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The ACA and Retirement: Is there a Link?

When older workers are able to get health insurance from a source outside of their jobs – Medicare, a spouse’s job, or an employer’s retiree health coverage – they become much more likely to decide it is time to retire.

So it’s reasonable to ask whether the Affordable Care Act, which provided millions of people with health insurance for the first time, has also helped to nudge more older workers into early retirement.

The answer, surprisingly, is no, according to a recent study for the University of Michigan Retirement and Disability Research Center.  This finding is important, because baby boomers who are poorly prepared financially to retire should be working longer – not retiring sooner – to improve their retirement outlook.

The researchers, who are at the University of Michigan and Vanderbilt University, estimated that the uninsured rate of 50- to 64-year-olds dropped substantially after the ACA went into effect in 2014 – from 16 percent in 2013 to 12 percent in 2016.  But when they tracked these older workers for several years, they found no evidence that they started retiring at a faster pace after the ACA established the state insurance exchanges and gave tax subsidies to people who purchased coverage on the exchanges.

The study also looked at whether retirement activity increased in response to a separate provision of the ACA: the expansion of the Medicaid health insurance program for low-income Americans.  The expansion, which was voluntary for each state, was achieved by increasing the income ceiling for eligibility. The federal government gave a financial incentive to states that broadened eligibility for Medicaid coverage, and about two-thirds of the states have expanded to date.

In comparing states that expanded their Medicaid programs to states that had not, the researchers again found virtually no change in low-income workers’ retirement trends.

There is widespread agreement that turning 65 and becoming eligible for Medicare motivates people to retire. So why is the ACA different?

One possible explanation is that the “political uncertainty” surrounding the ACA and Medicaid expansion “discourage[s] older workers from counting on them when making career decisions,” the researchers said. …Learn More

Illustration of mind blown

Health Plan Confusion and Bad Decisions

A popular idea for reducing healthcare costs is to arm consumers with detailed information about the prices of drugs and medical procedures so they can make smarter decisions.

But the academic community is reaching the opposite conclusion: people don’t understand the information they already have and are making bad decisions based on these misconceptions. The latest example is a survey of Wisconsin state workers who sometimes defer care because they are under the mistaken impression that they can’t afford it.

“Workers do not understand how health plans work, the role of deductibles, co-insurance and co-pays … and what goes into out-of-pocket costs,” concludes a report by the University of Wisconsin public affairs school, which surveyed 2,200 government workers.

Before getting into the specific findings, it’s important to note that Wisconsin’s employees are in an enviable position. They choose from just four health insurance options approved and overseen by the state. The broader implications of the report are more distressing, if one considers that millions of Americans buying insurance through the Affordable Care Act exchanges, Medicare Advantage plans, or Medicare Part D drug plans must sort through oodles of plan options with different copayments, deductibles, physician and hospital networks, or drug coverages.

The confusing patchwork of Part D plans hurts retirees’ pocketbooks, according to research in Health Affairs, which found that only one out of 20 retirees selects the cheapest drug plan to meet their medication needs. A different study found that health insurance buyers purchase overly expensive plans when they have to choose from a complex menu of options.

The Wisconsin report said state workers there are also overwhelmed: …
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Photo of Francey Jesson and her mother

For Family, Caregiving is a Choice

Francey Jesson’s life took a dramatic turn in 2014 when she lost her job at Santa Fe, New Mexico’s airport after a dispute with the city. In 2015, she relocated to Sarasota, Florida to be close to her family. One day, her mother, who has dementia, started crying over the telephone.

Jesson had always known she would be her mother’s caregiver, and that time had arrived. She and her brother combined resources and bought a house in Sarasota, and Jesson and her mother moved in.

“It wasn’t difficult to decide. What was difficult was everything that came with it,” she said.

One reason for the rocky adjustment was that Jesson, who is single, had been preparing herself mentally to take care of her mother’s physical needs in old age. But Kay Jesson, at 88, is in pretty good health. She requires full-time care because she has cerebral vascular dementia, the roots of which can be traced back to a stroke more than 15 years ago.

She is still able to function and has not lost her social skills. Her muscle memory is also intact, allowing her to chop onions while her daughter cooks dinner. But she forgets to turn off the water in the bathtub, mixes up her pills, can’t remember who her great-grandchildren are, and is unable to distinguish fresh food from rotting food in the refrigerator.

She’s also developed a childlike impatience and constantly interrupts her daughter, who works from home for her brother’s online company. “When she’s hungry, she’s hungry,” Francey Jesson said about her mother.

“Nothing ever stops for me. I can’t sit in a room and not be interrupted,” she said. “Sometimes I just want to watch TV for an hour.”

One way she copes is to approach caregiving with a combination of love and bemusement. She uses “therapeutic fibbing” to protect her mother’s feelings, for example, telling her that a friend who died has moved instead to Kansas so she doesn’t grieve over and over again.  Francey Jesson also resorts to humor in a blog she writes about her day-to-day experiences. In one article, “Debating with Dementia,” she recounted a conversation about the best way to repair some bathroom floor tile: …Learn More

Photo of tornado damage in Beavercreek, OH

Why Americans Can’t Come Up with $400

In Beavercreek, Ohio, the cleanup from a recent tornado has begun. But debris is still piled high on many residents’ lawns.

“What we’re seeing following this tornado is people not having enough cash to pay upfront for house debris removal even though insurance companies will reimburse them,” former mayor Brian Jarvis said on Twitter. The debris cleanup comes on top of other costs like temporary housing in this city east of Dayton.

Much was made recently of a survey in which four of every 10 American families said they could not cover an unexpected $400 expense. But no one explained why. New research has some answers.

Even when people have $400 in their checking or savings accounts, they don’t always feel like they have the money to spend. That’s because they may have already committed the funds to paying off their credit cards, according to an analysis by Anqi Chen at the Center for Retirement Research.

This problem isn’t confined to low- and middle-income people either: 17 percent of households earning more than $100,000 would have to scramble to find the extra $400.

The study uncovered what cash-strapped families have in common. …Learn More

Screenshot of SS statement

Social Security Statement Has Impact

When a Social Security statement comes in the mail, most people do not, as one might suspect, throw it on the pile of envelopes. They actually open it up and read it.

But are they absorbing the statements’ detailed estimates of how much money they’ll get from Social Security? RAND researcher Philip Armour tested this and found that the statement does, in fact, prompt people to stop and think about retirement: workers said their behavior and perceptions of the program changed after seeing the statement of their benefits.

The study was made possible after Social Security introduced a new system for mailing out statements. Workers used to get them in the mail every year. In 2011, the government took a hiatus and stopped sending them out. The mailings resumed in 2014 – but now they go out only before every fifth birthday (ages 25, 30, 35 etc.).

Armour was able to use the infrequent mailings to compare the reactions of the workers who had received a statement with those who had not during a four-year period, 2013-2017.

The statements bolstered their confidence that they could count on Social Security when they retire. More important, receiving them in the mail spurred some people to work more. To be clear, this is what they said – it isn’t known what they actually did.

Those who had been out of the labor market were much more likely, after getting a statement, to say they had returned to work. Working people under age 50 increased their hours of work.

Social Security benefits, on their own, usually are not enough to live on in retirement, and half of U.S. working-age households are at risk of falling short in retirement. But unfortunately, the study wasn’t able to detect another critical aspect of their retirement preparation: saving. …Learn More

Photo of a waitress

When Your Health, Job Demands Clash

Home health aides, nurses, teacher assistants and servers do a lot of lifting or standing for long periods, which takes a toll on their bodies.

For a middle-aged waitress, it might be a bad knee. For a baby boomer caring for an elderly person, it might be the strain of lifting a patient out of a chair.

In a new study, researchers calculated the percentage of workers who cite health-related obstacles to performing their jobs for nearly 200 occupations. A ranking of these percentages proved a fairly reliable indicator of what one would expect workers to do. Workers in the occupations with the largest share of people having difficulty performing their jobs were more likely to quit work and file for Social Security Disability Insurance (SSDI).

The chart below shows the occupations with the highest percentages of health-related obstacles. For example, some of the most hazardous jobs are welders and brazers, who assemble equipment made of aluminum. …Learn More

Photo of mom and daughter

Moms Help Jobless Sons and Daughters

“Families often serve as the first line of defense against adverse events,” a RAND study starts out.

In this case, the researchers are talking about a mother who protects her unemployed adult child by providing financial assistance, a request that’s not easy for a mother to resist.

RAND researchers Kathryn Edwards and Jeffrey Wenger find that women of all ages are very likely to help out and “significantly alter their behavior” when a son or daughter loses a job.

How much mothers’ sacrifices affect their standard of living are beyond the scope of this study. But although unemployment is at historic lows today, when a child does lose a job, a mother who provides assistance is potentially exposing herself and her husband to financial problems down the road.

The types of the assistance the women in the study provided varied for different groups. The youngest group, working-age mothers between 35 and 62, were the most willing to help an unemployed child, though women of all ages did to some extent.

Mothers employed full-time, and in some cases their partners or husbands, worked more to earn additional money, an option largely closed off to the retired women. Another way working mothers adjusted was to reduce their contributions to employer retirement funds. All of the women also cut their own food budgets for a year or more.

This study is a conservative take on their assistance, because it doesn’t include an indirect, but often costly, source of support that is an obvious solution for unemployed offspring: moving back home. Moving back in will, at minimum, increase their parents’ utility and grocery bills. …Learn More

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