Jim Carr By JIM CARR

NYSAFRAJuly 28, 2023 — I recently attended the New York State Alliance for Retired Americans (NYSARA) Board Meeting and Biennial Election Convention alongside Director of Retiree Services Karen Danish and retiree representatives from PEF Regions 8 and 12. The NYSARA, the New York chapter of the National Alliance for Retired Americans, advocates for seniors and to maintain the Social Safety Net. 

Some Facts About Those Over 50 Years Old, Nationally and in New York 

At the meeting, the night before our biennial election convention, Greg Olsen, Acting Director of the NYS Office for the Aging, made a presentation on the true worth of seniors in New York state and across the nation. He made many factual points about our contributions to society and the economy, as referenced below. 

Adults over the age of 50 make a significant contribution to our economy and to our national and state survival. Eighty-three percent of U.S. household wealth is held by people over the age of 50. Seniors should be strongly considered as politicians make decisions on budget and programs. 

Access to credit and assets allows the group to spend more on goods, services and investments than their younger counterparts. When added together, approximately $1.8 trillion in federal, state and local taxes were attributable to the longevity economy in 2018 and that is expected to quadruple by 2050. 

About 43% of federal tax revenue ($1.4 trillion) and 37% of state and local tax revenue collected in the U.S. ($650 billion) is raised from people older than 50. Americans over the age of 50 also spend more overall than under 50-year-old Americans. This accounts for a majority of the spending in several categories of goods and services, including; 

    • Health care
    • Nondurable goods 
    • Durable goods, utilities 
    • Motor vehicles and parts 
    • Financial services 
    • Household goods  

The 50-plus group also accounts for the majority of: 

    • Volunteering 
    • Philanthropy 
    • Entrepreneurs 
    • Charitable donations 
    • Tourism 

Seniors facing medical bills 

The article “Fact: Many Older Adults Face Unpaid Medical Bills Despite Insurance Coverage,” by Julie Carter and our friends at Medicare Rights is worth a read. If you can’t access the link, I’ve copied the article below: 

This week, the Consumer Financial Protection Bureau (CFPB) Office for Older Americans released an issue spotlight on medical billing and collections showing that many older adults have unpaid medical bills and are in collections. This is despite most older adults having health insurance coverage, including Medicare and Medicaid. The findings reveal that these bills are often the result of improper and inaccurate billing. 

According to the CFPB data, most people aged 65 and older have health insurance (98%). But nearly four million had medical bills that they were unable to pay in full in 2020. The highest incidence (13%) was among those without insurance, and the lowest was for those with Medicare plus employer-sponsored coverage (4%). Over two-thirds of those with unpaid bills (70%) had coverage from more than one source such as Medicare, Medicaid, Medigap, employer-based coverage, or Tricare. 

While the incidence of unpaid bills is lower for older adults (7%) than younger ones (11%), probably due to near-universal Medicare coverage, the dollar amount unpaid is increasing. In 2019, older adults reported $44.8 billion in debt; in 2020, that number rose to $53.8 billion. Those with unpaid bills were more likely to be older adults of color, to be in poor health, to have other debts, or to have incomes between 100 and 200% of the federal poverty level. 

The CFPB flags inaccurate billing as one of the main drivers of unpaid bills, showing that older adults are more likely to have numerous chronic health needs, conditions that are billed at a higher intensity which require greater documentation, and to rely on coverage from multiple sources. This combination can lead to delays in payment, errors in who is billed for what services, and providers seeking inappropriate reimbursement from patients. 

People who are dually eligible for Medicare and Medicaid see disturbingly high levels of unpaid medical bills. Most dually eligible individuals should have little out-of-pocket exposure to medical costs, but they report both higher incidence of unpaid bills and higher dollar figures for the bills than their non-dual counterparts. CFPB notes that this suggests providers are billing beneficiaries for amounts they do not owe. 

Unpaid medical bills cause personal and financial stress, landing people in collections and having negative effects on credit ratings. Recently, the three major credit bureaus stopped reporting cleared medical debt, medical debt in collection below $500, or medical debt in collections for under one year. But this does not alleviate the stress of unpaid bills or eliminate collections activities. 

At Medicare Rights, we urge CFPB, Medicare, and policymakers to do more to protect everyone, including older adults and people with disabilities, from high out-of-pocket costs and inaccurate billing. We support limiting Medicare beneficiary spending, expanding financial assistance, educating providers about billing rules, and improving oversight of providers and insurance payers. Stronger guardrails are needed system-wide. 

Access to Health Care Improvements in the 2024 NYS Budget that Positively Impact Seniors 

There were a number of improvements to health care access in the state budget. Some highlights include: 

  • $419 million to improve Medicare beneficiaries’ access to preventive and primary care
  • $8 million to strengthen the EMS first responder system and $26 million to increase Medicaid reimbursement rates for medical transportation. 
  • $1 billion to create a stronger health care system for the future. 
  • $890 million for mental health housing expansion. 

Retirees should have received a mailing titled, “The Empire Plan Special Report” in May explaining the July 1 changes in their health insurance coverage. You should’ve also received a new insurance card in advance of July 1, 2023. Please take the time to read the May 2023 Special Report. It explains important changes in your plan.