Phasing out payroll tax cap would make all earnings subject to Social Security tax starting 2032: Rep. Linda Sanchez bill phases out taxable wage cap after 2027 — gradually excludes smaller percentages: 80% in 2028, 60% in 2029, 40% in 2030, 20% in 2031, 0% by 2032 — "would dramatically extend life of program" and ensure "wealthy finally pay their fair share," according to Sanchez — called "major revenue provision" that would apply to both employee wages and self-employment income.

Switch from CPI-W to CPI-E for COLA calculations starting September 30, 2027 — better reflects senior expenses: Current COLA uses Consumer Price Index for Urban Wage Earners (CPI-W) — bill replaces with Consumer Price Index for Elderly (CPI-E) "intended to better reflect retiree expenses, especially healthcare and housing" — bill aims to ensure "cost-of-living adjustments accurately reflect real expenses seniors face."

Enhanced survivor benefits: widows/widowers get greater of 75% of combined benefits or deceased's primary insurance amount: Bill creates alternative survivor-benefit calculation effective for benefits after December 2027 — monthly survivor benefit = greater of deceased worker's PIA-based amount or 75% of sum of survivor's own retirement/disability benefit plus deceased worker's PIA — cosponsored by six Democratic representatives responding to trust fund projected depletion by 2032.

Lenders recognize Social Security as government-backed, lifetime income legitimizing home equity loan qualification: Many lenders consider SS benefits stable and reliable for approval process — can count toward income calculation along with pensions, retirement distributions, annuities, investment earnings, part-time employment — key challenge: SS benefits alone may not satisfy requirements if borrower has significant monthly obligations already impacting budget — lenders review entire financial picture, not single income source.

Debt-to-income ratio critical: low DTI improves approval odds, high DTI makes qualifying difficult: DTI measures how much monthly income committed to debt payments — example: $3,500/month combined SS + retirement income but large portion going to mortgage, credit cards, auto loans makes qualifying harder — conversely, paying down debts improves approval case even with modest income — adding new payment could stretch fixed budget too far if already high DTI.

Home equity (15-20% minimum retained), credit score, and available equity also determine approval: Lenders focus heavily on available equity during approval — older homeowners who purchased years ago often accumulated significant equity through mortgage paydown and home appreciation — higher credit scores improve approval chances and loan pricing — borrowers with substantial equity and clear funding plan can access cash without selling asset, but those with limited equity/funds should consider alternative options.

CMS/FDA integrating wearables into Medicare as HHS Secretary Kennedy pushes "Make America Healthy Again" strategy: ACCESS pilot program starting next month — CMS will reimburse device companies for wearables and apps treating chronic musculoskeletal pain, depression, diabetes, high blood pressure — full payment contingent on improvement in health outcomes, requiring comprehensive evidence generation and data reporting — Kennedy wants all Americans wearing health tracker within 4 years.

Continuous Glucose Monitors expanded coverage example: now covers all insulin users after Biden lifted strict eligibility requirements: Since 2017, CMS covered CGMs for certain Medicare diabetes patients — Biden admin 2025 expanded to anyone on insulin, scrapping blood glucose check requirements — companies/advocates pushing further: coverage for type 2 non-insulin diabetics (currently only if severe hypoglycemia history) — recent GLP-1 drugs (Ozempic, Mounjaro) improved CGM use value for broader patient populations.

Wearables cost-effectiveness unclear — insurers need gold-standard evidence of reduced spending before widespread adoption: Device industry optimistic but whether wearables cost-effective remains unclear — variation considerable by device type and health condition — insurer challenge: immediate financial burden vs. delayed/uncertain ROI, with data overload and false alarms sometimes increasing costs without better outcomes — researchers say "more research needed to fully understand long-term benefits" and strengthen evidence base.