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As the demographics of America shift, health care services must evolve to meet new and increasing demands. The main factor driving projected growth in federal spending on major health care programs is the aging population. The Congressional Budget Office has projected that the number of people age 65 or older will increase by roughly one-third over the next decade, and 80 percent by 2039..As was noted in last week's update, the AHCA would reform the current health system and negatively impact older Americans in several ways. It would restructure the Medicaid program, which funds nursing home care for many qualified Medicare beneficiaries. It would base premium subsidies on age instead of income, while allowing private health insurers to charge older Americans five times more than they charge younger folks for their coverage. And it would deplete Medicare's Hospital Insurance Trust Fund by eliminating two revenue sources that the ACA created, creating a funding crisis for the program..President Obama signed it into law shortly thereafter, saying it will improve the Medicare program "because it starts encouraging payments based on quality, not the number of tests that are provided or the number of procedures that are applied, but whether or not people actually start feeling better." The law took effect immediately, and upon the bill's signing, the Centers for Medicare and Medicaid Services announced that it had already begun reimbursing physicians at the full payment rate..Because this is an election year, elected lawmakers are likely to be listening extremely carefully to their constituents. Your help now, and that of family and friends, could make the difference in pushing through the ,000 lump-sum legislation..How many members does TSCL have?.But so far Members of Congress haven't received a paycheck. Eric Pianin, a journalist who covers the federal budget for The Fiscal Times, perhaps expressed it best as a "brilliant budget tactic that backfired." The House last March passed a new budget along party lines that would achieve a surplus within ten years, mainly through deep spending cuts and reforms to Medicare, Medicaid and other entitlements. Earlier this spring the Senate took up the challenge and passed a .6 trillion budget that has greatly different priorities for spending and taxes than the budget passed by the House. But neither Senate nor House negotiators have met in conference where the two chambers would negotiate differences and produce a compromise budget agreement..Medicare Part B premiums jumped .10 per month in 2020 - one of the biggest increases in recent years. While the Social Security cost-of-living adjustment increased benefits by 1.6 percent in 2020, Medicare Part B premiums climbed 6.7 percent, more than four times faster. A jump of this size can put older household budgets into a bind, forcing retirees to go without essentials when they run short before their next Social Security check..Another major piece of legislation that Congress is working on, one which has been passed and been signed into law by whomever has been President for the past 59 years, is the National Defense Authorization Act. As we explained last week, that's the annual bill that authorizes the pay for members of the U.S. military as well as other important issues dealing with the Department of Defense.."Medicare is also in the cross - hairs for massive changes," Johnson says. The budget resolution stipulates major changes that would focus Medicare on a system of private insurers, and provide beneficiaries with premium subsidies to shop for their own health insurance. A Congressional Budget Office report has found that similar proposals in the past would shift a growing portion of costs to older Americans. In that 2013 report, the CBO estimated that Medicare beneficiaries' premiums would be about 30 percent higher by 2020 than under current law.