00:11 S?: Dedicated to your elder care concerns and your resource for learning about how to manage your health, housing, financial and legal needs. This is a live call-in program, featuring John Ross and Lisa Shoalmire, elder law attorneys and senior advocates for the Ark-La-Tex. Aging Insight is dedicated to helping you navigate the challenges and blessing of growing older. So call in and ask your questions, the number is 903-793-1071. Now here are your hosts, John Ross and Lisa Shoalmire.

[music]

00:30 Lisa: So today, I thought I would talk about some things that we are anticipating with some changes, with a change of power. For those of you who may have watched some of the inauguration yesterday. Didn't really get to catch any of that. John and I were working, so not really a lot of time to pick up the news. So I wanted to kinda talk about a few things that we are anticipating. And of course, we're... President Trump has been... He has been sworn in for a whole 24 hours now, so we really don't know for sure what's coming down the pike, but we've had some signals from President Trump's campaign, as well as we're gonna look at some of his nominees that particularly are going to impact seniors.

01:30 Lisa: So I kinda wanted to go through some issues here that I think are going to really affect our seniors. And first of all, I want to put all of this in perspective. Presently, in the United States, seniors, those 65 and older, make up 46.2 million citizens in our country. That is about 15% of the US population. So seniors are a big group. Seniors, historically, have the highest voting participation rate, so 15% of the population is going to be eyeballing what is going on particularly with these senior issues. And remember, as John and I talk about it all the time, we are in the midst of what some people call a 'silver tsunami'. How do you like that? A silver tsunami.

02:37 Lisa: And that is that 10,000 people a day are turning 65. The Baby Boomers, that wave just keeps on changing the landscape and it's going to do that for the area of seniors as well. So, what are some things that we're anticipating? Alright. First and foremost, I think one thing that's on the table, for sure, is we anticipate that the estate tax or the death tax will absolutely go away. And John and I have referred to this a few times but the way the estate tax is set up right now, we get that question a lot at the office at Ross and Shoalmire, we get that question, "I wanna plan my estate, I don't want to pay any death taxes." Well, folks, most of my listeners, maybe even every single listener tuned in today, if the law didn't change a bit, you would not pay an estate tax.

03:44 Lisa: And here's why. Presently, the only estates that pay any tax at all have to be valued at over, wait for it, wait for it, $5.45 million and that's for a single person. So a married couple can have an estate worth about 11 million bucks and never pay a dime in estate tax. So now, if you are over that $5.45 million, then every dollar over that $5.45 million is gonna get taxed at about $0.40 on the dollar. So for those estates that it does impact, it has a big impact, $0.40 on the dollar. But in our local area, sure, there are a few folks that do have estate tax issues but it's just pretty rare at this point. So, very rare. So right now only about two in 1,000 estates are ever impacted by the estate tax or death tax. But even so, most people just don't even like the idea that what you've worked for and accumulated and been taxed on previously.

04:09 Lisa: Remember, you pay income tax and you pay tax on that income, and then if you save that income or you reinvest that income in other vehicles, and you happen to make up an investment or small business or whatever up to $5.45 million, most people say, "Hey, you know what? I've already been taxed on that. It's completely unfair for the government to tax it again just because I stopped breathing." So folks we are anticipating that one of the first things that Donald Trump is going to do is see about getting the estate tax completely repealed. Maybe there's some self-interest in that. But I suspect that President Trump has plenty of good lawyers and advisers to finagle his property in a way out of the estate tax anyway. But I think it's just sort of the principle of being taxed on what you've already paid tax on. And President Trump seems really to abhor this idea and I think it's a popular sentiment, so I think that will go away. So we're gonna take our first break, but stick with us because we're gonna keep talking about some things that we're anticipating coming out of the new presidential administration. Stick around.

[background conversation]

06:23 Lisa: Welcome back everyone to Aging Insight. This is Lisa Shoalmire here in the studio with you today and I thought that I would go over a few things that now that we're in a new presidential administration, some things that we believe are going to be on the table or maybe not on the table, if you have some fears and concerns, through this new administration. And the first topic we talked about is, we think President Trump is likely to get rid of the estate tax or the death tax altogether. Now, that doesn't mean that there might not still be some impact to you when you transfer property because of a death, but those details are yet to be worked out, whether or not you'll still get a step up in bases in the property. We just don't know those things yet. But we think the death tax is history, it's just a matter of time. One, of course the... What's the biggest issue for a senior? 

07:27 Lisa: The biggest issue for our seniors are the viability of Social Security and there's a lot of hucksters out there that they fear, they scaremonger, and they put seniors worried and anxious about Social Security. The deal with Social Security is, for most people in our area, and... Social Security is their primary source of retirement income. And nationwide, one in three seniors, one out of three, say that Social Security is essentially their only source of retirement income. And I will say this, that Social Security is the biggest poverty elimination program that we have as a government. It just is. Before Social Security, so many seniors were living in poverty, but that base of Social Security has helped bring a lot of people out of poverty. And of course, the point of Social Security was never to be the only source of retirement assets and income, but the reality is, for at least one out of three people, it is the only source and in our area, I would certainly say that it's a major source of retirement income.

09:01 Lisa: So, what can we expect? Well, a couple of things. First of all, even the news outlets that are not particularly favorable to President Trump, have agreed that President Trump has committed that he is not going to make any cuts to Social Security, that he doesn't plan on touching Social Security, and he's even used some very strong language. So pretty much, I think everybody believes him on this particular issue. And he has said that Vice President Mike Pence was quoted as saying that, "All Donald Trump and I have said about Social Security is we're going to meet our obligations to our seniors. That's it." So the vice president was repeating that same message and again, there's plenty of critics of President Trump and there's plenty of things that President Trump has sent mixed signals on, but Social Security is not one of them.

10:23 Lisa: So, most experts believe that Trump means what he says about Social Security and in addition to not cutting Social Security, President Trump has said while he was on the election campaign trail that he anticipates economic growth to actually bring more people into the workforce. And you know what happens when you bring more people to the workforce? When you bring more people into the workforce, you have more people getting paid and folks, you know where Social Security is funded. It's funded out of that little FICA tax that is part of a paycheck. So not only is Donald Trump saying he's not going to touch Social Security, he had said that he hopes that his policy's economic growth will employ more people and bring more funds into the Social Security trust fund. So, and this is one of those things I sure hope he's right. [chuckle] That would be wonderful, so and economic growth can erase a lot of ills, but we know we have issues there with Social Security, so it would be nice to get a good report and see more funds coming in to Social Security. So we're gonna take our news break, when we come back, we're gonna talk about three or four more issues that we expect coming up.

[background conversation]

11:43 Lisa: Well, welcome back everyone to Aging Insight. This is Lisa Shoalmire here live with you today in the studio. And as we come to the bottom of the hour of our program, always a good time for callers and it appears that we do have one. So let me get them on the air. Alright, caller, you're on Aging Insight. Hello? 

12:04 Caller-1: Hello. Yes, ma'am. A while ago you were talking about Social Security. I remember the big pushback when George Bush was president for privatization and it was supposed to be more efficient and all of that kind of stuff. That all sounds good. Remember the big stock market plunge we had...

12:25 Lisa: 2008.

12:25 Caller-1: Many years ago when a lot of people lost a lot of their savings? I lost some money. It wasn't a lot 'cause I didn't have much money invested in it but I lost a little. But some people lost huge amounts of money. Can you imagine if... And look, I vote Republican. I'm a Conservative, but I hated the idea because I know that there are vultures out there looking to get their hands on people's money whatever way they can.

12:52 Lisa: Sure.

12:53 Caller-1: And it's not that government is the answer, government creates a lot of problems but can you imagine this scenario if they had privatized a lot of Social Security and much money was in different funds and there was a big plunge and people inquired about their Social Security savings, and some investor said, "I'm sorry. You've lost your x amount... " and this applied to many millions of people but the repercussions of that would last for lifetimes.

13:25 Lisa: And you're exactly right. It's one of those things to where... I visited with a family this week actually that they were telling me that they lost half the value of their retirement assets in that stock market crash of 2008. And they have finally gotten it built up but they extended their work life and all sorts of things. I'm sure they could design a program that would let younger people maybe privatize and invest but then at some point, you'd come out of the market and you have... But that all sounds pretty complicated [chuckle] from that standpoint. The other issue though, we have is, is we have people who say, "Hey, I'm never gonna get back what I put into the system."

14:13 Caller-1: Speaking of Social Security, one big problem that we've had for quite a few years now is people getting on the Social Security disability when they're really not that disabled and their unemployment has run out and they can't find a job. So, "Hey I'm disabled. My back is hurtin'". And there's been quite a few people have done that and much more money has been channeled in that direction than previously, and that's something that the Obama Administration wouldn't tell you.

14:45 Lisa: Well, and that's very true especially once the recession came in 2008, and older workers and believe me, there is certainly a bias against older workers in the workplace, that they're more expensive, they're more expensive on your health insurance programs. They usually demand and earn a higher salary. And so, a lot of older workers who maybe still had five, seven, maybe even 10 years left in the workforce, they were laid off during that recession, they couldn't find other jobs. And so yes, they certainly looked around and many of those applied for disability and of course, were awarded that, so they went out of the workforce permanently on that.

15:32 Caller-1: Yeah, in the case of some of 'em, it was probably simply an act of desperation, and there's always gonna be a certain percentage that there's grabbed onto a gravy train, but some people, they're probably just desperate. How do I pay bills? 

15:46 Lisa: Right. So yeah, the Social Security deal, I hope that... I read a quote the other day on the internet that said, "Wishing this president to fail, is like wishing that the pilot flying your playing crashes, when you're all on the plane together." [chuckle] So, I hope that President Trump is right and that he's not going to touch Social Security and that he's going to boost our economic growth that will help shore up Social Security. But, I think it's a pretty safe bet. So, appreciate the call so much.

16:23 Lisa: So, one of the other, the Social Security, so I think if that's an issue for you just I think you know, just put it off the table, I don't think there's going to be, there's not enough political will to really do anything with Social Security. One other issue that we're expecting to be a positive for seniors under President Trump is income tax, income tax liability. President Trump, while he was campaigning, he proposed that a single filer, who had an adjusted gross income of under $25,000 would pay no taxes, okay? And this didn't just apply to seniors, it was any single tax filer who had an adjusted gross income of $25,000 or less, would pay no taxes and of course, that would apply... A married couple filing jointly could together have an adjusted gross income of $50,000 a year and pay no taxes.

17:31 Lisa: And in our area, I will say, you know, I have an opportunity to look at the financial picture of many seniors day in and day out and a lot of our seniors already are in a position where they're not paying any tax but if a couple could have 50,000 and not pay any income tax for many of my seniors that would certainly take them out of any income tax liability and the other thing is, and remember this is adjusted gross income they're saying that if you have less than 50 in adjusted gross income.

18:11 Lisa: I have a number of seniors I look at, they're invested in tax-free type investments, municipal bonds, things like that, and of course, those returns are not taxed. So, some... If you're looking at retirement, you may wanna talk to your financial advisor about focusing on tax-free income for retirement, because if you have IRAs and things like that, that a 401k plan or traditional IRAs, you're going to pay or there's the potential you would pay income tax, as you pull that money out, but if you can pull that money out but your other income sources keep your adjusted gross income below that 50,000 for a married couple, then that would be a real boon to my seniors. So, it would put more money in your pocket.

19:11 Lisa: So, we're waiting to see what kind of tax reform that President Trump is going to propose but this is something he talked about on the campaign trail. So, and of course, we all know that what is said on the campaign trail and what actually happens later are two different things. But that's certainly a direction that he talked about. So, I think what we're gonna do is, we're gonna take another break and when I come back, I wanna really jump into the one issue that I think there's a lot of gray area about and that's going to be Medicare and I'm gonna jump into that and we're gonna talk about some of the nominees, and the people that are gonna be, that are Trump's Cabinet Level Members in charge of Medicare and what has been said on the campaign trail because I think this is an area where we may see some changes that may not be as positive as we would hope. But if you will stick around and stick with us, we'll be right back.

[background conversation]

20:09 Lisa: Alright, everyone, welcome back to our final segment today on Aging Insight. And I know lots of folks on both sides of the political spectrum, and some folks are very upset and think it's the end of the world with President Trump taking office, and I have other folks that are just thrilled down to their pinky toe about this somewhat unexpected result in our political landscape. But regardless, whoever the president is, they're gonna set some policy initiatives, they're going to encourage Congress to pass certain laws and bills that impact us citizens in our every day life. And so John and I are particularly focused on the issues that impact seniors. And so we are always scouring the news information to find out anything we can that's going to help us assist the seniors here in our community.

21:19 Lisa: And one of the issues of course, one of the big issues is Medicare and I know many of you have heard that entitlement programs, which would include Medicare, because if you are 65 and you have all the work credits, or you were married to somebody who has all the work credits they need, then at the age of 65 you qualify for Medicare. I don't care if you're Ross Perot or a simple man living down at the homeless shelter, if you are 65 and you have work credits, you get Medicare. But of course, the cost of medical treatment as we've gotten more sophisticated... I wish I knew what all the components that went into our escalating medical cost are, if I did, I bet I could get a great job as a consultant, but the reality is medical costs have continued to outpace inflation, and so the Medicare program that provides healthcare insurance to seniors 65 and older, the costs have been escalating, and this has been a big focus.

22:37 Lisa: So, what has Trump said, what has President Trump said about Medicare? Well, we've been getting mixed messages. On the campaign trail, on numerous occasions, Trump said that he would leave Medicare untouched. Okay, well, okay, but he's also said that he would allow Medicare to negotiate directly with pharmaceutical companies over prices, an action that presently is now denied in the system. So President Trump had told a crowd in New Hampshire when he was on the campaign trail that he was going to let Medicare negotiate with the Big Pharma companies and he thought that they'd get drug prices down, that it would save $300 billion, that's with a "B", yearly, but one of the issues that came up is, would a Republican Congress allow Medicare, who is the 800 pound gorilla in the medical pharmaceutical consumer business, would Republican business-minded congressmen allow Medicare to really push these pharmaceutical companies on pricing? 

24:07 Lisa: And so that's one issue we just don't know. Also, Speaker of the House, Paul Ryan, he has had plans in the past that he was a proponent of, that would put some kind of cap on Medicare benefits, that cap based on the income of the senior, and this, that and the other, that could potentially increase premiums for seniors. And so Trump has not said whether or not that he and Paul Ryan are on the same page about that. So we just really don't know. Trump has continued to say that it's not fair to people that have been paying in for all these years, that we make big changes that really impact their ability to receive those benefits that they've been promised. But the bottomline is that President Trump has been pretty quiet about Medicare issues, and so there's not really a lot to go on, on that. So one of the things that you do look at, when you don't really get a lot of policy statements from the president himself, is you look at the place where his cabinet level officers are coming from that are gonna be over those programs.

25:31 Lisa: And so, I believe it was this past week that Trump had nominated Tom Price, Dr. Tom Price, he's a Republican congressman out of Georgia, represents a suburb of Atlanta, Georgia, I believe. Dr. Price was nominated by Trump as the cabinet member, the chair of the Department of Health and Human Services. And this is the agency that oversees Medicare, Medicaid, the National Institutes of Health, CDC, all of these things. And of course, Dr. Price was strongly endorsed by the American Medical Association, and he's an orthopedic surgeon that spent 20 years as a practicing orthopedic surgeon. He also was an assistant professor of medicine at Emory University.

26:26 Lisa: Dr. Price, he's married to a doctor, she is an anesthesiologist, and since 2009, Congressman Price, Dr. Price has filed a bill every year to replace the ACA known as ObamaCare. And he's really kind of a wonky kind of guy, obviously a very smart guy and so he went through a confirmation hearing last week. He continued to say that he wanted people to have access to medical insurance when it came to things like the Affordable Care Act, but he's not been very clear either on some of the Medicare issues, he's certainly well aware of them. I'm hopeful that because Dr. Price is well aware of the actual provision of medical services, and how those are delivered that he has a better understanding than a normal person would. But let's take a caller, we have just a little time here, so let me get this caller on the air. Alright, caller, you're on Aging Insight.

27:45 Caller-1: Well, I hate to bother you again but a while ago you were talking about pharmaceutical companies. I heard that the US pays high drug prices to subsidize those same drugs sold overseas at just a fraction of the cost.

28:00 Lisa: Well, and I do think that's true, if you care to, you can research on the internet and you can see what a brand drug is, what people in Canada or the UK are paying for that same drug. And Americans are typically always paying quite a bit more, and the pharmaceutical companies, well, Canada, UK, they have all national health systems so they are negotiating those prices.

28:29 Caller-1: Yeah. But I've heard that the same drugs marketed like say, in India, this is just a much smaller price. I realize there's a lot of poverty over there but I don't know what the ultimate answer is, but I do have problem with people in the United States subsidizing just about everything, for just about everybody.

28:51 Lisa: Right. And the pharmaceutical companies, their response is, "Look the research that we do on these drugs is expensive, time-consuming, it can take us 15, 20 years to bring a drug to market. We've got to get that paid for somehow. And so we charge an appropriate price to cover that," and then they negotiate with these other countries a lesser price.

29:14 Caller-1: Well, I have a sister who's a pharmaceutical sales rep. And I know that there's expenses and all of this kind of stuff, but my goodness alive.

29:25 Lisa: Yeah. And I've had a lot of folks say that the approval process of the FDA adds layers and layers of costs that otherwise wouldn't be there. And also, pharmaceutical companies are for-profit businesses. So when they develop a new drug that's effective, they want to milk it while they have the patent for it. So a lot of issues at play.

29:48 Caller-1: Well, I want them to make money. I just don't want US citizens to have to pay for everybody else's healthcare around the world.

29:56 Lisa: So it would be interesting if they could negotiate, if Medicare could negotiate that prices and see what impact that had there, and I suspect the pharmacy companies would come out and say, "Well, yeah, you can pay a lower price but that's just gonna make drugs that we're working on for things like Alzheimer's and that just to be slower developing, coming to market and is that what you want?" You know, I could certainly hear that argument from them. But thank you so much, I think it's always a good insight. Appreciate it.

30:25 Lisa: Alright, so we're about at the end of another episode of Aging Insight, but I want you all to be on the lookout for another Trump level appointee and her name is Seema Verma, Seema Verma and she is a health consultant that worked with Vice President, Mike Pence in Indiana to expand Medicaid under the Affordable Care Act there in Indiana. And she's considered very bright, very policy aware, but she has been named as the head of the Centers for Medicare and Medicaid. So for our seniors, Miss Seema Verma is going to be a key player to watch as she signals what is going to be happening with Medicare, if anything, she's been a proponent of things like block grants for care in the Medicaid area which, we're about out of time today but a lot of folks feel like block grants are actually they keep people from getting the care they need. Because once the money runs out, the money is gone.

31:47 Lisa: And so keep a look out and watch Miss Seema Verma. Her boss will be Dr. Tom Price. And it oughta be interesting to watch, so we'll all learn a little bit together. So remember to come out to our Basics at Brunch which, excuse me. No. This will be Eggs and Issues, this Thursday, January 26th at Trinity Baptist Church and I'm actually gonna go into some more detail about some of the things new president, new policies and we're gonna talk about that at Eggs and Issues, so I can't wait to see some of you there.

32:27 Lisa: In the meantime, I wanna make sure and give a shout-out to our sponsors, the Barnett Agency, Cowhorn Creek, Twin City Rehab, Texarkana Funeral Home, Inspirations of New Boston, Red River Federal Credit Union, Dierksen Memorial Hospice, Curt Green & Company, The Retreat at Kenwood, and I thought I'd remember to throw us in there, Ross and Shoalmire Elder Law Attorneys. We're here every Saturday, well, almost every Saturday live and in the studio. But that's what we're here for, we want to be a resource. You can also watch Aging Insight Television, for those of you who are Cable One subscribers, there is Aging Insight TV, it's on our local channel 10, KLFI and we talk about different things on there. You can check us out if you wanna again put a face to the voice on Aging Insight TV and please we've really been trying to make an effort to put more new stories and everything into our Aging Insight and Ross and Shoalmire social media accounts. Also you will find us on Twitter.

33:48 Lisa: So we're just, we're just going uptown, but it's really all about disseminating information and it's such a complex world, it is hard to keep up, but if you come to Aging Insight on Facebook and you can always email us a question. If you go to aginginsight.com I believe there's a link where you can email a question, if there's some topic you want us to cover, well let us know, we'll make it happen. So John and I will be back in the studio next Saturday, so we can't wait to see you then. Thanks for listening on Aging Insight.

34:34 S?: You've been listening to Aging Insight with John Ross and Lisa Shoalmire. Tune in next Saturday at noon for more Aging Insight on KTFS. The preceding program offers general advice, it does not create an attorney-client relationship. Every person's legal situation is unique, you should contact an attorney before taking action on any subject discussed on this program.

[background conversation]