Elder Law Prof Blog

Case Western Reserve Hosts Law-Med Conference on Diminished Capacity and the Law

Law and Bioethics Professor Sharona Hoffman, Co-Director of the Law-Medicine Center at Case Western Reserve University organized a terrific symposium on Cognitive Decline and the Law, held on March 1, 2024.  Thank you, Sharona, for inviting me to participate!   

In my talk, I  suggested that the time has come for clearer thinking on a long-standing legal standard, known in many jurisdictions as the "Lucid Moment" or the "Lucid Interval Doctrine," that has permitted attorneys' testimony on clients' orientation in time, place and person to suffice as evidence of sufficient capacity in legal transactions, even in the face of expert medical testimony about Alzheimer's Disease or other advanced dementias. Research demonstrates that Canadian academics have been  questioning reliance on "lucid intervals in dementia" as early as 2015.  My additional thanks to Penn State Dickinson Law student and research assistant extraordinaire, Noah Yeagley, for joining us at the conference and who was especially enjoying this conference opportunity to revisit his pre-law school graduate work in neuroscience.

The day began with a keynote presentation by Dr. Carol Barnes, University of Arizona, addressing "Brain Mechanisms Responsible for Cognitive Decline in Aging."  One key takeaway for me from her presentation was that while physical exercise is important for overall health, "learning new things" is probably even more important in maintaining cognitive function over time.  

The first set of panelists dug deeply into the roles of people supporting others in decision-making, whether with the aid of formal "supported decision-making agreements" and use of powers of attorney or different forms of substituted judgment.  Rebekah Diller, Clinical Professor at Cardozo Law, Megan Wright, Professor of Law and Medicine at Penn State Law, and James Toomey, Assistant Professor of Law at Pace University were the presenters on cutting-edge issues.

In the second panel, Neurology Professor Mark Fisher from the University of California Irvine was very timely in his focus on the potential for cognitive decline in both voters and candidates in politics, discussing a wide range of possible examples across history in the U.S. and Israel.  Associate Professor Jalayne Arias from Georgia State University School of Public Health demonstrated significant concerns in the overlap between criminality and dementia, whether from the standpoint of arrest, conviction, incarceration, or release of persons with cognitive declines.

Sharona Hoffman did double duty during the packed day, presenting issues of cognitive declines both in the workplace and on our roads.   She used humor to soften some of the tough news on the lack accountability for risk in either domain.  It was clear from the audience response -- in both the sold-out auditorium and on-line -- that everyone has a story about dementia and drivers, often from our own families.

My long-time friend working specifically in the "elder law" space, Nina Kohn, Professor of Law at Syracuse and now also a Distinguished Scholar in Elder Law at Yale Law School, gave the latest on proposed -- and much needed -- reforms in court-appointed guardianships, highlighting key concerns addressed in the Uniform Guardianship, Conservatorship, and Other Protective Arrangements Act,  adopted as of today in two states, Maine and Washington, and introduced or pending in at least four more states.

The speakers in the important last panel of the day were clearly looking to the future on research and developments in the diagnosis, care and community response needed for "healthier" approaches to problem-solving.  Dr. Jonathan Haines, a genetic epidemiologist at Case Western Reserve University, surveyed the advances and challenges in attempting to build a deep bank of genetic information on Alzheimer's Disease. Law Professor Emily Murphy at UC Law San Francisco outlined the emerging theory of "collective cognitive capacity" as an approach to the challenges posed by social, environmental, and economic factors that may be impacted by brain health and cognitive decline.  Tara Sklar, the Director of the Health Law and Policy Program for the University of Arizona College of Law spoke on the potentials and challenges for telemedicine in treating patients with cognitive declines. Professor Sklar is also the new chair of the AALS Section on Aging and the Law.  

A packed day, for sure, with support from Virginia Lefever, Editor for CWLR's journal of law and medicine, Health Matrix, who was receiving formal drafts of papers 
from presenters for a future issue.

And for those of us who were determined to follow Dr. Barnes' encouragement to "keep learning," the evening did not end early, as we continued with a tour of the University's wonderful public art spaces and then on to the world-renowned art collections at the Cleveland Museum of Art -- including a "First Friday" party that had lots of people dressed up and dancing!  "Hands"-Down, it was a great conference!

Medicare and Social Security Projections-Not Unexpected?

The news from the Congressional Budget Office underscores the reality that the SSA and Medicare Trustees have been pointing out for a while now.  According to an article yesterday in The Hill, CBO warns of sharp uptick in Social Security, Medicare spending,

Federal spending on Social Security and Medicare is projected to rise dramatically over the next decade, far outpacing revenues and the economy on the whole while putting new pressure on Congress to address accelerated threats of insolvency, according to new estimates from the Congressional Budget Office (CBO). 

The increase is driven by a variety of factors, including Social Security’s new cost-of-living adjustment, the rising cost of medical services under Medicare and greater participation rates in both programs, as the last of the baby boomers become eligible for retirement benefits. 

Further, in Social Security set to run short of funds one year earlier than expected the director of the CBO explains

Social Security funds are set to start running a shortfall in 2032, one year earlier than previously expected, the director of the Congressional Budget Office (CBO) said on Tuesday.

“The Social Security solvency date — the exhaustion date for the trust fund — is now within the budget window,” CBO Director Phillip Swagel said, referring to the 10-year period covered by the agency’s annual report.

If the Social Security funds become insolvent and there is no change to current laws, beneficiaries would see a more than 20 percent reduction in their benefits, Swagel added. 

This is the CBO’s second update to the Social Security insolvency date in the last two months, after it adjusted its projection down to 2033 in mid-December.

And finally, in Axios today, Medicare politics are on a crash course with reality

By the numbers: Medicare spending is expected to more than double by 2033 — climbing to $1.6 trillion, or over 4% of the entire U.S. economy, according to an estimate released yesterday by the Congressional Budget Office.

[T]he program's trustees have said the fund that pays for Medicare's hospital coverage will soon reach a dangerous tipping point — paying out more than it takes in. On that trajectory, it eventually wouldn't be able to pay for the coverage it's supposed to provide.

Want to read the full CBO report? It's here.  

Misquoting Bette Davis, "Fasten your seatbelts. It's going to be a bumpy ride."

Upcoming in November before USSC: Do Residents have Private Rights of Action for Violations of Federal Nursing Home Reform Act?

For those teaching Elder Law, Health Law, and Disability Law Courses this semester, there is a unique opportunity for students to hear relevant oral arguments before the United States Supreme Court.  One of the important federal laws that arguably changed -- for the better -- the standards for care in nursing homes was the Federal Nursing Home Reform Amendment of 1987 (FNHRA, adopted as part of OBRA '87).  But a long-festering central issue for the provisions known as the "Residents' Bill of Rights" is whether the law provides residents a privately enforceable right of action for alleged violations of the standards.  On November 8, 2022, the United States Supreme Court is scheduled to hear oral argument on two key concerns:

1. Whether in light of historical cases to the contrary, the Court should reexamine its holding that Spending Clause-related legislation confers a implied right to privately enforceable rights under 42 U.S.C. Section 1983; and
2. Whether, assuming Spending Clause statutes ever give rise to enforceable private rights under Section 1983, there are private rights of action for alleged violations of the Federal Nursing Home Reform Act's transfer and medication rules.

The case in question is Health & Hospital Corp. v. Talevski, originally filed in the United States District Court (Northern District) of Indiana.  Mr. Talevski, who has dementia, through his wife, alleges that while living in a nursing facility, he was prescribed powerful medications despite his family's objections, which functioned as prohibited "chemical restraints imposed for purposes of discipline or convenience rather than treatment." Further, he alleges he was improperly transferred over their objections away from the local care facility to a different, more distant facility.  Federal spending laws are at issue because the state's long-term care facilities are eligible for federal dollars and the state receives federal funding, including Medicaid funding, for such nursing care.  In this case, the District Court held that there was no private right of action. 

The U.S. Court of Appeals for the 7th Circuit reversed, at 6 F.4th 713 on July 27, 2021, finding that in the Act, "Congress spoke of resident rights, not merely steps the facilities were required to take.  This shows an intent to benefit nursing home residents directly." (emphasis in the original).  In reaching this decision, the 7th Circuit joined rulings by the 9th (2019) and 3rd (2009) Circuits directly confirming private rights of action under FNHRA. 

The Petitioner Nursing Facility seems to be playing to the newest justices on the Court, arguing that a long line of Spending Clause cases willing to recognize a cause of action under Section 1983, including Blessing  v. Freestone, 520 U.S. 329 (1997), are incorrectly decided or too generous in their willingness to recognize or infer fact-specific, private rights of action.  The Petitioner's argument is supported by an amicus brief, including one submitted on behalf of twenty-two states, resisting the financial implications of accountability asserted by individual patients.   The United States has submitted an amicus brief that expresses general support for individual actions, but argues against such a cause of action for nursing home residents. 

But, as one legal studies student observed in 2013 about what happens when minimum standards are not adequately enforced by authorities: 

Even though conditions in nursing homes have improved since the passing of the Federal Nursing Home Reform Amendment of 1987, the existence of substandard care in nursing homes, which Congress attempted to correct with the statute, still exists today. . . . [A case such as Grammer v. John J. Kane Reg'l Ctrs-Glen Hazel, 570 F.3d 520 (3d Cir. 2009) recognizing the right of residents to bring private actions under 1983] does open the door for state-run nursing homes to be held accountable for abuse and substandard care. . . . Considering that most of us at some point in our future will live the nursing-home experience first-hand, we should keep this topic on our radar.

Susan J. Kennedy, "Conflict in the Courts: The Federal Nursing Home Reform Amendment and Section 1983 Causes of Action,"  3 Law Journal for Social Justice 195, 209 (2013).  Some ten years later, the resident's case before the Supreme Court appears to have strong amici support, with amici briefs due in mid-September, arguing that without residents' ability to enforce their legal rights, "they will lose a powerful weapon for their protection.  This puts them at risk of harm and even death, as abuse, neglect and poor care are rampant in many facilities." Id. 

Did You Catch the SSA and Medicare Trustees' Reports?

 Early last month, the SSA Trustees released their annual report. Here's the bottom line:

 The combined asset reserves of the Old-Age and Survivors Insurance and Disability Insurance (OASI and DI) Trust Funds are projected to become depleted in 2035, one year later than projected last year, with 80 percent of benefits payable at that time.

The OASI Trust Fund is projected to become depleted in 2034, one year later than last year’s estimate, with 77 percent of benefits payable at that time. The DI Trust Fund asset reserves are not projected to become depleted during the 75-year projection period.

The full report is available here.

The Medicare Trustees also released their 2022 annual report, which is available here. Here's the bottom line for Medicare:

• The Hospital Insurance (HI) Trust Fund, or Medicare Part A, which helps pay for services such as inpatient hospital care, will be able to pay scheduled benefits until 2028, two years later than reported last year. At that time, the fund’s reserves will become depleted and continuing total program income will be sufficient to pay 90 percent of total scheduled benefits.

• The Supplementary Medical Insurance (SMI) Trust Fund is adequately financed into the indefinite future because current law provides financing from general revenues and beneficiary premiums each year to meet the next year’s expected costs. Due to these funding provisions and the rapid growth of its costs, SMI will place steadily increasing demands on both taxpayers and beneficiaries.

• For the sixth consecutive year, the Trustees are issuing a determination of projected excess general revenue Medicare funding, as is required by law whenever annual tax and premium revenues of the combined Medicare funds will be below 55 percent of projected combined annual outlays within the next 7 fiscal years. Under the law, two such consecutive determinations of projected excess general revenue constitute a “Medicare funding warning.”  Under current law and the Trustees’ projections, such determinations and warnings will recur every year through the 75-year projection period.   

Oh, and remember the hefty increase in the Part B premiums for 2022? It's going to be rolled back-just not this year.

[T]he Centers for Medicare & Medicaid Services (CMS) released a report that recommends cost savings from lower-than-expected Medicare Part B spending be passed along to people with Medicare Part B coverage in the calculation of the 2023 Part B premium. Earlier this year, Department of Health and Human Services (HHS) Secretary Xavier Becerra instructed CMS to reassess the 2022 Part B premium amount in response to a price reduction for Aduhelm™, a monoclonal antibody directed against amyloid for use in treating Alzheimer’s disease. Given the information available today, it is expected that the 2023 premium will be lower than 2022. The final determination will be made later this fall

 

Steps to Take When Moving Into Retirement

I found helpful this recent New York Times article, When You’re Tiptoeing Into Retirement, Take These Key Steps. I thought the setup to the article was spot-on "For many, getting to retirement age is not a simple matter of giving two weeks’ notice. You may want to extend a career or wind down work life or a business. If you’re able, you may want to keep working until you are 70 (and beyond), when you will receive the largest possible Social Security payment. These in-betweeners are slow-walk planning to arrive at the moment when they are not working anymore. What’s involved is a delicate jigsaw puzzle of decisions, nest egg bolstering and financial calculations. This transitory time also presents a meaningful time for reflection and short-term planning."  The article discusses "issues to consider' including the timing of taking Social Security Retirement (and some links to companies you can hire to help you with the decision), phased retirement, financing retirement, including tax planning, and whether to create a plan yourself, or with a professional. "More important, one of your key questions should be, “What do I truly want to do and how do I get there?” Whether you are envisioning partial or full retirement, it helps to have some specific goals."

Free Webinar: Social Security Overpayments

Mark your calendars for this upcoming webinar from the National Center on Law & Elder Rights,  on Social Security Overpayments and Low Income Adults. set for February 23, 2022 at 2 eastern.  The webinar will cover the following: "An overpayment of Social Security or Supplemental Security Income (SSI) benefits occurs whenever an individual receives more money for a month than the amount that should have been paid by the Social Security Administration (SSA). This training will review the options individuals have when they receive a notice of an overpayment from SSA. Presenters will cover the steps advocates can take to ensure the accuracy of an overpayment claimed by SSA, to reduce or eliminate the amount taken by SSA, and to enforce clients’ due process rights. Participants will also learn about recent changes SSA has made to address some of the problems with the overpayment appeal and waiver processes, and how advocates can be part of the efforts to tackle these problems. "  To register, click here.

Social Security Survivors Benefits for Those LGBTQ Who Could Not Marry

The New York Times reported a few weeks ago that SSA has agreed that those LGBTQ who were in a committed relationship and couldn't marry until marriage equality are entitled to survivors benefits. Social Security Opens to Survivors of Same-Sex Couples Who Could Not Marry

Challenging the policy that limited survivor’s benefits to married couples took years and a class-action lawsuit that bears Ms. Thornton’s name. In November, the agency dropped its Trump-era appeals against Thornton v. Commissioner of Social Security and Ely v. Saul, two federal lawsuits brought by surviving same-sex partners or spouses.

The Social Security Administration now allows gay men and lesbians to receive survivor’s benefits if they can show that they were in a committed relationship and would have married had that been possible. The change could mean greater economic protection for a population with higher poverty rates than American adults overall.

Important and good news!

Help in Choosing When to Claim Social Security Benefits

If you ever perused the Social Security website, you know there are a number of choices to make. Although SSA has a lot of info on its website, ever wish you could get some help? That's the subject of a recent article in the New York Times, To Get the Most From Social Security, Log On. "[T]he market for Social Security advice includes a variety of software tools that can analyze your circumstances and retirement income needs, and generate recommendations for getting the most out of benefits. A growing number of financial planners use software to advise clients on claiming, and some workplace retirement plans also offer such options."  The article mentions some of the more complex decisions that need to be made by individual beneficiaries, review some fee for use tools as well as free tools.  Check it out!

Thanks to Professor Naomi Cahn for sending me the link.

The Great Resignation Doesn't Mean More on Social Security

A few weeks ago, the Washington Post ran this article, The latest twist in the ‘Great Resignation’: Retiring but delaying Social Security

For better-off Americans, the pandemic economy created some of the strongest incentives to retire in modern history, with generous federal stimulus, incredible market gains, skyrocketing home values and health concerns drawing many Americans into early retirement.

The surprising twist? Many of these retirees also opted to put off claiming Social Security benefits, an exclusive Washington Post analysis shows. By delaying their benefits, these retirees can expect to collect higher monthly checks in the future.

The data in the article show retirements up about 5% but Social Security Retirement apps down about the same for the same time period.  Do we know what is going on?

 

America’s retiree population grew by about 3 million during the pandemic, about double what would have been expected given pre-pandemic trends, which has been previously reported. But the surprising surge in older Americans delaying Social Security upon retirement is another example of a number of unusual trends roiling the American labor market. Most notably, workers of all ages are quitting jobs in record numbers, in what has been dubbed the “Great Resignation.”

But why is this happening? Perhaps it's the "generous federal stimulus and unemployment insurance payments that enabled retirees to make ends meet in the short term; soaring stock and home prices that fattened retirement accounts; and pandemic-related restrictions at Social Security field offices nationwide that forced seniors to apply online."  We know that the pandemic is a great risk to all of us, but older workers can be even more vulnerable.  Once we are out of the pandemic, it will be interesting to see if this trend continues or reverses.

Will the 2022 SSA COLA be "record-breaking"?

I don't know if it will be "record-breaking", but the buzz is that it's going to be larger than that of recent history.  CNBC reported Social Security cost-of-living adjustment could be at least 6% in 2022, the higher amount being due to inflation, but the increase in purchasing power will be tempered by the Medicare Part B premiums and income taxes.   The Senior Citizens League (the source of the estimate) explains its process "Our forecast is based on CPI data through August, and there is still one more month of consumer price data to come in before we get the official announcement in October ... [and] [t]his year is particularly difficult to forecast with certainty... [due to] inflation patterns, caused in large part due to the COVID-19 pandemic, [which] were unprecedented...."

It won't be long before we get the official news from SSA. Stay tuned....

SSI Recipients and Disaster Related Assistance Webinar

Mark your calendars now for a free webinar,  Pandemic-Related Disaster Assistance for SSI Recipients, hosted by the National Center on Law & Elder Rights. Scheduled for September 21, 2021 at 2 eastern, the webinar description explains:

The Social Security Administration (SSA) recently changed their rules about how pandemic-related financial assistance can affect an individual’s eligibility for Supplemental Security Income (SSI) or monthly SSI benefit amount. Previously, SSA had been counting many types of assistance as income and resources for SSI purposes, resulting in individuals having their SSI benefits reduced or suspended, or having their applications for SSI benefits denied. However, due to the severity of the ongoing COVID-19 pandemic, SSA has decided they will not count most types of pandemic-related financial assistance against SSI eligibility or benefit amount.

This training will review the guidance issued by SSA on what types of financial assistance they now consider pandemic-related disaster assistance, what steps they will be taking to restore individuals’ SSI benefits, and what advocates can do to assist clients with contacting SSA to access or restore SSI benefits.

To register, click here.

Social Security & Medicare Trustees' Reports

We know they come out every year. This year is no exception. They are out! What do we learn from them? I'll give you the highlights here (those of you who have looked at the reports before know they are long and detailed....)

The Medicare Trustees' Report, released August 31, 2021, is available here.  The introduction explains the impact of COVID, and COVID vaccines, on Medicare, but not "Aduhelm, the Alzheimer’s disease drug that has been recently approved."  The introduction also references potential future scientific advances and how that would be factored into projections.  The one thing everyone wants to know from the Trustees Annual Report is what is the fiscal health of Medicare?  "The estimated depletion date for the HI trust fund is 2026, the same as in last year’s report. As in past years, the Trustees have determined that the fund is not adequately financed over the next 10 years. HI income is projected to be lower than last year’s estimates due to lower payroll taxes."  If you don't have time to peruse the entire report, read the introduction. It's very interesting!

Here's an excerpt from the conclusion:

The Trustees project that HI tax income and other dedicated revenues will fall short of HI expenditures in all future years. The HI trust fund does not meet either the Trustees’ test of short-range financial adequacy or their test of long-range close actuarial balance.

The Part B and Part D accounts in the SMI trust fund are expected to be adequately financed because income from premiums and general revenue are reset each year to cover expected costs. Such financing, however, would have to increase faster than the economy to cover expected expenditure growth.

The financial projections in this report indicate a need for substantial changes to address Medicare’s financial challenges. The sooner solutions are enacted, the more flexible and gradual they can be. The early introduction of reforms increases the time available for affected individuals and organizations—including health care providers, beneficiaries, and taxpayers—to adjust their expectations and behavior. The Trustees recommend that Congress and the executive branch work closely together with a sense of urgency to address these challenges.

The 2021 Social Security Trustees' Report is available through this page.

According to a summary provided by the SSA & Medicare Trustees, "Based on our best estimates, the 2021 reports show:"

• The Old-Age and Survivors Insurance (OASI) Trust Fund, which pays retirement and survivors benefits, will be able to pay scheduled benefits on a timely basis until 2033, one year earlier than reported last year. At that time, the fund's reserves will become depleted and continuing tax income will be sufficient to pay 76 percent of scheduled benefits.

• The Disability Insurance (DI) Trust Fund, which pays disability benefits, will be able to pay scheduled benefits until 2057, 8 years earlier than in last year's report. At that time, the fund's reserves will become depleted and continuing tax income will be sufficient to pay 91 percent of scheduled benefits.

 

Debt and Elders: GAO Report

This GAO report is a couple of months old, but I think it's important enough to bring it to your attention,  Retirement Security: Debt Increased for Older Americans over Time, but the Implications Vary by Debt Type.

Here are the fast facts from the report:

Older Americans held nearly half of the total debt in 2020—debt that may affect their retirement security. We found that older Americans had significantly more debt in 2016 than in 1989.

We also found that low-income, older Americans had greater "debt stress"—the ratio of debts to assets. In 2016, debt stress was about two times higher for minority households than White households.

Experts said that different debt types (credit cards, housing debt, etc.) have varying effects on retirement security. For example, carrying credit card debt with high variable interest rates may make it difficult for the elderly to save for retirement.

The full report is available here, the highlights here.

What Happens to Social Security Benefits If the Beneficiary Goes to Jail or Prison?

This semester at Dickinson Law, I've been teaching a comparative law module on Social Security Benefits.  We've been spending more time than usual examining issues associated with basic "retirement benefits" rather than the more complicated topics of Social Security Disability (SSD) and Supplement Security Income (SSI) benefits.  

A group of us ended the semester with an interesting hypothetical.  Imagine that a retired, older client has a DWI -- his second within some number of years -- involving property damage and, thankfully, no direct endangerment to anyone's life or safety.  Assume a damaged mailbox or telephone pole. The state law might treat that as a misdemeanor, but because it is a second offense, it could still mean substantial jail time.  The client is thinking about pleading guilty, even if the sentence is 60 to 90 days.  The older client might be thinking "the faster I get this over, the faster I can get home and headed back in the right direction with my life."

Do lawyers advise such clients of the potential impact of incarceration, whether in a jail or prison, on his or her right to receive  basic Social Security benefits?  This was a new topic for me and of course that sent me scurrying for information.  Here's what I've read so far:

• The Social Security Administration has a December 2019 brochure, entitled "What Prisoners Need to Know."  
• Federal statutory law currently provides, at 42 U.S.C. Section 402(x)(1)(A), that "no monthly benefits shall be paid" to any individual who is "confined in a jail, prison, or other penal institution or correctional facility pursuant to his conviction of a criminal offense" for 30 continuous days or more.  Does this mean the trigger for loss of benefits is 30+ days of confinement for any crime, even a misdemeanor? While a related regulation, at 20 CFR Section 404.468, provides that no monthly benefits shall be paid if the confinement is for a "conviction of a felony," (my emphasis added) it may be that regulation's language reflects pre-1999 statutory law.  See e.g., amendments to Section 402(x) set forth in  P.L. 106-170 (Dec. 17, 1999), 113 Stat. 1860, an act with the ominous name of "Ticket to Work and Work Incentives Improvement Act." 
• Cases explain that since 1983, the statutory mandate to suspend payments applies to basic retirement benefits, as well as SSD and SSI, and can also trigger a demand for refunds of any SS program funds "overpaid" during confinement, potentially reducing any future benefits the individual would otherwise receive once out of  jail. See e.g., Zipkin v. Heckler, 790 F.2d 16 (2d Cir. 1986). 
• Attempts to challenge the application of Section 402(x) by arguing the law violates substantive due process, equal protection or is unconstitutional as a bill of attainder or ex post facto law have not met with success.  See e.g., Butler v. Apfel 114 F.3d 622 (9th Cir. 1998).

Back to our hypothetical.  The client might be planning to go home after 30, 60, 90 days or more in jail, but what if the client was depending on SS retirement income -- reflecting his life-time work record -- in order to keep making house payments for that time? 

Originally the theory of suspending federal SS payments focused on "disability" payments, because the confined individuals were being maintained at public expense and their inability to work is a consequence of their criminal conviction, not their disability.  But what of the 1983 amendment, expanding the suspensions to SS retirement income?  In the Zipkin case linked above, at page 18-19, the Second Circuit rejected any distinction:

"We can perceive no reason why prisoners whose retirement benefits are suspended would have a need for replacement of income while prisoners whose disability benefits are suspended do not.  Rather, prisoners, as a group, do not have the need for a continuing source of income that nonprisoners typically may have. . . .  Social Security retirement benefits are designed to satisfy certain baseline economic needs, reasonably predictable when a worker retires. . . . They are not benefits held in trust and payable per se." 

It is a tough world, right?  But does it need to be this tough?  According to the Social Security Administration's recent statistics, among elderly Social Security beneficiaries, "21% of married couples and about 45% of unmarried persons rely on Social Security for 90% or more of their income."  Feel free to add your own thoughts in the "comments."

Webinar on Social Security Auxiliary Benefits

Mark your calendars for May 11 at 2 eastern for Title II Auxiliary Benefits: Social Security Benefits You’ve Never Heard of and Who is Eligible for Them.

When most people hear about “Social Security benefits,” the first thought that comes to mind is income for older individuals who have retired from work. It’s true that the Social Security system provides a foundation of retirement income that permits older adults to live in dignity, with over 46 million retired workers receiving benefits each month.

However, the Social Security system is also the foundation of economic security for millions of family members of retired, disabled, or deceased workers. In addition to retirement benefits, Social Security offers disability insurance protection to workers and their spouse and children, as well as life insurance that pays monthly survivors benefits to dependents if the worker dies.

Join this training to learn more about the eligibility requirements for benefits for spouses and ex-spouses, children, and parents. About one American family in four receives income from Social Security benefits, and many more could receive this income if they knew they were eligible. These benefits offer an opportunity to provide more financial stability to eligible older adult households.

To register, click here.

ABA BIFOCAL Latest Issue Released

The ABA Commission on Law and Aging has published vol. 42, Issue 3 (Jan.-Feb.2021),  its current issue of BIOFOCAL. The issue contains several articles, including a couple on Social Security Rep Payees, with the lead article, How Does Social Security Select Representative Payees for Adults? Results of an Independent Research Study

Almost four million older adults and adults with disabilities have representative payees appointed by the Social Security Administration (SSA) to manage their Social Security or SSI payments. How does SSA determine if a payee is needed? How do SSA staff select a payee? How do they choose an individual versus an organizational payee?  What are the considerations in long-term care residential facilities serving as the payee?  What about guardians serving as payee? How and to what extent does SSA maintain consistency in payee determinations?

In 2018, the Social Security Advisory Board (SSAB) charged researchers at Virginia Tech and the ABA Commission on Law and Aging to conduct an independent study focusing on these compelling questions.  The study team addressed SSA processes for selection of payees for adults. The underlying assumption was that a better understanding of selection practices ultimately could lead to process improvements, as well as a reduction in the potential for misuse and abuse of beneficiary funds while maintaining beneficiary rights.

A pdf of the full issue is available here.

Social Security Proposal to Restrict SSDI Benefits?

The Hill ran an item a couple of weeks ago, Social Security Administration is preparing to bar 500,000 Americans from getting benefits.

SSA’s proposal, as described in press reports, would make it harder for older workers to receive Social Security Disability Insurance (SSDI) benefits. By law (not regulation), SSA is required to consider age, education and work experience when determining whether a person meets the statutory definition of disability.

The implications are far reaching-if this proposal is passed.

In short, SSA’s proposal to tighten SSDI benefits fails to even advance past a very basic question about the suggested policy: What is the point? Looking at recent or modern data, the current system routinely denies benefits to older individuals with serious health problems and diminished prospects in the modern economy. Amplifying these outcomes by trying to get even more denials is not a rational policy approach.

The proposal would also exacerbate inequality in the United States along the lines of race and income. More than 25 percent of denied Social Security disability applicants are Black, a percentage that far exceeds the percentage of African Americans in the overall working age population. Additionally, nearly 40 percent of denied applicants live in poverty. SSA’s proposal to get more denials seems out of touch with regard to many of the serious problems facing the country.

It remains to be seen whether the administration will continue to push this through before President-elect Biden takes office.  Although the change could be undone, wouldn't it be nice if it just didn't happen?

Thanks to my colleague, Professor Mark Bauer, for sending me the article.

COVID and FInancial Harm

There's absolutely nothing good at all about COVID. I could list a number of ways it has harmed us, beyond health implications, but I just want to share one article with you from the New York Times, Female Workers Could Take Another Pandemic Hit: To Their Retirements.

Now, the pandemic recession is disproportionately damaging the careers of women — so much so that some experts call it a “shecession.”

In November, the national unemployment rate dipped to 6.7 percent from 6.9 percent, the Labor Department reported last week. But the pace of job growth has stalled, and millions have dropped out of the labor market altogether, especially women. One recent study found a disproportionate decline in employment for women of prime working age, 25 to 55, compared with men — and especially so for mothers.

The losses sustained are not just right now-but must be factored over time, including "missed wage growth, retirement savings and Social Security benefits."  Here is a great visual for this: a calculator developed by the center for American Progress.

The article discusses the importance of Social Security and includes info about President-elect Biden's plans for Social Security, which would

award work credit to people who cared for children or other relatives. It would also expand benefits for widows in certain circumstances, and bump up benefits for seniors who had collected payments for 20 years. Finally, it would adopt a new yardstick to determine Social Security’s annual cost-of-living adjustment — the CPI-E, an experimental Labor Department inflation measure designed to more accurately reflect the inflation experienced by seniors, especially health care expenses.

This is a good article-I plan to assign it to my students in the spring.

BTW, a shout out to the health care workers, first responders, essential personnel, everyone, who is keeping us going through this pandemic.  And to the scientists who created the vaccine, THANK YOU!!!!

How SSA Hold Harmless Works

Concomitant with the announcement of the Medicare premiums for 2021 comes a blog post from SSA explaining how the hold harmless provision works. How the Hold Harmless Provision Protects Your Benefits explains that with some exceptions,  "the “hold harmless provision” protects ... Social Security benefit payment from decreasing due to an increase in the Medicare Part B premium... To qualify for the hold harmless provision, [the recipient] must: .... Receive Social Security benefits or be entitled to Social Security benefits for November and December of the current year [and the recipient's] Medicare Part B premiums for December and January [are] deducted from [the SSA] monthly benefits."

Read the blog here.

Health & Income Security Gaps For Older Americans of Color

This is not a happy article for the day after Thanksgiving-but it is a darn important topic.  The Conversation published this article, Nearly two-thirds of older Black Americans can’t afford to live alone without help – and it’s even tougher for Latinos explains that

Older Americans who want to live independently face serious economic challenges. Half who live alone don’t have enough income to afford even a bare-bones budget in their home communities, and nearly 1 in 4 couples face the same problem.

Those numbers add up to at least 11 million older adults who are struggling to make ends meet, a new analysis shows.

The numbers are worse for older people of color. Dramatically higher percentages of Black, Latino and Asian older adults live on incomes that don’t meet their cost of living, even with Social Security. That can mean skipping needed health care, not having enough food, living in unhealthy conditions or having to move in with family.

These disparities often reflect lifelong disadvantages that add up as people of color encounter structural racism and discrimination that shape their ability to buy property and save for the future.

The authors used some data available about elders "to measure the true cost of living for older adults. It tracks expenses for housing, health care, transportation, food and other basics, county by county. We paired the index with state-level income data to determine the percentage of people who don’t have enough income to cover their cost of living." The results show that "disadvantages people of color face can extend through their lifetimes and can pass on to future generations."  Not only is income security an issue, so is health security "[s]ecuring and protecting health into later life is also more challenging for many people of color."

The results also showed state by state variations. The article concludes with various recommendations:

Today’s older adults who are struggling financially can’t go back, but there are several ways to help them now:

• Policies can promote affordable housing and affordable health care, which represent the biggest components of older Americans’ budgets.

• Governments can promote mechanisms that allow people to keep working into later life, which allows people to continue generating income and building wealth, and also delays drawing down other income sources such as pensions or Social Security benefits.

• Social Security and Medicare — the foundations of a secure retirement for millions of Americans — are essential for these groups. Older people of color rely more heavily than their white counterparts on Social Security and are at heightened risk when these programs are threatened.

• Making sure government assistance programs such as SNAP benefits for food and housing subsidies are accessible to the people who need them can also help. Ensuring access includes providing information in multiple languages and hiring outreach workers who understand the population’s needs.

Thanks to Professor Naomi Cahn for sending me the link to the article.