July 27, 2025 • 47 mins
There’s a lot of upheaval these days across Washington, as many federal agencies face significant cuts in staffing and programs, including the Social Security Administration. It’s not exactly clear what changes are going on inside the agency (the news seems to change by the week), but what IS clear is that many people are really anxious about the potential loss of their benefits and services—both near-term and in the coming years. Will Social Security be there for them when they need it? So today, we’re talking with Mark Miller, a nationally recognized expert on retirement planning and aging, who will spell out the many critical issues facing Social Security and Medicare today, and what the changes could mean for you. Mark is an awarded journalist, author, and podcaster who offers a holistic view of retirement security, including healthcare and Medicare, Social Security, and retirement investing. He writes frequently about retirement-related public policy issues, and his work appears at Reuters, The New York Times, Morningstar and WealthManagement.com; he also has a Substack newsletter and podcast on retirement. Mark’s latest book is Retirement Reboot: Common Sense Strategies for Getting Back on Track.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
the trust fund is being drawn down as the boomer age wave
(00:03):
accelerates and also due to a couple other factors.
But a lot of the reasons that trust fund has had a down and
is projected to be exhausted or depleted, currently the
projection is 2032.
Welcome everyone to 45 Forward.
I'm your host, Ron Roel.
Now there's a lot of people these days across Washington as many
(00:26):
federal agencies face significant cuts in staffing
and programs including the Social and Social and
Social Security Administration.
What's nothing that's clear is what changes are going on
suddenly, inside these agencies, the news seem to change
by the week, but what is clear is that many people are
really anxious about the potential loss of their benefits
and services, both near term and the upcoming years.
(00:46):
Will Social Security be there when they need it?
So today we're talking with Mark Miller, a nationally
recognized expert on retirement planning and aging,
who will spell out the many critical issues facing
Social Security and Medicare and Medicaid today,
and what they might mean for us.
Mark is an awarded journalist, author and podcast,
who offers a holistic view of retirement security.
He writes frequently about retirement-related public policy issues
(01:09):
and as work appears in many venues including
Reuters, the New York Times, Morningstar, and wealthmanagementcut.com.
He also has a Stubstack newsletter, podcast and retirement,
and he has a terrific book, Retirement Reboot, Common Sense
Strategies for Getting Back on Track.
There's a lot to talk about, so let's get on and
meet our guest, Mark Miller.
Mark, welcome to the show.
(01:29):
Hi, Ron, good to see you again.
Yeah, you've been on a couple of times,
and every time you have really great things to say
and update our audience.
So before we actually get into some of the topics,
there's a lot, as I mentioned, just tell me a little bit
about yourself.
People can read all about your biography.
I'm interested because like you on business journalists
and I sort of move toward retirement issues.
So what moved you to cover retirement and aging issues?
(01:52):
Well, as you mentioned, I came out of a background
covering business at financial news for many years.
I hear in the Chicago area for newspapers and magazines
and actually started a magazine for the tripping company
back around 2003, I think it was, about around topics
for they retire about it.
That only lasted a couple of years,
but it sort of wet my appetite for more in the area.
(02:15):
And that's when I went off and started a career as a freelancer
covering the space in the name ever since.
17, 18 years now on the speed.
I don't know.
There's a lot to cover, there's a lot of evolution.
I think people, well, certainly with the increasing longevity,
people realize that it's an important issue.
Lots of opportunities and challenges,
but lots of things and people need to think about to plan ahead.
Yeah, I just felt like it was a really critically important area
(02:38):
and one that was going to be a lot of growth in terms of interest
as the country got older.
You look at these sort of,
any life transitional topic is one where there's an information date
and this is certainly one.
Yeah, absolutely.
Yeah.
So there has been a lot of media coverage of the Trump administration
and DOGE's slash of employees and agencies,
including Social Security.
So before we talk about, you know,
(03:01):
you know, what's going on to accept them, we know,
tell us our audience about who wise is so important.
You know, what is it about Social Security especially?
But all these sorts of social insurance programs?
Yeah, this is in on my mind,
Social Security turns 90 in August this year.
Right.
It was passed in the August 14th, 1935.
So I've been doing some research for an article on this topic.
(03:22):
Yeah, you know, it is really so security.
It's a passage kind of ushered in the era of retire,
moderate era of retirement as we know it today.
In other words, a time where one could be,
you know, independent from work, you know,
and all the rage.
It wasn't really a concept before that there was a financial means
to do it.
There was no such thing as a pension or certainly a 401(k)
(03:46):
and none of that existed at the time.
Right.
You know, it was born out of a great depression at the time
that so I was here to his past in the law and signed by FDR.
40% for more of seniors were living in poverty in the United States.
It's that there was a human in cry to do something about it.
And you know, a handful of states had started various sorts of old age
(04:07):
pension programs or in some cases unemployment insurance programs,
which was sort of the, you know, the precursors to social insurance.
You know, by this phrase we mean programs where people pay in via tax
and do a collective risk pool and are able to draw a benefit based on participation.
So, so security is really ushered in the year of social insurance in the United States
(04:30):
followed later in the 1960s by the passage of Medicare.
So, you know, it's it's the one universal retirement program
that we have almost all Americans participate in it.
Participation is automatic.
And, you know, the distribution of benefits is merely universal.
So, you know, what I've found over the years is covering a lot of different topics
(04:52):
for a Jewish higherment that, you know, nothing gets interest quite as much
from reader as quite as much as Social Security and Medicare.
Yeah, and I think people are generally aware.
They know it's important, but I don't think they're aware of just how important
in terms of keeping people out of poverty and poor things, especially to women who live longer
(05:12):
than often whose benefits are interrupted by leaving and coming taking care of family.
So, it's also it's the fact that it's a guaranteed income source.
So, if your workers are receiving defined benefit pensions these days,
then the path.
So, although they're still quite prevalent in the public sector,
less so in the private sector, and people ask from time to time,
(05:33):
well, how much do I need to save from retirement?
It's a difficult question to answer unless you call on your lip.
But if you have a pension style of benefit, such as provided by Social Security,
which is also inflation adjusted, you know, this is a very different thing,
you know, it's going to be there as long as you live.
So, this is a really critical component of it.
And for people who are sort of middle income and lower income,
(05:57):
Social Security is usually the majority of their retirement income.
Plus, you know, it provides insurance in the event of a disability,
survivor insurance paid to widows and children.
So, you know, it's a form of insurance, really.
That is absolutely critical and so valuable.
Yeah, I think that your point about the universality of a two is important.
And then everyone participates.
(06:17):
It's not sort of a handout.
People participate.
They contribute to it, you know, it's people talk about,
well, you weren't it, you know, yeah, yeah, yeah, yeah.
And it's so, as you said, it's an important piece of retirement planning.
You cover, you know, broadly retirement planning.
So, I mean, you talk about Social Security, Medicare,
long-term care planning.
What can it do a little bit of that later on about, you know,
(06:38):
how this fits into the overall picture?
So, let's look at the system today.
Now, people are, you know, concerned about it.
As I mentioned in my intro, I think sometimes it's difficult to see exactly what's happening.
But from your perspective, what is it that you know about what's happening
to the potential benefits and what people can do about it?
(06:59):
Well, Social Security is facing a financial challenge.
And that the trust fund that, I think of the Social Security Trust Fund
as sort of the checking account for the program, you know, payroll taxes go into it
and benefits are paid out of it.
And since the night we've been building up very large surpluses
in that checking account as a result of the reforms that were passed in 1983.
(07:23):
And that was done in part in anticipation of the retirement age way
that would be coming as the large babies of her generation get retired.
And we're now in a recent point where the trust fund is being drawn down
as the boomer age way of it celebrates.
And also due to a couple other factors, income inequality actually is one reason
for the shrinking of the trust fund because a greater share of the wage-based
(07:49):
in the United States is above the cap on payroll taxes that are collected.
So, it escapes the payroll tax, if you will.
And then, to another factor is declining fertility rates in the United States,
which means lower birth rates means translates into fewer workers,
a ratio of workers paying versus people taking out.
So for a lot of reasons, that trust fund is headed down and is projected
(08:14):
to be exhausted or depleted currently the projection is 2033.
So, a lot of people mistakenly think that that, that sounds like,
oh, that means there won't be a benefit when we reached that point.
But what it means is that there would only be sufficient revenue coming in
from current taxes to pay about 77% of benefits.
(08:35):
So, that would be quite a cut.
It's an across-the-board cut to all current and future workers,
retiree, excuse me.
So, that would be a catastrophic doubt that I'm particularly
for people who are heavily reliant on so-scootive benefits.
So, something needs to be done about that.
That's been debated for, it's not a new development,
because we've known it's coming quite a while,
in something that's going to be done to address it.
(08:56):
Yeah, we can talk about some of those solutions in a bit,
and unfortunately, a lot of people project that Congress is not
going to do anything until 2032.
It's one of those things where they just pressed till the very end.
But, shorter term, I think people are worried about their benefits.
I guess there's been a lot of talk about longer wait lines.
(09:16):
People not getting calls backs and so forth.
What do you hear?
What is the short-term impact of just some of the staffing cuts
that we talk about?
All of its closures, not clearly that's really happening.
But, there may be some short-term things in what people can do
to make sure that they're on top of what their benefits.
(09:36):
Well, if you're already receiving so security,
there is not a reason to be concerned
that that'll be interrupted, I don't think.
The issue here is that there's been a customer service problem
at so security for many years.
It's not a brand new development.
Congress has starved the so security administration
of the budget that needs to operate.
It's on an inflation-adjusted basis, the budget's down,
(09:59):
25% of their time when the workload has been rising.
So, that was already creating problems in terms of their ability
to keep up in terms of the workforce.
And then, with the advent of the Trump administration
and the Elon Musk-driven, Elon Musk-driven,
go-on initiative, there have been additional slashing of the staff.
(10:20):
It's really, they've lost a lot of talent.
Whole layers of management,
and in reshuffling the debt in terms of reassigning of employees.
IT staff has left and drove.
So, there are lots of reasons to be worried about
about what's going on.
There are all kinds of full starts on new procedures
that we force people to go through in terms of
(10:43):
identifying, providing identification and approval
with AR to file for benefits.
And for a couple of months there,
it was extremely difficult to say on top of what is going on there.
And there's still been reason to be very worried about
the agency's ability to meet the needs of the problem.
Yeah, there are things that people can do to,
(11:04):
I think one of the things that our previous conversation
pension is that as we made these shifts,
I mean, some of the things that we're not sure
how they play out, I mean, I guess they're an overall hall,
some of the old software,
but fairly quickly,
whether they can actually instant these changes
in a way that doesn't disrupt things is not clear.
But that's one issue.
But then I also, you've talked me before about
(11:25):
the importance of online connection to Social Security.
Well, everybody should set up their online account
at the, as I say, that gov website.
That's probably the fastest and easiest way
to transact business at the Social Security Administration.
So I would definitely recommend that.
Beyond that, it's worth knowing
that you need appointments at field offices these days.
(11:46):
And it's probably not a strategy.
And if you need to transact business with them on the phone,
you should expect long wait times.
And I would say with applications for new benefits,
whether it's Social Security or Medicare,
or Social Security processes, Medicare applications,
now I would get those applications started,
at least several months,
and of the date that you need the benefit to start.
Yeah, and I think we mentioned that one of the backlogs,
(12:09):
serious backlogs is in disability benefits, is that right?
It is, yes.
You know, anywhere from 48 months waiting time
on initial applications,
that's been a long-running problem as well.
It's getting worse.
Yeah, so Mark, we love on it talking about,
but we're going to take a quick break,
but folks will be coming right back,
we'll be talking much more than Mark Miller,
so don't go anywhere.
(12:30):
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All right, welcome back folks to 45 Forward.
We're talking today about Social Security and Medicare
with Mark Miller, a nationally recognized expert in aging.
His latest book is Retirement Reboot.
(13:12):
I'm in Send Strategies for Getting Back Untracked.
So before the break, we are talking about some of the issues
of disruption and importance of keeping track of your account online.
So let's talk about some of the longer-term issues
that people do worry about.
I know that you're just a discussion with people.
And in general coverage, a lot of young people are worried
that the misdome is going broke,
(13:35):
and it's not going broke.
But let's talk a little bit more.
You mentioned the trust fund,
and let's talk a little bit more about,
basically, so that benefits will just basically diminish
if we don't do something to fix it.
So what are some of the things that are being discussed
about the solve of the problem?
I mean, there's a couple of ways to write the ship here.
You can either cut benefits, you can increase revenue,
(13:56):
you can do some combination of the two.
And it's worth noting that Social Security is a self-denounced program.
You know, it's entirely reliant on revenue from the payroll tax.
And so one of the myths out there about Social Security
here is that it's somehow a driver of the deficits, the federal debt.
(14:16):
Well, that actually doesn't make sense
because if Social Security were able to actually borrow money
from other parts of the government,
we wouldn't be facing this potential clip in 2033.
The reason for the clip is that Social Security cannot buy law,
borrow money.
You can either, as I was saying, you can cut benefits,
(14:41):
you can raise the payroll tax, right?
You could come up with new sources of taxes for people
who have proposed a Wall Street tax or a wealth tax
as a way to shore up the system.
But as we get closer and closer to that 2033 day,
the math limit doesn't work for doing it with benefit cuts
(15:01):
because it takes too long for those cuts to phase in
in a way that is meaningful for avoiding the solve and speed problem.
So that coupled with sort of the state of affairs and Congress
with the degree of polarization and dysfunction there,
a lot of people are thinking that we may get right up to that point
and need some kind of a short term, hopefully short term,
(15:24):
kind of a emergency solution, which might be in the form of an injection
of general revenue into the program.
Nobody I talked to thinks that we're going to reach 2033
and in fact have a 203% kind of benefits.
It seems hard to imagine that any member of Congress is going to allow that
to happen and have, you know,
(15:45):
constantly going back to face the voters.
Right. So, you know, there is the possibility of an injection of general revenue
into the program while a longer term solution is worked on.
But what's interesting there is it would mean that so it's
pretty wouldn't, in a fact, be borrowing to make benefit payments at that point
because we're in a deficit spending mode already as a country.
That's, you know, most of the, you know, the possible scenarios, I think.
(16:09):
Yeah. Yeah. I mean, people talk about, you know,
raising their time and age, but as you pointed out in your articles that
that's already been done one and that really is a benefit cut because
basically shortening, you know, the retirement benefits of people going forward.
Well, and you're basically raising the bar, the age at which you qualify
for 100% of your benefit.
(16:31):
So, and as I say, it's, it's kind of too late to do that in a way that would meaningfully
impact the solvency problem. And on top of all that, I think,
you know, raising the retirement age is not an equitable solution in the sense that,
you know, while the US has experienced gains in longevity,
the gains are not evenly distributed.
(16:51):
You know, the gains in longevity have really gone mainly
to higher income, better educated people. And so, you know,
when you talk about raising the retirement age for people who are not
living quite as long, that's an inacquitable approach, I believe.
Yeah, and there are certain jobs in which that's not really practical. I mean, not, you know,
that's white collar jobs, difficult manual labor jobs, is not really fair to that.
(17:15):
Right. Yeah. It's an interesting thing is that public
survey polling is repeatedly shown that the public prefers
new revenue as opposed to benefit cuts. And that's across the board.
It crosses all political and demographic lines, which is pretty rare these days.
So it kind of comes down to, you know, whether Congress is going to do what the public wants it to do
(17:37):
or not. Yeah, it seems to me that is an effect of, I mean, it's like, okay, raising the tap
of, you know, collecting revenue, it's like, okay, among that higher demographic, so they,
are they going to miss it as much as the lower sector? I mean, it seems to me that if you're
going to make a fix in the system, that that's, you know, an appropriate way to do it. Of course,
it's politically difficult when you have high income political donors. But now, do you see also,
(18:03):
I mean, younger people getting involved, it seems to me that they're, I've been noticing that,
you know, they're like getting engaged, they realize what the implications may be for themselves
and for their parents. Well, more generally, I think you've been at the case in all of that.
I think on this issue, when I notice a lot of skepticism among younger people, then they're going to,
(18:23):
they're so secure, it's going to be there for them. I think it's been so much negative spin and
hype on this that, you know, and just mistrust of government in general. And, you know, I think the
degree of worry and skepticism among younger people is quite high. You know, I wrote about that
for the New York Times last year and it was interesting to see just how progress it is. Yeah, I think
that, you know, a few months ago, I was involved with them just talking about Social Security on
(18:49):
college camp, a local college campus with ARP. And I think that, you know, some college students
stopped by and they were talking about it and it was like, well, if there are diminished returns
on Social Security for your parents, guess who's going to pick up the slack? You.
Well, you know, the benefit cuts that were enacted in 1983 already fall on
(19:09):
today's young people because it gradually phased in a higher retirement age from age 65,
up to age 67 for everybody born after 1960 and that implies an average about 18%
high benefits. So that's already in place. And, you know, I think it's an argument against
(19:29):
making further changes in the retirement age. Yeah. And now I also have seen, perhaps you
wrote about this as well, that there has been a surge in people also at closer to retirement age,
you know, applying early, just, you know, that anxiety, well, starting, you know, applying at 62.
Yeah, there has been a bit of an uptick in people applying early as a result of all the negative news
(19:51):
about the Social Security Administration this year, which is unfortunate. Yeah, it's, I don't think
it's fair to say it's been a massive upturn. It's been something that's been, you know, been
noticeable. One thing that's going on in Social Security Mission right now is if there's been a,
basically shutting off the valve of how they release a data of all kinds about the program,
by the SSA. So there's a lot less transparency over the last couple of months about what's
(20:14):
actually going on there, which is very concerning. Yeah, I'm not sure what you can do about that.
No, there are, I suppose you could raise your voice about it. Well, the SSA says that they're revamping
all their reporting systems, but, you know, well, I think it remains to be seen whether that
is the case or whether they're just trying to kind of draw the shade now and what they're up to there.
Again, it's sort of hard to tell what's going on, but, you know, and there's been talk about,
(20:37):
you know, access to Social Security data, you were much about what the potential impact would be of
that. Well, it means that, you know, analysts who are trying to track what's going on there are
having more trouble in discerning what's happening there. Okay. Well, I think one of my
conversations with you, actually listening to one of your previous webinars, I think one of the
things you talked about is that, you know, people should just speak up, you know, you said,
(20:59):
what can you do? Let your lawmakers know what you want. Right. I think, you know, there's a problem
with people sort of possibly watching and treating this as a spectator game where, you know, it's very
important to let people know. And legislators know what you want. Yeah. Yeah. Good. Okay. So we're going
to take another quick break. Well, we write back talking much more than Mark Miller,
(21:20):
Social Security expert, a nationally recognized expert on aging and retirement issues and he's
latest terrific book is called Retirement Reboot. A common sense strategies for getting back
on track. So don't go away. We'll be right back. Do you like what you're hearing? Well, we've got
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(21:46):
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(22:06):
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That's 45forward.org. Check it out and keep moving forward. 40.
Welcome back folks. Once again, we're talking today with aging and retirement ex-Mark Miller about
Social Security. And now we're going to shift a little bit to Medicare and Medicaid, specifically
(22:30):
about the reconciliation act that's in in volume, comments now and what the implications might be
for is social insurance and programs for older folks. So let's talk about that because it's
all right. It will write happening right now on a discussion about it. So what are your thoughts?
Right. And then you have the bills being debated in Congress as we are taping this. One interesting
(22:52):
thing in this bill is that it could actually hasten that Social Security trust fund insolvency
date by a year or two, mainly by reducing the amount of revenue collected from the income tax
on Social Security benefits, which is deposited to the trust fund. It would do that by the
(23:14):
Senate version of the bill increases the standard adoption dramatically, which in turn would reduce
the number of seniors paying taxes on that. But so, good news here for anybody who's paying
tax on the benefits as you're going to get some tax relief. But some analysis suggests that it could
bring that day even closer, which is certainly concerning. On the Medicaid side of things,
(23:36):
the big impact here would be on low income seniors, people who are eligible for both Medicaid
and Medicare. So this is the so-called dual eligible population, which is about one-fifth of all
Medicare beneficiaries. And they account for a disproportionate share Medicaid spending. But this
is the older part of the Medicaid population that tends to have greater healthcare needs. So that's,
(23:59):
you know, this is the group that is likely to see some impacts as states are facing significant
budget reductions out of this bill. And it's concerned that they'll respond by cutting out various
optional benefits, cutting payments to healthcare providers, limiting service availability. You know,
so this couldn't kind of create a domino effect that undermines health access for the most vulnerable
(24:21):
people on Medicare. And these work requirements that are in the bill would have a devastating impact
on disabled and elderly people. And a lot of studies have shown that the work requirements don't
really boost employment levels anyway. But so there's a lot of those kind of disastrous implications,
I think, scrolled or adults, particularly low income adults in the Medicaid side. When you look
(24:42):
at Medicare, there's a sort of a grab bag of provisions in Medicare. I wouldn't say that the Medicare
provisions in the bill are the big headline here, but nonetheless, there are some things. One,
again, talking about lower income seniors being impacted on the Medicare savings program. This is a
program that runs state-by-state health, lower income people pay to part B premiums. And there was
(25:06):
a rule put in place in the last year to buy an administration that was going to simplify and make
it easier for people to enroll in those programs. And there are rules being pushed back roughly 10 years.
So basically, put on ice. There are restrictions, new restrictions on eligibility for Medicare,
restricting it to only people who are U.S. citizens and green card holders. So this is part of the
(25:29):
holy integration crackdown. So eliminating eligibility for people with temporary protected status,
asylum seekers and refugees. The bill has a justice to payment-raised positions. Another
provision I think is interesting is it delays implementation of a new rule that places minima
(25:49):
staffing requirements on nursing homes. So it's an effort to try to boost staff at levels in
nursing homes and that's been delayed. And then, last thing I can mention about Medicare,
kind of interesting, for people who use health savings accounts while they're working,
there's a need to stop contributing to those when you enroll in Medicare Part A.
(26:09):
And this legislation proposed changing that so that people who are enrolled in Part A could continue
contributing to health savings accounts. So it kind of when eliminating what's been kind of a
complicated wrinkle in the NHSAs for people. That's kind of a quick wheel through everything in this bill
on those three topics. Yeah. Now, I know before all this legislation moved forward,
(26:35):
it seemed like there were some advances in Medicare, Medicare coverage, right? I mean,
that there are, are there some positive things that look forward to in terms of Medicare coverage?
Well, the big thing that was implemented this year was the new $2,000 cap on total lot of pockets
spending in Part D, right? The prescription drug program. So that's in place. This legislation
(26:57):
doesn't touch that. Okay. One thing that I'm kind of keeping an eye on, however, is that
one of the things that the Biden administration did for this first year of the new cap was put in place
essentially a mechanism to incent insurance companies to limit the size of premium increases.
(27:19):
The concern here is that because of the strengthening of the insurance with that $2,000 cap,
that insurers would increase premiums quite a bit. So this program that was put in place basically
capped premium increases at $3, to no more than $35. And that's a lot of listeners may have noticed
(27:44):
increases in their premiums of $35 this year. That's the reason for that. There's a question
as to whether that subsidy will continue next year. We don't know yet. If it does, then you know,
you can expect some stability and premiums. If it's not continued, it could create some
havoc in the Part D number enrollment for 2026. I always encourage people to keep an eye on,
(28:09):
they're plans when the new data is released in the fall. Everybody gets to notice
usually in September about what the coming year will look like. You really pay attention to that.
A lot of people don't bother to reach out to their coverage from your year.
In Part D and also in Medicare Advantage, it's really important to do that because these plans
(28:34):
can change from year to year. You know, drug coverage can change. Premiums can change.
A lot of pocket limits can change. So very important to do that and to
if a plan is no longer a good fit for you, you should definitely reshop it during the fall enrollment period.
I know you've written about the Medicare, traditional Medicare Advantage. Do you see any trends in that's
(28:55):
respect? Well Medicare Advantage is now over half of all Medicare enroll. Oh really?
And so that's really remarkable. And well documented issues in Medicare Advantage with Medicare
Advantage basically is managed care. All the things that are attendant to managed care,
you know, the red tape hassles associated with either genitals of care, prior authorizations,
(29:21):
you know, networks of healthcare providers, you know, he's a provider in network, out of network.
You know, there are some discussions about trying to reform that program. And, you know, I think the,
you know, the progress on that's been quite limited so far. There's also an issue with overpayments
in these programs that can be well documented. I think there's a growing interest in perhaps rainy
(29:44):
and those overpayments, but the politics around that are extremely difficult. Yeah. Yeah. So I mean,
this whole movement of, you know, waste fraud and abuse, I mean, it seems to me that a lot is made of
that, but talk a little about, you know, what the, the real, the facts are about.
Okay. That simple. That simple. Okay. Okay. So now within the age of, I mean, yeah, it seems like.
(30:08):
Is there fraud in Medicare? Yes. It's, you know, I think it's been documented that it's
relatively small as a percentage of total activity in the program, but the numbers seem large because
it's such a massive program, right? And of course, it should be combated and eliminated if at all possible.
But, you know, the, a lot of what's going on in social insurance these days goes on under the cover of,
(30:31):
we're not trying to really cut benefits for anybody that deserves that quote unquote. We're just
trying to cut waste fraud or abuse. And, you know, over and over again, it's been demonstrated that
the total amounts of that going on are relatively small. Yeah. And it's not within the agencies themselves.
It's on the outside. People scamming the system. For the fraud and the system to be fair. Right.
Thank you for that clarification. Yeah. And I think that, so I mean, it's a little counterintuitive
(30:54):
that we're, you know, cracking down on these inspectors general and these are agencies.
Cliring them all. Yeah. Yeah. So let's see. So let's shift a little bit to,
some of your broader perspectives on, you know, how this fits into retirement and long term,
you know, care planning. Because I think that that's something you read about, you've read about and
people don't think enough about it. So let's talk about how this fits into, you know, long-term
(31:19):
care in a broad sense as it fits into retirement planning. Well, I think a lot of people think that
Medicare will cover long-term care and it really does. And it covers a very short period of
school nursing care following a hospitalization that doesn't cover sort of the more routine
help with daily living needs that people might have. The problem with long-term care is it's a hard
(31:43):
risk to really think about. It's hard for people to really conceive that they may need something
like this and really do assess the risk is not easy. And we don't have very good mechanisms for
planning for it. I mean, the private, long-term care insurance market is largely dysfunctional. It's
strong quite a bit. It was never very often to start with. And we don't really have a social
(32:06):
insurance mechanism to deal with it. So all that's going on and at the same time, cost of care
are really jumping at a lot of the rates of the studies that are done show that the cost of the
price of most long-term care services is been jumping double and triple the rate of inflation in
recent years. And this is getting exacerbated by kind of this almost perfect storm of
(32:28):
colliding of supply and demand. You know, the time is getting older, the number of people, I mean,
either services is rising. And we are facing constraints on the supply side, both because
we don't pay enough to long-term care workers. The jobs are not regarded as good jobs, they don't
pay enough. And then the immigration crackdown that's going on is going to constrict the availability
(32:49):
of labor in that market as well in certain parts of the country as well. So I think there's good
reason to be very concerned about the future of long-term care. And the other piece of long-term
care is that I'm more affluent people can afford to self-funded if you can save enough to,
you know, to know that you're going to have money to pay for it. Or if you have high
so security benefits that can also help meet a long-term care need. And I often make the point that
(33:18):
delaying a so security claim as long as possible is one good way to help ensure you're in that risk.
You know, you're generating a higher monthly benefit that again, it's a question adjusted every
every years. You know, those are a couple ways to think about it. But, you know, I think it's an area
of some legitimate concern or worry. I've long felt that a smart approach to this would be kind
(33:43):
of a hybrid public and private approach. You have a social insurance component and everybody
participates in to provide sort of a base level of services and care. And then if people want to add
on to that with supplemental policies, you know, I think that could work. And I think that even
in the commercial insurance space, I think there was increasing recognition of that would be a
(34:07):
sensible approach. And I think, you know, a restructuring of the risk profile so that, you know,
you knew the government would take a piece of it and the commercial side would take a piece so
that would certainly be one way of dealing with that. You know, a couple of states have
gotten into this and trying to launch solutions at the state level. Yeah.
I should say being in this prominent example that they launched a state
(34:33):
program there and they're looking to add a this supplemental commercial marketplace component
sometime soon. But, you know, it's an area of concern. I think it's probably the biggest sort of
gaping hole in the, you know, in the, in the, in the, the, the, the, the system we have for
ensuring against risk and retirement. Yeah. I agree. I mean, it's, it's a really, it's a patchwork
(34:54):
system. It's, um, it really exacerbates, you know, the income gaps between the top and the bottom.
Yeah. And the only thing worth mentioning here is the Medicaid is the single largest
insurer of long term care, we're over half of all large and care is paid out of Medicaid.
Medicaid, I said Medicare, I meant to say, yeah, excuse me. Medicaid is the
primary and the biggest source of insurance, uh, long term care. And with these pots that
(35:18):
are going on and this budget reconciliation zone, it was really good reason to be worried about
the impact that that's going to have in the nursing home sector and on the long term care sector.
Also for Medicaid patients, it also will probably lead to further increases in, uh,
private air costs. So that's a great concern at this point as well.
(35:40):
Well, Medicaid situation. People qualify, sometimes qualify for Medicaid by spending
down. Qualify for Medicaid, you have to have very low, uh, levels of income and assets that,
you know, the rules vary from state to state. If I, that is one thing that happens is that
people go into long term care, that exhausting resources and then they go on to Medicaid.
(36:02):
Right. So we'll talk more about that because I want to talk more about in that in our last segment
and then some of your broader thoughts about how this all works with your retirement planning
and rebooting when necessary. So, hopefully one more segment I'm looking forward to talking
much more in our last segment with Mark Miller, the author of retirement reboot, come and send
(36:22):
strategies for getting back on track. So don't go anywhere. We'll be right back.
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(36:44):
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(37:10):
you need is just a click away. Well, come back to 45 forward once again we're talking with aging
retirement expert Mark Miller. And for the break we were talking about long-term care issues and
planning. So this is a big area that you mentioned Mark and I think that there's, I mentioned earlier,
we have a sort of a patchwork system and I think it really is a problem because this is something
(37:30):
that you know at least the statistics show that you know two-thirds of people are going to face some
sort of long-term care issue. You know as they get older. The problem is that it we're not sure what
kinds and so it seemed to me that what you're suggesting in terms of a you know a hybrid system so
public and private would make sense because you need to cover lots of situations and offer lots of
different options. And the problem with that solution is that it requires a tax increase. You'd have
(37:55):
to create a probably a payroll tax levity to support it. And so that's really tough to do
politically with we have one political party that absolutely refuses to raise taxes in time.
You mentioned this in issue that affects two-thirds of people and that's sort of reflects the general
landscape of retirement security. Roughly two-thirds of households getting close to retire that
(38:17):
probably not financially ready for it for a whole variety of reasons which is really the theme of
the book that I wrote a couple years ago. You know it's part of a bigger picture of inadequate
retirement preparation that yet I think reflats a number of things I think it reflects the stagnation.
(38:37):
It is really reflect what's been going on in the US economy over the last few decades
or than anything else. I don't say lack of preparedness as a way to point the finger quite the opposite.
And I think it's reflective of stagnation and wage growth. It's I did some some number crunching
for the book and the person approaching, person approaching retirement now has lived and worked
(39:00):
through several major economic downturns during the course of their career that often puts people
out of work for years at a time. You know you even get back to work you don't necessarily recover
the losses from that. And we think about the great recession that occurred not only to people
who lose jobs sometimes people lost their homes. So there was a lot of long-term economic damage
(39:26):
that explains I think a lot of what people are dealing with as they get close to retirement. So
the book was a time to start to explore you know what are sort of late in the game strategies and
things people can do. So yeah talking about the rebooting I mean other things know as I mean
the economy and our lifestyles have changed that we need to kind of shift in our retirement
(39:46):
planning thinking? Well you know I go through a list of really a menu of options that people can
think about everything from you know working longer and you know what I say working longer you hear
people sometimes say well I'll never retire right? I'll never be able to retire I'll have to work
forever. And that's you know that what I necessarily mean when I say that you know even working
(40:08):
a few years longer can be a really important lever for proving retirement outcomes because it
can enable a later-souce security filing and the higher benefits that higher monthly
or annual benefits that come with that can be an opportunity to say for retirement later in later
life and it can be in more years well it means fewer net years living off of retirement savings
(40:32):
and more living off of wages as well as more years on hopes on employer subsidized health insurance
you know for any number of reasons working longer can be a really important lever.
Lakes oh security filing for many people makes a lot of sense and again when I say that I
putt sometimes what people here is oh yeah I should wait till 70 and that's great you know if you can
(40:56):
do that but even waiting a little bit past a couple years past full retirement age or not filing
early is beneficial in most cases you know it's it's a there is not a one-size-fits-all solution here
I don't mean to suggest that I think there can be is a highly personal decision that depends a lot
on your personal circumstances there can be good reasons to claim early you know for example if you're
(41:22):
out of work and just you know need the money very badly or you're not in good health don't have
expectation of great longevity particularly for married couples or people with good reason to think
they have a chance to live long you know delaying your claim can be a very big strategy is it one
economist once said to me about this it's it's better to plan to live that to not to die right so
(41:43):
you know these are some of the things that explore in the book careful examination of your spending
you know I think a lot of times the focus is on income and savings not enough on you know scrubbing
the budget that things you might want to consider doing to bring your expenses in line is downsizing
part of the picture tapping home equity in some cases you know it's kind of a holistic look
(42:04):
and ways to get back country you know saving you know even with the I have a chapter on saving for
retirement and looking at the impact of even getting a late start it can be meaningful yeah yeah
so where can people get the book well it's available on the usual spots and if you visit my website
you can learn more about it the retirement revise.com is this is my website and there's
(42:27):
information about the book there right and other things people should know about I mean I you've got
yeah I do the newsletter these days I'm running from the New York Times in occasion like
your morning star I have sort of reciprocated in my own life where I'm scaling back a little bit
on all that I wouldn't say retired but to take my foot off the gas pedal just a little bit but
(42:48):
they still find my work in the New York Times and if you want to follow what I'm doing easiest way
if you go to that website just my intention is you can sign up for I do a really newsletter there
that comes out probably two to two times a month right I include their links to my latest articles
as well as links to work by other journalists that I found interesting links to studying links to
(43:08):
online webinars and things that I've run across that I think are worth casting a lot yeah yeah
could that say yeah good good have people want to contact you just go to the website and you know
retirement revise.com and send you an email okay yeah um I know you mentioned that people do get a
lot and you get a lot of information in social security are there have you noticed any sort of
(43:31):
broad trends in terms of what what kinds of questions you get from readers anything.
Well I think right now the big thing is worry about so security okay which we talked about
earlier the program I think that's good far and away what we're seeing the most of which is very
unfortunate yeah yeah so security is really a crown jewel of American public policy and I think
(43:52):
it's a shame that it's being you know anyway it's receiving the three minutes receiving right now
yeah yeah we need to do about it we know other than are there places people can
basically advocate I mean other than going to their legislators and saying this is important to
listen I mean I do know that you know a lot of it legislators or they do track the phone calls
(44:14):
and letters and emails and so forth. I think that's very important that they're showing up in public
I have a section in the last chapter my book arguing for sort of revival of social insurance in
the United States in addition to advocating I think educate yourself oh it's important for people
to understand kind of the myths and realities and not fall for the political spin about so security
(44:37):
the language around so security the hearing the political arena can be quite kind of tricky actually
you know when the politician says we need to protect so security you need more detail on what they
mean by that they said you need to protect it for future generations you need to know what they mean
by that do they mean by protecting it by cutting benefits or do they mean something else and they
mean you know raising rather so you know it's important to educate yourself about the language
(45:01):
of social security and be able to you know push beyond that another I think trick in the book here is
when your politician is talking about let's let's create a commission and have a you know a
closed-door commission do arrive at solutions well that's just a way for them to get behind a closed
door and come up with something that they're not putting their their fingerprints on now I think
(45:24):
we need accountability we need the future of social security to bait it out in the open I think that's
terribly important yeah so those are some of the things I think people should be aware of good good
yeah I think that certainly from my journalistic background when you get questions about you know
protecting social security my my always response was could you be more specific yeah absolutely
(45:45):
yeah that was always a good heart could you could you give me an example of what you're talking about
and I think that that really presses the issue and forces that's specificity really or clarification
could you clarify with that I think that's important yeah all right tell me tell me more yeah
when mark this has been very enlightening and I appreciate it uh they always start broken
informative and uh I'm gonna have you back probably in the fall as we get into that's Medicare season
(46:10):
so I just want to thank you again once again let people know uh rhymingervies.com
and uh you're also I think you're on social media as well run Facebook probably you can kind
you know follow you there as well once again yeah absolutely absolutely oh once again folks
Ron Roel 45 forward thanks for spending this hour with me and Mark Miller any suggestions or comments
(46:35):
you can email me at Ron Roel at gmail.com and be sure to join me next time when I'll be talking
with Robin Lombardo and Andrea Padinha for an inside look at how a dynamic senior central works
today so until then folks keep moving forward 45 forward
(46:59):
you
[BLANK_AUDIO]
the trust fund is being drawn down as the boomer age wave
(00:03):
accelerates and also due to a couple other factors.
But a lot of the reasons that trust fund has had a down and
is projected to be exhausted or depleted, currently the
projection is 2032.
Welcome everyone to 45 Forward.
I'm your host, Ron Roel.
Now there's a lot of people these days across Washington as many
(00:26):
federal agencies face significant cuts in staffing
and programs including the Social and Social and
Social Security Administration.
What's nothing that's clear is what changes are going on
suddenly, inside these agencies, the news seem to change
by the week, but what is clear is that many people are
really anxious about the potential loss of their benefits
and services, both near term and the upcoming years.
(00:46):
Will Social Security be there when they need it?
So today we're talking with Mark Miller, a nationally
recognized expert on retirement planning and aging,
who will spell out the many critical issues facing
Social Security and Medicare and Medicaid today,
and what they might mean for us.
Mark is an awarded journalist, author and podcast,
who offers a holistic view of retirement security.
He writes frequently about retirement-related public policy issues
(01:09):
and as work appears in many venues including
Reuters, the New York Times, Morningstar, and wealthmanagementcut.com.
He also has a Stubstack newsletter, podcast and retirement,
and he has a terrific book, Retirement Reboot, Common Sense
Strategies for Getting Back on Track.
There's a lot to talk about, so let's get on and
meet our guest, Mark Miller.
Mark, welcome to the show.
(01:29):
Hi, Ron, good to see you again.
Yeah, you've been on a couple of times,
and every time you have really great things to say
and update our audience.
So before we actually get into some of the topics,
there's a lot, as I mentioned, just tell me a little bit
about yourself.
People can read all about your biography.
I'm interested because like you on business journalists
and I sort of move toward retirement issues.
So what moved you to cover retirement and aging issues?
(01:52):
Well, as you mentioned, I came out of a background
covering business at financial news for many years.
I hear in the Chicago area for newspapers and magazines
and actually started a magazine for the tripping company
back around 2003, I think it was, about around topics
for they retire about it.
That only lasted a couple of years,
but it sort of wet my appetite for more in the area.
(02:15):
And that's when I went off and started a career as a freelancer
covering the space in the name ever since.
17, 18 years now on the speed.
I don't know.
There's a lot to cover, there's a lot of evolution.
I think people, well, certainly with the increasing longevity,
people realize that it's an important issue.
Lots of opportunities and challenges,
but lots of things and people need to think about to plan ahead.
Yeah, I just felt like it was a really critically important area
(02:38):
and one that was going to be a lot of growth in terms of interest
as the country got older.
You look at these sort of,
any life transitional topic is one where there's an information date
and this is certainly one.
Yeah, absolutely.
Yeah.
So there has been a lot of media coverage of the Trump administration
and DOGE's slash of employees and agencies,
including Social Security.
So before we talk about, you know,
(03:01):
you know, what's going on to accept them, we know,
tell us our audience about who wise is so important.
You know, what is it about Social Security especially?
But all these sorts of social insurance programs?
Yeah, this is in on my mind,
Social Security turns 90 in August this year.
Right.
It was passed in the August 14th, 1935.
So I've been doing some research for an article on this topic.
(03:22):
Yeah, you know, it is really so security.
It's a passage kind of ushered in the era of retire,
moderate era of retirement as we know it today.
In other words, a time where one could be,
you know, independent from work, you know,
and all the rage.
It wasn't really a concept before that there was a financial means
to do it.
There was no such thing as a pension or certainly a 401(k)
(03:46):
and none of that existed at the time.
Right.
You know, it was born out of a great depression at the time
that so I was here to his past in the law and signed by FDR.
40% for more of seniors were living in poverty in the United States.
It's that there was a human in cry to do something about it.
And you know, a handful of states had started various sorts of old age
(04:07):
pension programs or in some cases unemployment insurance programs,
which was sort of the, you know, the precursors to social insurance.
You know, by this phrase we mean programs where people pay in via tax
and do a collective risk pool and are able to draw a benefit based on participation.
So, so security is really ushered in the year of social insurance in the United States
(04:30):
followed later in the 1960s by the passage of Medicare.
So, you know, it's it's the one universal retirement program
that we have almost all Americans participate in it.
Participation is automatic.
And, you know, the distribution of benefits is merely universal.
So, you know, what I've found over the years is covering a lot of different topics
(04:52):
for a Jewish higherment that, you know, nothing gets interest quite as much
from reader as quite as much as Social Security and Medicare.
Yeah, and I think people are generally aware.
They know it's important, but I don't think they're aware of just how important
in terms of keeping people out of poverty and poor things, especially to women who live longer
(05:12):
than often whose benefits are interrupted by leaving and coming taking care of family.
So, it's also it's the fact that it's a guaranteed income source.
So, if your workers are receiving defined benefit pensions these days,
then the path.
So, although they're still quite prevalent in the public sector,
less so in the private sector, and people ask from time to time,
(05:33):
well, how much do I need to save from retirement?
It's a difficult question to answer unless you call on your lip.
But if you have a pension style of benefit, such as provided by Social Security,
which is also inflation adjusted, you know, this is a very different thing,
you know, it's going to be there as long as you live.
So, this is a really critical component of it.
And for people who are sort of middle income and lower income,
(05:57):
Social Security is usually the majority of their retirement income.
Plus, you know, it provides insurance in the event of a disability,
survivor insurance paid to widows and children.
So, you know, it's a form of insurance, really.
That is absolutely critical and so valuable.
Yeah, I think that your point about the universality of a two is important.
And then everyone participates.
(06:17):
It's not sort of a handout.
People participate.
They contribute to it, you know, it's people talk about,
well, you weren't it, you know, yeah, yeah, yeah, yeah.
And it's so, as you said, it's an important piece of retirement planning.
You cover, you know, broadly retirement planning.
So, I mean, you talk about Social Security, Medicare,
long-term care planning.
What can it do a little bit of that later on about, you know,
(06:38):
how this fits into the overall picture?
So, let's look at the system today.
Now, people are, you know, concerned about it.
As I mentioned in my intro, I think sometimes it's difficult to see exactly what's happening.
But from your perspective, what is it that you know about what's happening
to the potential benefits and what people can do about it?
(06:59):
Well, Social Security is facing a financial challenge.
And that the trust fund that, I think of the Social Security Trust Fund
as sort of the checking account for the program, you know, payroll taxes go into it
and benefits are paid out of it.
And since the night we've been building up very large surpluses
in that checking account as a result of the reforms that were passed in 1983.
(07:23):
And that was done in part in anticipation of the retirement age way
that would be coming as the large babies of her generation get retired.
And we're now in a recent point where the trust fund is being drawn down
as the boomer age way of it celebrates.
And also due to a couple other factors, income inequality actually is one reason
for the shrinking of the trust fund because a greater share of the wage-based
(07:49):
in the United States is above the cap on payroll taxes that are collected.
So, it escapes the payroll tax, if you will.
And then, to another factor is declining fertility rates in the United States,
which means lower birth rates means translates into fewer workers,
a ratio of workers paying versus people taking out.
So for a lot of reasons, that trust fund is headed down and is projected
(08:14):
to be exhausted or depleted currently the projection is 2033.
So, a lot of people mistakenly think that that, that sounds like,
oh, that means there won't be a benefit when we reached that point.
But what it means is that there would only be sufficient revenue coming in
from current taxes to pay about 77% of benefits.
(08:35):
So, that would be quite a cut.
It's an across-the-board cut to all current and future workers,
retiree, excuse me.
So, that would be a catastrophic doubt that I'm particularly
for people who are heavily reliant on so-scootive benefits.
So, something needs to be done about that.
That's been debated for, it's not a new development,
because we've known it's coming quite a while,
in something that's going to be done to address it.
(08:56):
Yeah, we can talk about some of those solutions in a bit,
and unfortunately, a lot of people project that Congress is not
going to do anything until 2032.
It's one of those things where they just pressed till the very end.
But, shorter term, I think people are worried about their benefits.
I guess there's been a lot of talk about longer wait lines.
(09:16):
People not getting calls backs and so forth.
What do you hear?
What is the short-term impact of just some of the staffing cuts
that we talk about?
All of its closures, not clearly that's really happening.
But, there may be some short-term things in what people can do
to make sure that they're on top of what their benefits.
(09:36):
Well, if you're already receiving so security,
there is not a reason to be concerned
that that'll be interrupted, I don't think.
The issue here is that there's been a customer service problem
at so security for many years.
It's not a brand new development.
Congress has starved the so security administration
of the budget that needs to operate.
It's on an inflation-adjusted basis, the budget's down,
(09:59):
25% of their time when the workload has been rising.
So, that was already creating problems in terms of their ability
to keep up in terms of the workforce.
And then, with the advent of the Trump administration
and the Elon Musk-driven, Elon Musk-driven,
go-on initiative, there have been additional slashing of the staff.
(10:20):
It's really, they've lost a lot of talent.
Whole layers of management,
and in reshuffling the debt in terms of reassigning of employees.
IT staff has left and drove.
So, there are lots of reasons to be worried about
about what's going on.
There are all kinds of full starts on new procedures
that we force people to go through in terms of
(10:43):
identifying, providing identification and approval
with AR to file for benefits.
And for a couple of months there,
it was extremely difficult to say on top of what is going on there.
And there's still been reason to be very worried about
the agency's ability to meet the needs of the problem.
Yeah, there are things that people can do to,
(11:04):
I think one of the things that our previous conversation
pension is that as we made these shifts,
I mean, some of the things that we're not sure
how they play out, I mean, I guess they're an overall hall,
some of the old software,
but fairly quickly,
whether they can actually instant these changes
in a way that doesn't disrupt things is not clear.
But that's one issue.
But then I also, you've talked me before about
(11:25):
the importance of online connection to Social Security.
Well, everybody should set up their online account
at the, as I say, that gov website.
That's probably the fastest and easiest way
to transact business at the Social Security Administration.
So I would definitely recommend that.
Beyond that, it's worth knowing
that you need appointments at field offices these days.
(11:46):
And it's probably not a strategy.
And if you need to transact business with them on the phone,
you should expect long wait times.
And I would say with applications for new benefits,
whether it's Social Security or Medicare,
or Social Security processes, Medicare applications,
now I would get those applications started,
at least several months,
and of the date that you need the benefit to start.
Yeah, and I think we mentioned that one of the backlogs,
(12:09):
serious backlogs is in disability benefits, is that right?
It is, yes.
You know, anywhere from 48 months waiting time
on initial applications,
that's been a long-running problem as well.
It's getting worse.
Yeah, so Mark, we love on it talking about,
but we're going to take a quick break,
but folks will be coming right back,
we'll be talking much more than Mark Miller,
so don't go anywhere.
(12:30):
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(12:52):
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All right, welcome back folks to 45 Forward.
We're talking today about Social Security and Medicare
with Mark Miller, a nationally recognized expert in aging.
His latest book is Retirement Reboot.
(13:12):
I'm in Send Strategies for Getting Back Untracked.
So before the break, we are talking about some of the issues
of disruption and importance of keeping track of your account online.
So let's talk about some of the longer-term issues
that people do worry about.
I know that you're just a discussion with people.
And in general coverage, a lot of young people are worried
that the misdome is going broke,
(13:35):
and it's not going broke.
But let's talk a little bit more.
You mentioned the trust fund,
and let's talk a little bit more about,
basically, so that benefits will just basically diminish
if we don't do something to fix it.
So what are some of the things that are being discussed
about the solve of the problem?
I mean, there's a couple of ways to write the ship here.
You can either cut benefits, you can increase revenue,
(13:56):
you can do some combination of the two.
And it's worth noting that Social Security is a self-denounced program.
You know, it's entirely reliant on revenue from the payroll tax.
And so one of the myths out there about Social Security
here is that it's somehow a driver of the deficits, the federal debt.
(14:16):
Well, that actually doesn't make sense
because if Social Security were able to actually borrow money
from other parts of the government,
we wouldn't be facing this potential clip in 2033.
The reason for the clip is that Social Security cannot buy law,
borrow money.
You can either, as I was saying, you can cut benefits,
(14:41):
you can raise the payroll tax, right?
You could come up with new sources of taxes for people
who have proposed a Wall Street tax or a wealth tax
as a way to shore up the system.
But as we get closer and closer to that 2033 day,
the math limit doesn't work for doing it with benefit cuts
(15:01):
because it takes too long for those cuts to phase in
in a way that is meaningful for avoiding the solve and speed problem.
So that coupled with sort of the state of affairs and Congress
with the degree of polarization and dysfunction there,
a lot of people are thinking that we may get right up to that point
and need some kind of a short term, hopefully short term,
(15:24):
kind of a emergency solution, which might be in the form of an injection
of general revenue into the program.
Nobody I talked to thinks that we're going to reach 2033
and in fact have a 203% kind of benefits.
It seems hard to imagine that any member of Congress is going to allow that
to happen and have, you know,
(15:45):
constantly going back to face the voters.
Right. So, you know, there is the possibility of an injection of general revenue
into the program while a longer term solution is worked on.
But what's interesting there is it would mean that so it's
pretty wouldn't, in a fact, be borrowing to make benefit payments at that point
because we're in a deficit spending mode already as a country.
That's, you know, most of the, you know, the possible scenarios, I think.
(16:09):
Yeah. Yeah. I mean, people talk about, you know,
raising their time and age, but as you pointed out in your articles that
that's already been done one and that really is a benefit cut because
basically shortening, you know, the retirement benefits of people going forward.
Well, and you're basically raising the bar, the age at which you qualify
for 100% of your benefit.
(16:31):
So, and as I say, it's, it's kind of too late to do that in a way that would meaningfully
impact the solvency problem. And on top of all that, I think,
you know, raising the retirement age is not an equitable solution in the sense that,
you know, while the US has experienced gains in longevity,
the gains are not evenly distributed.
(16:51):
You know, the gains in longevity have really gone mainly
to higher income, better educated people. And so, you know,
when you talk about raising the retirement age for people who are not
living quite as long, that's an inacquitable approach, I believe.
Yeah, and there are certain jobs in which that's not really practical. I mean, not, you know,
that's white collar jobs, difficult manual labor jobs, is not really fair to that.
(17:15):
Right. Yeah. It's an interesting thing is that public
survey polling is repeatedly shown that the public prefers
new revenue as opposed to benefit cuts. And that's across the board.
It crosses all political and demographic lines, which is pretty rare these days.
So it kind of comes down to, you know, whether Congress is going to do what the public wants it to do
(17:37):
or not. Yeah, it seems to me that is an effect of, I mean, it's like, okay, raising the tap
of, you know, collecting revenue, it's like, okay, among that higher demographic, so they,
are they going to miss it as much as the lower sector? I mean, it seems to me that if you're
going to make a fix in the system, that that's, you know, an appropriate way to do it. Of course,
it's politically difficult when you have high income political donors. But now, do you see also,
(18:03):
I mean, younger people getting involved, it seems to me that they're, I've been noticing that,
you know, they're like getting engaged, they realize what the implications may be for themselves
and for their parents. Well, more generally, I think you've been at the case in all of that.
I think on this issue, when I notice a lot of skepticism among younger people, then they're going to,
(18:23):
they're so secure, it's going to be there for them. I think it's been so much negative spin and
hype on this that, you know, and just mistrust of government in general. And, you know, I think the
degree of worry and skepticism among younger people is quite high. You know, I wrote about that
for the New York Times last year and it was interesting to see just how progress it is. Yeah, I think
that, you know, a few months ago, I was involved with them just talking about Social Security on
(18:49):
college camp, a local college campus with ARP. And I think that, you know, some college students
stopped by and they were talking about it and it was like, well, if there are diminished returns
on Social Security for your parents, guess who's going to pick up the slack? You.
Well, you know, the benefit cuts that were enacted in 1983 already fall on
(19:09):
today's young people because it gradually phased in a higher retirement age from age 65,
up to age 67 for everybody born after 1960 and that implies an average about 18%
high benefits. So that's already in place. And, you know, I think it's an argument against
(19:29):
making further changes in the retirement age. Yeah. And now I also have seen, perhaps you
wrote about this as well, that there has been a surge in people also at closer to retirement age,
you know, applying early, just, you know, that anxiety, well, starting, you know, applying at 62.
Yeah, there has been a bit of an uptick in people applying early as a result of all the negative news
(19:51):
about the Social Security Administration this year, which is unfortunate. Yeah, it's, I don't think
it's fair to say it's been a massive upturn. It's been something that's been, you know, been
noticeable. One thing that's going on in Social Security Mission right now is if there's been a,
basically shutting off the valve of how they release a data of all kinds about the program,
by the SSA. So there's a lot less transparency over the last couple of months about what's
(20:14):
actually going on there, which is very concerning. Yeah, I'm not sure what you can do about that.
No, there are, I suppose you could raise your voice about it. Well, the SSA says that they're revamping
all their reporting systems, but, you know, well, I think it remains to be seen whether that
is the case or whether they're just trying to kind of draw the shade now and what they're up to there.
Again, it's sort of hard to tell what's going on, but, you know, and there's been talk about,
(20:37):
you know, access to Social Security data, you were much about what the potential impact would be of
that. Well, it means that, you know, analysts who are trying to track what's going on there are
having more trouble in discerning what's happening there. Okay. Well, I think one of my
conversations with you, actually listening to one of your previous webinars, I think one of the
things you talked about is that, you know, people should just speak up, you know, you said,
(20:59):
what can you do? Let your lawmakers know what you want. Right. I think, you know, there's a problem
with people sort of possibly watching and treating this as a spectator game where, you know, it's very
important to let people know. And legislators know what you want. Yeah. Yeah. Good. Okay. So we're going
to take another quick break. Well, we write back talking much more than Mark Miller,
(21:20):
Social Security expert, a nationally recognized expert on aging and retirement issues and he's
latest terrific book is called Retirement Reboot. A common sense strategies for getting back
on track. So don't go away. We'll be right back. Do you like what you're hearing? Well, we've got
plenty more where that came from. Head over to 45forward.org where you'll find a full archive of over 200
(21:46):
episodes of the 45 forward podcast all hosted by Ron each week. Ron talks with fascinating guests,
spurts, advocates and everyday folks sharing insights and stories to help you live a better,
fuller life in your second half. We cover everything from health and caregiving to careers,
(22:06):
relationships and finding purpose, whatever helps you move forward with clarity and confidence.
That's 45forward.org. Check it out and keep moving forward. 40.
Welcome back folks. Once again, we're talking today with aging and retirement ex-Mark Miller about
Social Security. And now we're going to shift a little bit to Medicare and Medicaid, specifically
(22:30):
about the reconciliation act that's in in volume, comments now and what the implications might be
for is social insurance and programs for older folks. So let's talk about that because it's
all right. It will write happening right now on a discussion about it. So what are your thoughts?
Right. And then you have the bills being debated in Congress as we are taping this. One interesting
(22:52):
thing in this bill is that it could actually hasten that Social Security trust fund insolvency
date by a year or two, mainly by reducing the amount of revenue collected from the income tax
on Social Security benefits, which is deposited to the trust fund. It would do that by the
(23:14):
Senate version of the bill increases the standard adoption dramatically, which in turn would reduce
the number of seniors paying taxes on that. But so, good news here for anybody who's paying
tax on the benefits as you're going to get some tax relief. But some analysis suggests that it could
bring that day even closer, which is certainly concerning. On the Medicaid side of things,
(23:36):
the big impact here would be on low income seniors, people who are eligible for both Medicaid
and Medicare. So this is the so-called dual eligible population, which is about one-fifth of all
Medicare beneficiaries. And they account for a disproportionate share Medicaid spending. But this
is the older part of the Medicaid population that tends to have greater healthcare needs. So that's,
(23:59):
you know, this is the group that is likely to see some impacts as states are facing significant
budget reductions out of this bill. And it's concerned that they'll respond by cutting out various
optional benefits, cutting payments to healthcare providers, limiting service availability. You know,
so this couldn't kind of create a domino effect that undermines health access for the most vulnerable
(24:21):
people on Medicare. And these work requirements that are in the bill would have a devastating impact
on disabled and elderly people. And a lot of studies have shown that the work requirements don't
really boost employment levels anyway. But so there's a lot of those kind of disastrous implications,
I think, scrolled or adults, particularly low income adults in the Medicaid side. When you look
(24:42):
at Medicare, there's a sort of a grab bag of provisions in Medicare. I wouldn't say that the Medicare
provisions in the bill are the big headline here, but nonetheless, there are some things. One,
again, talking about lower income seniors being impacted on the Medicare savings program. This is a
program that runs state-by-state health, lower income people pay to part B premiums. And there was
(25:06):
a rule put in place in the last year to buy an administration that was going to simplify and make
it easier for people to enroll in those programs. And there are rules being pushed back roughly 10 years.
So basically, put on ice. There are restrictions, new restrictions on eligibility for Medicare,
restricting it to only people who are U.S. citizens and green card holders. So this is part of the
(25:29):
holy integration crackdown. So eliminating eligibility for people with temporary protected status,
asylum seekers and refugees. The bill has a justice to payment-raised positions. Another
provision I think is interesting is it delays implementation of a new rule that places minima
(25:49):
staffing requirements on nursing homes. So it's an effort to try to boost staff at levels in
nursing homes and that's been delayed. And then, last thing I can mention about Medicare,
kind of interesting, for people who use health savings accounts while they're working,
there's a need to stop contributing to those when you enroll in Medicare Part A.
(26:09):
And this legislation proposed changing that so that people who are enrolled in Part A could continue
contributing to health savings accounts. So it kind of when eliminating what's been kind of a
complicated wrinkle in the NHSAs for people. That's kind of a quick wheel through everything in this bill
on those three topics. Yeah. Now, I know before all this legislation moved forward,
(26:35):
it seemed like there were some advances in Medicare, Medicare coverage, right? I mean,
that there are, are there some positive things that look forward to in terms of Medicare coverage?
Well, the big thing that was implemented this year was the new $2,000 cap on total lot of pockets
spending in Part D, right? The prescription drug program. So that's in place. This legislation
(26:57):
doesn't touch that. Okay. One thing that I'm kind of keeping an eye on, however, is that
one of the things that the Biden administration did for this first year of the new cap was put in place
essentially a mechanism to incent insurance companies to limit the size of premium increases.
(27:19):
The concern here is that because of the strengthening of the insurance with that $2,000 cap,
that insurers would increase premiums quite a bit. So this program that was put in place basically
capped premium increases at $3, to no more than $35. And that's a lot of listeners may have noticed
(27:44):
increases in their premiums of $35 this year. That's the reason for that. There's a question
as to whether that subsidy will continue next year. We don't know yet. If it does, then you know,
you can expect some stability and premiums. If it's not continued, it could create some
havoc in the Part D number enrollment for 2026. I always encourage people to keep an eye on,
(28:09):
they're plans when the new data is released in the fall. Everybody gets to notice
usually in September about what the coming year will look like. You really pay attention to that.
A lot of people don't bother to reach out to their coverage from your year.
In Part D and also in Medicare Advantage, it's really important to do that because these plans
(28:34):
can change from year to year. You know, drug coverage can change. Premiums can change.
A lot of pocket limits can change. So very important to do that and to
if a plan is no longer a good fit for you, you should definitely reshop it during the fall enrollment period.
I know you've written about the Medicare, traditional Medicare Advantage. Do you see any trends in that's
(28:55):
respect? Well Medicare Advantage is now over half of all Medicare enroll. Oh really?
And so that's really remarkable. And well documented issues in Medicare Advantage with Medicare
Advantage basically is managed care. All the things that are attendant to managed care,
you know, the red tape hassles associated with either genitals of care, prior authorizations,
(29:21):
you know, networks of healthcare providers, you know, he's a provider in network, out of network.
You know, there are some discussions about trying to reform that program. And, you know, I think the,
you know, the progress on that's been quite limited so far. There's also an issue with overpayments
in these programs that can be well documented. I think there's a growing interest in perhaps rainy
(29:44):
and those overpayments, but the politics around that are extremely difficult. Yeah. Yeah. So I mean,
this whole movement of, you know, waste fraud and abuse, I mean, it seems to me that a lot is made of
that, but talk a little about, you know, what the, the real, the facts are about.
Okay. That simple. That simple. Okay. Okay. So now within the age of, I mean, yeah, it seems like.
(30:08):
Is there fraud in Medicare? Yes. It's, you know, I think it's been documented that it's
relatively small as a percentage of total activity in the program, but the numbers seem large because
it's such a massive program, right? And of course, it should be combated and eliminated if at all possible.
But, you know, the, a lot of what's going on in social insurance these days goes on under the cover of,
(30:31):
we're not trying to really cut benefits for anybody that deserves that quote unquote. We're just
trying to cut waste fraud or abuse. And, you know, over and over again, it's been demonstrated that
the total amounts of that going on are relatively small. Yeah. And it's not within the agencies themselves.
It's on the outside. People scamming the system. For the fraud and the system to be fair. Right.
Thank you for that clarification. Yeah. And I think that, so I mean, it's a little counterintuitive
(30:54):
that we're, you know, cracking down on these inspectors general and these are agencies.
Cliring them all. Yeah. Yeah. So let's see. So let's shift a little bit to,
some of your broader perspectives on, you know, how this fits into retirement and long term,
you know, care planning. Because I think that that's something you read about, you've read about and
people don't think enough about it. So let's talk about how this fits into, you know, long-term
(31:19):
care in a broad sense as it fits into retirement planning. Well, I think a lot of people think that
Medicare will cover long-term care and it really does. And it covers a very short period of
school nursing care following a hospitalization that doesn't cover sort of the more routine
help with daily living needs that people might have. The problem with long-term care is it's a hard
(31:43):
risk to really think about. It's hard for people to really conceive that they may need something
like this and really do assess the risk is not easy. And we don't have very good mechanisms for
planning for it. I mean, the private, long-term care insurance market is largely dysfunctional. It's
strong quite a bit. It was never very often to start with. And we don't really have a social
(32:06):
insurance mechanism to deal with it. So all that's going on and at the same time, cost of care
are really jumping at a lot of the rates of the studies that are done show that the cost of the
price of most long-term care services is been jumping double and triple the rate of inflation in
recent years. And this is getting exacerbated by kind of this almost perfect storm of
(32:28):
colliding of supply and demand. You know, the time is getting older, the number of people, I mean,
either services is rising. And we are facing constraints on the supply side, both because
we don't pay enough to long-term care workers. The jobs are not regarded as good jobs, they don't
pay enough. And then the immigration crackdown that's going on is going to constrict the availability
(32:49):
of labor in that market as well in certain parts of the country as well. So I think there's good
reason to be very concerned about the future of long-term care. And the other piece of long-term
care is that I'm more affluent people can afford to self-funded if you can save enough to,
you know, to know that you're going to have money to pay for it. Or if you have high
so security benefits that can also help meet a long-term care need. And I often make the point that
(33:18):
delaying a so security claim as long as possible is one good way to help ensure you're in that risk.
You know, you're generating a higher monthly benefit that again, it's a question adjusted every
every years. You know, those are a couple ways to think about it. But, you know, I think it's an area
of some legitimate concern or worry. I've long felt that a smart approach to this would be kind
(33:43):
of a hybrid public and private approach. You have a social insurance component and everybody
participates in to provide sort of a base level of services and care. And then if people want to add
on to that with supplemental policies, you know, I think that could work. And I think that even
in the commercial insurance space, I think there was increasing recognition of that would be a
(34:07):
sensible approach. And I think, you know, a restructuring of the risk profile so that, you know,
you knew the government would take a piece of it and the commercial side would take a piece so
that would certainly be one way of dealing with that. You know, a couple of states have
gotten into this and trying to launch solutions at the state level. Yeah.
I should say being in this prominent example that they launched a state
(34:33):
program there and they're looking to add a this supplemental commercial marketplace component
sometime soon. But, you know, it's an area of concern. I think it's probably the biggest sort of
gaping hole in the, you know, in the, in the, in the, the, the, the, the system we have for
ensuring against risk and retirement. Yeah. I agree. I mean, it's, it's a really, it's a patchwork
(34:54):
system. It's, um, it really exacerbates, you know, the income gaps between the top and the bottom.
Yeah. And the only thing worth mentioning here is the Medicaid is the single largest
insurer of long term care, we're over half of all large and care is paid out of Medicaid.
Medicaid, I said Medicare, I meant to say, yeah, excuse me. Medicaid is the
primary and the biggest source of insurance, uh, long term care. And with these pots that
(35:18):
are going on and this budget reconciliation zone, it was really good reason to be worried about
the impact that that's going to have in the nursing home sector and on the long term care sector.
Also for Medicaid patients, it also will probably lead to further increases in, uh,
private air costs. So that's a great concern at this point as well.
(35:40):
Well, Medicaid situation. People qualify, sometimes qualify for Medicaid by spending
down. Qualify for Medicaid, you have to have very low, uh, levels of income and assets that,
you know, the rules vary from state to state. If I, that is one thing that happens is that
people go into long term care, that exhausting resources and then they go on to Medicaid.
(36:02):
Right. So we'll talk more about that because I want to talk more about in that in our last segment
and then some of your broader thoughts about how this all works with your retirement planning
and rebooting when necessary. So, hopefully one more segment I'm looking forward to talking
much more in our last segment with Mark Miller, the author of retirement reboot, come and send
(36:22):
strategies for getting back on track. So don't go anywhere. We'll be right back.
Caring for a loved one can feel overwhelming. That's why we created caregivingnav.com,
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(36:44):
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from legal planning to home safety, from medical decisions to emotional support. It's all here,
all in one place. Just visit caregivingnav.com because you're not alone on this path. And the help
(37:10):
you need is just a click away. Well, come back to 45 forward once again we're talking with aging
retirement expert Mark Miller. And for the break we were talking about long-term care issues and
planning. So this is a big area that you mentioned Mark and I think that there's, I mentioned earlier,
we have a sort of a patchwork system and I think it really is a problem because this is something
(37:30):
that you know at least the statistics show that you know two-thirds of people are going to face some
sort of long-term care issue. You know as they get older. The problem is that it we're not sure what
kinds and so it seemed to me that what you're suggesting in terms of a you know a hybrid system so
public and private would make sense because you need to cover lots of situations and offer lots of
different options. And the problem with that solution is that it requires a tax increase. You'd have
(37:55):
to create a probably a payroll tax levity to support it. And so that's really tough to do
politically with we have one political party that absolutely refuses to raise taxes in time.
You mentioned this in issue that affects two-thirds of people and that's sort of reflects the general
landscape of retirement security. Roughly two-thirds of households getting close to retire that
(38:17):
probably not financially ready for it for a whole variety of reasons which is really the theme of
the book that I wrote a couple years ago. You know it's part of a bigger picture of inadequate
retirement preparation that yet I think reflats a number of things I think it reflects the stagnation.
(38:37):
It is really reflect what's been going on in the US economy over the last few decades
or than anything else. I don't say lack of preparedness as a way to point the finger quite the opposite.
And I think it's reflective of stagnation and wage growth. It's I did some some number crunching
for the book and the person approaching, person approaching retirement now has lived and worked
(39:00):
through several major economic downturns during the course of their career that often puts people
out of work for years at a time. You know you even get back to work you don't necessarily recover
the losses from that. And we think about the great recession that occurred not only to people
who lose jobs sometimes people lost their homes. So there was a lot of long-term economic damage
(39:26):
that explains I think a lot of what people are dealing with as they get close to retirement. So
the book was a time to start to explore you know what are sort of late in the game strategies and
things people can do. So yeah talking about the rebooting I mean other things know as I mean
the economy and our lifestyles have changed that we need to kind of shift in our retirement
(39:46):
planning thinking? Well you know I go through a list of really a menu of options that people can
think about everything from you know working longer and you know what I say working longer you hear
people sometimes say well I'll never retire right? I'll never be able to retire I'll have to work
forever. And that's you know that what I necessarily mean when I say that you know even working
(40:08):
a few years longer can be a really important lever for proving retirement outcomes because it
can enable a later-souce security filing and the higher benefits that higher monthly
or annual benefits that come with that can be an opportunity to say for retirement later in later
life and it can be in more years well it means fewer net years living off of retirement savings
(40:32):
and more living off of wages as well as more years on hopes on employer subsidized health insurance
you know for any number of reasons working longer can be a really important lever.
Lakes oh security filing for many people makes a lot of sense and again when I say that I
putt sometimes what people here is oh yeah I should wait till 70 and that's great you know if you can
(40:56):
do that but even waiting a little bit past a couple years past full retirement age or not filing
early is beneficial in most cases you know it's it's a there is not a one-size-fits-all solution here
I don't mean to suggest that I think there can be is a highly personal decision that depends a lot
on your personal circumstances there can be good reasons to claim early you know for example if you're
(41:22):
out of work and just you know need the money very badly or you're not in good health don't have
expectation of great longevity particularly for married couples or people with good reason to think
they have a chance to live long you know delaying your claim can be a very big strategy is it one
economist once said to me about this it's it's better to plan to live that to not to die right so
(41:43):
you know these are some of the things that explore in the book careful examination of your spending
you know I think a lot of times the focus is on income and savings not enough on you know scrubbing
the budget that things you might want to consider doing to bring your expenses in line is downsizing
part of the picture tapping home equity in some cases you know it's kind of a holistic look
(42:04):
and ways to get back country you know saving you know even with the I have a chapter on saving for
retirement and looking at the impact of even getting a late start it can be meaningful yeah yeah
so where can people get the book well it's available on the usual spots and if you visit my website
you can learn more about it the retirement revise.com is this is my website and there's
(42:27):
information about the book there right and other things people should know about I mean I you've got
yeah I do the newsletter these days I'm running from the New York Times in occasion like
your morning star I have sort of reciprocated in my own life where I'm scaling back a little bit
on all that I wouldn't say retired but to take my foot off the gas pedal just a little bit but
(42:48):
they still find my work in the New York Times and if you want to follow what I'm doing easiest way
if you go to that website just my intention is you can sign up for I do a really newsletter there
that comes out probably two to two times a month right I include their links to my latest articles
as well as links to work by other journalists that I found interesting links to studying links to
(43:08):
online webinars and things that I've run across that I think are worth casting a lot yeah yeah
could that say yeah good good have people want to contact you just go to the website and you know
retirement revise.com and send you an email okay yeah um I know you mentioned that people do get a
lot and you get a lot of information in social security are there have you noticed any sort of
(43:31):
broad trends in terms of what what kinds of questions you get from readers anything.
Well I think right now the big thing is worry about so security okay which we talked about
earlier the program I think that's good far and away what we're seeing the most of which is very
unfortunate yeah yeah so security is really a crown jewel of American public policy and I think
(43:52):
it's a shame that it's being you know anyway it's receiving the three minutes receiving right now
yeah yeah we need to do about it we know other than are there places people can
basically advocate I mean other than going to their legislators and saying this is important to
listen I mean I do know that you know a lot of it legislators or they do track the phone calls
(44:14):
and letters and emails and so forth. I think that's very important that they're showing up in public
I have a section in the last chapter my book arguing for sort of revival of social insurance in
the United States in addition to advocating I think educate yourself oh it's important for people
to understand kind of the myths and realities and not fall for the political spin about so security
(44:37):
the language around so security the hearing the political arena can be quite kind of tricky actually
you know when the politician says we need to protect so security you need more detail on what they
mean by that they said you need to protect it for future generations you need to know what they mean
by that do they mean by protecting it by cutting benefits or do they mean something else and they
mean you know raising rather so you know it's important to educate yourself about the language
(45:01):
of social security and be able to you know push beyond that another I think trick in the book here is
when your politician is talking about let's let's create a commission and have a you know a
closed-door commission do arrive at solutions well that's just a way for them to get behind a closed
door and come up with something that they're not putting their their fingerprints on now I think
(45:24):
we need accountability we need the future of social security to bait it out in the open I think that's
terribly important yeah so those are some of the things I think people should be aware of good good
yeah I think that certainly from my journalistic background when you get questions about you know
protecting social security my my always response was could you be more specific yeah absolutely
(45:45):
yeah that was always a good heart could you could you give me an example of what you're talking about
and I think that that really presses the issue and forces that's specificity really or clarification
could you clarify with that I think that's important yeah all right tell me tell me more yeah
when mark this has been very enlightening and I appreciate it uh they always start broken
informative and uh I'm gonna have you back probably in the fall as we get into that's Medicare season
(46:10):
so I just want to thank you again once again let people know uh rhymingervies.com
and uh you're also I think you're on social media as well run Facebook probably you can kind
you know follow you there as well once again yeah absolutely absolutely oh once again folks
Ron Roel 45 forward thanks for spending this hour with me and Mark Miller any suggestions or comments
(46:35):
you can email me at Ron Roel at gmail.com and be sure to join me next time when I'll be talking
with Robin Lombardo and Andrea Padinha for an inside look at how a dynamic senior central works
today so until then folks keep moving forward 45 forward
(46:59):
you
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