Previous PSARA Webinars Don’t Let Naked Profiteering Destroy Our Medicare - Webinar Monday, March 20, 2023, 5:00 p.m. F eaturing Dr. Ed Weisbart If You Missed this Interesting and Informative Webinar, Click HERE for a recording. *********** June 2022 Dr. Ed Wesibart webinar on Defending Medicare from ACO Reach https://us02web.zoom.us/rec/share/6TNaj35HMKAKnOqBszVkAPnIVsPN7JsWPur2FCmm3b6MtRUozYbArjtiMGKR43vR._szD7hnhwbdDMfDJ?startTime=1656543630000 On April 21 , 2023, Robby Stern gave an outstanding talk to m embers of the One Payer State Network on the fight to stop the privatization of Medicare. Watch on You Tube HERE PSARA 2022 Winter Membership Meeting with Guest Speakers Bill McKibben and April Sims Recording HERE. Have We Started Building Back Better A PSARA Webinar Featuring Congresswoman Pramilla Jayapal The webinar was on January 25 , 2022 and was excellent. To Watch a recording of this webinar, cli ck here: https://us02web.zoom.us/rec/share/U_r0DCFj9fcM_T3cjalJ-9k2KMNb3tD0fbbfTarHd_D-_YYS2IW1tFIGY4NgT-ir.sUDKpnQVT7B6Ipv5 Story Telling With Aunt Mama Stories about the Plaza Hotel and Trump in NewYork, saving Medicare, her barn in eastern Washington... Oh my! https://us02web.zoom.us/rec/share/8EN-PEhvJi778NVSHeiExlgs34yHTFy3Bs-Nifz2EPEk1zL22c7tXh-R8X0Xd7gU.RTEuPTBtrqkm5gwY A Very Special PSARA Event - A Webinar about Reparations Dr. Ron Daniels, the founder and president of the Institute of the Black World 21st Century (IBW) spoke about the long struggle for justice for Black Americans. If you missed this excellent webinar on Nov. 19, or would just like to listen again, go to this link: Reparations Defending Democracy in a Period of Far Right Insurrection by Leonard Zeskin and Devin Burghart https://us02web.zoom.us/rec/share/onS3iwBMPPI_QunOz7T6ecxct93_CmpMUeA9dixGSSe7iGQDhiKR626sikqeJOCJ.7FCibith0t7vCLW7?startTime=1632441625000

Frieda Takamura

This page outlines why privatization of Medicare is bad for the Medicare Trust Fund and for all Americans. Stop Privatization of Medicare Watch PSARA Co President Jeff Johnson lay out PSARA’s Plans for getting Medicare out of the Hands of Private Equity by Leveling the Playing Field Resources on preventing privatization of Medicare: PSARA’s Level the playing field resources page Read and Download PSARA’s Primer on Leveling the Playing Field Traditional Medicare was created in 1965 as a public good to provide a national health care system for seniors and the disabled in the United States and has proven to be our most efficient and effective public health care program with administrative costs accounting for only 2-3% of Medicare spending. However over the last 20 years the federal government has created various for-profit privatized health care programs within Medicare including Medicare Part D (prescription drugs), MediGap (Part B) (supplemental plans to cover Medicare’s 20% copays), and Medicare Advantage (Part C) which is permitted to take up to 15% of every Medicare dollar for administration and profits for managing Medicare claims. Additionally, the Trump administration doubled down on privatizing Medicare through the Direct Contracting Pilot, rebranded under the Biden Administration as ACO-REACH, which allows private equity firms and Wall Street companies to take up to 25% or more of every Medicare dollar for administration and profits for managing Medicare claims. Recent reports by the HHS Inspector General, academic researchers, and investigative journalists have uncovered wide-ranging fraudulent practices, confirming that upcoding, delaying medically necessary care, and the denial of claims by insurers and other private businesses managing Medicare claims, together account for defrauding the Medicare Trust Fund and Medicare beneficiaries of many billions of dollars annually. PSARA is working with groups across the nation that recognize privatization of Medicare is unacceptable and are fighting for major changes to fix it. Our campaign to terminate Medicare privatization and to protect and strengthen traditional Medicare is grounded in the following seven goals: 1. Expose and educate PSARA members, policy makers, and the wider public on how Medicare Advantage plans, Medicare Shared Savings plans, and other “innovative” reimbursement plans are undermining traditional Medicare, fleecing the Medicare Trust Fund and taxpayers, and delaying and denying critical care to seniors. 2. Level the playing field by allowing Medicare to offer the same level of benefits to beneficiaries as the Medicare Advantage plans. 3. Require private insurers and companies to pay back to the Medicare Trust Fund, with interest, the money they stole and make restitution to the Medicare beneficiaries to whom they delayed or denied care. 4. Remove fraudulent actors from the Medicare system. 5. The DCE/ACO REACH pilot can and should be terminated immediately. Until then, no further corporate participants should be allowed into the pilot. 6. Allow Medicare beneficiaries to move from Medicare Advantage plans to traditional Medicare during the annual open enrollment periods seamlessly. 7. Support Reps. Pocan and Khanna’s bill, the Save Medicare Act, relabeling Medicare Advantage plans “alternative private health plans” and fining private insurers that use Medicare in plan titles or advertisements. PSARA’s goal is to create a movement around protecting and strengthening traditional Medicare, ending Medicare as a profit center for private enterprise, and building a sound foundation for Medicare for All. We hope you will join us in this fight. More Resources Here

In the Advocate May 2025: We Remember Iris Rosechild Editor's Note: The Advocate mourns the passing of our friend and colleague Iris Rosechild. Iris volunteered as a proofreader for the Advocate for many years, and her way with words made the Advocate a better publication. She always kept us laughing and was a pleasure to work with. We'd like to share a remembrance of Iris by her friend Carla. Iris Rosechild, born Iris Chaya Golub in Brooklyn, New York, Oct. 27, 1943, died at the age of 81 in Seattle in the hospital, nine days after a fall in her apartment. Her father, Barry Golub, came from Russia when he was 11 to join his father here in America. He was an interior house painter, and his father was a tailor. Her mother, Rose Golub, was a housewife and the first generation from Austria. Rose and Barry spoke Yiddish to each other and were Socialists. Iris was the youngest of six daughters. Her Jewish identity was very important to her. Iris left home at 17 to be a bohemian with her boyfriend in Greenwich Village. Her favorite place was the Caricatura coffee house. She moved to the Haight Ashbury in San Francisco in the 60’s, became a flower child, and protested the Vietnam War. Eventually she moved to Seattle to attend the University of Washington and graduated with a BA in Women’s Studies. She was the first coordinator of the Feminist Therapy Referral Service, which was started by her partner, Cameron Justam, in 1976. Before that she was a counselor at the YWCA. Iris had a small business selling fashionable hats called Mad about Hats in the Bon Marché in downtown Seattle. She also sold socks in a business called Café Socks in Pike Place Market and in the former Broadway Market on Capitol Hill. She returned to New York to take care of her father and her sister who were dying. She earned a Master’s in Grief Counseling at Pace University. She got a job as a counselor in New York helping the homeless find permanent housing. She loved her job but quit to return to Seattle and Cameron. She did proofreading since 2018 for the Retiree Advocate, where her keen sense of the rhythm of words was appreciated. This was just one of her many volunteer commitments. She volunteered for the Seattle International Film Festival, the Seattle Jewish Film Festival, as well as Seattle Town Hall. She and Cameron have been in a lesbian film group for five years. She had an inimitable sense of style in everything she did. She had a signature sense of humor. She made great chicken soup. She was a reader and big library user. She was warm and caring for other human beings. She was a big animal lover. Her most recent pet, Cozmo, was a three-legged orange female cat who Iris doted on. Iris is survived by two sisters, Dorian and Ruth, four nieces, one nephew, and her partner of 49 years, Cameron. BACK TO THE ADVOCATE

Local and National Resources for Seniors Resources Labor Organizations Washington State Labor Council, AFL-CIO Statewide coalition of labor unions for political action and education on workers’ issues Seattle: (206) 281-8901, Olympia: (360) 943-0608 http://www.wslc.org/ County Labor Councils County coalitions of labor unions for collective political and job action: Martin Luther King County Labor Council (206) 441-8510 http://www.mlklabor.org/ Snohomish County Labor Council (425) 259-7922 http://www.snolabor.org/ Pierce County Labor Council (253) 473-3810 http://www.wa.aflcio.org/pcclc/ AFL-CIO America’s Union Movement, national coalition of labor unions http://www.aflcio.org/ Labor Constituency Groups Worker advocates within the labor movement: Asian Pacific American Labor Alliance (APALA) http://www.apala.org/ A. Philip Randolph Institute (APRI) http://apri.org/ Coalition of Black Trade Unionists (CBTU) http://www.cbtu.org/ Labor Alliance for Latin American Advancement (LACLA) https://www.lclaa.org/ Legacy of Equality, Leadership and Organizing (LELO) http://www.lelo.org/ , 206-860-1400 PRIDE at Work http://www.prideatwork.org/ Labor Archives of Washington State Funded by the Washington State Labor Council, the ILWU Longshore Division, the Harry Bridges Labor Center at the University of Washington, and many more labor unions and and individuals. http://www.lib.washington.edu/specialcollections/laws/ Senior Services and Information Advisory Council on Aging and Disability Services King County (206) 448-3110 or 1-(888) 435-3377 http://www.agingkingcounty.org/advisory-council/ Pierce County (253) 798-4600 or 1-(800) 562-0332 Snohomish County (425) 513-1900 or 1-(800) 422-2024 https://snohomishcountywa.gov/961/Council-on-Aging Washington Association of Area Agencies on Aging http://www.agingwashington.org/ National Alliance for the Mentally Ill 1-(800) 950-6264 http://www.nami.org/ National Council on Aging (NCOA) Nonprofit service and advocacy organization and a voice for older Americans – especially those who are vulnerable and disadvantaged 1-(800) 950-6264 http://www.ncoa.org/ Alzheimers Association Patricia.Hunter@alz.org http://www.alz.org/alzwa/ Crisis Clinic (206) 461-3222 http://www.crisisclinic.org/ Home Doctor Visits Tacoma-based doctors provide home visits in Tacoma and Seattle for homebound patients. Take Medicare allotments. (253) 589-6484 National Advocates Social Security Works National Organization that PSARA works with in the areas of Social Security and Mediare https://socialsecurityworks.org/about/ Physicians for a National Health Program (PNHP) PSARA works with PNHP on a range of Healthcare issues including Medicare, Medicaid and working for a single payer solution for all. PNHP has a local Chapter. National: https://pnhp.org/ Seattle: www.pnhpwashington.org Community Advocates Washington Community Action Network https://www.washingtoncan.org/ Transit Riders Union https://transitriders.org/ Washington Senior Lobby http://www.waseniorlobby.org/ Tenants Union Support for renters in housing justice (206) 723-0500 http://www.tenantsunion.org/ Government Washington State Toll-free Legislative Hotline Messages to Governor and Legislators 1-(800) 562-6000 Governor ’ s Office (360) 902-4111 http://www.governor.wa.gov/ Washington State Insurance Commissioner (SHIBA), State Health Insurance Benefits Advisor and Consumer Advocacy 1-(800) 562-6900 cad@oic.wa.gov Washington State Attorney General, Consumer Protection 1-(800) 551-4636 http://www.atg.wa.gov/ City of Seattle Mayor’s Office for Senior Citizens (206) 684-0500 Senior Information and Assistance (206) 448-3110 or 1-(888) 324-2277 Federal Senator Maria Cantwell 511 Dirksen Senate Office Building: (202) 224-3441 Local phone: (206) 220-6400 Maria_cantwell@cantwell.senate.gov http://www.cantwell.senate.gov/ Senator Patty Murray 173 Russell Senate Office Building: (202) 224-2721 Local phone (206) 553-5545 http://murray.senate.gov United States Representatives Susan DelBene - District 1 (202) 225-6311 www.house.gov/delbene Pramila Jayapal - District 7 (202) 225-3106 https://jayapal.house.gov/ Kim Schrier - District 8 Phone: (509) 850-5340 http://schrier.house.gov/ Adam Smith - District 9 (253) -896-3775 www.house.gov/adamsmith Marilyn Strickland - District 10 Phone: (360) 459-8514 For other Representatives, search by zip code at http://www.congress.org/news/ Regional Offices King County Information http://metro.kingcounty.gov/ Puget Sound Regional Council http://www.psrc.org/ Sound Transit Information http://www.soundtransit.org/ Port of Seattle Information http://www.portseattle.org/ Medicare 1-(800) 522-31177 Center for Medicare and Medicaid Services http://www.cms.gov/ Social Security Online http://www.ssa.gov/ Senior Centers Central Area Senior Center (206) 726-4926 North Shore Senior Center (206) 487-24411 Ballard NW Senior Center (206) 297-0403 Senior Center of West Seattle (206) 932-4044 Shoreline Senior Center (206) 365-1536 Southeast Senior Center (206) 722-2768 Other Useful Resources Seattle Housing Authority (206) 615-3300 http://www.seattlehousing.org/ Seattle Senior Housing Program (SSHP) Judith Anderson; Senior Property Manager (206) 615-3347 janderson@seattlehousing.org Noel House Programs (206) 441-3210 http://www.ccsww.org/ New Beginnings (206) 783-4520 or (206) 522-9472 (Crisis Line) http://www.newbegin.org/ WomenHeart http://www.womenheart.org/ Black Women’s Health Imperative http://www.bwhi.org “They Represent You” A nonpartisan resource published by The League of Women Voters http://www.lwv.org/

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

One Big Beautiful Bill, One Big Beautiful Billionaires Act, Rick Timmins In the Advocate August 2025: Rick Timmins The One Big Beautiful Billionaire Act: Tax Breaks for the Wealthy Paid for by the Rest of Us Rick Timmins The recently passed Republican budget plan is touted as a reduction in government spending and in taxes, and indeed it succeeds. It drastically reduces spending on social programs like Medicaid, Medicare, and education and sets the stage for major cuts in Social Security. The tax reductions significantly benefit wealthy individuals and corporations. The bill is said to be the largest transfer of wealth from the poor to the wealthy in American history. So how exactly are we paying to increase the wealth of the American kakistocracy? The bill has hundreds of provisions, stretching over approximately 900 pages, but this article will focus on the most malevolent aspects that will have the greatest impact on healthcare, the environment, and the economy. Healthcare takes a big hit. Sixteen million people will lose their health insurance through the Affordable Care Act or Medicaid, according to the Congressional Budget Office. There will be an increase of 51,000 preventable deaths due to loss of insurance and other aspects of the legislation. Those with the lowest incomes and the greatest needs will suffer the most. Medicaid spending will be reduced by $793 billion over 10 years, and there will be 10.3 million fewer enrollees. A total of 2.3 million Medicaid enrollees, including 1.3 million dual-eligible individuals (those with limited resources who qualify for both Medicaid and Medicare), will lose benefits due to delayed implementation of two Biden-era rules designed to reduce administrative barriers. The loss of coverage cascades into the loss of access to the Medical Savings Program and the Low Income Subsidy, which help pay for copays and drugs. Preventable deaths occur when healthcare and medication are inaccessible. Five and a half million people will suffer increased food insecurity by losing SNAP benefits due to reduction in spending for food aid by $300 billion, more stringent rules regarding work requirements, citizenship, and shifting program costs to states. Medicaid cuts of $465 million in 2026 will result in average yearly losses of 56 percent of hospitals’ net income which, in addition to the loss of Medicaid coverage by rural residents, will put 300-500 rural hospitals at risk of closure. The American Hospital Association (AHA) and state-level hospital groups have warned that the act could destabilize access to care in dozens of states, especially in regions already struggling with physician shortages. Medicare does not escape the Republican wrath. Legislative rules mandate that if a bill increases the budget deficit, it must be made up through automatic “sequestration” cuts. The budget increases the deficit by over $3.3 trillion. There is a limitation on Medicare cuts of four percent, amounting to $45 billion in 2026. The CBO estimates the total 10-year cuts would equal $490 billion, which will shorten the viability of the Trust Fund. Our health, of course, is interconnected with the environment, and this bill is dedicated to making it unhealthy. It repeals or phases out most clean energy tax credits introduced under the Inflation Reduction Act, including those for electric vehicles (EVs), solar panels, wind farms, and battery storage. It also introduces new taxes on renewable energy infrastructure, while expanding fossil fuel incentives, including credits for domestic coal and oil production. This undermines grid reliability and will increase electricity prices by 19% by 2030 and more than 60% by 2035. This disproportionately affects lower- income Americans. The Billionaire Bill will also result in more forest fires by eliminating $50 million for the management and protection of old-growth forests on National Forest System land. The intent is to cut the funding protecting the forests, open the areas for logging and development, and eliminate the environmental reviews. It is well-established that uncontrolled logging increases fire risk. This bill will reverse recent environmental progress, increase US carbon emissions by up to 574 million metric tons by 2035, potentially lead to the extensive destruction of carbon-sequestering forests, increase pollution from smoke and gas-powered vehicles, and contribute to atmospheric warming, all of which are devastating to health. The Billionaire Bill will also bring us an unhealthy economy. These provisions deliver substantial tax savings for high-income earners and corporations. Analyses show that 70% of the tax benefits flow to the top 20% of earners, with the top 1% alone receiving nearly 20% of the overall relief. Meanwhile, middle-class families see modest gains, and many lower-income households actually lose net benefits due to cuts to programs like Medicaid and SNAP. Increasing medical expenses due to loss of insurance or access to medicalcare will further decrease the economic resilience of the majority of Americans. The financial inequity in the country will expand. Because Trump’s budget will add between $3.3 trillion and $4.5 trillion to the national debt over the next decade, debt-to-GDP is now projected to reach 126% by 2034, raising concerns among fiscal conservatives and global investors. Job losses are expected in both the healthcare and clean energy sectors, with estimates suggesting up to one million jobs lost by 2030 due to program cuts and reduced investment. Only the greediest of the top 20% of earners (and the Trump cultists) will consider this bill “Beautiful.” Keep in mind that the crumbs tossed to the rest of us, like eliminating tax on tips or overtime pay, car loan interest deduction, “Trump accounts for kids,” the “bonus deduction” of $6,000 for those over 65 years, are all restricted and phase out in 2028. In conclusion, the Big Billionaire Bill increases the wealth of the richest Americans, takes away healthcare and other essential services from the rest of us, destroys the environment, increases pollution and global warming, and raises the national debt, thereby putting the national economy at risk of inflation and/or recession. Rick Timmins is a member of PSARA's Level the Playing Field Task Force. BACK TO THE ADVOCATE

In the Advocate May 2025: PSARA Position Paper on Immigration The US has failed to articulate a coherent and just immigration policy. Now, under the current administration, even the meager protections we have for those who come from outside US boundaries are being stripped away. The Trump administration has engaged in new levels of cruelty against immigrants – terrorizing people, shackling them in chains, deporting them to countries other than their own, and undertaking these acts regard- less of the person’s citizenship or paperwork status. The administration is threatening sanctuary cities and states with funding cuts, mobilizing the military and national guard to engage in the apprehension of migrants, and seeking millions more in funding for this war on immigrants. They have allies in our state among many county sheriffs who are flouting our “Keep Washington Working” law and using their local law enforcement officers to assist ICE. Everything else being equal, people don’t choose to migrate. Most of us prefer to remain with our families, on the land in which we’ve been raised, and in the culture with which we’re familiar. Yet, huge numbers are migrating for a number of reasons. They are forced to migrate because of brutal conflicts, rampant lawlessness and criminal violence in their home countries, a lack of safe, well-paying jobs, crop failures and food scarcity, and increasingly severe climate disasters. In our country we now have more than 200 jails and prisons for immigrants. Approximately 90% of detained immigrants are held in private detention centers. The current Trump regime has announced plans to build many more. PSARA, takes the following position on the attack on immigrants: We will follow the lead of immigrant rights groups locally, working to support their efforts toward defending and strengthening rights, protecting those being targeted, and securing sanctuary. We welcome all migrants and fight alongside them for housing, healthcare, living wage jobs, and public education, among other things. We emphatically oppose repression, detention, deportation, and the racist attacks to which migrants are being subjected. We act from a commitment to joining hands in respect and solidarity to build a new – and more just – Beloved Community. BACK TO THE ADVOCATE

August 2025 Original Medicare Prior Authorization Requirement In the Advocate August 2025: Robby Stern 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 THE ADVOCATE

Save Traditional Medicare stop WISeR The Trump Administration has been busy devising a new threat to your Traditional Medicare benefits. On January1, 2026 they are introducing a new control on Traditional Medicare in a six state demonstration program, which includes Washington State. This program, called WISeR, is an attempt to control your medicare benefits by requiring prior authorization before you and your doctor can make certain medical decisions. The administration is outsourcing these decisions to private companies whose compensation will be based on how much cost savings they can generate by limiting or eliminating patient procedures. PSARA opposes this demonstration and we are in good company. On this page you can access Senator Patty Murray’s video outlining her opposition, WA State Insurance Commissioner Patty Kuderer’s critique and concerns with the program, as well as the American Medical Associations letter in opposition to the program. This is an ongoing effort by the Trump administration to end traditional medicare in an attempt to further outsource Medicare to private equity companies. This despite the ongoing issues of private equities investments in the medical industry and Medicare advantage in particular. In late 2025 PSARA prepared a brief slide presentation (see bottom of this page) to provide more background on WISeR and what you can do to prevent it. This presentation will be updated after the November 2026 election. Please vote in November. Additionally, below are links to some late 2025 and 2026 Retiree Advocate Articles on WISeR. AARP, United Health Group, and WISeR , December 2025 Inside CMS’s Troubling WISeR Vendor List and the Power It Hands to Private Contractors , January 2026 The Fight for Medicare in 2026 , February 2026 PSARA Meets with Congressman Adam Smith to Talk About WISeR , May 2026 Sen. Murray's Speech to Senate Urging End to Trump Administration’s WISeR Program that is Delaying and Denying Seniors’ Health Care , August 2026 (Double click on the slide presentation to expand to full screen) Click here to hear Senator Patty Murray’s concerns on President Trump’s WISeR Program for Traditional Medicare beneficiaries On November 7, Rep DelBene introduced HR 5940, the “Seniors Deserve Smarter Care Act” that would prohibit implementation of WISeR. Rep Adam Smith on Cuts to Medicare and Medicaid Read WA State Insurance Commissioner Patty Kuderer’s critique and concerns with the WISeR Program Read the American Medical Association ’ s letter in opposition to WISeR On December 6th PSARA Board Members Robby Stern and Anne Watanabe (hosted by Dan Grey and Evegreen State College) discuss the attacks on Medicare and Medicaid. Click here to hear the interview 1/15