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    White House Deletes Tweet Crediting Biden With Social Security Increase

    The automatic cost of living increase that Social Security beneficiaries are receiving is a result of soaring inflation, not a policy achievement enacted by President Biden.WASHINGTON — The White House on Wednesday deleted a widely mocked Twitter post that misleadingly attributed a recent increase in Social Security payments to older Americans to “President Biden’s leadership.”The tweet, which had been posted on Tuesday, was removed without explanation a day later after it had been skewered by critics and contradicted by a new Twitter feature that allows users to fact-check erroneous assertions. The automatic 8.7 percent cost of living increase that Social Security beneficiaries are receiving is a result of inflation running at a four-decade high, not a policy achievement enacted by Mr. Biden.When asked on Wednesday about the removal of the tweet, Karine Jean-Pierre, the White House press secretary, suggested that it had lacked sufficient context.“Look, the tweet was not complete,” she said. “Usually when we put out a tweet, we post it with context, and it did not have that context.”Ms. Jean-Pierre went on to say that Medicare premiums are decreasing even as Social Security payments go up, suggesting that such information would have rounded out the original Twitter post.“That’s a little bit of context that was not included,” she said. “This means that seniors will have a chance to get ahead of inflation due to the rare combination of rising benefits and falling premiums.”In the final days before the midterm elections next week, Mr. Biden has repeatedly criticized Republicans for proposals that could scale back social safety net programs. He has insisted that he and the Democrats would protect and bolster Social Security and Medicare.The tweet that the White House deleted echoed a remark that the president made this week during a speech in Florida, when he declared, “On my watch, for the first time in 10 years, seniors are getting an increase in their Social Security checks.”When pressed about the similar sentiments, Ms. Jean-Pierre suggested that Mr. Biden was not trying to take credit for the cost of living increase.“We believe that we — we want to lay the — we want to lay our argument out fully,” Ms. Jean-Pierre said. “And that was important to do, as we put out, you know, information like that or as we put out a tweet.”She added: “And that was an incomplete tweet.” More

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    How to Improve Nursing Home Care

    More from our inbox:A Student Awed by bell hooksTrump Calling the Shots From the ShadowsTammy Bowman and her husband. Ms. Bowman’s sister died in an Indiana nursing home that did not isolate residents suspected of having Covid-19.Johnathon Kelso for The New York TimesTo the Editor: “How Nursing Homes Hide Their Most Serious Lapses” (front page, Dec. 10) exposes conditions in nursing homes, issues with their regulation and the underlying problems with the care of our seniors. The examples cited are believable, but might it have been more balanced to include the good work done in these settings?If it were easy to care for elderly people with significant health, memory and behavior problems, more of us would be keeping our frail parents at home with us. If it’s not possible for us to do it, it’s certainly not simple for nursing homes to care for many such people.It’s even more of a problem that their overworked staff are paid so little. Other than spending more to increase staffing at these places, what else could we do? Might we pay staff members based on the quality of care they give? Could each of us volunteer to help at our local senior facilities four hours a week?Might some seniors do well in smaller “group home” settings? Could society better support families that keep their elderly relatives in their homes? Could we admit more immigrants specifically to help care for our parents?I don’t excuse egregious lapses in care, but do we expect perfection from nursing homes? Think it’ll be better when you’re 90?Jesse SamuelsWest Hartford, Conn.The writer is a retired family physician.To the Editor:I strongly commend “How Nursing Homes Hide Their Most Serious Lapses.” This is not a new issue. I testified before the Senate Finance Committee in July 2019 and noted that according to the Department of Health and Human Services’ Office of the Inspector General, skilled nursing facilities failed to report an estimated 6,600 instances of potential abuse or neglect to state agencies in 2016 alone.One contributing factor is staffing shortages. A strong reason for the Senate to pass the House version of the Build Back Better Act is the act’s provisions that would provide funding for increased wages, tuition assistance and other incentives to attract qualified staff.One of the hardest decisions for any individual or family to make is to determine that a loved one requires nursing home care. The federal government must provide these consumers with reliable information on nursing home quality. Further, only facilities that are free from abuse and neglect should be permitted to participate in either Medicare or Medicaid.Bob BlancatoWashingtonThe writer is national coordinator for the Elder Justice Coalition.To the Editor:My wife and I are 86 and currently live in a nonprofit continuing care residential community in Tallahassee, Fla. Your article comes across as a generalized indictment of nursing homes. We observe interactions of staff and residents regularly. The management and staff have an incredibly difficult agenda to manage these days.Resident care and solvency are necessarily at the top of their agendas. Failure on one can lead to failure on the other. The most difficult problem they have is attracting, training and retaining high-quality staff. Constant interaction with often unruly residents continuously tests the limits of the staff’s physical and mental endurance. Adding to the woes is the seemingly unrelenting public and official scrutiny of the business.Peter D. HunterTallahassee, Fla.To the Editor:Your investigation revealing that more than 2,700 dangerous incidents in nursing homes identified by state inspectors were never publicly disclosed was timely and needed.I had a friend who worked as an administrator in a nursing home and regularly reported to us how corrupt and dishonest the place was. To maximize profits, it operated with too few staff members at all levels, which impaired services and quality of care. His protests and that of the head nurse went unheeded by the owners/operators, leading to his resignation. The state had its usual level of inspection and monitoring, which allowed deficiencies of care to go on.I have had aged relatives in a facility in another state. There, too, apparently, there are ongoing staff shortages and diminishing quality of food and other services — plus, during Covid, way too many violations of masking, vaccination and testing standards.I hope and pray I never am subjected to this sorry end-of-life situation.Lynn MeansHuntington, N.Y.A Student Awed by bell hooksClaire Merchlinsky/The New York Times; photograph by Karjean Levine/Getty ImagesTo the Editor:I first discovered the works of bell hooks as a middle schooler looking to fill my spare time with feminist literature. The book “Feminist Theory” (1984), criticizing white feminism, immediately stood out to me for its direct writing style. It didn’t take long for me to obtain dog-eared copies of her other books, all of which left me in awe, and established bell hooks as one of my favorite authors.Reading Kovie Biakolo’s Opinion guest essay “It Was bell hooks Who Taught Me How to ‘Talk Back’” (Dec. 27) helped me realize the influence that bell hooks has had on me in light of her recent death. Ms. hooks has encouraged generations of young women to speak out against oppression. I am now a high school freshman, and I am confident that the strength of Ms. hooks is something that I will remember as a staple of my girlhood.Sriya TallapragadaNew Providence, N.J. Trump Calling the Shots From the ShadowsFormer U.S. President Donald Trump’s Mar-a-Lago resort is seen in Palm Beach, Fla.Marco Bello/ReutersTo the Editor: Why would Donald Trump run in 2024? He already controls the Republican Party from the shadows with less transparency than if he were president.As a private citizen he is free to do what he likes with his money and to advance his agenda through congressional surrogates without taking an oath to defend the Constitution. It seems to me that he can do more damage from Mar-a-Lago than he could from the White House.Lawrence WeismanWestport, Conn. More

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    End the Secrecy. Open Up Adoption Records.

    More from our inbox:Facebook MisinformationErasing Older Women at the Art Institute of ChicagoA Conversation With VotersSam Anthony, left, with his birth father, Craig Nelson, at Mr. Anthony’s home in Falls Church, Va., in August.Debra Steidel WallTo the Editor:Re “With DNA and Friend’s Help, a Dying Son Finds His Father” (front page, Oct. 10):If we continue to keep the process of finding one’s birth family and opening birth records as difficult as possible, as with Sam Anthony, profiled in your article, we are preventing valuable family connections that should be a basic human right.Adoptees are often completely cut off from our birth families the second our adoption papers are finalized. If it weren’t for DNA testing I would never have discovered that two half-siblings of mine had been adopted into a different family a few states away.Adoptees should not have to go to great lengths to reconnect with their birth family. But, unfortunately, the complicated and often expensive process of DNA testing and hiring private investigators is often the only way to find biological relatives.When birth records are sealed, adoptees suffer in order to uphold an archaic standard that was meant to shroud adoptions in secrecy to prevent shame. We live in a different era now and, like Sam, deserve a right to our records.Melissa Guida-RichardsMilford, Pa.The writer is the author of “What White Parents Should Know About Transracial Adoption.”To the Editor:This is the latest article in The Times exposing the egregious practice of denying adoptees the truth about their beginnings and hiding the babies’ fate from their birth parents.Steve Inskeep’s March 28 essay, “I Was Denied My Birth Story,” revealed his fury about not knowing “the story of how I came to live on this earth. Strangers hid part of me from myself.”Lisa Belkin reviewed Gabrielle Glaser’s book “American Baby” (Book Review, Jan. 24), another tragic tale about when adoptions are closed.How many tragic tales do we have to hear to understand that birth parents, adoptive families and adoptees need to know one another? How many children must lie awake at night wondering why they were given away? How many adoptees do not know their genetic history?The solution is easy — open adoption in which birth parents and adoptive families choose each other and stay in touch through social media, texts, photos and visits.With Ancestry.com and 23andMe closed adoptions do not remain closed. Why not avoid the emotional pain by sharing the truth from the beginning?Nancy KorsWalnut Creek, Calif.The writer is an adoption facilitator.Facebook Misinformation  Illustration by Mel Haasch; Photograph by Anna Moneymaker for The New York TimesTo the Editor:Re “Misinformation Tripped Alarms Inside Facebook” (front page, Oct. 24):New disclosures that point to a disconnect between self-serving public statements of Facebook executives and the internal expressions of concern of lower-level employees surrounding the 2020 election paint a picture of a company policy that enables and protects misinformation.These revelations, especially those involving the Jan. 6 insurrection, suggest that management overlooks or even accepts incendiary content in its pursuit of profits — a practice that is often out of sync with the conscience of its employees and is at odds with the best interests of the public.Taken together with the recent testimony of the whistle-blower Frances Haugen, who detailed to Congress a corporate culture that places profits ahead of its users’ mental health, this new documentation clearly strengthens the case for congressional oversight and public awareness.Facebook’s reach and influence are so vast that its apparent unwillingness to filter misinformation exceeds the bounds of free speech, harming its users and putting democracy at risk. The company has had a good run, but the days of its free ride maybe numbered.Roger HirschbergSouth Burlington, Vt.Erasing Older Women at the Art Institute of Chicago  Art Institute of ChicagoTo the Editor:Re “Museum Ousts Volunteers in Diversity Push. Uproar Ensues.” (news article, Oct. 22):Alas, the invisible old woman! While your article on the Art Institute of Chicago’s decision to end the volunteer careers of 82 docents focused on the controversy over the racial makeup of the docents, it neglected to really deal with the overt age discrimination that such otherwise worthwhile pushes for greater diversity promote.Not all docents are older or female, but they tend to be. Largely, they can volunteer with such expertise and loyalty because after long careers and/or raising families, many finally have the time to turn to volunteering in their communities. Yet the museum — along with much of our society — invalidates these older women, erasing their presence.Dee BaerWilmington, Del.The writer is a senior guide at the Delaware Art Museum.A Conversation With Voters  Aaron Nesheim for The New York TimesTo the Editor:Re “The Anti-Robocall: Listening to Voters Talk” (news article, Oct. 21):This wonderful article identifies a way to improve the minimal communication that currently prevails among those holding different opinions regarding values and public policy.As psychologists and spiritual teachers have long observed, deep, nonjudgmental listening to others with diverse perspectives can increase compassion for one another and perhaps lead to compromise solutions to the serious problems afflicting our nation and the world.Would that our Congress might take heed and schedule such listening sessions about the national issues too often discussed secretly that leave the public uninformed. Broadcasting honest dialogues that state positions and not just attacks on the other side on TV and the internet would manifest a concern for an informed citizenry.Bruce KerievskyMonroe Township, N.J. More

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    ‘Ordinary Citizens’ Turned Rioters on Jan. 6

    More from our inbox:Republican Contempt for Voting RightsParler’s Free Speech PrinciplesI’ll Take the Jefferson StatueThe Transition From DrivingI Keep My Files on Paper, Not in the Cloud  Joseph RushmoreTo the Editor:Re “90 Seconds of Rage on the Capitol Steps” (front page, Oct. 17):This is one of the best pieces of reporting on the Jan. 6 riot to appear in some time. The role of Proud Boys, neo-Nazis and other committed insurrectionists and troublemakers is easy to understand in connection with the day’s events. The ability of seemingly ordinary, heretofore law-abiding citizens to be swept along in something like this, to the point of violently attacking police officers, is what needs our more considered attention.Donald Trump continues to hold rallies and deliver semi-coherent rants rooted in lies and fantasies. He remains a menace to American democracy, world peace and fundamental human decency.But perhaps we should worry less about the man at the microphone and more about the crowds that continue to cheer him even after all that has come before. Especially after all that has come before.W.T. KoltekLouisville, OhioTo the Editor:What are we to conclude about the insurrection participants you profiled? Their family members, friends and neighbors were quoted as saying that these were nice, giving and very helpful people. Some of the participants stated that they just wanted to be in the rally or to see President Donald Trump.Did they have a short circuit in their brains that made them participate in the riot? Is there some kind of contradiction between their lives back home and their violent behavior on Jan. 6?Not at all. We should not be distracted by the attempts to portray these participants as just ordinary folk. Some of them brought or used other items as weapons, as well as communication devices for coordinating their efforts. These participants engaged in a violent attempt to subvert our democracy and injure or kill our elected officials, as well as the police protectors of our nation’s democratic process and buildings.Actions have consequences. They are responsible for their behavior and must be brought to justice. No niceness can save them from judicial remedies.Robert RosofskyMilton, Mass.To the Editor:This article is chilling because it is likely that Donald Trump, if he becomes president again, would grant a blanket pardon to these and other so-called “patriots” for any federal crimes arising out of the Jan. 6 riots.The article notes that prosecutors and congressional investigators are looking into how “seemingly average citizens — duped by a political lie, goaded by their leaders and swept up in a frenzied throng — can unite in breathtaking acts of brutality.” This statement evokes Kristallnacht and the horror that followed.Donald Trump did goad this group. What these “ordinary citizens” are capable of in the thrall of a demagogue is frightening.Mr. Trump has learned this from Jan. 6. And from past Republican inaction, he’s also learned, and would certainly come into office believing, that the rule of law does not apply to him. That power and mind-set in the hands of this petulant little man are a true danger.Gary H. LevinFort Washington, Pa.Republican Contempt for Voting RightsProtesters demonstrate in support of voting rights on Tuesday in Washington.Shuran Huang for The New York TimesTo the Editor:Re “Voting Rights Impasse Puts Pressure on Filibuster,” by Carl Hulse (news analysis, Oct. 21):The Senate’s failure to pass the Freedom to Vote Act is a cynical corrosion of democratic values. The act would limit partisan gerrymandering, require disclosure of very large campaign contributions and increase election security. These common-sense safeguards are foundational to a functional democracy.Fortunately, my senators, Kirsten Gillibrand and Chuck Schumer, supported the act. But every Republican senator who blocked it — representing a minority of voters — demonstrates contempt for the system they’re elected to defend.Sarah RichardsonNew YorkParler’s Free Speech Principles Lynsey Weatherspoon for The New York TimesTo the Editor:Re “Hey Parler, My Blue City Isn’t Turning Red,” by Margaret Renkl (Opinion guest essay, nytimes.com, Oct. 18):Parler, a social media platform committed to free speech and to the preservation of a digital “town square,” has recently moved its headquarters to Nashville. Ms. Renkl’s premise is that Parler mistook Nashville to be a right-wing haven, and she zeroes in on my assertion that “Tennessee shares Parler’s vision of individual liberty and free expression.” Ms. Renkl wrongly suggests that these principles are somehow exclusive to those on the political right.At Parler, we draw our inspiration from the Constitution — not the Republican Party’s platform — and we defend the American principle of free speech, which, as far as we are aware, is a principle that transcends party politics and is valued on both the left and the right. Or at least it used to be.It is telling that so many on the left believe that “free expression” and “individual liberty” are code words for “conservative.” Worthy of discussion, isn’t it?George FarmerNashvilleThe writer is the chief executive of Parler.I’ll Take the Jefferson Statue  Dave Sanders for The New York TimesTo the Editor:Re “Jefferson Knocked Off Pedestal in New York Council Chamber” (front page, Oct. 19):Thomas Jefferson was a man of his era who, like all men in all eras, did not always live his ideals. Those ideals — that “all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness,” and that the only legitimate government is by consent of the people — are the cornerstones of every modern democracy, including our own.They have enabled our nation to evolve from a society in which slavery was tolerated into one in which, for most Americans, civil and human rights are paramount.The framers’ vision, and the nation that they founded based on an idea, eclipse the frailties that marked Jefferson and his contemporaries as human beings.As James Madison wrote, “If men were angels, no government would be necessary.”If the New-York Historical Society does not accept the City Council’s Thomas Jefferson statue, the city is welcome to relocate it on my front lawn.Rita C. TobinChappaqua, N.Y.The Transition From Driving Gracia LamTo the Editor:Thanks to Jane E. Brody for her thoughtful column “Keeping Older Drivers Protected on the Road” (Personal Health, Oct. 19).One additional point: To help ease the transition from driving, carefully choose where you live. If possible, pick a location where you can walk (or bike) to many of the places you want or need to go to: stores, doctors, cafes, the library, parks and so on. This will enable you to have a healthier and more pleasant life.And, for those now in your 40s and 50s, think ahead. Move to that more walkable neighborhood before you’re old.David W. SearsBethesda, Md.I Keep My Files on Paper, Not in the Cloud Sophia Foster-DiminoTo the Editor:Re “The Case for Filing Cabinets,” by Pamela Paul (Opinion guest essay, Sunday, Oct. 17):Two phrases from this article — “digitally functional people” and “special I.T. skills” — do not describe this senior citizen who finds file cabinets indispensable.I have an active two-drawer file cabinet that is used daily and culled yearly around tax time or when I need room for additions. My genealogy files contain original documents, pictures and even a braid of hair cut from an ancestor’s head circa 1863 — and my own personal and professional history to pass on to my progeny.My late son was a systems analyst with superior I.T. skills. Our difficulty in accessing his encrypted files in the cloud made his scraps of paper and his voluminous paper files crucial in settling his estate.So I will continue to file away without trying to remember passwords, or relying on internet service, which was out the other day.V.E. FranceWhite Plains, N.Y. More

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    How Deceptive Campaign Fund-Raising Ensnares Older People

    Older Americans, a critical source of political donations, often fall victim to aggressive and misleading digital practices. A broad Times analysis points to the scope of the problem.William W. Vaughan Jr. was a senior atmospheric scientist at NASA during the space race and later an accomplished academic, but as with so many aging Americans, time and technology had sapped him of some of his savvy, especially online.Computers made him feel “like a duck out of water,” his son Steve Vaughan said. So when Steve was sorting through the elder Mr. Vaughan’s papers after his death at 90 in December, he was unsettled by what he found on his father’s final credit card bill.The first item was familiar: $11.82 at the local Chick-fil-A in Huntsville, Ala. But every other charge on the first page, and there were dozens of them, was to the firm that processes online Republican campaign contributions, WinRed. Over four months last year, Mr. Vaughan had made 400 donations totaling nearly $11,500 — to Donald J. Trump, Mitch McConnell, Tim Scott, Steve Scalise and many others.The sum was far beyond the realm of his financial ability, his son said, and sure enough, he soon discovered handwritten notes outlining what appeared to be his father’s call disputing the charges with his credit card company. He is still seething at the avalanche of charges and “what they did to a 90-year-old” just before his death.“If it happened to him,” he said, “I have to figure it happened to other people.”It has.Mr. Vaughan died in December at age 90.The dirty little secret of online political fund-raising is that the most aggressive and pernicious practices that campaigns use to raise money are especially likely to ensnare unsuspecting older people, according to interviews with digital strategists and an examination of federal donation and refund data.Older Americans are critical campaign contributors, both online and offline. More than half of all the online contributions processed by WinRed in the last cycle, 56 percent, came from people who listed their occupation as “retired,” federal records show.Digital operatives in both parties deploy an array of manipulative tactics that can deceive donors of all age groups: faux bill notices and official-looking correspondence; bogus offers to match donations and hidden links to unsubscribe; and prechecked boxes that automatically repeat donations, which are widely seen as the most egregious scheme.But some groups appear to specifically target older internet users, blasting out messages with subject lines like “Social Security” that have particular resonance for older people, and spending disproportionately on ads for an older audience. In many cases, the most unscrupulous tactics of direct mail have simply been rebooted for the digital age — with ruthless new precision.“Everybody knows what they’re doing: They’re scamming seniors to line their own pockets and to raise money for campaigns,” said Mike Nellis, a Democratic digital strategist who is critical of deceptive practices.“You are targeting people who are less savvy online, who are more likely to believe what’s put in front of them,” Mr. Nellis said, lamenting tactics that “erase people’s humanity.”It is impossible to tell just how many older Americans are deceived by such methods, because age is not reported on federal filings. One useful measuring stick, digital experts say, is the number of donations that are refunded — which often occurs when contributors feel unsatisfied or duped.The New York Times analyzed refund data from 2020, working with the political information firm Political Data Inc., which matched refunded donors to the voter rolls. The results provide a rare window into just how disproportionately old the universe of donors who receive refunds is.Donation refunds skewed heavily to older peopleRepublican campaigns issued refunds at far higher rates (7.4 percent of WinRed contributions) than Democratic ones (2.3 percent on ActBlue) in the 2020 election. But the age distribution for both parties among California refunds was very similar.

    Note: Donations without an age listed were excluded.Source: Federal Election Commission and Political Data, Inc.Taylor JohnstonThe findings, which looked at refunds in one large and diverse state, California, showed that the average age of donors who received refunds was almost 66 on WinRed and nearly 65 on ActBlue, the equivalent Democratic processing site.Even more revealing: More than four times as much money was refunded to donors who are 70 and older than to adults under the age of 50 — for both Republicans and Democrats.More than 65,000 unique donors, who were refunded a roughly $25 million combined last election, were matched by name and ZIP code in California. The ages of donors being refunded in both parties were very similar, even as Republican campaigns issued online refunds at more than triple the overall rate of Democrats, records show.A Times investigation earlier this year revealed how the Trump operation had made donations automatically recur weekly, and had obscured that fact with extraneous text, causing a multimillion-dollar cascade of refunds and a surge of fraud complaints.Multiple banking officials said the flood of complaints against Mr. Trump’s operation came heavily from older donors. One fraud investigator recalled the case of an 88-year-old who worried that her family would presume she was developing dementia because the repeat charges had blown past her credit card limit.Exploiting the diminishing capacity of older people for cash extends far beyond politics. There is an entire initiative at the Justice Department devoted to elder abuse, and the F.B.I.’s Internet Crime Complaint Center reported nearly $1 billion in losses for those 60 and older in 2020.Most political tactics are legal, though the Justice Department recently called out nonexistent promises to match donations as an example of “material misrepresentations.”“You leverage data, technology, emotion and digital tactics to take advantage of a population,” said Cyrus Krohn, who oversaw digital strategy at the Republican National Committee more than a decade ago and now regrets some of his earlier work. “It’s like a kid in a candy store.”A rally for former President Donald J. Trump at The Villages, a retirement community in Florida, in October.Anna Moneymaker for The New York TimesWhy older people are ‘the perfect target’Daniel Marson, a clinical neuropsychologist who has studied financial decision-making among aging Americans, said older people face a double whammy online when combining their generational lack of familiarity with technology and age-related cognitive declines.The brain itself starts to shift with age, Dr. Marson and other neurological experts said. Processing typically begins to slow. Keeping track of multiple things is harder. Evaluating trustworthiness becomes more of a struggle.“They just don’t have the same digital literacy or capacity to engage in an internet world,” said Dr. Marson, the former director of the Alzheimer’s Disease Center at the University of Alabama at Birmingham.Certainly, millions of aging Americans are still adroit with technology and some don’t decline cognitively until a very advanced age.But even the kinds of silly deceptions that millennials and digital natives might roll their eyes at — like stress-inducing donation countdown clocks — can more easily distract or confuse many retirees who adopted computers later in life.Some campaigns use subject lines like “Final Notice #33716980” — which the Democratic Congressional Campaign Committee recently deployed — that can make it appear as if actual bills are at risk of defaulting. Some use breathless exaggerations, like a recent text from the House Republican campaign arm, which warned it would “lose the House for good!” if everyone did not contribute $9 by midnight.A fund-raising email from the Democratic Congressional Campaign Committee. Personal information has been redacted.Many older people interpret personalized messages literally.Tatenda Musapatike, a Democratic digital strategist, recalled having to explain to some older family members that Joe Biden was not in fact the person sending them an email asking for money.“It’s not naïve or foolish,” she said. “It’s from people being less online.”The daughter of one 69-year-old donor, who spoke on the condition of anonymity to safeguard her father’s wishes to remain private, described a call from her mother last year asking her to intervene in his excessive online contributions. “Mom came to me and said, ‘Dad donated $25,000,’” the woman said. Records show he made hundreds of donations via WinRed to a variety of Republican campaigns.“He’s taking what they say as truth,” she said, adding that he has begun exhibiting early symptoms of mental decline and insists he has not donated as much as he actually has.While she has unsubscribed him from as many email and text lists as she can, she remains worried. “I can’t watch him 24 hours a day,” she said.Text messages sent from the National Republican Congressional Committee urged people to donate with false deadlines and promises of matching contributions.David Laibson, a behavioral economics professor at Harvard who has studied the impact of aging on financial decision-making, said studies showed that half of people in their 80s or older have either some cognitive impairment short of dementia or actual dementia.“Who’s the perfect target?” he said. “They’re in their early 80s, they have a very substantial likelihood of cognitive impairment, and they probably still haven’t depleted their retirement nest egg.”In fact, the records show that more money was refunded to donors who were 80 and older than to adults under 50, on both ActBlue and WinRed, according to the examination of California refund data.ActBlue and WinRed both said they work with customers to solve any problems they encounter, but declined to comment further.Senator Amy Klobuchar of Minnesota, the chairwoman of the Rules Committee, which oversees federal elections administration, noted that many older Americans were particularly isolated during the coronavirus pandemic, and were simultaneously forced to be online more to connect with family and friends. “They had no choice,” she said, “so it is really easy to target them.”Ms. Klobuchar, a Democrat, recently introduced legislation to ban prechecked boxes that repeat donations after the Federal Election Commission unanimously recommended outlawing the practice in the wake of the Times investigation.“Politicians are always courting the votes of seniors,” she said. “Then, behind their backs, they’re scamming them for money. It’s pretty bad.”Some younger donors who are less internet-savvy also donated more than they intended.Daisy DeSimone, left, and her mother, Marian, at their home in New Jersey.Bryan Anselm for The New York TimesMarian DeSimone, the mother of Daisy DeSimone, who has a developmental disability, said her 30-year-old daughter was entrapped in a Republican recurring donation vortex last year that involved hundreds of small contributions totaling $2,700, about 85 percent of which went to two Trump committees.In a joint interview with her mother, Daisy said she contributed more than she intended, “by a lot,” and felt “frustrated” by her experience. She was most impassioned about the overwhelming volume of solicitations: “They would keep coming back to me, they would keep emailing me and texting me.”When her mother logged into her account to try to delete her from various lists, she discovered that the “unsubscribe” link from the Republican National Committee was in plain text. Unlike every other link, it was neither bold nor blue nor underlined. You had to hover above to see that it was a link at all.“Shameful!” she thought. At first, she had blamed her daughter for the deluge of donations. Now she sees her as a victim.Mothership Strategies, a Washington-based digital consulting firm, is known for its aggressive tactics in Democratic politics.Matt McClain/The Washington Post, via Getty Images‘A systemic campaign finance abuse issue’Overall, Republican campaigns issued refunds at far higher rates (7.4 percent of WinRed contributions) than Democratic ones (2.3 percent on ActBlue) in the 2020 election, a gap driven chiefly by Mr. Trump’s prechecked boxes scheme.But some Democratic donors did feel victimized.Susan Kraus is an 81-year-old New Yorker who, federal records show, made around 175 separate donations last year via ActBlue, totaling about $4,500.“That’s impossible,” Ms. Kraus said in an interview. “Never. I don’t know how that happened. But it wasn’t me doing it.” Both she and her son, Brett Graham, said she experiences short-term memory loss.“It’s almost like they were duplicating it,” she said. “Like there were tricks.” She recalls making donations with her phone but nothing at that scale, nor to the range of groups that records show she contributed to.“There isn’t a nice way to spin it,” said Mr. Graham, who helps manage his mother’s financial affairs. “This is a systemic campaign finance abuse issue.” He added that the overlapping pattern of giving was “not what a human being would do.” He was able to receive refunds for roughly $2,500 from two credit cards.The largest share of Ms. Kraus’s donations went to two interconnected groups, Stop Republicans and the Progressive Turnout Project, that she said she had never heard of. Both organizations share a Washington-based digital consulting firm, Mothership Strategies, that Democratic critics have singled out for its aggressive tactics.Of the top 10 Democratic groups with the oldest average age for refunded donors in California during the last election that refunded at least $75,000, all were Mothership clients.Those groups had an average age range of 74 to 78, the analysis of refund data shows. (WinRed does not itemize which campaigns provide refunds to particular donors, so an equivalent examination is not possible.)More than 40 percent of Facebook ads from Stop Republicans and the Progressive Turnout Project reached users over 65, according to a public database compiled by Bully Pulpit Interactive, a Democratic digital consultancy. In comparison, the Biden campaign devoted 18.5 percent of its Facebook ads to that demographic.Mothership said that it does not target people by age. Instead, it said, it screens based on interests and likelihood to donate — and that older people are simply more reliable donors.“We’re proud to raise the funds that allow our clients to outcompete Republican super PACs and elect progressive and diverse Democrats across the country,” Maya Garcia, a principal at Mothership, said in a statement. She added that the leaders of the firm “never want anyone to make an accidental contribution,” that it displays its organizations’ names prominently and that it works “to ensure all refund requests are handled quickly.”The company declined to say if it receives a commission on money it raises online. The Washington Post reported in 2019 that its commission was as high as 15 percent.A debate among Democrats on tacticsToday, most leading Republican groups deploy prechecked recurring boxes and other aggressive tactics, but in Democratic circles a debate is raging about the ethics of online solicitations. There are two clear camps: those who rose through the Democratic Congressional Campaign Committee, the party’s House fund-raising arm, and its highly aggressive program, including Mothership Strategies, and those more aligned with the presidential campaigns of Senator Bernie Sanders.The D.C.C.C.’s operation is one of the few Democratic groups that continue to use the prechecked boxes. It has also experimented with another processing platform while ActBlue moves to block the practice entirely. In June, one fund-raising pitch came from a sender listed as “SOCIAL SECURITY UPDATE (via DCCC)” — though on platforms like Gmail, the D.C.C.C. part was cut off unless people clicked through.Murshed Zaheed, a veteran Democratic digital consultant, is among those pushing for what he calls “ethical email,” which he defined as not deceiving supporters.“I cannot tell you how much I hate the words ‘email list,’” he said. He said the phrase “dehumanizes” people and treats them “as A.T.M. machines.”For Mr. Vaughan, the former NASA scientist, his final credit card bill was a maze of repeating charges to the same campaigns, sometimes on the same day.The note his son discovered had the words “WinRed charges to be refunded” written clearly. It was dated Nov. 25 — the same day that federal records show $1,144 was refunded.It was only about 10 percent of his total giving. His son has been unable to recoup the rest.Rachel Shorey contributed research. More

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    After 4 Years of Trump, Medicare and Medicaid Badly Need Attention

    President-elect Joe Biden has pledged to “marshal the forces of science” in his administration. Undoubtedly he needs to start by bolstering the credibility of the Food and Drug Administration and the Centers for Disease Control and Prevention.But a third health agency, central to the lives of older Americans, low-income families and the disabled, is sorely in need of his attention. Science has also been under assault at the Centers for Medicare & Medicaid Services, which provides federal health insurance to more than 130 million Americans at a cost of more than $1 trillion, nearly twice the Pentagon’s budget.C.M.S. does more than just write checks for medical care. Its scientists and analysts determine which treatments should be offered — I am the chairman of the committee that advises Medicare on those decisions — and how best to care for the patients it serves.Unfortunately, the Trump White House has steadily eviscerated the agency’s dispassionate approaches to making those determinations.Recently, for instance, the Trump administration set in motion a plan to strip C.M.S. of its ability to assess for itself whether new medical devices approved by the F.D.A. are appropriate for the older patients it covers. This is important because the benefits and risks of such devices and procedures, which range from implantable hips and cardiac stents to digital apps and laboratory tests, can vary widely based on patient age and disability.The proposed rule requires Medicare to pay for any new device so long as the F.D.A. labels it a “breakthrough.” And that word does not mean what you think it does.The F.D.A. calls a device a “breakthrough” when it is expected — though not yet proved — to be helpful to patients with serious conditions. The designation has nothing to do with how the device works in older patients, or even if it was studied in that population at all. The proposed rule would also require Medicare to cover any new drug or device if at least one commercial insurer covers it for its members, even if its members are young and healthy.Already, companies seldom generate enough data on their products for C.M.S. to assess their value for its patients. In 2019, for instance, data was insufficient in just under half of new F.D.A. drug approvals to assess benefits or side effects in older patients. The proposed rule would drain the last remaining motivation that companies have to study their treatments in the patients who are likely to ultimately receive them.C.M.S. scientists and analysts do more than evaluate new treatments. They also test alternative ways to organize and pay for patient care. The agency has found, for example, that enrolling people at risk of diabetes in gym sessions reduced how often they were hospitalized. But some seemingly obvious ways to improve health care don’t work: C.M.S. also found it could not reduce hospitalizations for cancer patients by paying their doctors to actively manage their patients’ care.The fact that so many promising ideas don’t work as expected is the reason C.M.S. needs to double down on evaluations of how medical care is delivered to its patients.This administration has gone in the other direction. Just before the election, the White House conjured up a plan to send older people a $200 prescription drug discount card in the mail. Research has already demonstrated that if you give people money to buy prescription drugs, they will buy more of them. The pharmaceutical industry knows this, too. That’s why it hands out coupons worth billions of dollars.These same studies also show that when people are indiscriminately given cash for medicines — instead of only those who need that money the most — it costs much more overall than it saves. No wonder the discount card giveaway would have cost around $8 billion. Fortunately, the president has yet to follow through with it.In another troubling development, the administration announced on Nov. 20 that it would run an experiment in which reimbursements to physicians will be cut for dozens of high-cost drugs they administer in the office, such as chemotherapies and treatments for inflammatory diseases.C.M.S. financial analysts warned that the cuts will lead many Medicare patients to lose access to these important treatments. Scientists should evaluate this prediction by including a comparison group of patients whose doctors would not receive a cut in payment. But the agency administrator made it clear that she didn’t believe the warning. No comparison group is planned. That is no way to evaluate whether our nation’s vulnerable would be helped or hurt by this significant policy change.Another example of a poorly designed experiment involved taking Medicaid coverage away from able-bodied people who are not working or going to school, under an ill-founded theory that doing so would inspire them to seek employment. Such a study is best done narrowly, so that any harms are minimized. Instead, the administration invited multiple states in 2018 to test the outcome.A Harvard study found that a work requirement in Arkansas led to a rise in the number of uninsured people and no significant changes in employment. Thousands of Medicaid beneficiaries in Michigan and New Hampshire were set to lose their coverage before work requirements in those states were ended. Given those results, the overall program should have been canceled. The administration broadened it.Through its reliance on scientific evaluation of what it should pay for, and how, C.M.S. has remained financially viable for more than half a century. As the new president plans to fix the damage done by the current president, this vital agency demands his attention.Peter B. Bach is a physician at Memorial Sloan Kettering Cancer Center. He served as a senior adviser to the administrator of the Centers for Medicare and Medicaid Services in 2005 and 2006.The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips. And here’s our email: letters@nytimes.com.Follow The New York Times Opinion section on Facebook, Twitter (@NYTopinion) and Instagram. More