Do older Americans want bigger Social Security checks and expanded Medicare coverage – or do they want their benefits cut?

That is the fundamental question for seniors and their families with less than two weeks until the mid-term elections. The majority party in Congress has proposed time and again to slash Social Security and Medicare benefits under the guise of ‘entitlement reform.’ Leader Mitch McConnell just attributed the swelling federal debt to retirees’ earned benefits – when the real culprit was the 2017 tax package that mainly benefited the wealthy and big corporations. The majority party’s 2018 and 2019 budgets would have taken a $500 billion bite out of Medicare and $64 billion from Social Security. And make no mistake – conservative tropes like raising the eligibility age, imposing a more meager inflation formula, and means testing are benefit cuts.

The choices for older voters in the November elections couldn't be clearer.

For seniors living on fixed incomes, the fate of their earned benefits is the ultimate “pocketbook issue.” According to the Center for Budget and Policy Priorities (CBPP), Social Security provides the majority of income to most elderly Americans. Some 40 percent of seniors rely on their Social Security checks for at least 90 percent of their income. Medicare beneficiaries spend 25% of their income on out-of-pocket medical costs. As time goes by, more and more of their Social Security benefit checks will be consumed by rising health care costs.

Plainly put, millions of American seniors are feeling the pinch. They need a raise in the form of bigger Social Security checks and expanded Medicare benefits. The average Social Security retirement benefit is a little more than $1400 per month – enough to keep most seniors out of poverty but by no means extravagant. Our organization often hears from beneficiaries who are grateful for Social Security, but still are living hand to mouth.

A retiree named Shirley says that her Social Security benefit pays for gas, electric, groceries, and clothing. “Without Social Security, which my husband and I paid into for up to 50 years, we would have to be on welfare,” she explains.

Joe, a beneficiary with no retirement savings, receives a $2100 monthly benefit, but barely manages to balance his bank account every month after paying for rent, meals, and other living expenses.

Virginia receives a widows’ benefit from Social Security. “If I didn't have this, there is no way I could pay my rent, bills and buy groceries,” she says. “If they take it away, I will be living in my car.”

Who would argue that these seniors’ lives would be a little easier with a modest boost in benefits? Congressman John Larson’s (D-CT) Social Security 2100 Act would give seniors a benefit increase of about $70 per month. To some, that may not sound like much. But think of what an extra $70 could mean for a senior living on a fixed income. That benefit increase could pay for at least one of the following expenses:

3 bags of groceries

3+ prescription copays

2 tanks of gas

Oil change

Monthly phone bill

Monthly utility bills

Monthly home/renters’ insurance premium

Now imagine how much money seniors would save if traditional Medicare were expanded to include dental, vision, and hearing coverage, given what retirees currently pay out of pocket in those categories:

$4,700 (average) for a pair of high quality hearing aids

$800-3,000 for a dental crown

$900-1100 for a root canal

$114 (average) for eye exam

$200 (average) for prescription eyeglasses

These costs would be covered under legislation introduced by Rep. Lucille Roybal-Allard (D-CA) known as the Seniors Have Eyes, Ears, and Teeth Act. But this bill has little chance of becoming law unless voters elect a majority in Congress that supports improving earned benefits.

The next Congress could also give retirees a boost by improving the way Social Security cost-of-living adjustments (COLAs) are calculated. COLAs are currently based on the consumer price index for wage earners (CPI-W), which does not adequately reflect increases in seniors’ true living expenses. (Retirees typically spend more of their income on housing and medical expenses, for instance, than working-age wage earners.) The Consumer Price Index for the Elderly (CPI-E), which accounts for inflation in goods and services that seniors depend upon, would be a much fairer formula for determining COLAs. In fact, Rep. Larson’s bill – and legislation introduced by Rep. John Garamendi (D-CA) – would require the use of the CPI-E to determine annual Social Security COLAs. Again, this is a proposed benefit boost that could become law if the election changes the balance of power on Capitol Hill.

President Trump promised during the 2016 campaign that he would not cut Social Security and Medicare – a theme he has reprised this fall in the run-up to the mid-terms. YET, he has openly betrayed this promise by embracing proposals from his own administration and his allies in Congress to slash spending on both programs.

The choices for older voters in the November elections couldn't be clearer. Either vote for candidates and incumbents who have a track record of protecting and improving earned benefits, or keep the current majority who boldly attack the programs that provide the only health and retirement security that seniors, the disabled and their families can depend on. Boost or cut. It’s the voters’ choice now.