January 2023

Employers Routinely Avoid Paying Overtime

Walk into a restaurant, retail store or hotel, and you might encounter a manager who seems to be doing the same tasks as the people he’s managing. Maybe you’re in one of those jobs.

A lawsuit by employees against a retail store revealed how meaningless the title of manager can be: the store managers were “stocking shelves, running cash registers, unloading trucks and cleaning parking lots, floors and bathrooms.” Hardly the types of responsibilities that go with overseeing one’s coworkers.

The employees were suing for overtime pay under a Depression-era federal law to receive back pay for overtime when they worked more than 40 hours per week.

Employers are exempt from paying overtime under this rule, however, if the employee is a manager earning more than $35,568 per year, rather than an hourly wage. One last requirement to qualify for the overtime exemption is that employers must give the worker executive or administrative duties that include supervising others on the job.

To satisfy the amorphous definition of who qualifies as a manager, new research finds that U.S. employers are much more likely to come up with creative, “fake-sounding” managerial titles – bingo manager, food-cart manager, director of first impressions, carpet-shampoo manager, and lead shower-door installer – for jobs paying just above the overtime pay threshold.

Employers “strategically use job titles to exploit regulatory [pay] thresholds,” which saves more than 13 percent for each manager who qualifies as exempt from the overtime rule, said the researchers, who include a Harvard Business School professor. The practice is “systematic” and saves U.S. employers some $4 billion in payroll costs every year.

The situation for workers used to be worse, however. Millions more became eligible for overtime pay when the pay threshold was increased 50 percent, to $684 per week – or $35,568 per year – in January 2020, from the $455 per week rate in place at the time of this study. …Learn More

Middle Class Gets the Most from Medicare

width=This is a fact of retirement life: older Americans haven’t paid as much into Medicare and Medicaid as government spends on their healthcare and nursing home stays.

But it is middle-class retirees who get the most out of the system, according to a new study.

Middle-income households receive about $230,000 to $260,000 more in Medicare and Medicaid benefits, on average, during their retirement years than the total amount they’ve paid in. Their contributions consist of the Medicare payroll and income taxes deducted from workers’ paychecks, the portion of their federal and state income taxes devoted to Medicare and Medicaid, and the Medicare Part B and D premiums they are paying in retirement.

The net benefit of the programs to the middle class dwarfs the $153,000 in average net benefits for retired households in the top fifth of the lifetime earnings distribution, and it also exceeds the $196,000 gain for the bottom fifth.

The middle class is defined as the second, third, and fourth of the five earnings groups the researchers analyzed in this study. The annual data used to calculate the health spending and payment estimates for this analysis are adjusted for inflation.

width=Americans over 65 receive a third of all the medical care provided in this country. This new research, funded by the U.S. Social Security Administration, uses government administrative data to compare the benefits of Medicare and its smaller companion program, Medicaid, for each earnings group.

There are two reasons the middle class gets the most from the system. First, although the top earners live the longest and receive the most medical care, the middle class lives almost as long and ends up receiving a significant amount of care. …Learn More

Medicare to Cover 3 New Dental Procedures

“Is it medically necessary for a person to be able to chew?” Dr. Lisa Simon, a physician and dentist at the Harvard School of Dental Medicine, asks.

This is a serious question for older Americans in fragile health. I know a 93-year-old man whose teeth problems make it extremely difficult for him to eat meat and many other foods on the dinner table.

Two-thirds of retirees do not have dental insurance, which means they may decide to forgo getting expensive dental care. The importance of dental care to nutrition and health is also an equity issue for older Blacks and low-income retirees, who are more likely to be missing all of their teeth.

Medicare has historically paid for very few dental procedures. But the Centers for Medicare and Medicaid Services has expanded its existing, limited coverage to include treating patients who have oral infections prior to an organ transplant and patients who need a cardiac procedure or treatment of head and neck cancers.

Simon, who advocates for integrating dental care into overall medical care, argues in the journal Health Affairs that Medicare’s expansion of coverage for medically necessary procedures does not go far enough.

“These provisions are an overly narrow interpretation of what makes a health care service          ‘necessary,’ ” Simon writes.

She lists several examples of medically necessary conditions that don’t seem to fit Medicare’s updated definition. They include cancer patients who have oral inflammation during chemotherapy, diabetes patients with periodontal disease, and elderly women being treated for osteoporosis with injections that put them at risk of painful jaw deterioration. …Learn More

What’s Up with Medicare Advantage Ads?

Starting months before my 65th birthday, my mailbox has been swamped with advertisements for Medicare Advantage insurance plans. The ads are still coming in.

And then there are the television commercials with promises of Advantage plan benefits that original Medicare doesn’t cover – vision, dental and hearing services, rides to doctors’ appointments, zero premiums. Sounds amazing, doesn’t it?

The advertising blitz surely has contributed to the doubling in Advantage plan enrollment since 2013, to 28 million last year. The plans are overtaking Medigap plans, which the nonprofit Commonwealth Fund estimates do not bring in as much profit for brokers as Advantage plans.

It is true that the vast majority of Advantage plans provide some type of vision, dental and hearing coverage. And retirees with these benefits in their Advantage plans spend slightly less for the services than other retirees, the Kaiser Family Foundation, a healthcare non-profit, found.

But the devil is in the details.

For example, the average dollar limit for vision benefits in Advantage plans was $160 in 2021, said Meredith Freed, Kaiser’s senior policy advocate. That $160 probably wouldn’t be enough to pay for an exam and buy the prescription glasses. The television and mailed advertisements are short on these details.

Or consider dental coverage for preventive services, such as cleanings and X-rays. This coverage might be useful, but the plan might not cover cavities, root canals and caps. Or, if they are covered, a $1,000 limit is fairly common and insufficient for many expensive procedures, Freed said. And what about the two out of three Advantage plans that do not charge a premium? The ads touting “zero premiums” aren’t usually clear that you’re still responsible for Medicare’s Part B premium of $164.90 per month.

“I’m hesitant to use the word misleading,” Freed said. But when choosing a Medicare Advantage plan, “Unfortunately, it’s on the consumer to dig more when they’re interested in a plan” to understand not only how the specific plans work but also how Medicare’s underlying benefits work, she said.

An analysis of Google search data has found that older Americans are not finding the kind of information online that they are seeking about their Medicare options. Instead, they are being bombarded with advertising by insurance companies, agents, and brokers, according to the Commonwealth Fund.

Older people search for Medicare information online from a diverse range of sources – patient advocacy groups, the media, and federal agencies including Social Security and the Centers for Medicare and Medicaid Services (CMS). A minority of the searches are for insurance industry information.

But online advertisements by agents, brokers, and insurers are prevalent in the top links in their Google searches and account for 87 percent of all online Medicare ads. …Learn More

Great Depression Holds Lesson for Our Time

Photograph by Lewis Hines, West Virginia 1937

Photograph by Lewis Hines, West Virginia 1937.

The Great Depression, sparked by a devastating collapse in stocks followed by 25 percent unemployment, remains the deepest recession in U.S. history.

A new study laying out the long-term negative impacts to Americans born during that time might be consequential for today’s youngest citizens –  teenagers born during the Great Recession of 2008 and 2009 and toddlers born in the midst of the steep COVID downturn in 2020.

The researchers found that the stresses and financial strains on parents from the Depression’s extraordinarily high unemployment over a protracted period of time did long-term damage to the health and careers of their children that persisted late into their lives. In a separate but related paper, they also found that people exposed to the Depression in utero experienced an acceleration in the aging process after age 75.

“The shock of the Great Depression was massive and everyone, no matter what group they belonged to, was to some extent impacted,” concluded the researchers, Valentina Duque and Lauren Schmitz.

For a whole host of reasons, a parent’s loss of income and joblessness have a huge impact on their children’s development and socioeconomic status, which in turn determine how they will do when they grow up. Prenatal stress on mothers, for example, has been linked to lower earnings for their offspring as adults. In utero stress also contributes to cognitive and behavioral problems late in life.

A father’s financial distress can harm the long-term health of children if the family can’t afford to buy nutritious groceries and quality healthcare or isn’t able to relocate to another part of the country with better job prospects.

To assess the Depression’s impact on health and careers, this study used a survey of older Americans. The researchers identified adults born in the 1930s to analyze how they fared late in their careers based on how severe the Depression was in the state where they were born or lived as young children.

The analysis, using IRS tax records, indicated that the offspring of the Depression’s parents living in states with larger declines in wages earned less throughout their careers – the impact in utero was larger than for the workers exposed to the Depression as young children.

The Depression created other deficiencies too: by the time the people born in more depressed states reached their 50s and early 60s, they were less productive and less attached to the labor force than their counterparts who grew up in states with stronger economies during that difficult time. They also had poorer health, were more often disabled, and had higher mortality due to health problems like diabetes and cardiovascular disease.Learn More

Falling Math Scores May Cut Future Earnings

Scores on 8th grade standardized math tests dropped during the pandemic, reversing a large part of the gains students had made since the 1990s. U.S. Secretary of Education Miguel Cardona called the news last October “appalling.”

But declining scores only confirmed for many parents what they had witnessed as their children struggled to engage in classes conducted over Zoom when the schools were closed down.

Now comes some of the fallout. The decline in math scores between 2019 and 2022 is expected to reduce the lifetime earnings for the average student by nearly 2 percent, or $19,400 in today’s dollars, according to a new study.

This may not sound like a lot spread out over a decades-long career. But think about it this way: after years of rising test scores and incomes, recent 8th graders may lose several hundred dollars a year in income just because they grew up during a pandemic.

And the impact of being competent in mathematics goes beyond lost earnings. Lower test scores lead to lower graduation rates, fewer kids in college, and more teen pregnancies, arrests and incarceration. So, it’s important to make sure these kids make up for lost time by improving their test scores during high school. …Learn More

Long Wait Times Deter Disability Applicants

Applying for federal disability benefits is a precarious situation for workers who were either forced, or have chosen, to quit their jobs due to an injury or chronic medical condition. There are no guarantees an application will be approved, and it can be hard to find a job after waiting months for a decision on whether they qualify for the benefits.

In new research documenting how long individuals wait for a decision on their initial disability applications to a Social Security Administration (SSA) field office, the average ranges from about seven to nine months.

The entire process can take twice as long if SSA denies the request for benefits and the applicant appeals within the agency or to an administrative law judge or federal court, the researchers found.

Wait times between the initial filing and resolving all appeals fluctuated quite a bit, at least during the study’s time period – 1996 through 2014 – but ended at a higher level than where they started. The waits in exurban and rural areas increased more than in urban areas.

Why does this matter? In addition to the burden on applicants of having to wait, long waits may be dissuading people from applying for disability. Counties that took longer to process applications and resolve all the appeals saw fewer applications the following year, the researchers found.

The impact of wait times on future applications provides preliminary “evidence of the importance of how SSA processing interacts with applicant behavior,” the researchers said.

The amount of time it takes to process an application can vary for all sorts of reasons. Certain severe medical conditions that are clearly disabling can speed things up. But submitting an incomplete application or applying to a particularly busy field office can lengthen the process. …Learn More