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    By: The My Medicare Matters Team It’s time a year again! Medicare’s Open Enrollment Period (OEP) is almost here, starting October 15th and ending December 7th. If you’re already enrolled in a Medicare plan this is the time of year where you can re-evaluate your coverage to make sure you are still enrolled in the best

    The post Check Your Mail: Changes to the 2018 Medicare Open Enrollment Period Mailings appeared first on My Medicare Matters.

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    By: The My Medicare Matters Team Choosing a Medicare plan is an important, but difficult decision. This choice could determine your health for years to come and save (or cost) you hundreds of dollars in out-of-pocket costs. However, during the Medicare Open Enrollment Period (OEP)/Annual Election Period (AEP) October 15 through December 7, you can

    The post How to Choose a Medicare Plan During the Open Enrollment Period appeared first on My Medicare Matters.

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    By: Ann Kayrish, NCOA’s Senior Program Manager for Medicare This open enrollment people with Medicare will have more plans to sift through than in past years. The Centers for Medicare & Medicaid Services (CMS) will now allow Medicare Advantage (MA/Part C) plans to offer an increased number and variety of plans in a service area. Medicare

    The post 10 Must-Ask Questions When Comparing Medicare Advantage Plans appeared first on My Medicare Matters.

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    By: Brandy Bauer, Associate Director of NCOA’s Center for Benefits Access. Reposted from NCOA.org. Did you or someone you work with fall into the Medicare Part D “donut hole” this year? The donut hole, or Part D coverage gap, occurs when a person reaches a certain spending limit for their medications ($3,820 in 2018), and must pay more of

    The post Avoiding the Part D Donut Hole appeared first on My Medicare Matters.

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    By: The My Medicare Matters Team Medicare changes every year, some of the changes like the expansion of the diabetes prevention program are narrow and impact a subset of Medicare beneficiaries, while other changes like the addition of the Medicare Advantage Open Enrollment Period impact a larger group of Medicare beneficiaries. Regardless of how big

    The post What’s New for Medicare in 2019 appeared first on My Medicare Matters.

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    By: The My Medicare Matters Team About 1.3 billion people in the world live with some form of vision impairment. The reasons vary but the fact is, your risk of developing vision problems drastically increases as you age. Over 91% of people age 55+ use some form of vision correction, so having access to quality vision care

    The post 6 Ways to Get Vision Coverage When You Retire appeared first on My Medicare Matters.

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    February 7, 2019
    Press Release
    For Immediate Release

    Elaine Weiss, (202) 243-7280 or eweiss@nasi.org

    Washington, DC – The National Academy of Social Insurance is seeking innovative ideas to address the income adequacy needs of older workers who must claim Social Security retirement benefits early, due to ill health, an inability to continue to perform physically demanding jobs, or other factors. The Academy, in collaboration with AARP, has launched a Social Security Policy Innovations Challenge open to applicants across the country and from a variety of disciplines. (Visit the Academy’s website for more information about the Challenge.)

    Most beneficiaries rely on Social Security benefits as their principal or only source of income in retirement. Under the current Social Security benefit structure, early claimants receive substantially reduced monthly benefits throughout their lifetimes. The average retirement benefit is only slightly above the federal poverty level for income.

    “Our goal is to find problem-solvers who are concerned about older workers who are unable to secure jobs that pay enough to live decently and save for retirement,” said William Arnone, Chief Executive Officer of the National Academy of Social Insurance. “Participation in this Challenge is an opportunity to find much-needed solutions for those not eligible for Social Security Disability Insurance (SSDI) and at high risk of falling into poverty.”

    A panel of judges, consisting primarily of Members of the Academy as well as other experts, will conduct a blind review of all proposals based on a set of evaluation criteria (learn more). Challenge judges will also examine the proposals to ensure that they do not adversely impact the existing SSDI system and its recipients.

    “We believe that good ideas that have undergone rigorous factual analysis can drive better policymaking,” said AARP Chief Public Policy Officer Debra Whitman. “This Challenge serves as an opportunity to foster the kinds of innovative ideas that will challenge outdated beliefs and make this vital program stronger for future generations. We are excited to collaborate with the National Academy of Social Insurance and its membership of experts to discover new ways to protect vulnerable workers and retirees.”

    Experts are encouraged to apply, but expertise in Social Security policy is not a requirement for participation in the Challenge. The Academy will work with applicants to develop policy ideas that are innovative, feasible, and have the potential to improve economic security for workers with limited employment opportunities, who lack the financial security to postpone claiming Social Security benefits until they reach full retirement age. The application process will include an opportunity for applicants to learn more about Social Security and related benefits, as well as relevant research findings about the income needs of this target population. Each winning proposal will receive an award of up to $20,000-$25,000.

    About the National Academy of Social Insurance

    Since the Academy was founded in 1986, it has provided rigorous inquiry and insights into the functioning of our nation’s social insurance programs – Social Security, Medicare, Unemployment Insurance, and Workers’ Compensation. Now comprised of over 1,000 of the nation’s top experts in social insurance and related policies and programs, the Academy studies how social insurance can continue to meet the changing needs of American families, employees, and employers. The Academy also looks at new frontiers for social insurance, including areas of uninsured or underinsured economic risks and related policies. To learn more about the Academy’s work, please visit www.nasi.org, or follow @socialinsurance on Twitter. 

    About AARP

    AARP is the nation’s largest nonprofit, nonpartisan organization dedicated to empowering people 50 and older to choose how they live as they age. With a nationwide presence and nearly 38 million members, AARP strengthens communities and advocates for what matters most to families: health security, financial stability and personal fulfillment. AARP also produces the nation's largest circulation publications: AARP The Magazine and AARP Bulletin. To learn more, visit www.aarp.org or follow @AARP and @AARPadvocates on social media.


    The National Academy of Social Insurance is a non-profit, nonpartisan organization made up of the nation’s leading experts on social insurance. Its mission is to advance solutions to challenges facing the nation by increasing public understanding of how social insurance contributes to economic security.

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    By: The My Medicare Matters Team A new opportunity to switch Medicare Advantage/Part C plans is happening right now. The annual Medicare Advantage Open Enrollment Period (MA OEP) which runs from January 1 to March 31 offers anyone enrolled in a Medicare Advantage plan an opportunity to either: Switch from one Part C plan to another, or Switch from a Part C

    The post A Second Chance to Switch Medicare Advantage Plans appeared first on My Medicare Matters.

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    February 14, 2019
    Press Release
    For Immediate Release

    Meghan Griffin (202) 243-7286

    WASHINGTON, DC — The Board of Directors of the National Academy of Social Insurance has approved the election of 45 distinguished social insurance experts to the Academy, adding to the total active Membership of over 1,100. (A complete list of individuals newly-elected to the Academy can be found below.)

    “Members are essential to the Academy’s work,” says William Arnone, the Academy’s Chief Executive Officer. “We welcome our newest cohort with great excitement. They bring a wealth of expertise and experience across a range of policy areas that affect every person and family in this nation. We look forward to recognizing their contributions to social insurance policy and engaging their talents in support of the Academy’s mission.”

    The Academy advances solutions to challenges facing the nation by increasing public understanding of how social insurance contributes to economic security. This mission encompasses established social insurance programs – Workers’ Compensation, Unemployment Insurance, Social Security, Medicare and Medicaid – as well as related policy areas, including long-term services and supports, paid leave, other social assistance programs, and private employee benefits.

    "This year's newly-elected Academy Members are among our country's leading reformers, doers, and creative thinkers. Their work focuses on the practical challenges of how we protect each other when faced with life's financial and health hardships that are difficult to handle alone. In addition to longstanding programs like Social Security, Medicare and unemployment insurance, they also address how we tackle increasingly important issues, such as paid family leave. ”  – Shaun O’Brien, Membership Committee Chair

    Those elected to Membership in the Academy have distinguished themselves by improving the quality of research, administration, or policymaking in an area of social insurance. Academy Members make significant contributions to the Academy’s research, education, and leadership development initiatives by volunteering their time on study panels, committees, at conferences and in other Academy programs.

    Prospective Members are nominated by current Academy Members in recognition of their significant and ongoing professional contributions to the field of social insurance. For more information about Membership in the Academy and a full list of active Members, please visit the “Membership in NASI” section of the Academy’s website (www.nasi.org).

    Individuals elected to Membership and their affiliations at the time of nomination:

    Eileen Appelbaum
    Center for Economic Policy Research

    Charles Barrilleaux
    Florida State University

    Romina Boccia
    The Heritage Foundation

    Kyle Burkhalter
    Social Security Administration

    Joel Cantor
    Rutgers University

    Anne Case
    Princeton University

    Amitabh Chandra
    Harvard Kennedy School

    Angus Deaton
    Princeton University

    Marcus Dillender
    W.E. Upjohn Institute for Employment Research

    Tammy Dixon
    Segal Consulting

    Camille Dobson
    National Association of States United for Aging and Disabilities

    Patricia Gabow
    Denver Health

    Ben Gitis
    American Action Forum

    Kali Grant
    Georgetown Center on Poverty and Inequality

    Kathy Greenlee
    Greenlee Global, LLC

    Tracey Gronniger
    Justice in Aging

    Kristina Hamilton
    UDW/AFSCME Local 3930

    Dan Hawkins
    Association of Community Health Centers

    Tara O'Neill Hayes
    American Action Forum

    Amy Herr
    West Health Policy Center

    Hilary Hoynes
    University of California, Berkeley

    Abbie Hudgens
    Tennessee Bureau of Workers' Compensation

    Elisabeth Jacobs
    Washington Center for Equitable Growth

    Kathleen Kennedy Townsend
    Economic Policy Institute

    Desmond King
    Nuffield College, Oxford University

    David Laibson
    Harvard University

    Margie Lariviere
    State Compensation Insurance Fund

    Nicole Maestas
    Harvard Medical School

    Victor Miller
    Economic and Management Consulting

    Stipica Mudrazija
    Urban Institute

    Kathleen Mullen
    RAND Corporation

    Nicole Nestoriak
    U.S. Bureau of Labor Statistics

    Amanda Ream
    United Domestic Workers, AFSCME

    Eveka Rodriguez
    Grant Thornton LLP

    Martha Roherty
    National Association of States United for Aging and Disabilities

    Matt Salo
    National Association of Medicaid Directors

    Richard Scheffler
    UC Berkeley School of Public Health

    Lauren Schmitz
    National Institute on Aging

    Sara Sills
    Medicaid Branch, Office of Management and Budget

    Katrinka Sloan

    Michael Stephens
    Social Security Administration

    Aaron Tripp

    Mark Walls
    Safety National Casualty Corporation

    Richard Wharton
    Social Security Administration

    James Ziliak
    University of Kentucky, Center for Poverty Research


    The National Academy of Social Insurance is a non-profit, nonpartisan organization made up of the nation’s leading experts on social insurance. Its mission is to advance solutions to challenges facing the nation by increasing public understanding of how social insurance contributes to economic security.

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    The Academy’s 31st annual policy conference – Regenerating Social Insurance for Millennials and the Millennium – was by all measures a success. It represented a different approach to one of the Academy’s signature events in both style and substance.

    In reflecting on it from several perspectives – as a host, participant, moderator, and presenter – I offer some observations to Academy Members and other attendees regarding the theme, the planning process, and what we learned.

    First, the conference theme and title. Unlike most of the Academy’s previous conferences which typically focused on one major policy area, our 2019 conference examined a wide range of policy issues from the angle of segments of the nation’s population who face major economic risks not covered by our current social insurance infrastructure. This approach resulted in a high-level treatment of policy issues, instead of the deeper dive that has characterized most of our past conferences.

    The conference title was carefully and deliberately selected to suggest that the concept of social insurance is a dynamic one and needs to be examined periodically in view of new risks confronting Americans. The Webster’s dictionary definition of the word “regenerate” is “to reform morally” or “to undergo rebirth.” It also connotes being “revitalized” or “renewed.” Adding “Millennials and the Millennium” made the point that, although its generational focus was on one particular cohort, all of us living in this century have a stake in the social compact embodied in our nation’s social insurance programs.

    Second, the conference planning process. In celebration of the Academy’s 30th anniversary in 2017, the Founding Board Members presented at our annual gala torches to individuals representing a new generation of social insurance thought leaders. At that time, we let the torch recipients know that this symbolic act would be followed by more substantive involvement in the Academy’s activities. With that promise in mind, we reconstituted the torch recipients as our conference planning committee. They are:

    • Jean C. Accius, Vice President of the Long-Term Services & Supports and Livable Communities Group within the AARP Public Policy Institute
    • Ramsey L. Alwin, Director of Thought Leadership for Financial Resilience in the Office of Policy, Research, and International Affairs at AARP
    • Jeff N. Cruz, Senior Advisor to Senator Bernie Sanders (I-VT) on the Senate Budget Committee for Social Security
    • Walt Dawson, Atlantic Fellow for Equity in Brain Health, Global Brain Health Institute (GBHI), University of California - San Francisco
    • Kathryn Anne Edwards, Associate Economist, RAND Corporation
    • Alex Lawson, Executive Director, Social Security Works
    • Kathleen Romig, Senior   Policy Analyst, Center on Budget and Policy Priorities
    • H. Luke Schaefer, Associate Professor, School of Social Work and Gerald R. Ford School of Public Policy, and Director, Poverty Solutions, University of Michigan
    • Elisa A. Walker, Social Insurance Specialist in the Social Security Administration’s Office of Research, Demonstration, and Employment Support.

    Also participating on the planning committee were Josie Kalipeni, Director of Policy and Federal Affairs at Caring Across Generations, and Alexandra Bradley, formerly the Academy’s Lead Policy Analyst for Health and Caregiving. In addition to serving on the planning committee, Jean, Ramsey, Walt, Kathryn, Kathleen, and Luke served as panelists or moderators during the conference.

    Third, what did we hear and what did we learn from the conference?

    Based on the comments we received both during and after the conference, many who attended found the panels stimulating and enlightening. Attendees appreciated the diversity in topics covered and in the panels themselves. The intergenerational composition of the attendees as well as the panels was singled out by many as making this conference quite distinctive from those of previous years.

    One common refrain was the desire by attendees to have more time for interaction with panelists and with each other. For the first time at an Academy conference, attendees were asked to use a smartphone-based event app (MeetApp) to facilitate new ways of interaction and engagement. MeetApp was well received by those who used it, but some expressed a strong preference for more traditional means of audience participation and dialogue. Others expressed their preference for fewer panels and more networking opportunities. We will be taking this into account as we plan for next year’s policy conference.

    Finally, what are the Academy’s follow-up plans?

    As you may know, the overarching theme of the Academy’s policy work is inequality. Prior to this year’s conference, our focus has been on disparities in income and wealth from the perspectives of race, class, and gender. We will add generational cohorts to this framework.

    One of the products of the conference is a new “Chartbook” of data particularly salient for understanding the economic situation facing Millennials and younger generations. A current version of the Chartbook is available on the event page. We will continue to update this Chartbook and encourage you to submit suggestions to Griffin Murphy, Research Assistant for Income Security, at gmurphy1@nasi.org.

    Two of the conference panels also provided previews of forthcoming Academy publications. The Academy’s concept paper on “Assured Income” will be issued later this month. The final report of the Academy’s Study Panel on Caregiving will be issued in March with a full release event in May. Stay tuned for more information about both.

    As always, we encourage you to provide feedback on our 2019 Conference and to be in touch with your suggestions going forward by emailing me directly at warnone@nasi.org.

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    The Academy’s 31st annual policy conference, Regenerating Social Insurance for Millennials and the Millennium, included a diverse, intergenerational mix of health, economic, retirement, and social policy experts, public and private sector professionals, and social entrepreneurs. Our 2019 conference sought to provide a platform for candid intergenerational dialogue to discuss new socio-economic risks and explore ways to improve the current system of social insurance programs.


    What are issues facing Millennials and younger generations?

    The opening reception of the conference introduced the economic issues facing Millennials, such as housing affordability, caregiving responsibilities, and student loan debt. The panel focused on how the experiences of younger generations might translate into intergenerational policy solutions. The opening panel featured: Jean Accius, Vice President of Long-Term Services & Supports and Livable Communities Group at the AARP Public Policy Institute, Evan Avila, 2018 iOme Challenge Winner, Katie Kirchner, National Director at the Roosevelt Network, and Hans Riemer, Councilmember At-Large in Montgomery County, Maryland. Donna Butts, Executive Director of Generations United, moderated the panel. The reception concluded with the audience watching a recent Saturday Night Live gameshow skit, “Millennial Millions”, which also highlighted, with great humor, the economic risks and intergenerational dynamics introduced by the opening panel.


    What do we know about these new conditions facing Millennials and younger generations to help us design better policy solutions?

    Session 1 kicked off the conference with a deeper dive into a range of uninsured and underinsured risks facing Millennials and other generations. Colleen Campbell, Managing Director of Postsecondary Education at the Center for American Progress, led with a presentation on the distribution of student debt, underscoring the fact that those with debt balances of $10,000 or less are significantly more likely to default on their loans than those with higher balances. Campbell highlighted that the effects of student debt on Millennial home-ownership are small (Campbell Slides). Continuing the conversation on housing, Laurie Goodman, Co-Director of the Housing Finance Policy Center at the Urban Institute, commented on Millennial trends in homeownership, real incomes vs. real rent in metropolitan areas, and outcomes of Millennial adults who live with their parents for extended periods of time (Goodman Slides). Yulya Truskinovsky, Assistant Professor of Economics at Wayne State University, then presented cutting-edge research on the demographics of caregivers and the economic impact of caregiving, including the effects on earnings around the birth of a first child for men and women (Truskinovsky Slides). Last but not least, Elisabeth Jacobs, Senior Director for Family Economic Security at the Washington Center for Equitable Growth, noted that the average unemployment rate is rising for those aged 20-34 since the 1950s--both absolutely and relative to unemployment rates for older workers--before discussing the current state of unemployment insurance (UI), and potential policy solutions (Jacobs Slides). Kathryn Edwards, Associate Economist at RAND Corporation, organized and moderated the session. Audience questions ranged from clarifications on how, for example, student debt is a social insurance issue, to potential impacts of a more robust UI system on young lower-income workers.

     Panelists in Session 2, moderated by Ramsey Alwin, Director of Thought Leadership and Financial Resilience at the Office of Policy, Research, and International Affairs for AARP, engaged in a provocative discussion on the future of work. Panelists included Shelly Steward, Research Manager for the Future of Work Initiative at Aspen Institute, Romina Boccia, Director of the Grover M. Hermann Center for the Federal Budget at The Heritage Foundation, Jessica Fulton, Director of Economic Policy at the Washington Center for Equitable Growth, and Aliya Robinson, Senior Vice President of Retirement and Compensation Policy for the ERISA Industry Committee. Steward began by describing the erosion of the traditional employer-worker relationship, while also commenting on how technological innovations are impacting the workplace. Boccia then described how gig-work, a major departure from the traditional worker contract, might be beneficial to the workforce insofar as it allows for workers to freely choose their hours. Fulton followed with comments on how social insurance might be used to strengthen economic security for vulnerable subsects of our population, ensuring that automation and new work arrangements do not exacerbate existing inequalities. Robinson concluded the panel’s opening remarks by discussing how employers have adapted to attain the high levels of talent that they need to thrive. Following the presentations, Alwin guided debate around whether current programs adequately protect against new workplace risks, how social insurance might adapt to address these risks, and whether the establishment of new programs might be necessary.


    Addressing an interrelated set of issues: Paid leave, long-term services and supports, and early child care

    Session 3, moderated by Josie Kalipeni, Director of Policy and Federal Affairs at Caring Across Generations, previewed findings from the Academy’s Universal Family Care Study Panel. The Study Panel’s lead policy analyst, Alexandra Bradley, highlighted existing state paid family and medical leave programs, including the variation in their structures, funding sources, and eligibility rules. She closed with comments on potential pathways to create state-based early child care and education programs (Bradley Slides). Ben Veghte, director of the project, followed with an overview of the study panel, policy considerations for long-term service and supports programs, and closed by emphasizing the pillars of a Universal Family Care program (Veghte Slides). The session continued with comments from Kalipeni and two discussants: Henry Claypool of the Community Living Policy Center at UCSF, and Indivar Dutta-Gupta, Co-Executive Director at the Georgetown Center on Poverty and Inequality. Dutta-Gupta discussed the potential impacts of Universal Family Care for individuals with low-incomes and how caregiving responsibilities affect participation in work. Claypool provided insights into the impact of improving caregiving programs, or implementing Universal Family Care, on the quality of care and well-being for those with disabilities and touched on how the caregiving workforce may need to adapt to provide these integrated caregiving services. Panelists then answered audience questions on state capabilities in developing these programs, portability across state lines, and caregiving workforce development.


    Where you stand matters: Differences and similarities between what Millennials and policy experts think about economic conditions  

     In a luncheon discussion led by Cathy Koch, EY Americas Tax Policy Leader, conference participants submitted answers to selected questions from EY’s 2018 survey on “The Millennial Economy.” The EY survey polled a representative sample of Millennials on important economic topics, including questions on home-ownership, marriage, taxes, student loans, American Institutions, and overall outlook on the economy. See the questions we asked, how our audience answered (by clicking on the questions), and EY’s findings here.  


    What’s happening with healthcare reform and what does this mean across generations?

    After the luncheon, Session 4 discussed the impact of recent health care legislation and current health reform proposals on coverage and economic security from a wide range of perspectives. Renée Landers, Professor of Law at Suffolk University Law School, began by discussing provisions of the Affordable Care Act (ACA) that have impacted coverage and quality of care for Millennials. Cindy Gillespie, Director of Arkansas Department of Human Services, then touched on the connection between health insurance and labor market incentives by discussing Arkansas’ Medicaid work requirement program. Jane Horvath, Principal at Horvath Health Policy, commented on the effects of prescription drug prices on the health care system, and specifically the effects on the Millennial generation. Deborah Ojeda-Leitner, Science and Technology James Marshall Public Policy Fellow, closed the panel by discussing the Millennial support for Medicare-for-All and how a single-payer system might improve racial/ethnic inequities in access to health care coverage. After presenting, the panelists had a robust discussion led by Walt Dawson, Atlantic Fellow at the Global Brain Health Institute, about tradeoffs in achieving universal health care and insuring a greater number of younger individuals.


    Demystifying Social Security for Millennials (and all generations)

    Moderator Helaine Olen, writer for the Washington Post, opened Session 5 by introducing the misconception among millennials and younger generations that Social Security will likely not be around when they reach retirement. Kathleen Romig, Senior Policy Analyst at the Center on Budget and Policy Priorities, echoed Olen’s concern and provided a history of how this myth arose, and how it continues to be perpetuated. Romig ended on a high note, noting that Social Security is overwhelmingly popular among all ages of voters, even if there is fear over the program’s long-term sustainability (Romig Slides). Rebecca Cokley, Senior Fellow at the Center for American Progress, commented on the myths around Social Security Disability Insurance-- that it is easy to enroll in SSDI and that those on SSDI are enjoying a rich lifestyle of “champagne wishes and caviar dreams” (Cokley Slides). Meg Bostrom, Co-Founder of Topos Partnership, continued by presenting on effective frameworks that Social Security advocates might use to combat these various myths (Bostrom Slides). Olen then facilitated a comprehensive dialogue among panelists, including discussions on the rise of the stigma and myths regarding SSDI, the widespread lack of awareness of the intergenerational benefits of Social Security, and how to build arguments for supporting the program and implementing policy solutions. Panelists then answered audience questions on current financing, means-testing benefits and the implications for those with disabilities, and generational differences in perceptions on SSDI.


    Inequality and (universal basic) income

     The final session of the conference discussed the concept of assuring a base level of income to all Americans. Bill Arnone, CEO of the National Academy of Social Insurance, began by introducing the Academy’s soon to be released concept paper on “Assured Income”. Arnone discussed how traditional social insurance and social assistance programs have functioned to provide an assured income for certain segments of the population, and how they might be adapted to do so for a broader set of beneficiaries. Sam Hammond, Director of Poverty and Welfare Policy at the Niskanen Center, expanded on how an assured income might fit into the current social insurance framework, and economic implications of an assured income program. Building on Hammond’s comments, Taylor Jo Isenberg, Managing Director of the Economic Security Project, discussed the underlying values behind designing an assured income program, and provided an overview of the current assured income landscape. Dorian Warren, President of Center for Community Change, concluded the panel’s remarks by emphasizing the current state of inequality and poverty in America, and how an assured income may work toward the longstanding goal of ending poverty. While Warren did not endorse the idea, he argued that it is, at the very least, worth investigating. During the Q&A session led by H. Luke Shaefer, Associate Professor at the School of Social Work and Gerald R. Ford School of Public Policy, and Director of Poverty Solutions at the University of Michigan, the panelists explored important questions regarding the financing and benefits of an assured income, and the implications for current safety net programs.


    The end of this conference does not represent the end of the conversation on strengthening economic security across generations. The Academy’s work will continue to research areas of economic insecurity for Millennials and younger workers, and explore intergenerational policy solutions to improve the system of social insurance programs for the 21st century.


    For more information, please contact Bill Arnone, Chief Executive Officer, at warnone@nasi.org.


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    By: The My Medicare Matters Team Women are often the first line of defense when protecting their family’s health, but in doing so tend to put their concerns on the back burner. These quick tips can help keep you happy and healthy as you juggle your everyday responsibilities. 1. Get breast cancer screenings every 1

    The post 5 Healthy Aging Tips Every Woman Should Know appeared first on My Medicare Matters.

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  • 03/29/19--12:04: Assured Income
  • William Arnone, Peter Barnes, Renée M. Landers, Griffin T. Murphy
    April 2019

    In describing the “Need for Security”, the 1935 Committee on Economic Security wrote that “the one almost all-embracing measure of security is an assured income. A program of economic security, as we vision it, must have as its primary aim the assurance of an adequate income to each human being in childhood, youth, middle age, or old age—in sickness or in health.” Although almost eighty-five years have passed since the Committee’s report, its “primary aim” remains unfulfilled.  

    This concept paper examines the possibility of providing a base level of income to certain subsets of, and perhaps to all, U.S. citizens as a means to increasing their economic security. The authors begin by highlighting the extent of contemporary financial insecurity and continue with a discussion on how an assured income program might complement existing social insurance and social assistance programs. This is followed by an examination of past and present programs that share goals with the assured income concept described, and an exploration of how these programs might provide a basis for the Social Security Administration’s administering an assured income benefit.


    Support for this concept paper was provided by the Economic Security Project.

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    The My Medicare Matters Team Enrolling in a Medicare plan is a big decision. While you’re able to switch plans each year if you’re unhappy (in some situations more frequently) you still want to choose the best plan for your needs the first time. This means taking your out-of-pocket costs into consideration along with other

    The post A Guide to Medicare Part C Costs appeared first on My Medicare Matters.

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    With most Americans focused on taxes this month, it’s a good time to take a look at the relationship between federal income taxes and social insurance contributions.

    Overview of Federal Taxes and Distributional Effects

    The latest report by the Joint Committee on Taxation, Overview of the Federal Tax System As In Effect for 2019, provides a comprehensive starting point. This report breaks out the current federal tax system into four elements:

    • Income taxes on individuals and corporations
    • Payroll taxes on wages and self-employment income
    • Estate, gift, and generation-skipping transfer taxes
    • Excise taxes on selected goods and services

    The Joint Committee on Taxation’s analysis indicates that, while individual income taxes are projected to account for half of all federal receipts in 2019, social insurance contributions will account for over one-third of those receipts.

    Its analysis also projects that, while wages and salaries will account for 66.6% of all gross income received by individual taxpayers in 2019, 12.1% will come from Social Security, pensions, and individual retirement account distributions.

    Finally, and quite significantly, the analysis also indicates that 67.8% of taxpayers will pay more in “employment taxes” than in individual income taxes. The highest percentages of such taxpayers are those with incomes between $10,000 and $100,000.

    (Tax credits play an important role in determining the net tax burden on low- and moderate-income workers, in particular. More on these below.)


    What the FICA?

    FICA stands for Federal Insurance Contributions Act. While FICA has some characteristics of a “tax,” (e.g., it is compulsory and collected by the Internal Revenue Service), it differs significantly from federal income taxes in that it is earmarked for one exclusive purpose, namely the payment of Social Security and Medicare benefits and associated costs. Revenues generated by FICA are therefore not directly available for other federal purposes.

    This earmarking was famously justified by President Franklin D. Roosevelt, who said, “with those taxes in there, no damn politician can ever scrap my Social Security program” (Dewitt, Larry. “Research Note #23,” Research Notes and Special Studies by the Historian’s Office, Social Security Administration, 2005).

    Referring to FICA as a “payroll tax” raises concerns about the regressive nature of the FICA rate, if it is perceived simply as a tax. A preferred alternative term is “contribution.” This characterization recognizes that FICA payments are dedicated, and directly related to, both eligibility for future Social Security and Medicare Part A benefits, and the amount of Social Security benefits. Describing the payments this way also connects FICA with the certainty of those benefits.

    Moreover, FICA payments are more like premiums than taxes, since they provide insurance protection for those who pay into the system. The term “contributions” also captures the relationship between the past earnings, on which FICA is based, and future Social Security benefit amounts, in which those who earn more get higher benefits. Social Security’s progressive benefit structure, along with the availability of the EITC, mitigate the apparent regressivity of the flat FICA rate and capped wage base.

    Additionally, emphasizing the contributory nature of Social Security implies that it would be unfair to introduce eligibility conditions, like a means test, which would keep benefits from people who have paid toward their own protection.


    Contributions to Social Insurance

    The primary source of revenue to finance Social Security (Old Age, Survivors, and Disability Insurance - OASDI) and Medicare (Hospital Insurance - HI) is FICA, which is paid by employers and employees. For employers, FICA is based on their payroll. For employees, it is based on their individual earnings in covered employment.

    The OASDI rate is 6.2% of covered wages up to the taxable wage base, or cap, which is $132,900 in 2019. The HI rate is 1.45% of covered wages with no wage cap.

    The employee portion of the HI rate is also increased by an additional 0.9% on wages received in excess of specific threshold amounts ($250,000 for married taxpayers filing jointly, $125,000 for married taxpayers filing separately, and $200,000 for all other taxpayers). The employee’s FICA is generally withheld and, along with the employer’s share, remitted to the federal government by the employer.

    Self-employed individuals are treated in effect as both employees and employers. The Self-Employment Contributions Act (SECA) applies to net income from self-employment. The SECA rate equals the combined employee and employer OASDI and HI FICA rates.


    Proposed Changes to Social Security Contributions (and Benefits)

    It is important to understand Social Security through a social policy lens, as well as a tax and federal budgetary lens. From this perspective, there are some critical social policies to address:

    1. The extent to which a smaller share of total U.S. wages is subject to FICA due to widening wage inequality;
    2. The growing disparity in life expectancy between higher- and lower-income individuals.

    As the Academy stated in our 2017 Report to the New Leadership and the American People on Social Insurance and Inequality: “Some observers note that there is reason to increase the progressivity of Social Security to compensate for two trends in equality: 1) growing inequality in the distribution of income; and (2) growing inequality in longevity by income.”

    Proposals to expand Social Security, such as Rep. John Larson’s “Social Security 2100 Act” address the first issue by increasing the extent to which wages are covered by FICA. As average wages have been growing at a far slower rate than higher wages, only approximately 83% of total wages are currently subject to FICA, down from 90% in 1982. The Larson legislation, which would apply FICA to wages above $400,000, would affect only the top 0.4% of wage earners.

    A proposal by William Gale of The Brookings Institution would increase the percentage of wages subject to FICA to 86% by the end of 2024 and then index the wage base cap for growth in the average wage index plus 0.5 percentage points. (Gale, William. Fiscal Therapy, 2019, p. 157)

    The second issue affects proposals to increase the Social Security Normal Retirement Age, which is already set to reach age 67 for those born in 1960 or later. As noted by William Gale: “Divergent trends in life expectancy make Social Security less progressive because they raise the total lifetime benefits that the rich receive as opposed to the poor” (Gale, William. Fiscal Therapy, 2019, p. 159).


    Last but not least – Refundable Tax Credits

    While not a form of social insurance, tax credits are also based on earnings (and work). Similar to social insurance, tax credits protect millions of Americans from falling into poverty.

    Among the most significant tax benefits provided to many Americans are refundable tax credits. “Refundable” means that, if the amount of a credit exceeds a taxpayer’s tax liability, the excess may generate a refund to the taxpayer. Two of these refundable tax credits are the Child Tax Credit and the Earned Income Tax Credit (EITC).

    Taxpayers may claim a tax credit for each child under age 17. The amount of the credit per child is $2,000 in 2019. The aggregate amount of child credits that may be claimed is phased out for those with incomes over certain threshold amounts.

    The EITC is available to low-income workers who satisfy certain requirements. The amount of the credit varies depending on the taxpayer’s earned income and the number of qualifying children. For 2019, the maximum EITC is $6,557. The credit amount begins to phase out at various income levels.

    If the EITC were treated like earnings, it would have been the single most effective antipoverty program for working-age people, lifting about 5.8 million people out of poverty, including 3 million children in 2018 (Center on Budget and Policy Priorities). While four out of five eligible workers take advantage of the EITC, millions miss taking it because either they do not claim it, or they do not file a tax return, which is a prerequisite.

    As we continue to look at the future of the nation’s social insurance programs and assess various policy options, we welcome your questions and comments on taxes and contributions.


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    April 24, 2019
    Press Release
    For Immediate Release

    Bethany Cole (202-243-7009)

    The National Academy of Social Insurance has announced the formation of a new Study Panel to examine potential changes to Medicare eligibility. The Medicare Eligibility Study Panel is co-chaired by Marilyn Moon, American Institutes for Research, and Cori Uccello, American Academy of Actuaries.

    "As a social insurance program, Medicare has a well-established and extraordinarily popular track record,” said Moon. “As the nation explores a wide range of policy options addressing the health care needs of all Americans, Medicare is at the center of discussion and debate,” said Uccello.

    The Study Panel will issue a final report of findings in 2020, which will be disseminated to the broadest possible policy audience, as well as to the media. The Academy’s 32nd annual policy conference slated for March 2020, in Washington, DC, will center on the Panel’s work and cover related issues.  

    Elizabeth Docteur, Elizabeth Docteur Consulting, and Renée Landers, Suffolk University Law School, are the Co-Principal Investigators. William Arnone, the Academy’s Chief Executive Officer, is the Project Director.

    Study Panel Members

    Marilyn Moon, Co-Chair, American Institutes for Research

    Cori Uccello, Co-Chair, American Academy of Actuaries

    Peter Arno, University of Massachusetts-Amherst

    Robert Berenson, The Urban Institute

    Jonathan Blum, Health Management Associates

    Cristina Boccuti, West Health Policy Center

    Melinda Buntin, Vanderbilt University

    Sheila Burke, Baker, Donelson, Bearman, Caldwell & Berkowitz

    Philip Caper, Maine ALLcare

    Christine Eibner, RAND Corporation

    Elizabeth Fowler, Johnson & Johnson

    Sherry Glied, New York University

    Jacob Hacker, Yale University Law School

    Chip Kahn, Federation of American Hospitals

    Steven Lieberman, The Brookings Institution

    Mary Murley, United Healthcare

    Tricia Neuman, The Kaiser Family Foundation

    Jonathan Oberlander, The University of North Carolina at Chapel Hill

    Shaun O'Brien, American Federation of State, County and Municipal Employees (AFSCME)

    Lisa Potetz, Health Policy Alternatives

    Murray Ross, Kaiser Permanente

    John Rother, National Coalition on Health Care

    Cathy Schoen, New York Academy of Medicine

    Paul Starr, Princeton University

    Paul Van de Water, Center on Budget and Policy Priorities 

    Bruce Vladeck, Medicare Rights Center

    Reginald Williams, Avalere

    Stephen Zuckerman, The Urban Institute

    Since the Academy was founded in 1986, it has provided rigorous inquiry and insights into the functioning of our nation’s social insurance programs – Social Security, Medicare, Unemployment Insurance, and Workers’ Compensation. Now comprised of over 1,000 of the nation’s top experts in social insurance and related policies and programs, the Academy studies how social insurance can continue to meet the changing needs of American families, employees, and employers. The Academy also looks at new frontiers for social insurance, including areas of uninsured or underinsured economic risks and related policies. To learn more about the Academy’s work, please visit www.nasi.org, or follow @socialinsurance on Twitter. 

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    William Arnone and Griffin Murphy
    April 2019

    Each year, the Report of the Social Security Trustees updates projections about the future finances of Social Security’s two trust funds, the Old-Age and Survivors (OASI) Trust Fund and the Disability Insurance (DI) Trust Fund. The 2019 Social Security Trustees Report projects that revenues will be sufficient to pay all scheduled benefits until 2035 and roughly three quarters of scheduled benefits thereafter. The DI Trust Fund is now projected to cover scheduled benefits until 2052 (compared with 2032 in last year’s Trustees Report), and the OASI Trust Fund until 2034. On a combined OASDI basis, Social Security is fully funded until 2035, but faces a projected shortfall thereafter, if Congress takes no action before then.

    The 2019 Trustees Report shows that in 2018, Social Security income from payroll contributions, tax revenues, and interest on reserves exceeded outgo by $3 billion. Reserves, now at $2.9 trillion, are projected to begin to be drawn down in 2020 in order to pay full scheduled benefits. After the projected depletion of the combined OASDI trust funds, Social Security contributions and tax revenues would continue to be received and would cover about 80 percent of scheduled benefits (and administrative costs, which are less than 1 percent of outgo). Timely revenue increases and/or benefit reductions could bring the program into long-term balance, preventing the projected shortfall.

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    The political air is charged these days with claims that various policy ideas, like Medicare-For-All and the Green New Deal, are “socialistic.” Such charges have been made in American history since the late 19th century, often in response to bold new policy concepts put forward to address gaps in income and health care security. This leads us to revisit a fundamental question – what differentiates Socialism from Social Insurance?

    Social Insurance as Collective Action

    In the words of Robert M. Ball, Founding Chair of our Academy: “Social insurance derives its unique strength from the principle that the best form of self-protection is mutual aid on a universal scale; when everyone contributes, everyone can be protected.” Academy Member and historian Edward D. Berkowitz also quotes Bob Ball:

    “Through this form of collective action, nearly everyone, old or young, sick or well, could be covered, and everyone would be in the ‘same boat,’ creating ‘broad support for maintaining the well-being of the program and protecting the quality of benefits.’” (Berkowitz, Edward D., Robert Ball and the Politics of Social Security)

    Antagonists of social insurance often impede a meaningful conversation by conflating the concept of collective action with that of collective ownership of the means of producing goods and services, which is the original definition of socialism. The former, not the latter, is a key basis of social insurance.

    In a recent email conversation with Academy Member Dan Fox, he observed: “Proponents of social insurance recognize a broader definition of collective responsibility. In the United States, this definition has included protecting, and often promoting, the private, commercial interests of institutions, service-providing professions, and private companies in the supply chains that serve them.”

    Academy Members Michael Graetz and Jerry Mashaw also remind us: “Americans will remain committed to a market economy with free movement of the factors of production. Indeed, it is this commitment that makes an effective social insurance system so important.” They also note that “society’s willingness to pay for social insurance depends both on what it can afford and, more fundamentally, on how it draws the line between collective and individual or family responsibility.”

    They add: “Substantial risks to economic well-being that are not individually controllable should be buffered by collective social insurance, arrangements that reduce those economic risks to a tolerable level.” (Graetz, Michael J. and Jerry L. Mashaw. True Security: Rethinking American Social Insurance)

    Opposition to Social Insurance

    One of my first messages to Members as the Academy’s Chief Executive in July 2016 focused on this question. As I noted then, in an issue of the Boston Review, Elizabeth Anderson, Professor of Philosophy and Women’s Studies at the University of Michigan, wrote a provocative analysis of the origins and evolution of social insurance worldwide and in the United States. Among her major contentions were the following:

    • Ideological opposition to social insurance has portrayed it as a “socialist or communist scheme designed to undermine private property and free markets.” This ideology is based on the assumption that “poverty was either inevitable—in the case of disability or death of able-bodied workers within the family—or caused by vices such as laziness, alcoholism, gambling, and sexual licentiousness.”
    • At the same time, social insurance represented a novel way to address poverty — “one compatible with individual liberty, universal dignity, equal democratic citizenship, and distributive justice.” Indeed, for Germany’s Otto von Bismarck, who instituted the first such plans, “social insurance was erected as a defense against communist and socialist revolution, and as proof that a system of private property and markets could deliver a decent standard of living and security to all.”

    Historian Nancy MacLean has written that the policies “implemented by elected officials during the Great Depression saved liberal democracy in the United States from the rival challenges of fascism and Communism in the face of capitalism’s most cataclysmic collapse.” Despite this, opponents of the New Deal charged that “it was nothing more or less than the Socialistic doctrine called by another name.” MacLean quotes another opponent as saying, “a small welfare state is perhaps better than a large one, of course, but it is still an evil, as it is the essence of communism-socialism.” In effect, these challengers and their current-day followers define socialism as “synonymous with any effort by citizens to get their government to act in ways that either cost money to support anything other than police and military functions or encroached on private property rights.” (MacLean, Nancy. Democracy in Chains)

    Political Charges of “Socialism”

    In his series, Covered: A Week-by-Week Look at the 1965 Politics that Created Medicare and Medicaid, Bob Rosenblatt, a Senior Fellow at the Academy, described the American Medical Association (AMA)’s opposition to Medicare, which included “an innovative publicity program in 1962, when the organization financed and distributed a record album featuring the actor and conservative spokesman Ronald Reagan. The 11-minute album, called ‘Ronald Reagan Speaks out against Socialized Medicine,’ delivers a strong warning against the dangers of government involvement in health care: ‘One of the traditional methods of imposing statism or socialism on a people has been by way of medicine,’ he says. ‘It’s very easy to disguise a medical program as a humanitarian project.’” The AMA’s opposition to “socialized medicine” had begun much earlier in the New Deal era and was amplified during the administration of Harry Truman.

    Another misleading term often used by some opponents of social insurance is “collectivism,” which they usually contrast with “individual liberty.” During the 2005 debate over private accounts in Social Security, for example, the concept of “ownership” was also deployed as an alternative to “collectivism.” The word “collectivism” itself has an ideological connotation that is different from the notion of “collective responsibility.”

    As political scientist Daniel Béland has noted: “Because the American ideological repertoire is centered on individualism and self-reliance, there is little room for discourse about social solidarity in the field of social policy reform.” (Béland, Daniel. Social Security: History and Politics from the New Deal to the Privatization Debate)

    Current Health Care Debates and “Socialism”

    Nowhere are the charges of “socialism” more rampant today than in the strident debate over health care coverage, access, and costs. For example, television commercials that attack proposals to use an international index to curb drug prices under Medicare label such proposals as “foreign socialist price controls.”

    Perhaps most prominently, the renewed debate over health care resurrected such charges. In 2008, as the Affordable Care Act was being developed, Academy Founding Member Merton Bernstein wrote:

    “The multi-billion dollar differences in non-benefit costs between Medicare on the one hand and private insurance and public means-tested programs on the other argue for locating insurance where it costs least – in Medicare. Medicare does not own or provide health services any more than private insurers do. Medicare uses private insurers to perform its detailed administrative clerical work. No ‘socialism’ is involved; only practicality and common sense.”

    In her recent assessment of health care reform proposals, Expanding Access to Public Insurance Plans, Cori Uccello, Senior Fellow of the American Academy of Actuaries, and Member of the National Academy of Social Insurance, and co-chair with Marilyn Moon of our new Study Panel on Medicare Eligibility, distinguishes “single payer” health insurance from “socialized medicine” as follows:

    “(S)ingle payer means the health insurance system covers the health care spending for all of a specified population and is financed by the government, typically from tax revenues. Although the term describes how the system is financed, it does not define who employs the health care providers. The term ‘socialized medicine’ differs from ‘single player’ in that the former refers to a system in which the government not only pays for the medical spending, but also owns the health care facilities and employs the physicians and other health care workers.”

    In addition to this critical distinction of ownership, socialism differs from social insurance when it comes to the role, if any, of profit in the provision of benefits. The former eliminates profit, while the latter accepts it.

    A personal anecdote

    I experienced firsthand such labeling when I was being considered in 2009 for the position of Comptroller General of the United States to lead the Government Accountability Office (GAO). As the position is non-partisan, I met with both Democratic and Republican leaders of Congress to introduce myself and my vision of the agency. When I met with one of the Republican legislative leaders, the first question he asked me in dead seriousness was, “So, are you an Obama socialist?” I was quite taken aback and was tempted to respond, “If you think President Obama is a socialist, you don’t know what socialism is.” Instead, I held back and responded, “No, I’m a business Democrat.”

    FLASH CONTEST: See below for details

    What’s next?

    No doubt, in a Presidential campaign with very high stakes, both parties will seek to attach labels to the other side that are designed to inflame their bases. “Socialistic” continues to be one of the weaponized terms. Countering such labels will be essential to a more informed and enlightened debate on policy differences.

    Finally, the previously cited Professor Elizabeth Anderson’s conclusion is one that proponents of social insurance need to emphasize, especially as the United States remains an outlier on social policy among advanced nations:

    “Robust and universal social insurance is a constitutive feature of a sound economy based on private property and markets, not a threat to it.”


    FLASH CONTEST: The first dues-paying Academy Member to correctly identify the Republican quoted above will win one (1) full registration to our March 2020 Policy Conference on Medicare eligibility. Send your answer to me at warnone@nasi.org.

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