reported their patients were sicker than they actually were. Medicare Advantage (MA) insurers are paid a certain amount per patient (capitated payment) based on the individual’s health-related risk factors rather than Original Medicare’s fee for service. The NYT article explains what the whistleblowers exposed. “One of the whistleblowers, Dr. James Taylor, a physician and coding expert, who worked for Kaiser in Colorado, described meetings in which he was told to find additional diagnoses that could be worth millions of dollars. ‘The cash monster was insatiable,’ he said." According to the NYT article, “In the Kaiser case, executives routinely pressured doctors to add thousands of diagnoses, sometimes weeks or months after the patients had been treated, according to the Justice Department, which joined the lawsuits in 2021. The extra diagnoses helped the company earn bonus funds from the government. MA insurers are paid higher insurance premiums when plans cover sicker patients.” The NYT article went on to say “The Justice Department lawsuit stated ‘The doctors would sometimes sit together at lunch or after work, with food and drinks provided by Kaiser, to code their visits with additional diagnoses...the insurer linked doctor and facility pay bonuses to adding more diagnoses.' “According to the lawsuit, the government estimated that Kaiser received one billion dollars from 2009 to 2018 from additional diagnoses, including roughly 100,000 findings of aortic atherosclerosis, or hardening of the arteries. But because its doctors would be forced to follow up on too many people, the organization stopped automatically enrolling those patients in a heart attack prevention program.” KP indicated. when they reached this settlement, that they decided to settle the lawsuit “to avoid prolonged litigation.” The settlement allowed KP to state that they never did anything wrong. Had the settlement required KP to admit wrongdoing, they could have been excluded from the MA program. KP is not alone in this practice. MedPAC, an independent congressional agency, created in 1997, analyzes and provides policy advice to Congress regarding the Medicare program. They issued reports in March, 2025, and January, 2026, indicating that MA insurers were overcharging the Medicare Trust Fund by $85 billion in 2025 and are projected to overcharge by $76 billion in 2026. Instead of profits (because KP is a “nonprofit”), Kaiser has extensive “reserves," supposedly to cover times when costs exceed revenues. As of the beginning of 2026, KP’s estimated financial reserves were estimated at $67 billion held in cash and investments. Here is an example of KP’s investments. Innovaccer, Inc. is the company that has been selected by CMS/CMMI to implement the WISeR program in Ohio. WISeR is the newest privatization attack on Original Medicare. Created and overseen by CMS/CMMI, WISeR expands the use of prior authorization in Original Medicare, using artificial intelligence as a tool for determining if certain procedures recommended by a Medicare beneficiary’s physician will be covered by Medicare. Innovaccer receives a higher reimbursement rate for denying coverage for these procedures. A leading investor in the funding of Innovaccer Corporation is Kaiser Permanente. Evidently, they hope to receive significant returns from the reserve funds invested in Innovaccer. In 2024, KP’s top nine executives were paid, according to their Form 990 filed with the IRS, approximately $56 million in salaries, with CEO Greg Adams’ salary close to $13 million (one million+ per month)! The salary numbers do not include additional perks that add significantly to the total compensation package. While Kaiser’s executives may earn less than executives of for-profit Medicare Advantage corporations, KP executives and the KP system are a part of overcharging our worker-funded Medicare Trust Fund by Medicare Advantage. We, the people who paid into the Medicare Trust Fund, are learning that our hard-earned wages are being fleeced by both for-profit and not-for-profit insurance corporations. After knowledge comes action. CMS has issued a 2027 Advanced Rate Notice related to reimbursement rates for MA insurers. There is an opportunity for public comment with a deadline of February 25th. The CMS proposal of an increase of 0.9 of 1% is meeting stiff resistance from the insurers who received an outrageous 5% increase in 2026. Our voices will need to weigh in. Please look for a PSARA email with instructions on how to register a comment and suggested language for a message. Robby Stern is President of the PSARA Education Fund and a member of PSARA's Executive Board. < Back to Table of Contents

The Retire Advocate < Back to Table of Contents January 2026 Balcony Solar: Simple, Do-It-Yourself Solar Power Anne Shields Why is Residential Solar So Expensive in the US ? The costs of permitting and fees for rooftop solar are much higher in the US than in Europe or Australia due to fragmented, varying local requirements that create inefficiencies and delays. The difference is dramatic: a technical report from Tesla’s think tank outlines why US rooftop installation costs are three times higher than costs in Germany. Several studies report that inflated costs in the US are primarily due to the ”soft costs” in rooftop solar, which account for around 60 percent of total installation costs. The National Renewable Energy Laboratory (NREL) identifies numerous categories of soft costs, including permitting, inspection and utility interconnection, installation labor, sales tax, overhead, net profit margins, and marketing. The US residential solar industry has entered a new era as federal tax credits for rooftop solar will expire on December 31, 2025. With the federal Investment phasing out at the end of 2025, most industry analysts anticipate a short-term decline, but it is far from a death knell for the industry. After all, while incentives may fade, energy demand is projected to rise sharply over the next few years and decades. McKinsey Consulting projects that total US electricity demand will rise by nearly 25 percent by 2030. That growth cannot be met without expanding solar energy generation through smaller, localized systems. What is “Balcony” Plug-in, Portable Solar? Balcony solar is a simple, do-it- yourself, “plug-and-play” solar panel and device that can be installed easily without an electrician. Plug-in is a more accurate term than balcony for these portable systems because they can be installed on a deck, a carport, an RV, or almost any stable surface. In a plug-in system, the solar panel is connected to a device that converts solar power to electricity and is plugged into a standard 120V outlet. The system can provide up to 800 watts, enough to run a small fridge or a laptop. A plug-in system is affordable because it avoids almost all the costs associated with rooftop solar installation. Renters can purchase, install, and take the portable panels and system along if they move. In March 2025, Utah became the first state to pass legislation allowing plug- in solar systems. Utah’s Solar Power Amendment passed with overwhelm- ing bipartisan support, allowing Utah residents to connect their systems directly to 120V outlets without permits, inspections, interconnection applications, or utility fees. Utah requires that plug-in systems meet nationally recognized electrical code standards and safety certification standards. At least six states are following Utah’s lead with new regulations allowing plug-in solar. Legislators in Maine, New Hampshire, New York, Pennsylvania, South Carolina, and Vermont will review bills allowing plug-in solar during their respective legislative sessions. At the time of this writing, it has not been established whether Washington State legislators might pursue legislation allowing plug-in solar during the 2026 short session, but it is clear that state legislation will be necessary. Construction and solar permitting websites for numerous counties and cities explicitly state that “balcony solar is illegal in Washington State,” referring the reader to state building codes. Anne Shields is a member of PSARA's Climate and Environmental Justice Committee. < Back to Table of Contents

The Retire Advocate < Back to Table of Contents May 2025 We Want to Hear From You! Tell Us About your Experiences with Social Security Have you experienced unacceptably bad results when contacting (or trying to contact) the Social SecurityAdministration (SSA)? Years of underfunding by Congress has left the Agency with 57,000 employees, the lowest staffing in 50 years. At least7,000 more are being cut right now. Offices are being closed. Hold times on the toll-free number are way too long, andthe MySSA website has been crashing. One million disability claims and appeals await decisions, processing times have tripled, and 30,000 applicants die each year while waiting for a final decision. PSARA wants to share powerful personalstories about degraded services and harm to workers and their families with our elected repre- sentatives and/or the press. At the same time, we want to hear from you about what SSA programs and services mean to you and to your family, andwhat would happen if they were lost or further eroded. Retirees, disabled individuals, their spouses and dependent chil- dren, and surviving spouses and children in the event of a worker’s death, all rely on timely and compassionateservice delivery. The same is true for clients who apply for Medicare and Supplemental Security Income. Incomeverifications needed to qualify for other programs, and referrals to these providers, are also vitally impor- tant. Help us save Social Security and restore service delivery. Please share your personal stories with organizer@psara.org . < Back to Table of Contents

The Retire Advocate < Back to Table of Contents May 2025 March 27 Detention Center Rally Richard Burton Approximately 300 labor and community activists, including many PSARA members, gathered outside the ICE concentration camp in Tacoma, aka the “Northwest Ice Processing Center” on the evening of March 27. They gathered to express their collective outrage over the ongoing human rights abuses in the camp and specifically the summary detention of two labor activists, Alfredo ‘Lelo’ Juarez Zeferino and Lewelyn Dixon. Dixon (known to loved ones as “Aunty Lyn”) has lived in the US for more than five decades. She works at the University of Washington Medical Center as a Lab Technician and is a member of SEIU 925. In early March, she was abducted at the airport, returning from a trip. A family relative traveling with her waited for hours while she went through the security line with no information. The family member was finally informed via a phone call from Dixon that she’d been detained by ICE. She’s been held now for nearly two months Alfredo “Lelo” Juarez is an organizer and member of Familias Unidas por la Justicia and Community to Community (groups primarily working in Whatcom and Skagit Counties). He came to this country as a young teenager. He was detained and sent to the detention center on Tuesday, March 25. According to witnesses, Lelo was on his way to drop off his partner at her workplace. When he stopped his car, ICE agents confronted him. Not leaving his vehicle, he tried to exercise his rights. But ICE agents broke his car window. At the rally, Lelo’s younger brother took the mic to thank attendees for showing up for his brother and to call for his brother’s release. Unfortunately, these are only two of the estimated 1,500 people being detained in this prison camp, run by a for-profit private company, GEO, which is contracted by ICE. Despite right-wing rhetoric, this ICE facility, like hundreds of other such facilities around the country, is a site for civil, not criminal, detention. That is, those held in this prison camp are not detained because a court has concluded that they are a threat to public safety, nor because they have committed a crime, but simply because they are awaiting the outcome of their immigration proceedings. There are nearly continuous protests and hunger strikes being undertaken by detainees inside this prison against their mistreatment. One reason for these protests is the fact that gross violations of international law are a matter of course there. The United Nations’ Standards of Rules for Treatment of Prisoners, known at the “Nelson Mandela Rules, explicitly prohibit indefinite and prolonged solitary confinement and the imposition of solitary confinement in the case of detainees with mental or physical disabilities. Despite this, however, ICE’s own data reveals that, on average, this ICE prison camp detains people longer in solidarity confinement than any other ICE facility in the country, and detainees are regularly subjected to the use of chemical agents. PSARA activists in Pierce County have participated in many rallies and community events denouncing this prison camp in our midst. We have developed ties with other groups and activists working both to improve conditions for detainees while also calling for the place to shut down. A small but important piece of progress is a piece of legislation in Olympia, HB 1232, allowing officials from our state’s Department of Health to inspect the facility. This bill has passed both chambers in Olympia but with an amendment from the Sen- ate that will now need to be considered by the House. Please contact your state reps to urge them to pass this bill be- fore the April 27 end-of-session. Richard Burton is PSARA's Co-VP for Outreach. < Back to Table of Contents

The Retire Advocate < Back to Table of Contents August 2025 CMS Expands Prior Authorization in Original Medicare Washington One of Six Designated States Robby Stern The Centers for Medicare & Medicaid Services (CMS) announced on June 27, “The CMS Launches New Model to Target Wasteful, Inappropriate Services in Original Medicare.” We know from a study by the Medical Payment Advisory Commission (MEDPAC) that Medicare Advantage (MA) overcharges the Medicare Trust Fund annually at least $80 billion per year. One would think wasteful inappropriate services must exceed that number or why would they be prioritizing expanding prior authorization in Original Medicare? (A PNHP study estimates overcharges are much higher, up to $140 billion annually.) MEDPAC estimates that up to $5.8 billion in Medicare spending in 2022 was spent on services with minimal benefit. Five billion eight hundred thousand is a lot of money, but it is approximately 7 percent of $80 billion overpayments to MA. We don’t know why they chose to focus on the much smaller amount possibly lost to ""fraud, waste, and abuse.” Maybe they are trying to level the playing field in the wrong direction. Maybe they secretly want more of us in Medicare Advantage so they plan to add more prior authorizations into Original Medicare. We don’t know their motives, but below are excerpts from what they did say. "The Centers for Medicare & Medicaid Services (CMS) is announcing a new Innovation Center model aimed at helping ensure people with Original Medicare receive safe, effective, and necessary care. Through the Wasteful and Inappropriate Service Reduction (WISeR) Model, CMS will partner with companies specializing in enhanced technologies to test ways to provide an improved and expedited prior authorization process relative to Original Medicare’s existing processes, helping patients and providers avoid unnecessary or inappropriate care and safe- guarding federal taxpayer dollars… “CMS is committed to crushing fraud, waste, and abuse, and the WISeR Model will help root out waste in Original Medicare,' said CMS Administrator Dr. Mehmet Oz. 'Combining the speed of technology and the experienced clinicians, this new model helps bring Medicare into the 21st century by testing a streamlined prior authorization process, while protecting Medicare beneficiaries from being given unnecessary and often costly procedures…. “Low-value services, such as those of focus in WISeR, offer patients minimal benefit and, in some cases, can result in physical harm and psychological stress,' said Abe Sutton, Director of the CMS Innovation Center. 'They also increase patient costs, while inflating health care spending.' "The WISeR Model will test a new process on whether enhanced technologies, including artificial intelligence (AI), can expedite the prior authorization processes for select items and services that have been identified as particularly vulnerable to fraud, waste, and abuse, or inappropriate use. These items and services include, but are not limited to, skin and tissue substitutes, electrical nerve stimulator implants, and knee arthroscopy for knee osteo- arthritis. The model excludes inpatient- only services, emergency services, and services that would pose a substantial risk to patients if significantly delayed. "Companies selected to participate in the model will operate in assigned geographic regions and must have clinicians with appropriate expertise to conduct medical reviews and validate coverage determinations. Importantly, while technology will support the review process, final decisions that a request for one of the selected services does not meet Medicare coverage requirements will be made by licensed clinicians, not machines. "Model participants will receive payments based on their ability to reduce unnecessary or non- covered services (inappropriate utilization) and lower spending in Original Medicare. … "The WISeR Model will not change Medicare coverage or payment criteria. Health care coverage for Original Medi- care beneficiaries remains the same, and beneficiaries retain the freedom to seek care from their provider or sup- plier of choice… The WISeR Model does not impact people enrolled in Medicare Advantage." Trying to cut through the bureaucratic writing, what they are saying is CMS is changing Original Medicare coverage(which they deny) by expanding the list of medical treatments recommended by our providers subject to prior authorization beginning in 2026. CMS will contract with private, no doubt for-profit companies that will determine if the recommended treatment is unnecessary or inappropriate and/or constitutes waste, fraud, and abuse. The contractor may utilize AI to make the determination subject to a final decision by a licensed clinician that works for the contractor. These companies are essentially “bounty hunters."" They are compensated based on their record of denying care and reducing spending in original Medicare despite the data that shows Original Medicare spends 22% less per patient than Medicare Advantage. Introducing “bounty hunters” into Original Medicare... what could possibly go wrong?! On June 23, HHS Secretary Kennedy and CMS Administrator Oz announced an insurance industry voluntary pledge to fix what they termed the broken prior authorization system in Medicare Advantage and Medicaid. The voluntary agreement with Medicare Advantage and Medicaid insurers addressed time limits for decisions on prior authorization. Standard decisions are to be made within seven days. Urgent medical requests are to be made within 72 hours. The appeals process for denials, if necessary, extends the time before the Medicare/Medicaid beneficiary receives the treatment the provider has recommended. This is a voluntary program for insurers participating in Medicare Advantage. The WISeR Model, which expands prior authorization in Original Medicare, is mandatory in the six designated states. Neither beneficiaries nor providers can opt out. PSARA will launch an effort, with our national allies, to stop WISeR before it starts in 2026. Robby Stern is President of the PSARA Education Fund and serves on the PSARA Executive Board. < Back to Table of Contents

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 March 2025 Mexico: Unequal Trade and Trump’s Nonsense Michael Righi What is Trump thinking with all this back-and-forthing on tariffs? Is it really linked to fentanyl labs and immigrants? Is there a hidden agenda? The idea of Trump “thinking,” rather than just blustering and bullying, may be a bit of a stretch. But let’s try to figure some things out. Trump has, of course, threatened 25% tariffs on imports from Mexico and Canada. As he often does, he claimed victory whenMexico moved some troops toward the border, which they were always planning to do. So the tariffs are on pause. Trump backed off. Trump’s justifications for higher tariffs wander all over the place. Besides using them to supposedly stop the flow of drugsand migrants, he claims countries are selling us too much stuff, stuff that could be made in the US. The US does have a trade deficit with Mexico, which has resulted from the signing of the North American Free TradeAgreement in 1994. This allowed US corporations, ever in search of cheaper resources, less regulation, and cheaper labor in particular, to produce in Mexico and export back to the US with minimal tariffs. We know the effects of NAFTA on jobs in US manufacturing towns. What is perhaps less discussed are the effects in Mexico. US agri corporations, subsidized by the US government, dumped tons of corn and wheat into Mexican markets at prices 15% to 30% below the cost of production. This drives down prices and drives millions of small Mexican farmers into poverty and off their land. Mexico now imports 40% of its grain, whereas before NAFTA it was 7%. Folks went north, to the maquiladoras, low-wage component and parts factories supplying US corporations. Or across theborder. Sin Maiz No Hay Paiz Trade and trade rules reflect relative economic and military power. NAFTA and the World Trade Organization (WTO) are agreements that privilege the free movement of goods and capital and profit. Under existing trade rules, workers and small farmers lose. For the last three decades, the global 1% captured over half of all increases in income. That’s not only because of trade, ofcourse, but trade played a part. Neoliberalism and its promise of “all boats rising” has failed. The WTO has a “trade court” that interprets trade rules. Over the last several years, Mexico, under President Lopez Obradorand now Claudia Sheinbaum, has adopted policies to support Mexican farmers, and move to healthier food. Corn is themain grain: “Without corn there is no country.” Part of agricultural policy has been to restrict and eventually phase out the import of US genetically-engineered corn. GM corn in the US is grown with the chemical glyphosate, a known carcinogen. Any trade restriction, no matter how reasonable,according to WTO rules, is banned. Mexico produced a brilliant synthesis of the evidence on the harms caused by glyphosate. They argued they have a right toprotect their people, their farm- ers, their indigenous food practices. The WTO trade court ruled for the US, and this was under the Biden administration. Might makes right. Bringing Jobs Back? Trump claims to want to bring back jobs to the US and punish Mexico for the trade imbalance. But it is not about Mexico and the US. Workers here and in Mexico have similar interests in not being thrown in competition with each other, and having wages driven down. Food producers (not Big Ag) and consumers in both countries need high quality standards and climate-sustain- ing production. Does Trump really think 25% tariffs will bring manufacturers back to the US? Does he care? Car manufacturers bring parts and components across the border several times per car in their supply chain strategies. Are they willing to refashion supply chains? Mainly what Trump is doing is introducing a whole lot of uncertainty into corporate decision making. Would some strategic tariffs and an industrial policy that fostered research and development and targeted loans to clean energy firms, and training for skilled workers make sense? Absolutely. But if you think that’s the path Trump is on, I have a bridge I could sell you. Trump’s tariffs and threats of tariffs are going to cause problems. They are a tax, so they will raise prices. Costs will go up, so firms might respond by cutting jobs. Trading partners will retaliate with their own tariffs. If prices rise, the Fed will keep interest rates high. As usual, all that hurts working families. So, what is Trump going on about? Part of it is a show of dominance, playing to his base. But perhaps the main point? Republicans want more tax cuts for the wealthy, and they are going to have to find some ways to fund those cuts. Tariffs do raise some revenue, so that may be the point. The 1% need more. Michael Righi is a retired economics professor and a member of the Retiree Advocate editorial board. < Back to Table of Contents

The Retire Advocate < Back to Table of Contents September 2025 Deceit, Resistance, on Social Security’s 90th Birthday Steve Kofahl Thursday, August 14, marked the 90th anniversary of the passage of the Social Security Act. At his Oval Office event, President Trump asserted that the Administration had eliminated the federal taxation of Social Security benefits and improved customer ser- vice at the Social Security Administration (SSA). Both claims are false. His “One Big Beautiful Bill” provides a tax deduction of as much as $6000 for some beneficiaries, but about half of them will still pay taxes on their benefits when the tax deduction offset is considered. The SSA Chief Actuary finds that the loss of Trust Fundincome resulting from this legislation advances the date when the Trust Funds will be depleted by six months, from early 2034 to late 2033. The deportation of undocumented workers may advance the date by another six months, according to some analysts. Trumplied when he previously asserted that undocumented workers receive benefits, and that 235,000 of them had been removedfrom the beneficiary rolls this year. Undocumented workers pay Social Security taxes on their earnings, but are ineligible to receive benefits under the Social Security Act. More deportations mean less income to the Trust Funds. The alleged service improvements are a ruse, a product of changes in both SSA field office procedures and the Agency’s displayof service data. Workers have been repeatedly redirected to address high-profile workloads and backlogs, at the expense oftheir regular assigned duties. Field Offices no longer take benefit applications on a walk- in basis. Instead, visitors are scheduled for a future telephone interview that will likely be several months later. The delay is not measured or reflected in public-facingperformance reports, nor is the public harm acknowledged. To make matters worse, SSA launched a flawed 800# chat-box in April. It too-often responds to a different question than the one asked by the caller, fails to route the call to a live agent when requested, and/or terminates the call. Absent a caller’s intent to file and date of contact being documented by SSA, there can be a permanent loss of benefits because there are strict limits on retroactivity. The National Academy of Social Insurance has released an initial report documenting the inherent problems in utilizing artificialintelligence (AI) at the SSA, and continues to study the subject, but SSA Commissioner Bisagnano is committed to expanding its use, no doubt to justify steeper future staff cuts. Increasing the use of AI in making disability determinations at the SSA is aparticular concern, because of accuracy and equity issues. A trained human, who is not pressured to deny an application or appeal, must always be the final disability decision-maker. The American Federation of Government Employees, National Council of Social Security Field Operations Employees (AFGE Council 220) led over 50 actions on August 14. It revealed that benefit applications increased 18% between January and May, that in 46 states over 10% of SSA staff was lost in the 12 months ending in March (9% in Washington State), and that more than 30% of offices lost more than 10% of their staff. SSA has shed 7,000 employees, with staffing at a 50-year low. Senators Cassidy (R-LA) and Kaine (D-VA) have proposed creation of a $1.5 Trillion private investment fund over five years that would be placed in escrow for 70 years to “save” Social Security. Treasury Secretary Scott Bes- sent (like Bisagnano, a Social Security Trustee by virtue of office, charged with protecting the Trust Funds), called Trump’s $1,000 tax-deferred accounts for newborns a “backdoor for privatizing Social Security.” We need to make it crystal clear to our elected representatives that we will not tolerate any privatization of our earned Social Security benefits, that Congress should “scrap the cap” on earnings subject to the payroll tax, and that SSA staffing and personalized service must be fully restored ASAP! Steve Kofahl is a former President of AFGE 3937, representing Social Security Administration workers, a member of PSARA's Executive Board, and a Co-Chair of PSARA's Social Security Task Force. < Back to Table of Contents

The Retire Advocate < Back to Table of Contents January 2026 Fossil Fuels Have Put Us in an Existential Fix Jefl Johnson “The Oil and gas industry makes $3 billion a day in pure profit. Generates over $4.3 trillion dollars a year in revenue. It is the seventh largest industry in the world ranked above food production, automobile production, coal mining, and at $1.4 trillion, the pharmaceutical industry doesn’t even crack the top ten. The industries listed above oil and gas are completely dependent on oil and gas. The more they grow, the more we grow. That’s the scale, that’s the size of this thing.” This is the opening monologue by the independent oilman character, Tommy Norris, played by Billy Bob Thornton, in the Taylor Sheridan‘s TV production, “Landman”. Exact numbers or not, they are staggering. And the amount of climate and species damage caused by fossil fuels is even more staggering. Since the signing of the Paris Climate Accord in 2016, the world’s major banks have lent approximately $7.9 trillion dollars to the fossil fuel industry, 20 percent of which has gone toward fossil fuel exploration and expansion. These numbers are real and are also staggering. In December 2024, one month prior to Trump’s second inauguration, six major U.S. banks (JP Morgan Chase, Citigroup, Bank of America, Morgan Stanley, Wells Fargo, and Goldman Sachs) withdrew from the United Nations sponsored net zero banking alliance. This gives new meaning to Trump’s expression “burn, baby burn.” As our planet gets hotter every year, the interest on our credit card payments, our checking and savings accounts, and our pension funds are financing climate disaster. Can we do something about this? Yes. Should we do something about it? Absolutely! Easy first steps are to bank on the community level. We can do our banking and get our credit cards from credit unions, financial companies that don’t loan money or buy the debt of fossil fuel companies. But if we really want to make a difference, we can organize around getting our private and public pension funds to stop investing our pension dollars in fossil fuel assets. We can organize around getting the Washington State Investment Board (WSIB) to stop investing the 18 pension funds they oversee in fossil fuel assets. While the WSIB makes it difficult to precisely identify how much of their assets are invested in fossil fuels, a reasonable estimate is $6-8 billion directly invested in fossil fuels and at least as much in indexed funds that contain fossil fuel investments. All told, somewhere in the neighborhood of 5-7% of the WSIB portfolio. Why is it so important to divest, or to use a less pejorative financial term "rebalance," WSIB assets out of fossil fuels? Right out of the chute, fossil fuel assets continue to underperform the overall stock market. Since the end of the last bear market, October 2022, the Standard and Poor index of funds grew by 92 percent, while fossil fuels pulled up the rear at 17 percent. You don’t need to be a math major to understand that our pension assets would earn more money if they weren’t invested in fossil fuels. But given the real and palpable urgency of reducing carbon emissions and slowing down and reversing climate disaster, if a well-respected fund like the WSIB rebalanced their portfolio out of fossil fuels it would send a clear message to other institutional investors that you can earn great returns while also protecting our planet. Not too shabby of a rationale. As a species, humans are great at making excuses not to do something. Particularly when billionaires and their representatives tell us there is a better way. Engage, they say, don’t divest. A cursory reading of the history of the corporate response to asbestos and cigarettes should be fair warning. Simply engaging corporations in a discussion around lowering carbon emissions will kill us on a grander scale than anything we have known before. Climate disaster is the greatest existential crisis there is. The situation that we are in right now recalls for me two sayings I am quite fond of. The first by our dear friend Michael Righi, recently passed, who used to say “every billionaire is a policy failure.” We have to stop taking our advice from people who benefited the most from extractive industries and who will be the least impacted by climate disaster. The second is by humorist and social commentator Will Rogers. Rogers used to say, “If you find yourself in a hole, stop digging.” Acknowledging that fossil fuel investments have put us in an existential fix is a first step. Now it’s time to stop making it worse, time to stop digging! Over the next several months I will continue to research and write about ending the financing of climate change. In the meantime, if you are persuaded by this article or the group of essays I wrote last year, “Protecting our Assets, Protecting Our Asses”(visit our website at psara.org and click the image on our homepage) then please write letters, emails, or postcards to our political leaders (Governor, Lt. Governor, State Treasurer, Director of Labor and Industries) and to our union leaders and tell them it is time to act. Jeff Johnson is Co-President of PSARA and a retired President of the Washington State Labor Council < Back to Table of Contents