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Hales Home Care joins forces with Macmillan Cancer Support – Home Care Insight

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Home Care Insight     •     August 22, 2019, 8:01 am
Hales Home Care joins forces with Macmillan Cancer Support  Home Care InsightThe business plans to educate staff on dealing with cancer in the workplace and support *service* users following a…
Barnstable Patriot     •     August 22, 2019, 7:13 am
Caretaker shortage affects who will care for us in the twilight years  Barnstable PatriotThe disconnect between Maine’s aging population and its need for young workers to care for that population is…
Citizens Voice     •     August 22, 2019, 8:05 am
What have Dems done for you lately? – Opinion  Citizens VoiceEditor: If you are a retired, taxpaying property owner living on a fixed income like Social Security or disability, I have a question for…
Finger Lakes Times     •     August 22, 2019, 6:17 am
ViiV Healthcare Reports Positive Phase III Study Results of Investigational, Long-acting, Injectable HIV-Treatment Regimen Administered Every Two Months  Finger Lakes TimesLONDON–(BUSINESS…
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The post Hales Home Care joins forces with Macmillan Cancer Support – Home Care Insight appeared first on Home Living Aid.

Daily Care For Seniors brings you Stander's Security Pole & Curve Grab Bar providing safe, secure support for sitting, standing or

Daily Care For Seniors brings you Stander's Security Pole & Curve Grab Bar providing safe, secure support for sitting, standing or

‘I’m Gonna Die in Here’: 19-Year-Old Mentally Ill Woman Remains in Jail for Spitting – Phoenix New Times

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Phoenix New Times     •     August 22, 2019, 2:00 pm
‘I’m Gonna Die in Here’: 19-Year-Old Mentally Ill Woman Remains in Jail for Spitting  Phoenix New TimesValentina Gloria remains in jail after spitting during a mental health episode. A leaked video…
Yellowhammer News     •     August 22, 2019, 1:51 pm
7 Things: Alabama House speaker remains neutral on toll roads, Jones dodges a bullet, Tuberville drubbing his opponents and more …  Yellowhammer NewsSpeaker McCutcheon neutral on Mobile Bay Bridge…
Golden Star     •     August 22, 2019, 2:07 pm
Black Press Kootenay Career Fair underway in Cranbrook  Golden StarWhatever your skillset, you’ll have the opportunity to utilize it, thanks to the Black Press Extreme Education and Career Fair…
Grimsby Live     •     August 22, 2019, 1:56 pm
Heart of Your Community 2019: Nominate a Child of Courage  Grimsby LiveNominate the unsung heroes who make a difference in our community for the Grimsby Telegraph Heart of Your Community Awards 2019.
Fortune     •     August 22, 2019, 12:46 pm
The 50 Best Places to Work in Aging Services  FortuneSee which companies made this year’s list of the best workplaces in senior housing and at-home care.
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Assured Income

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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.

Taxes, Contributions, and Social Insurance

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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.

 

New Medicare Eligibility Study Panel at the National Academy of Social Insurance

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April 24, 2019
Press Release
For Immediate Release
Contact: 

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. 


Social Security Finances: Findings of the 2019 Trustees Report

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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.

Socialism or Social Insurance?

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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.

Strengthening Social Insurance: The Role of Policy Innovation Challenges

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The National Academy of Social Insurance and AARP will soon be announcing the winners of the 2019 Social Security Policy Innovations Challenge: Ensuring Adequacy for Workers. Through this Challenge, we will identify 3-5 feasible policy proposals that specifically address the income adequacy needs of older workers, who must claim Social Security retirement benefits before their full retirement age due to ill health, an inability to continue to perform physically demanding jobs, or other factors. (This 2019 Challenge in some ways builds on past crowdsourcing efforts the Academy has led over the past decade. As discussed further below, the Academy’s Challenges have produced a range of feasible ideas and policy proposals for strengthening Social Security.)

 

Focus of the 2019 Challenge: Under the current Social Security benefit structure, early claimants receive substantially reduced monthly benefits throughout their lifetimes. Given that the average retirement benefit is only slightly above the federal poverty level for income, and that most beneficiaries rely on their Social Security benefits as their principal or only source of income, this reduction in benefits likely leaves early claimants without adequate income for the remainder of their lives. This is a significant challenge facing the nation, and so far, policymakers lack a clear plan of action. With the results of this 2019 Challenge, we seek to provide impetus for evidence-based policy action.

 

Policy Innovation Challenges at the National Academy of Social Insurance

For over a decade, the Academy has used “Policy Innovation Challenges” to help unearth previously overlooked options for strengthening the nation’s social insurance programs, with a particular focus on  Social Security due to its central role in protecting Americans from a variety of common life risks. Essentially, an innovation challenge is a form of crowdsourcing – one that relies on a more structured process to gather, evaluate, and hone promising ideas.

While expertise does not always lead to innovation, when it comes to public policy, crowdsourcing is more fruitful when the crowd has a certain level of familiarity with the subject matter. As a membership organization comprised of over 1,000 of the nation’s top experts in social insurance and related areas, the Academy is a natural hub for “Policy Innovations Challenges” around social insurance. Academy Members come from a variety of disciplines and organizational backgrounds, which is another key factor for a successful crowdsourcing and innovation process. We are also an organization focused on increasing public understanding, so we aim to reach not just policy experts but also beneficiaries and advocates for stakeholders of the programs.

With the 2019 Challenge, we sought to improve the process with a full-day ‘”facilitated discussion” where potential participants with less Social Security expertise (but nonetheless valuable knowledge and perspectives to add) could learn more about Social Security in order to develop a feasible policy proposal. Preliminary results of the 2019 Challenge indicate that this interaction among various levels of expertise and backgrounds further supports the necessary conditions for policy innovation.

 

Brief recap of results from prior Policy Innovation Challenges


2008: Innovation Awards to Strengthen Social Security for Vulnerable Groups

This early “Policy Innovation Challenge,” part of the Rockefeller Foundation’s Campaign for America’s Workers, produced a dozen winners, including a proposal for “Strengthening Social Security for Workers in Physically Demanding Occupations” (highlighting an issue that is a focus of our 2019 Social Security Policy Innovations Challenge). The winning proposals also included ideas for providing targeted support for elderly Americans experiencing long-term homelessness, family elder caregivers, and widows and widowers. The summary report from this Innovation Challenge provides background information on the pros and cons of common strategies to ensure Social Security’s long-term solvency. And the twelve winning papers, available as part of a comprehensive report on the project/challenge, offer ideas that, a decade later, remain highly relevant for various constituencies that particularly rely on the program.

 

2010-2011: Innovative Projects to Strengthen Social Security for Vulnerable Populations (Grassroots Outreach and Education Initiatives)

In this program, the Academy collaborated with the Ford Foundation to address a different aspect of the Social Security conundrum: how to get more of the constituencies with the biggest stake in the program’s long-term solvency more engaged in advocating for it? Ironically, it may be the very stability and ubiquity of Social Security that renders it periodically vulnerable. This includes attempts to undermine it through calls for privatization in the 1980s and 2000s, and as well as assertions that it will no longer be available for younger generations, even though economic trends suggest that today’s Millennials may actually need Social Security’s protections even more. Because it is just there, paid into every pay period and paid out every month, Americans do not have the regular opportunity to debate Social Security as they do policies that require periodic appropriation. So the Academy issued a call for proposals from organizations to educate people “outside the beltway” about its critical importance, develop user-friendly education materials, and build advocacy among vulnerable groups, like communities of color, women, people with disabilities, low-wage workers, and children.

Nine national and grassroots organizations received grants in the first round, another fourteen received awards in a second round later that year, and in a third round the following April, ten more awards were given. Many of these awardees continue to be important advocates in for Social Security. For example, Generations United works to break down barriers between post-retirement and pre-retirement Americans, and Latinos for a Secure Retirement continue to educate Latinos of all ages about their stake in Social Security.

 

2016: AARP Policy Innovation Challenge: Social Security Adequacy and Solvency

The Academy supported AARP’s efforts with a full-day forum to explore and debate ideas presented by the winners of AARP’s Policy Innovation Challenge, as well as other retirement security experts.

 

What’s next? Stay tuned in July and in the following months as we share the results of this year’s Social Security Policy Innovations Challenge. Each winning proposal will receive an award of up to $20,000-$25,000. For more information about Policy Innovation Challenges at the Academy, please contact: Elaine Weiss at eweiss@nasi.org.

Designing Universal Family Care: State-Based Social Insurance Programs for Early Child Care and Education, Paid Family and Medical Leave, and Long-Term Services and Supports

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Benjamin W. Veghte, Alexandra L. Bradley, Marc Cohen, Heidi Hartmann, eds.
June 2019

This report explores strategies that states could pursue to better support families in meeting evolving care needs over the lifespan. The first three chapters of the report explore the challenges families face in the realms of early child care and education (ECCE), paid family and medical leave (PFML), and long-term services and supports (LTSS). For each care domain, the panel identifies policy options along with the tradeoffs associated with specific policy choices; this is done within the context of assuring universal access, affordability, and financial stability through well-defined financing mechanisms. The concluding chapter explores how an integrated approach to care policy might be designed—one offering families a single point of access to ECCE, PFML, and LTSS benefits—under an umbrella program called Universal Family Care. Each chapter outlines challenges that states would need to navigate regarding how a new social insurance program would relate to existing federal and state care programs. Each chapter also addresses implementation considerations.

This analysis was developed over a year of deliberations by a Study Panel of 29 experts in care policy from a variety of perspectives. The report does not include recommendations but instead identifies the building blocks and tradeoffs associated with a range of options in the design of a state-based social insurance program. While there are other approaches for improving care supports, this report focuses specifically on social insurance solutions. As well, while there is nothing that precludes such approaches from being adopted at the national level, the focus of this analysis is on the potential for state action. Although addressed primarily to state policymakers, this analysis should be of interest to providers, advocacy organizations, insurers, administrators, and federal policymakers, as well as to any person interested in these issues.

Download the full report.

Read the press release.

Download infographics for each chapter: 

Explore Universal Family Care(This link takes you to a site managed by Caring Across Generations.)

 

This project is being conducted in conjunction with the Academy’s “Leveraging Social Insurance to Combat Inequality” project, funded by the Ford Foundation. It also received support from Caring Across Generations, a campaign to transform how we care for our families at every stage of life.

Addressing Social Security's Long-Range Financial Stability

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Significant proposals to enhance Social Security’s long-range financial stability are emerging from a variety of sources. Although there was only one mention of Social Security during the first round of Democratic Presidential debates in June, it is likely to get much more attention from candidates in the coming months.

Recently, I attended the annual Peter G. Peterson Foundation’s Fiscal Summit in DC. (The Peterson Foundation has been a long-time supporter of the Academy’s work.)

The Summit featured a “Solutions Initiative,” in which seven policy organizations from across the political spectrum put forward plans “to set America on a stronger, more sustainable fiscal path.” In keeping with Peterson’s priorities, the overriding goal of each plan was to reduce the federal debt over the next 30 years. Each organization’s plans include proposals that would change elements of Social Security, which the Peterson Foundation notes is “currently the largest program in the federal budget and represents an essential part of Americans’ retirement.”

Given this range of political perspectives, it should be no surprise that the seven organizations – American Action Forum (AAF), American Enterprise Institute (AEI), Bipartisan Policy Center (BPC), Center for American Progress (CAP), Economic Policy Institute (EPI), Manhattan Institute (MI), and Progressive Policy Institute (PPI) – address Social Security’s challenges in different ways. Five of the seven propose some reduction in benefits for some beneficiaries, and all but one propose raising additional revenues.

Of the seven organizations, four identify Social Security as one of their top three priorities.

The following is a summary of each organization’s Social Security proposals.

American Action Forum (AAF)

  • Move to price indexing in the calculation of benefits
  • Means-test benefits for higher-earnings beneficiaries
  • Incorporate the chained Consumer Price Index (CPI) to calculate Cost-of-Living Adjustments (COLAs)
  • Reform the Disability Insurance (DI) formula for the calculation of work history

(Douglas Holtz-Eakin, AAF’s President, serves on the Academy’s Board of Directors.)

American Enterprise Institute (AEI)

  • Institute a flat-dollar benefit paid to all retirees and widow(er)s, regardless of their earnings history or labor force attachment
  • Supplement this benefit with automatic enrollment of workers in employer-sponsored retirement plans with a default contribution of 3 percent of earnings split evenly between the worker and the employer
  • Increase the early retirement age gradually from 62 to 65
  • Eliminate Social Security contributions for all workers age 62 and older
  • Institute experience rating for the employer share of the DI payroll tax     

Bipartisan Policy Center (BPC)

  • Establish a Basic Minimum Benefit and replace Supplemental Security Income (SSI) for beneficiaries with low incomes
  • Index the full retirement age to account for ongoing increases in longevity, gradually raising the age over decades
  • Allow surviving spouses to receive 75 percent of their deceased spouse’s benefit in addition to their own
  • Base COLAs on the Chained CPI
  • Make the benefit formula more progressive
  • Limit the spousal benefit
  • Calculate benefits using annual, rather than averaged, income, and count more years in the benefit formula

(Bill Hoagland, BPC’s Sr. Vice President, is a former member of the Academy’s Board of Directors. Jason Fichtner, who helped in the development of BPC’s plan, serves on the Academy’s Board of Directors.)

Center for American Progress (CAP)

  • Eliminate the taxable maximum wage base
  • Improve Social Security benefits

In a memorandum accompanying its plan, CAP noted that: “Public investments in areas like infrastructure, education, and social insurance make workers more productive, help sustain employment, and reduce inequality.”

(Rebecca Vallas, a CAP Senior Fellow, serves on the Academy’s Board of Directors.)

Economic Policy Institute (EPI)

  • Raise the taxable maximum payroll cap to a level that would cover 90 percent of earnings
  • Adopt the coverage expansions in the Sanders-DeFazio Social Security Expansion Act

Manhattan Institute (MI)

  • Gradually raise the full-benefit retirement age from 67 to 69 by 2030
  • Set initial Social Security benefits lower than under current law for those with higher lifetime earnings
  • Eliminate COLAs for those whose post-retirement incomes exceed $85,000 (single) and $170,000 (married)
  • Increase the contribution rate by 1 percentage point.

Progressive Policy Institute (PPI)

  • Establish a flat work credit for each year an individual spends in the workforce regardless of what they were paid
  • Earn up to five years of work credits for time taken out of the workforce to serve as a caregiver
  • Index the ages at which an individual may claim both reduced and maximum benefits to longevity
  • Retain a special early retirement age that allows low-income workers to claim an unreduced benefit at age 62
  • Link annual COLAs to the Chained CPI
  • Index the COLA to average wage growth after a beneficiary has been eligible for Social Security for 15 years
  • Increase benefits for widow(er)s who are at risk of falling into poverty when their spouse dies
  • Cap and means-test spousal benefits

More information about these proposals may be found on the Peterson Foundation’s website.

The Academy’s Ongoing Focus on Social Security

As we noted in the Academy’s 2017 Report to the New Leadership and the American People on Social Insurance and Inequality: “To continue to provide adequate benefits over the long term, reforms will be needed.”

The Academy continues to focus on Social Security in many ways.

Our website contains a robust collection of Social Security materials, which we update regularly.

Our “outside the Beltway” forums over the past year have featured Academy Founding Board Member Henry Aaron’s Social Security plan as a framework for discussing policy options to restore the program to financial soundness.

We produce an annual Issue Brief, Social Security Finances: Findings of the 2019 Trustees Report.

Our 2019 Annual Policy Conference, Regenerating Social Insurance for Millennials and the Millennium, included a panel on “Social Security Across the Lifespan: Addressing Misconceptions among Young People.”

We conduct an annual Summer Academy for Interns and Young Professionals, Demystifying Social Security. This year’s will be held on August 13th from 8:30 am to 4:30 pm. Please encourage people in your network to attend.

Our Concept Paper, Assured Income, published in April, includes a section on how Social Security might provide a vehicle for delivering some form of assured income to all Americans.

In collaboration with AARP, we are conducting a Social Security Policy Innovations Challenge. The Challenge is focused on workers with limited employment opportunities who lack the financial security to postpone claiming Social Security benefits until they reach full retirement age. Awardees will be announced soon.

Looking Ahead

In collaboration with Matthew Greenwald & Associates, we will be conducting an update to our 2014 survey and report, Americans Make Hard Choices on Social Security: A Survey with Trade-Off Analysis. We expect to release our new survey findings in early 2020.

As always, we welcome your comments, suggestions, and questions about the Academy’s Social Security activities, as well as any other aspects of our policy work.

Please send them to me at warnone@nasi.org.             

In Memoriam: Merton Bernstein

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Merton C. Bernstein 

1923 - 2019

Merton Clay Bernstein, Walter D. Coles Professor of Law Emeritus, Washington University in St. Louis died at home in Brewster, MA on August 3, 2019.  

His groundbreaking book, The Future of Private Pensions, won the Elizur Wright Award for best book on insurance in 1964 and opened the door for appearances on CBS’s 60 Minutes in 1971 and NBC’s Peabody award-winning White Paper: Pensions – The Broken Promise (1972), two programs that pushed pension reform onto the national agenda.  In 1988 he coauthored with his wife, Social Security: The System that Works, providing the general reader with a positive rationale for the program, its strengths, and its accomplishments.  

At Washington University he founded and directed a unique Congressional and Administrative Internship in Washington, D.C.  for selected third year law students. His earlier experience in government service informed the classes he taught – especially labor law, social legislation, and arbitration.

In 1993, the Washington University Law Quarterly published tributes to his skills as a teacher, arbitrator, public servant, original thinker, humorist, optimistic doer, and writer with intelligence and imagination.  Professor Lance Liebman, Dean and Professor of Law at Columbia noted that in the 1970’s almost no one in American law schools taught or wrote about the millions of people affected by various social insurance systems.  “The major reason the word is ‘almost’ and not ‘no one’ was Mert Bernstein.”  Vol. 71, No. 4, p. 1007.

After 25 years at Washington University  Mert and his wife moved to Brewster in 2000 where they continued to write and speak on social insurance. Until he was sidelined by Parkinson’s, he was working on tort reform achieved by consolidating all medical services including those arising out of workers’ compensation, automobile insurance, product liability insurance,  and other medical tort claims into one plan using the economies generated by the elimination of redundant administrative arrangements to finance coverage for the uninsured.

Born March 26, 1923 in New York City, he was educated in the city’s public schools, Oberlin College (B.A. 1943), Columbia University Law School (LL.B. 1948), and the U.S. Army (1943-1945).  He married his life partner, Joan B. Brodshaug, in 1955.  Their four children, Johanna Wilt (Ian Wilt), Inga Bernstein (Christine Nickerson), Matthew (Mac) Bernstein (Barbara), and Rachel Bernstein (Scott Frank), produced eight grandchildren, Alexandra Wilt, Shiloh, Max, and Leo Bernstein, Kaja and Grace Nickerson, and Noah and Carly Frank. 

Between 1949 and 1959 he practiced law, served as an attorney at the NLRB and the Office of Solicitor in the U.S. Dept. of Labor, Counsel for the National Enforcement Commission and the Senate Subcommittees on Labor and Railroad Retirement, and was Legislative Assistant to U.S. Senator Wayne Morse of Oregon.

In 1959 he began teaching with stints at the University of Nebraska, Yale, Ohio State, and Columbia. In 1975-76 he received a Fulbright Award and taught at Leiden University in the Netherlands.  

In 1982-83 he was principal consultant to the National Commission on Social Security Reform (the Greenspan Commission).  He served on the Secretary of the Treasury’s Advisory Committee on the Integration of Pensions and Social Security, advised the Committee on Retirement Income for the White House Conference on Aging, chaired the Advisory Committee on Research of the Social Security Administration, and testified numerous times before Congress.  In the late 1970’s he helped form Save Our Security (SOS), a coalition of organizations that opposed cuts to Social Security benefits.  He authored Private Dispute Settlement (1968) and countless articles on social insurance, private pensions, labor, and arbitration in professional journals and the popular press.

In his spare time he conducted labor arbitrations for over forty years and ran for Missouri’s Democratic nomination for U.S. Senate in 1991-92, coming in third in a field of fourteen.  His platform: campaign finance reform, single payer health care, and strengthening Social Security. 

In the 1980’s, Mert, a founding board member of the National Academy of Social Insurance, proposed that the Academy establish an internship now known as the Merton C. Bernstein Internship on Social Insurance. Over 250 students studying economics, gerontology, journalism, political science, public policy, social work, actuarial science and related subjects have engaged in policy development and implementation of social insurance in a 12 week summer program.

Above all, he always had time for his family, his horses, music, photography, and various local boards and committees where he lived.  He charmed the world with his smile and wit. 

A gathering in memory of Mert for family and friends will be held on Saturday, August 10, 2019, 1:00 at the Brewster Meeting House, First Parish UU, 1969 Main Street (Route 6a), Brewster, MA.

Contributions in Mert’s memory may be made to the Merton C. Bernstein Internship in Social Security to carry on his work.  Contact Kristine Quinio, Director of Development, National Academy of Social Insurance, 1200 New Hampshire Ave., NW, Ste. 830, Washington, DC  20036, or at kquinio@nasi.org or 202-243-7008, (a 501(c)(3) organization).

 

Mert Bernstein speaks with an attendee of the Academy's 2015 Conference. 

Expertise and Engagement

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As we strive to enhance our Academy’s effectiveness in fulfilling our mission – increase public understanding of how social insurance contributes to economic security and advance solutions to challenges facing the nation – one of my major concerns in today’s polarized environment is the distrust of expertise among segments of the U.S. population.

Some of this distrust is due to deliberate efforts to undermine evidence-based research. My January 2017 message to Academy Members, “What does a “post-truth” era mean for the Academy?” addressed this. There are, however, other factors in such distrust.

Nervous States

Nervous States: Democracy and The Decline of Reason, by political economist William Davies (W.W. Norton & Company, 2018) examines factors contributing to this distrust in expertise. The book is a riveting examination of the challenge confronting organizations of expertise like our Academy.

In the book’s introduction, Davies identifies the crux of this challenge: “Knowledge becomes more valued for its speed and impact than for its cold objectivity, and emotive falsehood often travels faster than fact.” The title is based on his observation that “(i)n the murky space between mind and body…lie nervous states: individuals and governments living in a state of constant and heightened alertness, relying increasingly on feeling rather than fact.” One of the contributing factors to such states is “real-time media, available via mobile technologies.”

Davies notes, “we spend more of our time immersed in a stream of images and sensations, with less time for reflection or dispassionate analysis.” A similar theme underpins The Death of Expertise, by political scientist Thomas Nichols (Oxford University Press, 2017).

Engagement in an era of distrust

Our Academy has sometimes been described as an “honest broker” or “neutral intermediary” in the public policy space. Maintaining these roles – especially at a time when others may be embroiled in policy disputes – is critical to our credibility and trustworthiness.

How do organizations of experts like the National Academy of Social Insurance translate our policy research into understandable and actionable findings, especially when increasing numbers of Americans rely more on “real-time media” for facts and knowledge?

Furthermore, why should people – particularly those who are the current and future beneficiaries of social insurance and related programs – trust expertise that seems so detached from their daily life experience? How will we frame policy issues and communicate our research to engage key social insurance stakeholders more effectively? How might we include the “voices of beneficiaries” in our policy work?

Clearly, we need more engagement with our stakeholders – especially in the attention marketplace of social media – where emotional content, messaging, and translation are the keys to effective communication. This leads to another critical question for our Academy:

How will we break through some of the barriers to appreciating and relying on the Academy’s work and expertise, without jeopardizing our reputation?

According to Davies, “mounting inequality…means that, in certain ways, the facts produced by experts… simply do not capture lived reality for many people.” Davies adds: “Indicators such as GDP capture things in the aggregate, while GDP per capita captures what this means for people on average. But the divisive effect of economic inequality is such that aggregates and averages are simply no longer credible representations of how things are.”

In short, according to Davies, “statistical frameworks have moved even further away from lived experiences.” He warns: “When individuals feel unrepresented by the pronouncements of economists and statisticians, why should they continue to listen to policy experts?”

Developing a new engagement strategy for the Academy

Throughout the Academy’s thirty-two-year history, we have carefully maintained our reputation for evidence-based research and a nonpartisan approach to policy. In today’s polarized environment, such a posture is often met with skepticism. We need to recognize this perspective and seek ways to overcome it.

One suggestion Davies offers is that organizations like ours reconnect policy to “deep human needs, bringing shared feelings – including shared vulnerability – directly into the public domain.” In the final analysis, Davies predicts that organizations that emerge in today’s charged environment will be due to “survival of the truest” based on “authentic expertise.” Striking the right balance between reason/thinking and emotion/feeling is the key to our effectiveness. How we frame issues must reflect both.

As Members of our Academy, your suggestions on how we might enhance our engagement activities are always welcome. Please send them directly to me at warnone@nasi.org. Please also feel free to share your reactions to this piece using the comment box below.


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‘Undervalued, underpaid and overworked’: Why home care workers are quitting in droves – Becker’s Hospital Review

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Becker’s Hospital Review     •     August 22, 2019, 6:22 pm
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President Trump signs new initiative to speed up loan forgiveness for disabled veterans – FoxReno.com

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FoxReno.com     •     August 23, 2019, 1:50 am
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