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Kai Ryssdal: Senior citizens and others who get Social Security checks have come to count on something called a COLA. A Cost of Living Adjustment. A yearly bump in their checks tied to inflation. Come January, though, the COLA will be decidedly flat, since the recession has put the brakes on inflation. But Tamara Keith reports from Washington, not everybody measures their cost of living the same way.

TAMARA KEITH: Social Security payments to seniors normally increase a little bit every year. In 2010, the Social Security trustees project there will be no increase at all.

That’s because Social Security payments are tied to the Consumer Price Index. And that’s down from where it was last year, in part because of the dramatic drop in gas prices. But 67-year-old Barbara LaBelle says her cost of living hasn’t come down. Take her medical expenses.

BARBARA LABELLE: They’ve raised my co-pays and now I pay for lab work which I didn’t have to pay before. So as many doctors as I’m seeing, I’m shelling out high co-pays.

Her experience points to a problem many seniors face. Health-care costs are rising a lot faster than the rate of inflation. Cristina Martin Firvida is with AARP.

Cristina Martin: They count on that cost of living increase to help them meet those health-care expenses that continue to rise each and every year.

So advocates are pushing Congress to help seniors out with a cost of living adjustment or COLA anyway. Sandy Wise is with the National Committee to Preserve Social Security and Medicare. Here’s what the committee wants.

SANDY WISE: Give either some kind of modest COLA increase to help people out in this situation. Or just a flat payment, a one-time payment, to compensate them for the lack of a COLA.

Barbara LaBelle’s only source of income is her $900 a month Social Security check. And she’d love to get a raise, one way or another.

In Washington, I’m Tamara Keith for Marketplace.