Tag: Income

Do you qualify for hospital charity care?
Back in October 2021, I wrote a post for Just Care on how to lower your hospital costs if your income is low. Many people who qualify for charity care are unaware that they might qualify for a free or low-cost hospital care under a hospital’s policy. If you are able, before going to the hospital, find out whether it offers charity care, and, if so, who qualifies and whether any physicians are excluded from their charity care policy.

The Affordable Care Act requires non-profit hospitals to offer charity care to people with low incomes. They might reduce their charges or, in some cases, cancel them altogether if your income is below a certain level. But, most people don’t know about this requirement, and hospitals don’t often tell you about it.

Since it became law, many nonprofit hospitals have made it a lot more difficult for people struggling to pay for their hospital care to get charity care. Moreover, some physicians who provide you care at the hospital might not be covered under the hospital’s charity care policy, reports Filipa Carvalho for the Lown Institute. However, hospitals must disclose their financial assistance policy (FAP), including which physicians are covered and which are not.

If your income is low, it’s wise to ask your hospital about its policy for providing charity care and for an application before you are admitted to the hospital. You might want to see about using a different hospital if it appears that it will be challenging to get charity care.

When using a hospital offering charity care (a non-profit hospital), even if your income is higher than the hospital’s income limit, you should still apply, if paying the bill will put you in medical debt. You have 240 days from receiving a hospital bill to apply, and it could save you thousands of dollars.

If the hospital sends a collection agency after you, call the hospital and let the staff know you are applying for charity care and you’d like them to stop the collection agency from trying to get you to pay.

Here’s more from Just Care:
July 2, 2024
People with low incomes struggle to access care in US
The United States rations care based on ability to pay, creating severe health inequities. People with low incomes in the US are more likely to suffer from chronic conditions and struggle to access care than people in other wealthy nations. The Commonwealth Fund found income-related disparities are prevalent in nearly all 11 high-income countries it studied, but health disparities based on income are the worst in the US.

People with low incomes in the US suffered from greater income-related disparities than people in the other 10 countries. In the US, more than one in three people with low-incomes has at least two chronic conditions. Other advanced nations also indicate greater chronic conditions among people with low incomes.

That said, in the US, about one in three people with low incomes suffer from anxiety or depression, more than every other country except Australia and Canada. People in Germany and Switzerland were least likely to suffer from anxiety and depression. Fewer than one in six of them suffer from these conditions.

Disparities based on income in the US are evident in all key aspects of life. More than one in four (28 percent) people with low incomes worry about their ability to pay for housing, food and other fundamental needs. In other countries studied, between six and 22 percent reported these worries.

One in two people in the US with a lower income skip care, including visits to the doctor, tests, treatments and prescription drugs because of how much it costs. In other advanced nations such as Germany, Norway, the UK and France, around one in eight people with low incomes skip care because of how much it costs.

More than any other advanced nation, people in the US struggle to pay bills for their health care. More than one in three people with lower incomes in the US (36 percent) face difficulty. In other nations, between one in six and one in 14 face difficulty.

In the US, many adults with low incomes don’t have a primary care doctor or place to go to get their care. And, only about 40 percent of them are able to get care the day or day after they try to get it. In Germany and the Netherlands, more than 60 percent of people can get same day or next day care.

And, just 58 percent of people with low incomes in the US are able to get care after hours. Forty-five percent of Americans with low incomes go to the emergency room for needed care in cases in which they could have simply gone to the doctor’s office had they had access to a doctor.

Health care is a human right. Everyone regardless of income in the US, the wealthiest country in the world. should be able to go to the doctor and get the care they need without worry about the cost. Shouldn’t the US do at least as well by its citizens as New Zealand, Germany and Japan?

Here’s more from Just Care:
December 21, 2020
Medicare for All lowers taxes for most Americans
Emanuel Saez and Gabriel Zucman, economics professors at UC Berkeley, report in The Guardian that Medicare for All–a public health insurance program, which Senators Bernie Sanders and Elizabeth Warren both support–would lower taxes for most Americans and lead to a big pay raise for many Americans as well. (Note: Warren’s financing plan imposes no taxes on middle class Americans; it puts their share of insurance premiums back in their pockets.)

Saez and Zucman explain that no matter how you do the financing around Medicare for All, because it saves so much money, it does not raise taxes. They argue that in order to talk about health care in America, you need to start with its huge cost, 20 percent of GDP. With Medicare for All, the cost of health care for the vast majority of Americans comes down.

Health insurance premiums are equivalent to taxes, only they are paid to corporate health insurers instead of the federal government. People or their employers must pay these premiums. Unlike choice of restaurants or clothing, where you can pick lower cost options or forgo it, you cannot (or should not) do so with health care or health insurance. Health care is like education. Everyone needs it, and for that reason other countries pay for it through taxation.

In the US, working people are charged a fixed rate for their health care–based on a variety of factors including age and geography–which Saez and Emanuel call a poll tax. Health insurance costs are not based on ability to pay as they are in other wealthy nations. Rather, they are regressive. In fact, once you add in the cost of health care, the US tax system overall is “highly regressive.” It’s about 30 percent for the lower-income earners, 40 percent for the middle-income earners and 23 percent for billionaires. CEOs pay the same amount for their health insurance as their secretaries.

The health care system in the US is unsustainable. Medicare for All would end the poll tax and establish a progressive tax. Consequently, workers would benefit substantially through increased income. For example, if you earned $50,000 a year and had employer coverage, the $15,000 or so your employer pays for your health insurance would increase your income to $65,000. Your health insurance tax, based on ability to pay, would be $4,000, leaving you with $61,000 in come, ahead by $11,000 a year.

You can visit TaxJusticeNow.org, a web site with a tax calculator that Saez and Zucman developed, to see how you would fare financially with Medicare for All. You could see how different Democratic presidential candidates’ tax plans would affect low-, middle- and high-income people’s tax rates. With Sanders’ Medicare for All plan, only the bottom 90-plus percent of income earners would benefit financially.

If you support Medicare for all, please let Congress know. Please sign this petition.

Here’s more from Just Care:
October 30, 2019
Top Social Security questions and answers
The New York Times answered the top Social Security questions from its readers.

Question 1. Is Social Security in good financial shape?

Social Security is in good financial shape today and at least for another 15 years. By 2035, however, Social Security will face a shortfall. If Congress does not make changes, Social Security would be able to pay out only 80 percent of scheduled benefits. Congress can and always has made changes to keep it paying out full benefits.

There is good reason for Congress to act. According to Richard W. Johnson at the Urban Institute, unless Congress acts, another one-third of retirees could be pushed into poverty. Fortunately, there’s a bill in Congress, the Social Security 2100 Act that would strengthen Social Security over the long term. All it would take is increasing payroll tax rates by 0.1 percent a year through 2043 and applying payroll contributions to all earnings over $400,000.

In 1977, Congress intended for Social Security to cover 90 percent of people’s earned income. But, it now only covers 83 percent of wages. The average wage has not increased as quickly as wages above the Social Security cap, which is $132,900 today.

Question 2. How do Social Security spousal benefits work?

If you have been married for at least one year, you can claim a benefit as high as 50 percent of your partner’s benefit if your partner is claiming benefits. You can claim the benefit before your full retirement age, but it will be lower because you are claiming before your full retirement age.

Usually, you must file for your own benefit and your spousal benefit at the same time. Social Security will pay you your own benefit and your spousal benefit as well, but only if your personal benefit is less than half of your spouse’s benefit.

If you were born before 1954, you can file for a “restricted claim.” You would then get only your spousal benefit and you could continue to accrue retirement credits on your account until age 70.

You also get a survivor benefit if a spouse dies so long as you were married for at least nine months before your spouse died. This benefit is usually 100 percent of your former spouse’s benefit.

If you are divorced but had been married for at least 10 years and are now single, you can get a spousal or survivor benefit from your ex-spouse. If you get married again, you lose these benefits. You cannot get spousal or survivor’s benefits from your new partner unless you have been married a minimum of one year.

Spousal benefits apply to same-sex married couples.

Question 3. Will I get benefits for the rest of my life and will they be taxed?

Once you claim Social Security benefits, you will get them for the rest of your life, and they will be adjusted up a bit for inflation. They may be taxed if your gross income, nontaxable interest income and half your Social Security benefit are greater than $25,000 for an individual or $32,000 for a couple filing jointly.

If you file a federal income tax return as an individual and your combined income is above $34,000, as much as 85 percent of your benefits may be taxable. If your income is between $25,000 and $34,000, you may need to pay income tax on as much as 50 percent of your benefits.

If you file a federal income tax return as a married couple and your combined income is above $44,000, as much as 85 percent of your benefits may be taxable. If your combined income is between $32,000 and $44,000, you may have to pay income tax on as much as 50 percent of your benefits.

Here’s more from Just Care:
August 7, 2019
Congress may end tax deduction for medical expenses
The House Republicans are proposing a tax bill that would end the tax deduction for medical expenses. This tax deduction benefits people whose medical spending represents more than ten percent of their adjusted gross income. Given high health care costs, almost nine million middle and low-income people benefit from the deduction; according to AARP, most of them are over 65.

Sarah Kliff explains for Vox that out-of-pocket costs for health care services and prescription drugs, including deductibles, as well as the cost of a joining a weight-loss club, are tax-deductible medical expenses as defined by the IRS. And, people who work for themselves can usually include the cost of their health insurance premiums as a tax-deductible medical expense if their total medical spending is more than 10 percent of their adjusted gross income.

Unlike some tax deductions, many working families benefit from the medical expense deduction. Three percent of Americans with annual incomes under $20,000 take the medical expense deduction as compared to one percent of people earning $1 million or more. To put these numbers in context, in 2014, just over 60 million people, earned under $20,000 a year. About 130,000 Americans earned over $1 million in 2014.

AARP is lobbying against the elimination of this tax deduction because it benefits millions of older people with high health care costs, including people needing long-term care. People with incomes under $20,000 who use the medical expense deduction claim an average of $9,136 in medical expenses.

Bloomberg News reports that the Senate tax proposal keeps the tax deduction for medical expenses. The Senate Finance Committee will begin considering the tax proposal next week; it is not clear whether the medical expense deduction will ultimately stay or go.

Whatever the future of the medical expense tax deduction, given the GOP control over both houses of Congress and the GOP desire to lower tax rates for the wealthy, the data suggest that the tax bill will drive up taxes for many middle and working class families.

Here’s more from Just Care:
November 9, 2017
Health care has become increasingly unaffordable
A new paper by Ezekiel Emanuel, Aaron Glickman and David Johnson, published in the JAMA Network reveals that working people spend twice as much of their income on health care today as they did in 1999: A powerful signal that health care has become increasingly unaffordable.

The cost of health care has become so prohibitive that one in four Americans say that they postpone it. And, almost six in ten Americans (57 percent) worry about their ability to get and afford needed medical care.

Emanuel et al. create an “Affordability Index” that tracks the percentage of people’s income that is going to health care premiums over time, for the 178 million people receiving employer-sponsored health insurance. In 2016, the average was 30.7 percent. In 1999, it was less than half that, 14.2 percent. The researchers include both employee and employer contributions towards health care premiums in their calculations, assuming that if employers were not making these contributions, employees would see higher wages.

The raw numbers are staggering. The average premium for a family insurance policy in 2016 was $18,142. The median income was $59.039. Put differently, the average cost of health care coverage rose 4.7 times faster than income (213 percent v. 45 percent) between 1999 and 2016.

The pace of health care cost increases is unsustainable. Emanuel and his colleagues hope that their index can lead policymakers to pay attention to elements of the health care sector that are rising faster than others and rein them in.

A better way to go would be for Congress to enact improved Medicare for all. Click here to sign a petition to Congress.

Here’s more from Just Care:
November 8, 2017
2014 data on income and savings of people with Medicare

A new Kaiser Family Foundation report reveals that income and assets for people with Medicare have slightly improved in the last year, not adjusting for inflation, though they are still far lower than most people realize. Kaiser also projects that they will continue to improve in the next 16 years. That said, the income gap is projected to widen, and people with Medicare with incomes in the top 5 percent will see greater improvement than people in the bottom quartile.

In 2014, half of all people with Medicare have annual incomes under $24,150 (up from $23,795 in 2013, adjusted for inflation to 2014 dollars) and only one in 20 of them had incomes above $93,000. One in four have incomes under $14,350.

Race and ethnicity, age and gender continue to matter when it comes to income. White people with Medicare have substantially higher median incomes than Blacks and Hispanics. Median income of White people with Medicare is more than double that of Hispanics, $27,450 as compared to $12,800, and about two-thirds higher than Blacks with Medicare, $16,150.

People between the ages of 65 and 74 have far higher median incomes, $29,700 than other age cohorts of people with Medicare. People with disabilities under 65 have the lowest median income at $17,050. People 85 and older have median incomes that are also quite low, at $18,850.

Marital status also matters significantly when it comes to income. Median income for individuals who are married is at $28,300, almost double that of single individuals at $14,450.

For more information from the Kaiser Family Foundation on wealth of people with Medicare, click here. For an interactive tool breaking down income and assets based on education levels and more, click here.

October 8, 2015
Income and assets of people with Medicare: Kaiser Foundation shows you the money

In case you think that older people are living large, the Kaiser Family Foundation has an interactive tool that will quickly change your mind. What’s particularly interesting is the demographic data.

Overall, in 2013, half of all people with Medicare had incomes below $23,500 and four out of five had annual incomes of less than $48,000. Only ten percent had annual incomes above $70,000. One in 20 had annual incomes above $94,000.

Not surprisingly, average annual income rises with education. In 2013, college graduates with Medicare had an average annual income of $41,000 as compared with high school graduates, whose average annual income was only a little more than half that, $21,400.

Average annual income for men with Medicare, $25,850, was almost 20 percent higher than for women, $21,800

Average annual income for White people with Medicare, $26,400 was almost double that of Hispanic people, $13,300 and about 60 percent more than Black people, $16,350. (Here are four things to know if your income is low and you have Medicare. And here are five programs to lower your costs if you have Medicare.)

Savings were also far less than many would presume. In 2013, half of all people with Medicare had savings below $62,000, and four out of five of them had savings below $317,000. Only ten percent had savings above $620,000 and one in 20 had savings above $1,113,000.

Education is a big driver of savings. Average savings for college graduates was $216,200, more than four times savings of people with only high school degrees, $49,200.

Average savings for men, $69,600, was almost 30 percent higher than for women, $54,700.

Average savings for White people with Medicare, $89,500 was almost ten times more than Hispanic people, $9,300 and almost nine times more than Black people, $10,300. (Not surprisingly, the vast majority of Americans want to expand Medicare and Social Security or keep them at current levels.) Fortunately, Medicaid covers significant health care costs for people with Medicare with low incomes.

See detailed income and asset information for yourself on the Kaiser web site.

September 18, 2015