The recommendation of MedPAC would combine the deductibles for Part A and Part B services. Currently the deductibles are charged separately and for good cause. About 80 percent of Medicare beneficiaries never pay a Part A deductible because they don't require hospitalization in most years. The Part A deductible for hospital inpatient services is ,156, a cost that is covered in full today by all Medigap supplements. Some Medigap supplements also cover all of the Part B deductible, which is 0 in 201Costs differ for seniors enrolled in Medicare Advantage depending on the plan. Co-payments would also change and vary by the type of service and provider. .TSCL has filed three lawsuits under the Freedom of Information Act requesting copies of the agreement and other information and has placed ads in The Washington Times in opposition to the proposed agreement. We will continue to closely monitor the totalization matter. .This week, a federal court rejected the Obama administration's immigration appeal, and The Senior Citizens League (TSCL) saw two key bills gain new cosponsors. .Medicaid already uses this strategy to lower drug costs, and pays much lower prices than Medicare for the same drug. In June we reported that Medicare spending on the highest price category of prescription drugs, called "specialty drugs," increased from .7 billion in 2010 to .8 billion in 201Spending on the same drugs under Medicaid, the program that provides healthcare for low-income Americans, grew much more slowly over the same period, rising from .8 billion to .9 billion. .Here's where to go for help with these services: .President Gives First State of the Union .A majority of seniors 65 and older who receive Social Security depend on it for at least 50 percent of their total income, and one in three beneficiaries rely on it for 90 percent or more of their total income. TSCL is fighting proposals to cut COLAs. TSCL believes that seniors could receive a more fair COLA if the government were to use a consumer price index that more closely tracked the spending patterns of seniors. ."The distinction between inpatient or outpatient can make a tremendous difference to what Medicare patients have to pay," says TSCL Executive Director, Shannon Benton. Inpatient stays are covered under Medicare Part A. Inpatients who are hospitalized for three days or more qualify for Medicare's limited nursing home stay coverage. Observation stays are considered outpatient services covered under Part B. Observation patients can have much higher copayments costs and sometimes get hit with huge bills for non-covered drugs. .The state of Virginia, however, offers retirees a chance to retain certain parts of coverage but "opt out" of others. If Paula "opted out" of Part D drug coverage, for example, and took medical, dental, and vision coverage alone, she would pay 6 per month. The portion of the premium for the drug coverage through the state of Virginia was a whopping 4 per month.