What happens if your boss does not give you a pay raise but your health insurance premium increases? You take home less dough. It stings, but it’s reality for American workers. However, many people who rely on the federal government for income and health insurance are protected from such a reduction in income.

Retired Americans on Social Security generally receive a cost-of-living increase each year. Though modest, it is large enough to cover the increase in their monthly Medicare Part B premium, which is deducted from their Social Security check. But last week the Social Security Administration announced there would be no cost-of-living increase for recipients in the upcoming year, mostly due to low inflation and falling gas prices.

Seniors will not receive a raise, but the cost of the government health insurance they rely on continues to increase. So what happens? A "hold harmless" provision in federal law protects about 70 percent of them from any decrease in monthly income. The majority will not have to pay more than the current monthly $104.90 premium. Who makes up the difference in the increased cost of Medicare?  The unlucky 30 percent of beneficiaries not held harmless under the law will pay about 50 percent more each month.  These include retired federal employees, new enrollees, seniors who have deferred Social Security benefits and those with high incomes.

These individuals obviously aren’t too excited about covering everyone’s share of higher health costs. Neither are states, which use Medicaid funds to pay Medicare premiums for some low-income enrollees. Though it’s hard to feel bad about a senior who earns $100,000 a year paying an additional $77 a month, there is something fundamentally wrong about a fraction of enrollees bearing all the expense. It’s unfair.

Of course, addressing the issue falls to Congress — which can’t seem to agree on anything. House Speaker John Boehner balked at a proposal from Democrats to protect seniors from premium increases, which could cost an estimated $12 billion.

A short-term fix is not the answer anyway. Lawmakers need to tackle this by putting on their “big picture” thinking caps. That means rethinking and possibly nixing the “hold harmless” provision in federal law responsible for creating the mess. This would not be popular with seniors, a group of voters lawmakers never want to anger. But someone has to pay the health care bill for more than 50 million Americans. Senior premiums cover only 25 percent of the cost of Medicare Part B, while general revenues pick up 75 percent. Taxpayers foot the majority of the expense of the entire $613 billion health insurance program through payroll and income taxes.

Without the hold harmless provision, the average premium for Medicare beneficiaries would increase about $15 a month in 2016, according to Medicare trustees. All recipients would contribute more. That would be fair.

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