Transcript The Effect of Health Reform on Retirement

The Effect of Health Reform on
Retirement
Presenter: Helen Levy, PhD
Coauthors: Tom Buchmueller, PhD
Sayeh Nikpay, PhD
University of Michigan
August 2015
Executive summary
• Many studies suggest health insurance affects
retirement.
• The Affordable Care Act (ACA) makes new
affordable health insurance options available for
early retirees, including – in some states –
Medicaid expansion.
• How has this affected retirement prior to age 65?
• We find no evidence that it has had any effect on
retirement.
The Affordable Care Act
• January 1, 2014 start date for new coverage
• Private health insurance expansion
– Exchanges/marketplaces (every state), individual
mandate, insurance market regulations, premium
tax credits (100 – 400% of poverty)
• Medicaid expansion
– Medicaid for individuals up to 138% of poverty
– Not available in all states (Supreme Court
decision)
ACA & retirement
• In 2015, 12 million covered through exchanges
and another 12 million new Medicaid enrollees
(US Department of Health and Human Services)
• These changes have reduced the fraction of
adults ages 18-64 who are uninsured from 20%
(2013) to 15% (2015) (Sommers et al., JAMA July 2015).
• Has the availability of these new health insurance
options led some older workers to work less,
either by retiring or by switching to part-time
work?
Our analysis
• We analyze trends in retirement and part-time
work among older workers both nationally
and in states that expanded Medicaid,
compared to those that did not.
• Data: Current Population Survey, basic
monthly data through June 2015
Did not expand Medicaid
Expanded Medicaid
201504
201501
201410
201407
201404
201401
201310
201307
201304
201301
201210
201207
201204
201201
201110
201107
201104
201101
201010
201007
201004
201001
200910
200907
200904
200901
200810
200807
200804
200801
200710
200707
200704
200701
200610
200607
200604
200601
200510
200507
200504
200501
Fraction of 55-64 year olds who are retired
Source: Basic monthly CPS, 2005 through 2014
0.25
1/1/2014
ACA coverage begins
0.20
0.15
0.10
0.05
0.00
Fraction of 55-64 year olds who are retired
Source: Basic monthly CPS, 2005 through 2014
0.25
1/1/2014
ACA coverage begins
0.20
0.15
We do not see any increase in
retirement in January 2014, overall
or in states that expanded Medicaid.
0.10
0.05
Did not expand Medicaid
Expanded Medicaid
201504
201501
201410
201407
201404
201401
201310
201307
201304
201301
201210
201207
201204
201201
201110
201107
201104
201101
201010
201007
201004
201001
200910
200907
200904
200901
200810
200807
200804
200801
200710
200707
200704
200701
200610
200607
200604
200601
200510
200507
200504
200501
0.00
Fraction of 55-64 year old workers who work <30 hours
Source: Basic monthly CPS, 2005 through 2015
0.16
1/1/2014
ACA coverage begins
0.14
0.12
0.10
0.08
Nor do we see any increase in part-time
work among older workers.
0.06
0.04
0.02
Did not expand Medicaid
Expanded Medicaid
201504
201501
201410
201407
201404
201401
201310
201307
201304
201301
201210
201207
201204
201201
201110
201107
201104
201101
201010
201007
201004
201001
200910
200907
200904
200901
200810
200807
200804
200801
200710
200707
200704
200701
200610
200607
200604
200601
200510
200507
200504
200501
0.00
Conclusions/next steps
• To recap: we do not find any increase in
retirement or part-time work among workers
ages 55 through 64 following the implementation
of the ACA coverage provisions in January 2014.
• Maybe it’s too soon?
• King v. Burwell ruling, June 2015
• We plan to look at transitions into retirement
using Health and Retirement Study data.
– These data also include health insurance information,
including availability of retiree coverage.
Backup slides start here
How have other outcomes changed?
Source: Sommers et al, “Changes in Self-reported Insurance Coverage, Access
to Care, and Health Under the Affordable Care Act,” JAMA, July 28, 2015.
Workers ages 55 to 64 by insurance status
Source: Health and Retirement Study, 2012
100%
90%
22%
80%
70%
17%
60%
0%
8%
50%
5%
41%
39%
18%
20%
42%
23%
7%
40%
1%
1%
30%
18%
16%
4%
2%
2%
5%
1%
18%
17%
18%
20%
42%
10%
4%
1%
9%
0%
< High School
= High School
Some college
Uninsured
Medicare and/or Medicaid
Nongroup insurance
Coverage from spouse's employer
Coverage from former employer
Coverage from own employer, WITH retiree option
Coverage from own employer, WITHOUT retiree option
College +