Tag Archives for Medicare

New Census data reports the graying of U.S. population 

Published in RINewsToday on June 26, 2023

The nation’s population continues to gray and this is documented by a series of demographic profiles from the 2020 Census recently released. The release of this updated census data must be a wake-up call to Congress and federal and state officials who oversee aging programs and services.

According to Zoe Caplan, statistician demographer in the U.S. Census Bureau’s Sex and Age Statistics Branch, the U.S. population age 65 and over grew from 2010 to 2020 at the fastest rate since 1880 to 1890. The nation’s over-age-65 population grew nearly five times faster than the total population over the 100 years from 1920 to 2020, says Caplan in a May 25, 2023 posting on the agency’s website.

In her posting, Caplan says that in 2020, a whopping 1 in 6 people in the United States were age 65 and over. In 1920, this statistic was just 1 in 20. 

The 2020 Census reported that the older population increased by 50.9 million, from 4.9 million (or 4.7% of the total U.S. population) in 1920 to 55.8 million (16.8%) in 2020. This represents a growth rate of about 1,000%, almost five times that of the total population (about 200%).

Growth in older population spiked 2010-2020

According to Caplan, the older population has been growing for the past century but the decade before 2020 saw its fastest increase since 1880 to 1890. “From 2010 to 2020, the age 65 and over population experienced its largest-ever 10-year numeric gain — an increase of 15.5 million people. The next largest 10-year numeric increase, 5.7 million between 1980 and 1990, was less than half that size,” she says.

From 2010 to 2020, Caplan stated that the 65 and over population experienced the largest-ever percentage-point increase, from 13.0% to 16.8% of the total population. “Before 2010, it took 50 years (from 1960 to 2010)  for the nation’s older population’s share of the total population to grow by the same number of percentage points,” she said.

The 2020 Census Data reveals that while the nation’s population grew from 2010 to 2020, the size and rate varied by age groups for other age groups. The 65 to 74 age group was the largest of the older cohort groups, with 33.1 million people, representing over half of the age 65 and over population (or 1 in 10 Americans), she said.

“The 65 to 74 age group experienced the largest growth of any older age group the previous decade,” says Caplan, noting that its numbers grew by 11.4 million or (52.5%), increasing from 21.7 mil­lion in 2010 to 33.1 million in 2020.  

Caplan says that the 75-to-84 age group grew at about half that rate (25.1%) but is expected to pick up the pace in the next decade as baby boomers age into this group. Additionally, she noted that the 85-to-94 age group had a relatively slower growth (12.6%) than other older age groups, increasing from 5.1 million to 5.7 million.  The population 95 years and over also expe­rienced a large growth rate (48.6%), increasing from about 425,000 in 2010 to 631,000 in 2020, she added. 

The 2020 date also indicated that for those people age 70 and over, males experienced a larger percentage growth between 2010 and 2020 (42.2%) than females (29.5%). Meanwhile, the percentage of centenarians have grown 50% since 2010, the fastest recent census-to-census percent change for that age group.  

Finally, while the U.S. population age 65 and over population grew, the Census 2020 data indicated that the nation’s population remained relatively young when compared with other nations. Caplan noted that Japan has the largest percentage (28.5%) of older residents.  Many European countries, along with Canada and Hong Kong, have larger percentages of older residents than the United States, says Caplan, noting that the United States ranked 34th (16.8%) among these places.

Japan had the largest share (28.5%) of older residents. The United States ranked 34th (16.8%) among these places. Many European countries, along with Canada and Hong Kong, had higher shares of older residents than the United States, adds Caplan.

Nation’s median age creeps closer to Age 40

Just last week, the U.S. Census Bureau reported that the nation’s median age increased by 0.2 years to 38.9 years between 2021 and 2022.  Median age is the age at which half of the population is older and half of the population is younger.

“As the nation’s median age creeps closer to 40, you can really see how the aging of baby boomers, and now their children — sometimes called echo boomers — is impacting the median age. The eldest of the echo boomers have started to reach or exceed the nation’s median age of 38.9,” said Kristie Wilder, a demographer in the Census Bureau’s Population Division in a statement released on June 22, 2023.

“While natural change, nationally, has been positive, as there have been more births than deaths, birth rates have gradually declined over the past two decades. Without a rapidly growing young population, the U.S. median age will likely continue its slow but steady rise,” she says.

According to the statement, a third (17) of the states in the country had a median age above 40.0 in 2022, led by Maine with the highest at 44.8, and New Hampshire at 43.3. Utah (31.9), the District of Columbia (34.8), and Texas (35.5) had the lowest median ages in the nation. Hawaii had the largest increase in median age among states, up 0.4 years to 40.7.

No states experienced a decrease in median age. Four states — Alabama (39.4), Maine (44.8), Tennessee (39.1), West Virginia (42.8), and the District of Columbia (34.8) — had no change in their median age from 2021 to 2022.

Can Rhode Island cope with a population growing older?  

“It is no secret that the Rhode Island population is growing older,” says Maureen Maigret, Chair of the Aging in Community Subcommittee of the Long-Term Care Coordinating Council, whose Subcommittee was charged with looking at Rhode Island’s older population, its demographics, services and programs to assist them to age in place in the community along with identifying gaps in services. “We issued a comprehensive report in 2016 showing that persons age 65 and over in Rhode Island would go from 14.4% of the state population in 2010 to 25% by 2040,” she said.  

According to Maigret, the US Census 2021 estimates shows the state’s 65 and over population is now at 18% and some its communities have already reached 20%. “Our older population is also becoming more diverse. White older adults went from 93.4% in 2010 to 86.4% in 2021 (RI Healthy Aging Data Report.) while Hispanic older adults increased from 3.8% to 6.5%. Our Subcommittee continues to work to implement recommendations we made in nine different areas important for aging in the community,” adds Maigret, noting that she has been working with advocates and legislative champions to implement and put them into law or practice.

“We have made some significant progress in expanding home care for those not impoverished enough to be on Medicaid, to expand respite services for caregivers and this year to fund the Office of Healthy Aging and Disability Resource Center. But we still have much more work to do,” says Maigret.

“I am especially concerned that studies show some 80% of persons age 65+ will not be able to afford two years of home care and many may need more than that. So that is something we need to address by changes in Medicaid and Medicare providing support for unpaid family caregivers who provide enormous amounts of long-term care to loved ones in need.  We also be providing more funding for local senior center programs that are shown to promote health and reduce social isolation with its negative health outcomes,” says Maigret.

Maigret says that funding for the Village Common of RI that, an organization that provides trained and vetted volunteers in local villages to provide supports such as transportation to medical appointments, grocery shopping, friendly visits, minor home tasks — all types of supports to help older adults remain in their own homes, should also be allocated. “More communities are interested in starting these types of volunteer programs of mutual support but funding is needed to support the infrastructure,” she advises.  

Maigret expresses concern that so many older Rhode Islanders are economically insecure. Twenty seven percent of older households are living on less than $25,000/year yet it costs an older Rhode Island couple in good health renting their home about $41,448 annually to meet basic living expenses (Elder Index).

“Economic insecurity is a special problem for older women who comprise 56% of the state’s 65 and over population and are more likely to live alone,” she says noting that their average Social Security checks amounts to $11,584 compared to $14,578 for men, and mean personal income for women is about $25,000 less than older males.

Maigret encourages state leaders to pay attention to these “age-related” demographics as they consider budget and policy priorities. And she would like to see each of the state’s communities assess their age-friendliness, like Newport, Cranston and Providence have done.” Other communities should follow Pawtucket’s lead of promoting fitness for older adults by creating  adult outdoor exercise area adjacent to its senior center or in local parks.

Addressing the State’s Shrinking Health Care Workforce

“The main focus in addressing issues related to meeting the needs of the state’s growing older population is to address the critical need for a robust healthcare workforce,” says John Gage, President & CEO of the Rhode Island Health Care Association.  “Reimbursement must support appropriate staffing levels at livable wages throughout the long-term care continuum – home care, assisted living residences and nursing facilities,” he says. 

“As the generations shift, there will be a greater need for long-term care supports and services with a shrinking workforce.  Sustainable funding is essential to the ability to provide this care, and it has never been more evident than today,” warns Gage.  “In the wake of the Covid-19 pandemic, current statistics from the U.S. Bureau of Labor Statistics indicate that Rhode Island’s nursing home workforce is down some 20% from pre-pandemic levels,” he says, stating a detailed analysis of the workforce for hospitals and nursing homes indicates that  nursing home RNs have declined by 16.5%, LPNs by 18.3% and CNAs by 25.4%.  It is estimated that, nationwide, recovery of the nursing home workforce will not occur until 2027 based on the small, incremental improvements quarter over quarter, adds Gage.

“Presently, 17% of our neighbors are aged 65 and older, and nearly a quarter (24%) are age 60 and above!  Recognizing this trend, we are actively engaged in anticipating and meeting the needs of our growing population of older adults in our state,” says Director Maria Cimini, of the Rhode Island’s Office of Healthy Aging.

“At numerous State and non-profit spaces, we are present to ensure that the needs of older adults are central to discussions surrounding  health care, housing, transportation, education, accessible communities, and caregiving,” she adds.

“We embrace the opportunity presented by the recently passed Legislative Commission to Study the Services and Programs for Older Adults to collaborate with Rhode Islanders working with seniors. Together, we will share our experience with aging populations, promote valuable resources, and identify what we all need to make RI a great place to grow up and grow old,” says Cimini.

For a copy of the 2020 Census Brief, “The Older Population: 2020,” go to https://www2.census.gov/library/publications/decennial/2020/census-briefs/c2020br-07.pdf.

For a copy of the LTCCC’s Aging in Community Subcommittee June 2016 Report, “Aging in Community” go to  https://www.rilegislature.gov/Reports/AiC%20Full%20Final%20Report%206.13.16.pdf.

For a copy of the LTCCC’s Aging Community Subcommittee December 2016 Strategic Plan, “Aging in Community, go to https://www.rilegislature.gov/Reports/Building%20an%20Age-Friendly%20Community.pdf.

For a copy of Rhode Island Healthy Aging Data 2020 Report, go to

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Trustee reports: Social Security and Medicare still face financial woes

Published in RINewsToday on April 10, 2023

Over a week ago, the Trustees of the Social Security and Medicare trust funds released their annual reports on the financial health of these two programs. As in prior years, the trustees found that the Social Security and Medicare programs both continue to face significant financing issues.

The latest Social Security projections show the program is quickly heading toward insolvency and calls for Congress to find policy solutions sooner rather than later to prevent abrupt changes to tax or benefit levels.  The Washington, DC-based National Committee to Preserve Social Security and Medicare (NCPSSM) and other aging advocates are urging Congress to take prompt action to strengthen and expand Social Security, while Republicans have been calling for cuts to future retirees’ benefits and at least partly privatizing the program. 

This 270- page 2023 Social Security Trustees Report warns that if Congress does not act, Social Security’s Old-Age and Survivors Insurance and Disability Insurance (OASI and DI) Trust Funds, which help support payouts for the elderly, survivors and disabled, will become depleted in 2033 (that’s a year earlier than forecast last year), becoming totally insolvent in 2034 when beneficiaries would only receive about 80% of their scheduled benefits. 

According to the Social Security Administration (SSA), roughly 66 million people received monthly Social Security checks in 2022 (175,840 in Rhode Island). A vast majority, or about 57 million of those beneficiaries, received benefits through the OASI Trust Fund, compared to nearly 9 million people who received benefits through the DI Trust Fund. 

The trustees say that Social Security funds would be fully depleted in 2034 because of expectations of a slowed economy and reduce labor productivity, considering inflation and economic input.

Although the DI Trust Fund asset reserves are not projected to become depleted during the 75-year projection period, being able to pay full benefits through 2097, the combined Social Security funds would only be able to pay 80% of the scheduled benefits after 2034, says the trustees report.

Taking a look at Medicare’s fiscal health

Medicare, the hospital insurance trust fund referred to as Medicare Part A, will only be able to pay scheduled benefits in full until 2031, according to the 273-page trustees’ annual report. The program covered 65 million seniors and people with disabilities in 2022, and will only be able to cover89% of total scheduledbenefits at that time.

Although the Medicare Part A Hospital Insurance trust fund will become insolvent in just eight years, Medicare spending as a whole (including Parts A, B, D, and Medicare Advantage, will continue to grow over the coming years.

The Medicare Trustees project a shortfall of 0.62 percent of payroll, or 0.3 percent of Gross Domestic Product (GDP), noting that it would take about a 21 percent (0.6 percentage point) increase in the payroll tax rate or a 13 percent spending cut to restore the program’s solvency.

The improvement of Medicare’s hospital trust fund’s finances over last year’s projections can be tied to lower estimates for health care spending after the height of the Covid-19 pandemic along with more projected income that the trustees estimate coming from a larger number of covered.

Dueling political statements

With the Social Security and Medicare Trust Fund reports released on March 31, 2023, the Chair and Ranking Members of the House Ways and Means (HWM) were quick to issue dueling statements to give their political spins. HMW’s Subcommittee on Social Security has jurisdiction on bills and matters related to the Social Security Act.

House Ways and Means Chairman Jason Smith (R-Missouri) charged that reckless Democratic spending has impacted the financial viability of the Social Security and Medicare Programs.  “Thanks to President Biden’s economic failures, seniors’ hard-earned benefits are further under threat. Social Security’s combined trust funds are expected to become insolvent a full year sooner than forecast in the previous report as a result of a slowed economy and Democrats’ inflation continuing to outpace wage growth. And Medicare’s latest report comes amidst Biden’s plans to slash seniors’ access to innovative new cures and treatments,” says Smith, stressing that “the first step to protecting these programs is “growing the economy – not budget gimmicks or tax increases that hold back economic growth.

On the other hand, House Ways and Means Committee Ranking Member Richard E. Neal (D-MA) counters Smith’s political perspective. “While Democrats are committed to the long-term health of these programs, Republicans are launching another shameful assault on the economic well-being of millions of workers and retirees with their plan to make drastic cuts to Social Security and Medicare, warns Neal. “Their playbook is clear: slashing a critical resource that Americans have rightfully earned to give another tax cut to the top 1%. Democrats won’t let their reckless attacks stand, and we will continue to defend and protect Social Security and Medicare for generations to come.”

Rhode Island Congressmen were quick to give their comments about the release of the two trustee reports, too. “Unlike the nearly three-quarters of House Republicans who endorsed slashing Social Security in 2022 – reducing benefits by $729 billion over 10 years – House Democrats are working to protect Social Security for generations to come,” says Congressman David N. Cicilline, representing Congressional District 1.  Cicilline, who is retiring his seat on May 31, 2023, has pushed to expand and strengthen Social Security over his six-terms in office.

Cicilline asks: “Sixty-six million Americans rely on this essential program to make ends meet and we cannot allow Republicans to make any cuts to this hard-earned benefit. The drug spending savings implemented by our Inflation Reduction Act will not only keep money in seniors’ pockets but will also drive down costs to Medicare itself. We’ve been taking real action to strengthen these programs and help our seniors – what have Republicans done?”  

As Rhode Island’s newly elected Congressman, Seth Magaziner says he will “fight tooth and nail to protect Rhode Islander’s hard-won Social Security benefits.”   In responding to the trustee’s report about Social Security’s financial woes, Magaziner called for raising the cap on Social Security taxes, forcing “millionaires and billionaires to pay the same rate as teachers and fire fighters.”

“I stand ready to work with anyone who is serious about strengthening Social Security, not cutting hard-earned benefits,” says Magaziner. 

While there are few fixes being proposed by either party or leader, some fixes identified by the Program for Public Consultation at the University of Maryland that “Americans might be willing to support” include:

–        raising the Social Security payroll tax cap

–        reducing benefits for high earners

–        gradually raising the retirement age

–        increasing the payroll tax

–        raising the minimum benefit

–        changing cost-of-living adjustment calculations

–        increasing benefits for beneficiaries over age 80

Social Security advocacy group gives its two cents

“Contrary to conservative claims, Social Security is not ‘going bankrupt’; the program will always be able to pay benefits because of ongoing contributions from workers and employers. In fact, this is yet another Trustees report showing that Social Security remains strong in the face of turmoil in the rest of the economy,” says Max Richtman, NCPSSM’s President and CEO in a release on the Social Security Trustee Report. He notes that the program’s insolvency date has stayed roughly the same even after a global pandemic and recent economic upheavals. 

Congress can strengthen Social Security by bringing in additional revenues into the program, says Richtman.  NCPSSM endorses legislation introduced by Senator Bernie Sanders (D-Vermont) and Congressman John Larson (D-Connecticut) to keep the trust fund solvent for the rest of this century while expanding program benefits.  Both bills would adjust the Social Security payroll wage cap so that higher-income earners begin contributing their fair share, he notes.

As to Medicare, in a release Richtman called on Congress to take “pre-emptive action now” to protect the Medicare Part A trust fund from becoming depleted in 2031, three years later than estimated in their previous report, at which time Medicare could still pay 89% of benefits.  

“Beyond trust fund solvency, the Trustees reported that the standard Medicare Part B premium will rise next year to $174.80 per month – a $10 or six percent monthly increase,” says Richtman. “Any increase is a burden to seniors living on fixed incomes, who too often must choose between paying monthly bills or filling prescriptions and getting proper health care.  Seniors need relief from rising premiums and skyrocketing out-of-pocket health care costs,” he said. 

“We support President Biden’s plan to strengthen Medicare’s finances, as laid out in his FY 2024 budget.  His plan would bring more revenue into the program, rather than cutting benefits as some Republicans have proposed.  Building on the prescription drug pricing reforms in the Inflation Reduction Act, the President’s budget proposal would lower Medicare’s prescription drug costs — and some of those savings would be used to extend the solvency of the Part A trust fund,” said Richtman.

For a copy of the 2023 Social Security Trustee Report, go to https://www.ssa.gov/OACT/TR/2023/.

For a copy of 2023 Medicare Trustee Report, go to https://www.cms.gov/oact/tr/2023.

Social Security has new, easier to use website

Published in RINewsToday on January 30, 2023

Over a month ago, the U.S. Social Security Administration (SSA) launched a redesigned website to assist beneficiaries to find what they need more easily. New pages and improvements based on public feedback will continue to be unveiled in the coming months. You may have already received an email to check out your new personal account page, though not everyone has yet.

“SSA.gov is visited by over 180 million people per year and it is one of our most important tools for providing efficient and equitable access to service,” said Kilolo Kijakazi, Acting Commissioner of the Social Security Administration, in a December. 6, 2022 statement announcing this redesign. “Whether providing service in person or online, our goal is to help people understand what they may qualify for and seamlessly transition them to an application process.” Improved self-service capability allows people to skip calling or visiting an office, which helps Social Security staff focus on those visitors who need in-person assistance,” she says.

Kijakazi noted that the redesign will make it easier to do business with the federal agency. “Its redesign is intended to provide a clear path to the tasks customers need to accomplish,” she said, noting that many of the most visited sections of SSA.gov are now live with a more user-friendly and task-based approach.

According to SSA, visitors to SSA.gov can use interactive tools to check eligibility for benefits.  The screener is a convenient and simple way for people to learn if they might be eligible for benefits.

Beneficiaries can also save time on Social Security Number (SSN) and card online services, too.  If a beneficiary loses their SSN card, they may not need a replacement. In most cases, simply knowing their SSN is enough. If a person does need a replacement card, they may be able to request a replacement online by visiting www.ssa.gov/ssnumber.

Individuals can also start an application for an updated card or request an SSN for the first time. People may never need to visit an office and, if they do need to visit an office to complete the application, they will save a lot of time by starting online.

People can also apply for Supplemental Security Income (SSI) benefits on line by starting an application and requesting an appointment to apply for SSI benefits by just answering a few questions at www.ssa.gov/benefits/ssi/.

Finally, for most benefits, people can apply online or start an application online. In many cases, there are no forms to sign. The agency will review the application and reach out with questions or for more information. Visit www.ssa.gov/onlineservices to apply for retirement, disability, or Medicare.

Many Social Security services do not require the public to take time to visit an office. Using a my Social Security account, a personalized online service, people can start or change direct deposit, or request a replacement SSA-1099. For individuals already receiving Social Security benefits, they can print or download a current Benefit Verification Letter if they need proof of their benefits.

People not yet receiving benefits can use their online account to get a personalized Social Security Statement, which provides their earnings information as well as estimates of their future benefits. The portal also includes a retirement calculator and links to information about other online services. SSA encourages people without a my Social Security account to create one today at www.ssa.gov/myaccount/. This part of the site is operational 5am to 1am, Monday through Friday – 5am to 11pm on Saturday – 8am to 11:30pm on Sunday.

One thing pandemic times have done is make us more proficient in the computer and using online services, and those who run official sites have focused on making them simpler, and easier to use.