Posts Tagged "policy"

ACA Policyholders May Dodge a Bullet

It looks like some 13 million people who buy their health insurance on the state and federal exchanges may not see large hikes in their premiums next year after all.

The more generous premium subsidies for Affordable Care Act (ACA) policyholders approved in 2021 under the American Rescue Plan for COVID relief are set to expire at the end of this year. There have been months of uncertainty over whether Congress could pass a bill to continue the subsidies.

But The Washington Post reports that the House and Senate are on a path to agreeing to extend them for three more years, along with allowing Medicare to negotiate the prices of some prescription drugs.

Last year, the American Rescue Plan enhanced the ACA’s original subsidies by capping insurance premiums at 8.5 percent of a worker’s income for 2021 and 2022. If the caps are renewed, ACA policyholders would also avoid the “double whammy” of insurance companies’ 2023 premium hikes, which they have started submitting to their state insurance regulators.

The prospect of an agreement comes months after state insurance commissioners warned lawmakers that the uncertainty around whether the subsidies would continue meant that some insurers would raise 2023 premiums by more than they might have. ACA subsidies make health insurance more affordable to more people, which takes some pressure off of premiums by expanding the pool of customers and reducing insurers’ risk.

Two groups that historically have paid more for health insurance are benefitting the most from a premium cap set at 8.5 percent of income: middle-income workers, who tend to pay a larger percentage of their income for an ACA policy, and older workers, who pay higher premiums because insurers view them as risky.

Before the caps were put in place, workers earning four or more times the federal poverty level did not get any subsidies and paid full price for ACA coverage. Without the assistance, for example, a 40-year-old earning about $51,500 would be paying 20 percent more – or $438 per month instead of the $365 she currently pays, according to the Kaiser Foundation.

Premiums would’ve been 62 percent higher in New York and more than double in Wyoming. …Learn More

Does Private Disability Affect Federal Rolls?

Does Private Disability Affect Federal Rolls?

Economists have long thought that if employees have disability insurance on the job, they might never migrate over to the government’s disability rolls. A new study finds just the opposite.

In Canada, the existence of short-term disability in the private sector increased the number of people going into the national government’s program by 18,300 in 2015 and increased program spending by 5 percent, according to a researcher at the University of Toronto.

The logic behind this is that enrollment rises in the government program, which provides long-term benefits, because a negative incentive is at play. If employees with a disability or workplace injury have short-term coverage at work, they will have a regular source of income to tide them over while they apply for government benefits and wait for a response.

The Canadian study has implications for the United States, because the two countries’ programs are similar. The connection between U.S. government and employer disability is also of interest because some policymakers here would like to see mandates for employer disability become more widespread. Ten U.S. states and the District of Columbia currently require employers to provide the coverage for serious medical conditions.

This research adds a new voice to a lively debate on both sides of the U.S.-Canada border. Others have argued that when companies offer short-term disability, they prevent some people from going onto the government rolls by giving them time off to recover from an illness or injury before it becomes chronic. Employers also have an incentive to control their insurance costs by preventing injuries or accommodating employees with disabilities so they can keep working. …Learn More

Medicare

Enrollment Trends in Medicare Options

Most retirees manage to get by on less than they earned as workers. Yet they devote a much larger percentage of their income to medical care than working people.

To limit their annual spending on care, retirees usually buy some type of insurance policy to help pay the bills Medicare does not cover. But a big shift is under way: the Medigap and employer plans that once dominated are now in decline. Only about a third of retirees have one of these two supplementary arrangements, down from two-thirds in 2002.

Retirees are instead swarming into Medicare Advantage plans  – HMOs run by insurance companies – which doubled enrollment in the past decade to become the most popular form of coverage. A small minority of retirees go without any policy at all, so the only premium they pay is for Medicare Part B’s physician coverage. (The Part A hospital coverage has no premium.) At the same time, the vast majority of retirees today enjoy prescription drug coverage, either through a stand-alone Part D plan or as part of an employer or Advantage plan.

Helen Levy at the University of Michigan digs into what the market changes mean for retirees’ bottom line in recent research funded by the U.S. Social Security Administration.

With fewer employers offering retiree health insurance, new Medicare beneficiaries focus on the tradeoffs between Medigap and Advantage policies. A big reason the Advantage plans have taken off is lower premiums, which are, on average, substantially below the premiums on Medigap plans. Advantage plans’ other appeal is that they frequently cover extra services like dentists and eyeglasses.

Both Advantage and Medigap plans can still leave beneficiaries with high out-of-pocket spending. The federal limit on Advantage plans’ deductibles and copays increased this year to $7,550 per year, though insurers are permitted to reduce this cap. Many Medigap plans do not have out-of-pocket maximums at all. However, these plans tend to give more protection from large medical bills overall.

Just as important to retirees as paying the bills is the risk of being socked with inordinately high spending on hospital and physician care in a bad year. Levy defines this unpredictability as retirees having to shell out more than 10 percent of income out of their pockets, excluding all premiums.

Under this standard, about 23 percent of the retirees in the study with Advantage plans spent more than 10 percent of their income for care – versus 17 percent of Medigap buyers.  About 28 percent of those without any coverage outside of Medicare exceeded the 10-percent threshold. …Learn More

Man building a house

Changing Social Security: Who’s Affected

Due to the strength and agility required for physical labor, half of blue-collar workers sign up for Social Security as soon as they’re eligible – at age 62.

But a large majority of white-collar workers wait so they can lock in a larger monthly check for retirement.

White-collar vs Blue-collar age 62In a new study, Lindsay Jacobs at the University of Wisconsin found that blue- and white-collar workers would also respond very differently to potential increases in the program’s two benchmark ages: the earliest eligibility age and the full retirement age.

Raising the earliest eligibility age to 64 would not change retirees’ lifetime benefits. But a two-year hike in the full retirement age would amount to a significant benefit cut – and with the depletion of Social Security’s trust fund projected for 2035, some version of this change might one day be considered.

The first change – raising Social Security’s earliest claiming age – would require a much bigger adjustment by blue-collar workers. Jacobs predicted that this group would respond by working an extra year, on average, compared with a few more months for white-collar workers.

Requiring workers to wait longer for their benefits does have a financial advantage: a larger Social Security check every month. The problem for some blue-collar workers is that they couldn’t make it to 64. One result, then, is that increasing the early retirement age would push up applications to Social Security’s disability program, according to the study funded by the Retirement and Disability Research Consortium.

Jacobs gauged the impact of raising the early retirement age based on how quickly workers’ declining health would affect their ability to work as they age. To understand how they would react to raising the full retirement age, she examined how workers’ decisions about retiring, saving, and signing up for Social Security would change under various policies. She classified the workers as blue- or white-collar using data that describes job tasks to show that the physical demands at work influence these decisions.

The second possible change would increase the full retirement age by two years, which amounts to an across-the-board cut in benefits regardless of when workers claim them. In response, white-collar workers, who are already more inclined to hold out until the full retirement age, would be more likely to work even longer to reach the new, higher benchmark age.

But blue-collar workers would bear the brunt of the benefit cuts, because their physically demanding jobs would often prevent them from working longer to offset the cuts. …
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child drawing with chalk

Medicaid for Children Pays Off Later

Medicaid health insurance, which covers a third of the nation’s children, has a payoff down the line: fewer adults on disability.

A well-known benefit of Medicaid is that low-income children covered under the insurance program turn into healthier adults. But a recent study found that these health improvements translate to another positive outcome for adults: fewer applications to Social Security’s Disability Insurance (SSDI) program, which provides monthly cash benefits to people who are not healthy enough to work.

The study, conducted by researchers at Middlebury College and Vanderbilt University, used U.S. Census data to follow 63,000 individuals between ages 25 and 64 who were exposed to Medicaid for various lengths of time during childhood, depending on when they were born and when their state first implemented the program, which Congress passed in 1965.

First, the study confirmed the health benefits of Medicaid coverage for children: the adults in the study could more easily pass a few basic tests of health and physical stamina, such as lifting 10 pounds, standing for an hour, and walking up 10 stairs.

And better health did, indeed, reduce their applications for SSDI – and ultimately, the number of adults receiving disability benefits. In fact, the longer they would have been insured under Medicaid as children, the less likely they were to apply for disability, said the study, which was for NBER’s Retirement and Disability Research Center.

This is a clear example of how early intervention can reduce government spending down the road. …Learn More