Specialty-tier drugs are defined by Medicare, as those that cost more than 0 per month in 2019, and include drugs used to treat cancer, hepatitis C, multiple sclerosis (MS), and rheumatoid arthritis. Even when Part D enrollees reach the Medicare Part D catastrophic coverage phase, when co-insurance drops to 5%, beneficiaries who take these drugs can continue to face thousands of dollars in annual out-of-pocket costs, according to the Kaiser study. The study found that annual out-of-pocket costs for specialty drugs in 2019 are expected to average ,994 across the 28 specialty-tier drugs that are covered by drug plans. .For example, the CMF report offers suggestions on how House member offices can most effectively absorb additional cuts. Most notably, these include salary freezes, a potential shift to increased e-mail use over traditional mail, and limited travel expenses to district functions. .Survey participants also support making changes to modestly increase benefits by using a senior CPI, the Consumer Price Index for the Elderly (CPI-E), to determine the annual cost of living adjustment (COLA), and to provide a boost of about per month. TSCL is meeting with Members of Congress to enact these changes. With 73% of survey participants reporting that their household expenses in 2015 rose by more than a month, while average Social Security benefits are stuck around ,250 due to low or no COLAs, TSCL is making a strong case that older Americans need a raise! .The extensions will cost approximately 0 billion over ten years, and billion of that will be paid for by spending cuts and revenue increases. The remaining 0 billion, however, will be added to the budget deficit. .The study found that a person who retired in 2000 — with an average Social Security benefit of 6 per month — would have ,246.20 per month by 2020. However, because retiree costs are rising at a substantially faster pace than the COLA, that individual would require a Social Security benefit of 0.00 more per month, or a total of ,626.20 in 2020, just to maintain his or her 2000 level of buying power. .There are two points to remember about the first rule: Medicare has always been barred from negotiating prices directly with drug companies; and other countries regulate their health care spending more heavily, including for prescription drugs. ."For the third year in a row, millions of older Americans will once again see no increase in their net operating Social Security payments, particularly if Medicare Part B premiums remain 4 per month in 2018, as currently forecast by the Medicare Trustees," says TSCL's Social Security and Medicare Policy Analyst, Mary Johnson. "The problem is that a substantial portion of beneficiaries currently are paying a Part B premium that is about less than that now," Johnson says. .Most individual taxpayers will pay lower taxes, at least in the first few years, tax analysts say. But the tax cuts affecting middle-to-low-income people are temporary, and are set to expire in just eight years, by the end of 2025, while the tax cut for families in the very top income bracket is permanent. That's expected to leave the majority of taxpayers with higher tax bills down the road — something most people living on fixed income simply can't afford. TSCL is still assessing the expected impacts of the new legislation. .Have you had a similar experience? Share your experience with TSCL.