Middle Income 50-Somethings Will Be Big Losers From Trumpcare

President Trump’s multi-pronged administrative attack on the Affordable Care Act would sharply increase premiums for middle-aged people who purchase insurance in the individual market, likely driving many to drop coverage.

Most would not feel the effects until 2019, though some will face sharply higher premiums in 2018—rate hikes they’ll see when the open enrollment season begins next month.

The President announced several changes to the ACA this week. They are complicated and address different parts of the 2010 law. But the overall effect will be that millions of older, sicker Americans will be priced out of comprehensive coverage while many younger, healthier people may get access to new low-cost, low-benefit policies. Those who are aged 50-64, just before they are eligible for Medicare, could be among the biggest losers.

What Are Adult Day Centers—Besides The Basis For Political Insults?

Adult day centers seem to have made it into the political debate in Washington, though not in a good way. In his nasty weekend  back-and-forth with President Trump, Senator Bob Corker (R-TN) suggested the White House has become an “adult care center” and wondered if the staff had “missed a shift” when Trump launched his Sunday Twitter storm. Yesterday, Rep Diane Black (R-TN)—who wants to run for governor—replied that the Senate “is an adult day care center” that can’t get anything done.

Leaving aside this mature level of political discourse, the name-calling does raise an important question: What are adult day centers and how do they work?

A Step Down The Road To Better Medicare For Those With Chronic Disease

Last week, the Senate quietly and unanimously passed a bill that would improve some Medicare benefits for people with chronic disease. The measure would do many good things but the most important is this: It would take important steps toward breaking down the wall between medical treatment and non-medical supports and services in Medicare, beginning a process that would make it much easier for frail seniors to receive the right care when they need it.

Graham-Cassidy’s Pre-Existing Conditions Rule Is A Very Big Deal

The still-evolving Senate Republican replacement for the Affordable Care Act could make health insurance unaffordable for more than 50 million middle-aged Americans by allowing insurers to raise premiums for those with pre-existing conditions. Other provisions would allow carriers to boost insurance costs for even health people aged 50-64.

The bill would give states federal dollars to help subsidize those rate increases, though  it would also slash the federal contribution to Medicaid in most states. Overall the combined federal share of Medicaid and insurance subsidies would be $160 billion lower over the next 10 years than under the ACA, according to the Kaiser Family Foundation.

Why Big Storms Like Irma and Harvey Are Needlessly Killing Frail Elders

You probably saw the headline: Six die in a Florida nursing home in the wake of Hurricane Irma. They won’t be the last frail elders to die needlessly.

Many frail seniors who were living on the edge are going to die in southeast Texas and Florida in the coming weeks.  We will probably never know how many because most will die in their homes or in hospitals—one at a time. Unlike the attention-getting visibility of six deaths in one facility, these will be silent deaths, unnoticed by all except their families and friends.

Stand-alone  Long-Term Care Insurance Continues To Fade Away

Only about 89,000 people bought private long-term care insurance in 2016, a nearly 14 percent decline from 2015, according to an industry survey.  Nearly all were bought in the individual market, though about 15,000 people purchased coverage through their jobs.

The sales decline continues a stunning trend. At the market’s peak in 2002, consumers bought 750,000 traditional policies, eight times what they purchased last year. For the second year in a row, the total number of people covered by long-term care insurance fell slightly as more dropped coverage, died, or exhausted benefits than bought new policies.  Roughly 7 million people currently own traditional policies, a number that has not changed in a decade even as the population of those 55 and older (those most likely to buy or use long-term care insurance) has grown by 30 milllion.

Older Adults May Be Making Much More Money Than We Thought

Older adults in the US may be making nearly one-third more, on average, than commonly thought, according to an important new study by two US Census Bureau researchers. Their report, published last month, finds that the median household income for those 65 and older was about $44,400 in 2012, significantly higher than the $33,800 previously reported by Census.

The implications of the study, by Adam Bee and Joshua Mitchell, are extremely important. It found that, based on these new measures, the poverty rate among seniors was about 6.9 percent, much less than the official 9.1 percent rate. And the importance of Social Security to many older adults may also have been overstated. Using traditional Census measurements, Social Security lifted about 15 million seniors out of poverty. These new data suggest the retirement program kept about 10 million out of poverty.

Are We Getting Closer To A Cheap, Simple Alzheimer’s Test? What Would It Mean?

Have you seen the stories about new tests for Alzheimer’s Disease that supposedly are just around the corner? The claims: A simple blood test, an eye test, even a smell test that could show that you are at high risk for Alzheimer’s decades before you develop symptoms. They are promising, scary, and–so far–premature.

Sadly, we’ve seen this movie before. Like most Alzheimer’s-related science, there turns out to much less to these stories than their promoters claim. For years, we’ve heard about the drug cures, or the brain-training products, diets, or exercise programs that can delay dementia. None have panned out. And it is far too early to know if cheap, accurate, and non-invasive early testing will either.

How The Lives Of Seniors In The US Match Up Against The Rest Of The World

Older adults in the US are better off, on average, than those in other countries, according to a new index developed by researchers at Columbia University and the University of Southern California. However, while US seniors do relatively well by quality of life measures such as social connections at work and across generations, they fall in the middle of the pack when it comes to physical well-being and financial and personal security.  And, not surprisingly, the gap between those doing well and those doing relatively poorly is greater in the US than in many other developed countries.

Federal Judge OKs A Class Action Lawsuit Over Appeals In Medicare Observation Cases

Two of the greatest sources of frustration for Medicare recipients and their families are observation status and the government’s incredibly complex appeals process. On Monday, a federal judge in Hartford CT, certified a class action lawsuit aimed at addressing both. The judge’s eventual decision in the case (Alexander v. Price) could have far-reaching effects on both the burgeoning use of observation status in hospitals and the rights of people getting Medicare to dispute decisions about their care.