Public Policy & Aging E-Newsletter

Volume 4, Number 1, January 2010

This bimonthly e-newsletter highlights key developments and viewpoints in the field of aging policy from a wide variety of sources, including articles and reports circulating in the media, academy, think tanks, private sector, government and nonprofit organizations.

The goal of this email publication is to reach teachers, students, and citizens interested in aging-related issues, especially those who may not have sufficient access to policy information disseminated both in Washington and around the country.

I. WHAT’S HAPPENING IN WASHINGTON?

A. "Aging in America in the Twenty-First Century: Demographic Forecasts from the MacArthur Foundation Research Network on an Aging Society": In this Milbank Quarterly article, authors Jay Olshansky, Dana Goldman, Yuhui Zheng, and John Rowe argue that current government projections may significantly underestimate the future life expectancy of Americans. It outlines implications associated with this underestimation, specifically that cumulative outlays for Medicare and Social Security could rise by $3.2 to $8.3 trillion from current government projections by 2050. The study also points to likely positive consequences for society due to longer life expectancies, including new and expanded markets in health care and leisure and a more experienced workforce.

B. Federal and State Income Tax Incentives for Private Long-Term Care Insurance: This AARP report highlights federal and state governments' efforts to help make long-term care insurance more affordable and to encourage purchases by providing tax subsidies for private long-term care insurance. It describes these tax subsidies for long-term care insurance, their value to taxpayers, and their costs to federal and state governments. The report concludes with questions for policymakers, including whether tax subsidies are an effective way of incentivizing purchases, whether they are fair, and whether they are worth their cost. To view this report in brief, click here.

C. Medicare Part D 2010 Data Spotlights: The Kaiser Family Foundation has issued a collection of analyses related to the Part D Medicare stand-alone drug plan options available to seniors in 2010. Each of these spotlights focuses on a key aspect of the drug plans that will be available to Medicare beneficiaries in 2010, and examines relevant trends since the Medicare drug benefit took effect in 2006. Spotlight topics include premiums, benefit design and cost sharing, key changes since 2006, and the coverage gap.

II. WHAT’S HAPPENING AROUND THE COUNTRY?

A. Reauthorization Listening Forum Series: In advance of the 2011 reauthorization of the Older Americans Act, the Administration on Aging (AoA) plans to convene a series of Reauthorization Listening Forums early in 2010 to get input from the aging network, stakeholders, policymakers and the public-in particular older Americans-on key issues that will impact our growing aging population and their families. Dates and locations include: Dallas on February 18th; Washington, DC on February 25th; and San Francisco on March 3rd. To receive the latest information on these forums, subscribe to the AoA e-newsletter here.

B. State of Aging: 2009 State Perspectives on State Units on Aging Policies and Practices: The National Association of State Units on Aging released a report that describes how states are grappling with financial pressures due to the economic decline while successfully strengthening core services, expanding person-centered access to information systems, increasing use of technology, and preparing for the aging baby boom generation. The report compares 52 states and territories on the structures of the state units, the types of home- and community-based programs administered, the use of cost sharing, and the use of evidence-based programs in health promotion and disease prevention.

C. Aging Strategic Alignment Project: This report, released by the Benjamin Rose Institute and the Administration on Aging, presents profiles of each state's home- and community-based service (HCBS) programs for two target populations: older adults and adults with physical disabilities. The report begins with an overview of findings from cross-state comparisons, and includes individual profiles of 48 states and Washington, DC. The findings are intended to provide states with information that can help guide their efforts to expand and improve HCBS programs.

III. THIS ISSUE'S MAJOR POLICY STORY: HEALTH CARE REFORM, AN UNCERTAIN FUTURE

My co-editors-Sarah Frey and Greg O'Neill-and I anticipated that this section in this issue would highlight key provisions of the long-awaited and much-contested health-care reform legislation as they affect baby boomers and older Americans. Alas, we will circulate this issue of Public Policy & Aging E-Newsletter in a time of uncertain transition, between the election of Scott Brown to the U.S. Senate and President Obama's State of the Union address. It is not clear what, if any, parts of the Senate and House measures will survive economic fears in a mid-term election year, but I feel confident that the articles below are worth reading. Let me offer a passage from Alexis de Tocqueville's Democracy in America:

"Equality of condition, while it makes men feel their independence, shows them
their own weakness: they are free, but exposed to a thousand accidents; and
experience soon teaches them that although they do not habitually require the
assistance of others, a time almost comes when they cannot do without it."

For those of you who wish for a more contemporary forecast of current events, we include Bill Galston and Elaine Kamarck's "Change You Can Believe in Needs a Government You Can Trust" (Item E).

Most of us are experienced enough and mature enough to acknowledge the fragility of the human condition. We have reckoned with the forces of Nature, dealt with vicissitudes, and at some level we acknowledge that our freedom is constrained. This is why social insurance is so critical in modern America: it provides some measure of protection against hazards we cannot address alone. Regardless of our political persuasions, We the People need to reform our access, coverage, and financing of health care. Let us hope the wisdom will prevail as our lawmakers deliberate our collective destiny.

--Andy Achenbaum


A. Kaiser Health Tracking Poll: Public Opinion on Health Care Issues: This January Kaiser Family Foundation Health Tracking Poll finds that Americans are divided over congressional health reform proposals, but also that large shares of people, including skeptics, become more supportive after being told about many of the major provisions in the bills, such as the availability of tax credits for small businesses, the creation of health insurance exchanges, and the inability of insurers to deny people coverage because of pre-existing conditions. The notable exceptions were the individual mandate and the overall price tag, both of which tended to make people less supportive of reform efforts. The poll finds that even after a year of substantial media coverage of the health reform debate, many Americans remain unfamiliar with key elements of the major bills passed by the House and Senate.

B. The Economic Case for Health Care Reform: Update: The Council of Economic Advisers released a report that reviews the case for reform that genuinely reduces the growth rate of health care costs, and presents updated estimates that the congressional proposals will reduce the growth of health care costs for individuals, businesses, and the government. In addition to slowing the growth rate of health care costs, the report argues that, if passed, current congressional proposals will result in higher standards of living for workers, more private sector job creation, and lower government budget deficits.

C. Implications of Health Reform for Retiree Health Benefits: This Employee Benefit Research Institute issue brief examines how health reform proposals would impact the future of retiree health benefits. In general, the proposals' provisions would have a mixed impact: in the short term, the reinsurance provisions would help shore up early retiree coverage, and Medicare Part D coverage would become more valuable to retirees; in the longer term, insurance reform, new subsidies for individuals enrolling for coverage through insurance exchanges, and enhanced Medicare Part D coverage would create incentives for employers to drop coverage for early retirees and Medicare-eligible retirees.

D. Health Insurance Coverage for Older Adults: Implications of a Medicare Buy-In: As Congress debates comprehensive health reform legislation, the idea of a Medicare buy-in option for uninsured adults ages 55 to 64 has re-emerged as a potential component. This Kaiser Family Foundation policy brief profiles the more than 4 million uninsured people between ages 55 and 64, and examines historical proposals to allow uninsured older adults to purchase Medicare coverage. It also examines barriers to securing affordable coverage in the current marketplace, and the effect of premiums and eligibility criteria on the potential uptake of a Medicare buy-in.

E. Change You Can Believe in Needs a Government You Can Trust: This Third Way report analyses the public's trust in government over time. It concludes that the public has lost faith in the federal government over the past eight years, and suggests that an aggressive strategy to regain the public trust will be necessary if progressives want to accomplish big things in the coming years. The paper dissects this longstanding decline in public trust, relives the early years of the Clinton Administration, and offers a trust strategy for moving forward.

IV. WORTH NOTING

A. WHAT'S HOT: Minority Aging Research: With support from sanofi-aventis, The Gerontological Society of America (GSA) recently released the premiere issue of a new aging-focused newsletter titled WHAT'S HOT. Based on presentations from GSA's 62nd Annual Scientific Meeting in November 2009, this issue explores the impact of the economic crisis on older workers' health, the perceived prevalence of job discrimination among older workers, and health care utilization patterns among older Asian minorities. To join an online discussion group related to topics addressed in the issue, click here.

B. The Economic Crisis: How Fare Older Americans?: This article, which introduces the Generations issue titled "The Great Recession: Implications for an Aging America," summarizes the implications of the current economic downturn for older Americans and those who serve older Americans. It outlines the economic, psychosocial, and political shocks, and identifies the resulting opportunities for policy and program enhancements. To view the table of contents for the entire issue, click here.

C. Health and Aging Policy Fellows Program Application Deadline Approaching: The deadline to apply for a 2010 Health and Aging Policy Fellowship is April 15, 2010. Supported by The Atlantic Philanthropies, this national program seeks to provide professionals in health and aging with the experience and skills necessary to contribute to the development and implementation of health policies that affect older Americans. The program is open to physicians, nurses, social workers, and other clinicians (e.g., pharmacists, dentists, clinical psychologists) with a demonstrated commitment to health and aging issues and a desire to be involved in health policy at the federal, state, or local level. For more information, click here or e-mail Phuong Huynh, deputy director of the program.

A. Healthcare Strategies for an Ageing Society: This new report from the Economist Intelligence Unit outlines future directions for health care systems, and explores several issues that need to be addressed if healthcare systems are to adapt to an aging world. These topics include changing assumptions about the financial impact of aging on health care; making geriatric care a bigger part of medical training; reconsidering care options; making treatments more appropriate to older populations; using technology to deliver key skills remotely and enable home-based care; and resetting public mindsets about the elderly.

B. Pensions in Crisis: Europe and Central Asia Regional Policy Note: This World Bank report analyzes the impact of the global financial crisis on pension systems in Europe and Central Asia (ECA), reviews the policy responses implemented by individual governments, and provides recommendations for strengthening pension systems. To improve the long-run sustainability of pension systems in the ECA, the report recommends that these countries index public pensions to inflation rather than wage growth, increase retirement ages of men and women to age 65 or older, and promote public awareness of pension issues.

C. NGO Committee on Ageing-New York Website: The NGO Committee on Ageing at the United Nations Headquarters in New York recently updated their website with pertinent information and news related to the United Nations and the global aging agenda. The Committee works collaboratively to raise world awareness of the opportunities and challenges of global aging, and advocates within the UN community to further integrate aging into UN policies and programs.

VI. PERSPECTIVES ON POLICY: ROB HUDSON, EDITOR, PP&AR

Enhancing Elderly Financial Security

The latest issue of Public Policy & Aging Report explores both the sources of and possible solutions to the economic vulnerability created by the "Great Recession" of 2007-09. Richard W. Johnson centers his attention on the deteriorating employment situation of older workers. The number of unemployed workers aged 55 or older doubled between November 2007 and July 2009. Christian E. Weller focuses his concern on how to counteract wealth loss among older Americans. His analysis and recommendations center on how to meld the best features of defined benefit and defined contribution savings plans. Annamaria Lusardi highlights the importance of the woeful level of financial literacy and numeracy among older adults. Her research finds such illiteracy at the root of the problem, in turn leading to both a lack of financial planning and, ultimately, to a lack of wealth. The analysis of David C. John calls attention to the widespread inability of retirees to manage their savings so that they last throughout retirement. Toward a remedy, he emphasizes the utility of annuities. Finally, Raymond O'Mara III and Pamela Perun introduce a life-course perspective to the savings issue, arguing that our goal should be broader than retirement savings alone. They propose a "Savings for Life" system in which four products-Child Accounts, Home Accounts, America's IRAs, and Security Plus Annuities-would represent a long-term investment in a better national savings system.

To purchase the current issue of PP&AR, or to subscribe, click here, and then click on "Public Policy & Aging Report."

The Public Policy & Aging E-Newsletter is a free bimonthly email publication. If you would like to subscribe, please click here and type “Subscribe” in the subject line. If you would like to unsubscribe to this newsletter, please click here and type “Unsubscribe” in the subject line.

Newsletter Editors: Sarah Frey and Greg O'Neill, National Academy on an Aging Society; Andy Achenbaum, University of Houston.

The Public Policy and Aging E-Newsletter is supported in part by a grant from the AARP Office of Academic Affairs.