@article {11141, title = {How Can Policymakers Close the Racial Gap in Retirement Security?}, year = {2020}, institution = {Urban Institute }, address = {Washington, D.C.}, abstract = {Financial insecurity at older ages is a growing policy concern. Retirement income largely depends on earnings received at working ages, which determine Social Security benefits, any employer pensions that retirees receive, and a person{\textquoteright}s capacity to set aside additional funds for retirement. Although earnings have been growing for women, bolstering their future retirement income, earnings have stagnated over the past few decades for men in the bottom three-quarters of the earnings distribution (Machin 2016; Rose 2015), threatening their retirement security. }, keywords = {Aging, Income and wealth, Poverty, race and ethnicity}, url = {https://www.urban.org/research/publication/how-can-policymakers-close-racial-gap-retirement-security}, author = {Richard W. Johnson} } @article {10109, title = {The financial burden of paid home care on older adults: Oldest and sickest are least likely to have enough income}, journal = {Health Affairs}, volume = {38}, year = {2019}, pages = {994-1002}, abstract = {Paid home care can significantly improve the lives of older adults with disabilities and their families, but recipients often incur substantial out-of-pocket spending. We simulated the financial burden of paid home care for a nationally representative sample of non-Medicaid community-dwelling adults ages sixty-five and older. We found that 74 percent could fund at least two years of a moderate amount of paid home care if they liquidated all of their assets, and 58 percent could fund at least two years of an extensive amount of paid home care. Among older adults with significant disabilities, however, only 57 percent could fund at least two years of moderate paid home care by liquidating all of their assets, and 40 percent could fund at least two years of extensive paid home care. Paid home care could become less affordable if growing labor shortages raise future costs.}, keywords = {Community-dwelling, Financial burden, Long-term Care}, issn = {0278-2715}, doi = {10.1377/hlthaff.2019.00025}, url = {http://www.healthaffairs.org/doi/10.1377/hlthaff.2019.00025}, author = {Richard W. Johnson and Wang, Claire Xiaozhi} } @article {10353, title = {Delayed Retirement and the Growth in Income Inequality at Older Ages}, year = {2018}, month = {02/2018}, institution = {The Urban Institute}, abstract = {As concerns about retirement savings have intensified, many older adults have begun working beyond traditional retirement age. By working longer, they can improve their retirement security by increasing their future monthly Social Security payments and shortening the time they must rely on their savings. But does delaying retirement deepen income inequality for older adults by leaving those with health problems behind? Delayed retirement can boost financial security but excludes workers with health problems Employment and income for 62-to-64-year-olds has increased substantially over the past two decades for people in good health. But employment and income have stagnated for older Americans with health problems, who face lower income than their healthier counterparts for the rest of their lives. To assess how later retirement affects income inequality at older ages, we examined how the relationship between health status, employment, and income has shifted for people eligible for early Social Security retirement benefits but too young to receive full retirement benefits.}, keywords = {Income inequality, Retirement}, url = {https://www.urban.org/research/publication/delayed-retirement-and-growth-income-inequality-older-ages}, author = {Richard W. Johnson} } @article {9614, title = {Distributional Effects of Alternative Strategies for Financing Long-Term Services and Supports and Assisting Family Caregivers}, number = {WP$\#$2018-1}, year = {2018}, month = {03/2018}, pages = {2-65}, institution = {Center for Retirement Research at Boston College}, address = {Boston, MA}, abstract = {We use two historical data sources {\textendash} the Health and Retirement Study and the Medicare Current Beneficiary Study {\textendash} to consider the patterns in older Americans{\textquoteright} severe disability and their use of long-term services and supports (LTSS) by age and socioeconomic status. We then use a dynamic microsimulation model to project how the effects of various interventions to support those with severe disabilities and their caregivers would be distributed across the income distribution. The interventions that we examine fall into three broad classes: tax credits for caregiving expenses, respite care for people in the community with family caregivers, and new social insurance programs. Within each broad class of policies, we examine how sensitive outcomes are to changes in policy details (such as, in the case of tax credits, deductible levels, refundability, and income phase-outs). This paper found that: Older adults with less education and less wealth are more likely to report disabilities and service use than their more educated and wealthier counterparts.This pattern persists when we look at people at a point in time but also, more robustly, when we look at their disabilities prospectively. In a sample of older adults who do not report disabilities at baseline, we find that those with fewer economic resources earlier in life are generally more likely to develop disabilities and use paid LTSS over the next two decades, but the differences narrow when we restrict the sample to people who do not develop disabilities until their late 70s. The policy implications of this paper are: The uneven distribution of disability risks across the population poses challenges for developing effective LTSS policies. Those most likely to need LTSS often lack enough resources to contribute to LTSS programs, and programs that try to contain costs by using underwriting or imposing work requirements often disqualify those who most need coverage.Certain classes of policies, such as respite care benefits, tend to direct much of their benefits to those in lower income quintiles, according to our projections. Caregiver tax credits and social insurance programs generally distribute benefits more proportionally, although impacts vary depending on how the policies are specified.Policy design details can significantly affect distributional outcomes. Provisions{\textquoteright} effects can be sensitive to the stacking order in which they are implemented.It can be useful to examine trends and proposals not only cross-sectionally but also over longer time periods. For example, the distributional effects of social insurance programs depend on the relatively high early-life mortality of those with less education and lower earnings and wealth. }, keywords = {Disabilities, Insurance, Taxes}, url = {http://crr.bc.edu/wp-content/uploads/2018/03/wp_2018-1.pdf}, author = {Melissa Favreault and Richard W. Johnson} } @article {9909, title = {How Secure Is Employment at Older Ages?}, year = {2018}, month = {12/2018}, pages = {1-30}, institution = {Urban Institute}, address = {Washington, DC}, abstract = {Tracking older adults in the Health and Retirement Study from 1992 to 2016, we find that about one-half of full-time, full-year workers ages 51 to 54 experience an employer-related involuntary job separation after age 50 that substantially reduces earnings for years or leads to long-term unemployment. The steady earnings that many people count on in their 50s and 60s to build their retirement savings and ensure some financial security in later life often vanishes, upending retirement expectations and creating economic hardship. This problem will likely intensify as more people realize they must work longer to enjoy a comfortable retirement.}, keywords = {Ageism, Discrimination, Employment and Labor Force, Retirement Planning and Satisfaction}, url = {https://www.urban.org/research/publication/how-secure-employment-older-ages}, author = {Richard W. Johnson and Gosselin, Peter} } @article {10351, title = {Is It Time to Raise the Social Security Retirement Age?}, year = {2018}, month = {11/2018}, institution = {The Urban Institute}, abstract = {Social Security faces a long-term financing problem. The program now spends more than it collects each year, and Social Security{\textquoteright}s trustees project that it will be unable to pay full benefits beginning in 2034. Reducing the payment period by raising the age at which beneficiaries can begin collecting benefits would improve Social Security{\textquoteright}s finances. But some older people, especially those with limited education and incomes, could suffer financially if they had to wait longer to collect retirement benefits. This report examines how raising Social Security{\textquoteright}s early entitlement age (EEA), currently 62, might affect beneficiaries and discusses ways to protect adults who might not be able to work until qualifying for Social Security benefits.}, url = {https://www.urban.org/research/publication/it-time-raise-social-security-retirement-age}, author = {Richard W. Johnson} } @article {9121, title = {Hispanics{\textquoteright} retirement transitions and differences by nativity.}, journal = {Journal of Aging and Health}, volume = {29}, year = {2017}, month = {09/2017}, pages = {1096-1115}, abstract = {

OBJECTIVE: This study examines differences in retirement decisions between older Hispanics and non-Hispanics, with a special focus on the role of nativity.

METHODS: We use 1998-2012 waves of the Health and Retirement Study. We estimate survival models of retirement and compare retirement transitions for U.S.-born Hispanics, foreign-born Hispanics, non-Hispanic Whites, and non-Hispanic Blacks.

RESULTS: Foreign-born Hispanics retire significantly later than other racial and ethnic groups. Controlling for personal characteristics, their risk of retirement is 39\% lower compared with non-Hispanic Whites. Retirement transitions do not differ significantly between U.S.-born Hispanics and non-Hispanic Whites.

DISCUSSION: Difference in retirement timing between U.S.- and foreign-born Hispanics may partly be due to lower incomes and wealth accumulation of foreign-born Hispanics. Workforce development initiatives, policy initiatives promoting retirement savings, and Social Security reforms could improve future retirement security for older Hispanics, and make retirement a viable option for more foreign-born Hispanics.

}, keywords = {Hispanics, Racial/ethnic differences, Retirement Planning and Satisfaction}, issn = {1552-6887}, doi = {10.1177/0898264317711608}, author = {Mudrazija, Stipica and Richard W. Johnson and Wang, Claire Xiaozhi} } @article {10490, title = {Financing Long-Term Services And Supports: Options Reflect Trade-Offs For Older Americans And Federal Spending.}, journal = {Health Affairs (Project Hope)}, volume = {34}, year = {2015}, month = {2015 Dec}, pages = {2181-91}, abstract = {

About half of older Americans will need a high level of assistance with routine activities for a prolonged period of time. This help is commonly referred to as long-term services and supports (LTSS). Under current policies, these individuals will fund roughly half of their paid care out of pocket. Partly as a result of high costs and uncertainty, relatively few people purchase private long-term care insurance or save sufficiently to fully finance LTSS; many will eventually turn to Medicaid for help. To show how policy changes could expand insurance{\textquoteright}s role in financing these needs, we modeled several new insurance options. Specifically, we looked at a front-end-only benefit that provides coverage relatively early in the period of disability but caps benefits, a back-end benefit with no lifetime limit, and a combined comprehensive benefit. We modeled mandatory and voluntary versions of each option, and subsidized and unsubsidized versions of each voluntary option. We identified important differences among the alternatives, highlighting relevant trade-offs that policy makers can consider in evaluating proposals. If the primary goal is to significantly increase insurance coverage, the mandatory options would be more successful than the voluntary versions. If the major aim is to reduce Medicaid costs, the comprehensive and back-end mandatory options would be most beneficial.

}, keywords = {Aged, Financing, Government, Humans, Insurance, Insurance Coverage, Long-term Care, Medicaid, Middle Aged, Policy Making, United States}, issn = {1544-5208}, doi = {10.1377/hlthaff.2015.1226}, author = {Melissa Favreault and Gleckman, Howard and Richard W. Johnson} } @article {5814, title = {Racial, Ethnic, and Gender Differentials in Employer-Sponsored Pensions}, year = {2010}, institution = {Urban Institute}, address = {Washington, D.C.}, abstract = {The best approaches to narrowing racial, ethnic, and gender differentials in retirement wealth are outside the current employer-sponsored pension system, Barbara Butrica and Richard Johnson told the U.S. Department of Labor{\textquoteright}s ERISA Advisory Council. These tactics include automatic IRAs for employees, efforts to raise wages earned by blacks and Hispanics, more federal funding for training and workforce development, better educational opportunities for future workers, and more financial education for workers and students. Protecting Social Security for low-income seniors is also crucial. Their testimony presents detailed information about differences in pension coverage and wealth. }, keywords = {Demographics, Pensions}, url = {http://www.urban.org/UploadedPDF/901357-racial-ethnic-gender-differentials.pdf?RSSFeed=UI_RetirementandOlderAmericans.xml}, author = {Barbara A Butrica and Richard W. Johnson} } @article {5823, title = {Work Ability and the Social Insurance Safety Net in the Years Prior to Retirement}, year = {2010}, institution = {The Urban Institute}, abstract = {A patchwork of public programs primarily Social Security Disability Insurance, workers compensation, Supplemental Security Income, and veterans benefits provides income supports to people who are unable to work. Yet, questions persist about the effectiveness of these programs. This report examines the economic consequences of disability in the years leading to retirement. Using data from the Health and Retirement Study, the analysis follows a sample of Americans age 51 to 55 in 1992 and computes their disability status, disability benefit receipt, and income until age 64, just before they qualify for full Social Security retirement benefits. The results underscore the precarious financial state of most people approaching traditional retirement age with disabilities. Fewer than half of people who meet our disability criteria ever receive disability benefits in their fifties or early sixties. Poverty rates for those who do are more than three times as high after benefit receipt than before disability onset.}, keywords = {Disabilities, Employment and Labor Force, Public Policy, Social Security}, url = {http://www.urban.org/UploadedPDF/412008_work_ability.pdf?RSSFeed=UI_RetirementandOlderAmericans.xml}, author = {Richard W. Johnson and Melissa Favreault and Corina D Mommaerts} } @article {5791, title = {Work and Retirement Patterns for the G.I. Generation, Silent Generation, and Early Boomers: Thirty Years of Change}, number = {WP$\#$2010-8}, year = {2010}, note = {Using Smart Source Parsing pp Center for Retirement Research, Working Papers, Center for Retirement Research at Boston College}, institution = {Center for Retirement Research at Boston College}, address = {Boston}, abstract = {This study examines how the shifting choices and constraints facing older workers have changed work and retirement patterns over the past 30 years. Health improvements, declines in physical job demands, changes in Social Security rules, and the erosion in traditional defined benefit pension coverage and employer-sponsored retiree health insurance have altered work incentives at older ages. This paper compares labor force exits by older workers born 1913 to 1917 (part of the G.I. Generation), 1933 to 1937 (part of the Silent Generation), and 1943 to 1947 (part of the Baby Boom Generation). The analysis uses 16-year longitudinal panels from the Health and Retirement Study and decades-long administrative earnings records linked to respondents in the Survey of Income and Program Participation. The results show that early boomers worked longer than members of the Silent Generation, and that the pathways older workers follow out of the labor force have become more complex over time. The median retirement age for men was about one-half year higher in the 1943-47 cohort than in the 1933-37 cohort (62 vs. 61.5), but differences were more pronounced at older ages. By age 65, for example, 40 percent of early boomer men had not yet retired, compared with only 20 percent of Silent Generation men. Both male and female workers in the 1933-37 cohort were much less likely than their counterparts in the 1913-17 cohort to follow the traditional retirement path of exiting the labor force from full-time employment and never returning to work.}, keywords = {Demographics, Employment and Labor Force, Pensions, Retirement Planning and Satisfaction}, url = {https://crr.bc.edu/working-papers/work-and-retirement-patterns-for-the-gi-generation-silent-generation-and-early-boomers-thirty-years-of-change/}, author = {Richard W. Johnson and Barbara A Butrica and Corina D Mommaerts} } @article {5744, title = {Do Health Problems Reduce Consumption at Older Ages?}, number = {WP$\#$2009-9}, year = {2009}, institution = {Center for Retirement Research at Boston College}, address = {Boston}, abstract = {High out-of-pocket health care costs may have serious repercussions for older people and their families. If their incomes are not sufficient to cover these expenses, older adults with health problems may have to deplete their savings, turn to family and friends for financial help, or forego necessary care. Or they may be forced to reduce their consumption of other goods and services to pay their medical bills. This paper uses data from the Health and Retirement Study (HRS) and the related Consumption and Activities Mail Survey (CAMS) to examine the impact of health problems at older ages on out-of-pocket health care spending and other types of expenditures. The analysis estimates fixed effects models of total out-of-pocket health care spending, out-of-pocket health care spending exclusive of premiums, total spending on all items except health care, and total spending on all items except health care and housing. The models are estimated separately for households ages 65 and older and those ages 51 to 64. The results show that medical conditions increase health spending, particularly for households ages 51 to 64, but that health conditions do not generally reduce nonhealth spending. Medical conditions do, however, reduce nonhealth spending for low-income households ages 51 to 64, suggesting that holes in the health safety net before the Medicare eligibility age force some low-income people to lower their living standards to cover medical expenses.}, keywords = {Healthcare, Medicare/Medicaid/Health Insurance}, url = {https://crr.bc.edu/working-papers/do-health-problems-reduce-consumption-at-older-ages/}, author = {Barbara A Butrica and Richard W. Johnson and Mermin, Gordon B.T.} } @article {5770, title = {Older Workers on the Move: Recareering in Later Life}, year = {2009}, institution = {AARP{\textquoteright}s Public Policy Institute}, abstract = {Recareering or career change is common at older ages. Workers who change careers typically move into jobs that pay less then their previous jobs and are less likely to offer pension and health benefits. On the positive side, new careers tend to offer more flexible employment arrangements, less stressful working conditions, and fewer managerial responsibilities. This report examines the extent and nature of career change by older workers and its consequences for later-life employment. Using data from the Health and Retirement Study (HRS), the analysis tracks a sample of workers ages 51 to 55 and employed full time in 1992 and computes the percentage who changed employers, occupations, or industries by 2006, when they were ages 65 to 69. In addition, the report measures the impact of personal and job characteristics on the likelihood that older workers switch employers and occupations. The report also examines how job characteristics such as wages, health insurance coverage, and pension coverage change when older workers move into new careers. Tabulations compare the new and old jobs in terms of occupation, industry, selfemployment, flexible work options, part-time work, stressful work conditions, managerial responsibilities, overall job satisfaction, and prestige scores that rank occupations in terms of social standing. Special attention is paid to the circumstances surrounding later-life job separations that influence career change. Older job changers who say they are retiring from their previous employers are especially likely to downshift into less demanding, more flexible new careers that pay less than their former positions. Laid-off workers and those who simply say they quit their former jobs are more likely than retirees to take new jobs in the same occupation. For this study, recareering involves a move to a new employer in a new occupation. The terms occupational change and career change or recareering are used interchangeably.}, keywords = {Employment and Labor Force, Retirement Planning and Satisfaction}, url = {https://assets.aarp.org/rgcenter/econ/2009_08_recareering.pdf}, author = {Richard W. Johnson and Kawachi, Janette and Lewis, Eric K.} } @article {7350, title = {Volunteer dynamics of older Americans.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {64}, year = {2009}, month = {2009 Sep}, pages = {644-55}, publisher = {64B}, abstract = {

OBJECTIVES: The impending retirement of boomers has spurred interest in tapping their productive energies to benefit society. This study examined volunteer transitions among older adults to understand the factors that affect volunteer dynamics.

METHODS: Using data from the Health and Retirement Study, the analysis examined entries into and exits from formal volunteer activities between 1996 and 2004 by adults aged 55-65 at study baseline. The study showed the duration of volunteer activities, the probability that older adults start and stop volunteering, and the factors that significantly predict volunteer transitions.

RESULTS: The findings reveal considerable stability among both volunteers and nonvolunteers; however, older adults are more likely to stop volunteering than to start. Volunteers who contribute intensely and for many years and who are married to volunteers are the least likely to quit. And nonvolunteers are more likely to start volunteering if they have been uninvolved for few years and their spouses volunteer.

CONCLUSIONS: The results point to the need to focus efforts on retaining older volunteers to maximize volunteer engagement during later years. Recruiting older adults in volunteer activities early on, ideally before they retire, could also help meet volunteer needs.

}, keywords = {Aged, Aging, Cross-Sectional Studies, Female, Humans, Life Change Events, Male, Middle Aged, Probability, Retirement, United States, Volunteers}, issn = {1758-5368}, doi = {10.1093/geronb/gbn042}, author = {Barbara A Butrica and Richard W. Johnson and Sheila R Zedlewski} } @article {5681, title = {What Happens to Health Benefits After Retirement?}, year = {2007}, institution = {Boston College, Center for Retirement Research at Boston College}, abstract = {Because most workers receive health benefits from their employers, retirement often disrupts health insurance coverage. Some employers offer health insurance to retirees, but many firms are cutting retiree health benefits by passing more costs to retirees or eliminating benefits altogether. Few alternatives exist. Private nongroup coverage is generally quite expensive, and few people in their 50s and early 60s qualify for publicly financed benefits. Many workers who cannot obtain retiree benefits from their own employers or their spouses employers delay retirement to age 65, when Medicare coverage begins. This brief examines the availability and cost of health insurance coverage at ages 55 to 64 and changes in coverage after retirement. Today most workers with employer health benefits retain their coverage when they retire early, although their required premium contributions have increased sharply over the past ten years. In the future, however, steady declines in the share of younger workers with access to retiree health benefits may jeopardize income security for the next generations of retirees.}, keywords = {Medicare/Medicaid/Health Insurance, Retirement Planning and Satisfaction}, url = {http://crr.bc.edu/briefs/what_happens_to_health_benefits_after_retirement_.html}, author = {Richard W. Johnson} } @article {7166, title = {Why Do Boomers Plan to Work Longer?}, journal = {The Journals of Gerongology, Series B: Psychological Sciences and Social Sciences}, volume = {62}, year = {2007}, pages = {S286-94}, publisher = {62}, abstract = {OBJECTIVE: Recent changes in retirement trends and patterns have raised questions about the likely retirement behavior of baby boomers, the large cohort born between 1946 and 1964. This study examined recent changes in retirement expectations and the factors that drove them. METHODS: Using data from the Health and Retirement Study, the analysis compared self-reported probabilities of working full time past ages 62 and 65 among workers aged 51 to 56 in 1992 and 2004. The study modeled retirement expectations for both generations and used the estimated regression coefficients to identify the forces that accounted for generational differences. RESULTS: Between 1992 and 2004, the mean self-reported probability of working full time past age 65 among workers aged 51 to 56 increased from 27 to 33 . Lower rates of retiree health insurance offers from employers, higher levels of educational attainment, and lower rates of defined benefit pension coverage accounted for most of the growth. DISCUSSION: Given the continued erosion in employer-sponsored retiree health benefits and defined benefit pension plans, boomers will likely remain at work longer than members of the previous generation. Lengthier careers will likely promote economic growth, increase government revenue, and improve individual financial security at older ages.}, keywords = {Employment and Labor Force, Retirement Planning and Satisfaction}, url = {http://psychsoc.gerontologyjournals.org/}, author = {Mermin, Gordon B.T. and Richard W. Johnson and Daniel P. Murphy} } @article {5648, title = {How Secure Are Retirement Nest Eggs?}, year = {2006}, institution = {Boston College, Center for Retirement Research}, abstract = {Life s uncertainties can upend the best-laid retirement plans. Health can fail as people grow older, or their spouses can become ill. Older people can lose their jobs, and often have trouble finding new ones. Marriages can end in widowhood or divorce. Health, employment, and marital shocks near retirement can have serious financial repercussions, raising out-of-pocket medical spending, reducing earnings, disrupting retirement saving, and forcing people to dip prematurely into their nest eggs. This brief examines different types of negative events that can strike near retirement. It reports the incidence of widowhood, divorce, job layoffs, disability, and various medical conditions over a 10-year period, and estimates their impact on household wealth. Data come from the Health and Retirement Study (HRS), a nationally representative survey of older Americans conducted by the University of Michigan for the National Institute on Aging. The survey interviewed a large sample of non-institutionalized adults ages 51 to 61 in 1992 and re-interviewed them every other year. The analysis uses data through 2002, the most recent year available. The results show that many people in their 50s and 60s experience negative shocks that threaten retirement security. Job layoffs, divorce, and the onset of work disabilities near retirement substantially erode retirement savings. The findings highlight the limitations of the safety net when things go wrong in late midlife.}, keywords = {Adult children, Consumption and Savings, Health Conditions and Status, Net Worth and Assets}, url = {http://www.bc.edu/centers/crr/ib_45.shtml}, author = {Richard W. Johnson and Mermin, Gordon B.T. and Cori E. Uccello} } @article {7108, title = {The Impact of Elder Care on Women{\textquoteright}s Labor Supply}, journal = {Inquiry}, volume = {43}, year = {2006}, pages = {195-210}, publisher = {43}, abstract = {Adult daughters traditionally have served as primary caregivers for frail unmarried adults, but the levels of care they have provided in the past may interfere with their growing work responsibilities. This paper examines the impact of time transfers to elderly parents on labor supply at midlife. Using a sample of women ages 55 to 67 in the Health and Retirement Study, we estimate panel data models of annual hours of paid work controlling for the endogeneity of time assistance to parents. The results indicate that time help to parents strongly reduces female labor supply at midlife.}, keywords = {Adult children, Demographics, Healthcare}, author = {Richard W. Johnson and LoSasso, Anthony T.} } @article {5647, title = {A Profile of Frail Older Americans and their Caregivers}, year = {2006}, institution = {Washington, DC, The Urban Institute}, keywords = {Health Conditions and Status, Healthcare}, url = {http://www.urban.org/UploadedPDF/311284_older_americans.pdf}, author = {Joshua M Wiener and Richard W. Johnson} } @article {5628, title = {Understanding Expenditure Patterns in Retirement}, year = {2005}, institution = {Center for Retirement Research at Boston College}, address = {Boston}, abstract = {Understanding the consumption needs of retirees is critical to assessing the adequacy of retirement income and the possible impact of Social Security reform on the well-being of older Americans. This study uses data from the Health and Retirement Study, including a recent supplemental expenditure survey, to analyze spending patterns and consumption needs for adults ages 65 and older. Results indicate that typical older married adults spend 84 percent of after-tax household income, and nonmarried adults spend 92 percent of after-tax income. Even at older ages individuals devote a larger share of their expenditures and income to housing than any other category of goods and services, including health care. Fully 8 percent of married adults report after-tax incomes that fall short of our estimated basic-needs threshold, consisting of housing, health care, food, and clothing. By comparison, only 3 percent of married adults have incomes below the official poverty level.}, keywords = {Consumption and Savings, Income}, url = {https://www.urban.org/research/publication/understanding-expenditure-patterns-retirement}, author = {Barbara A Butrica and Joshua H. Goldwyn and Richard W. Johnson} } @article {7020, title = {Who foregoes survivor protection in employer-sponsored pension annuities?}, journal = {Gerontologist}, volume = {45}, year = {2005}, month = {2005 Feb}, pages = {26-35}, publisher = {45}, abstract = {

PURPOSE: Retirees in traditional pension plans must generally choose between single life annuities, which provide regular payments until death, and joint and survivor annuities, which pay less each month but continue to make payments to the spouse after the death of the retired worker. This article examines the payout decision and measures the share of married retirees with pension annuities who forego survivor protection.

DESIGN AND METHODS: The analysis consists of a probit model of the pension payout decision, based on data from the 1992-2000 waves of the Health and Retirement Study.

RESULTS: More than one quarter (28\%) of married men and two thirds of married women receiving employer-sponsored retirement annuities declined survivor protection. Men with small pensions and limited household wealth, men in better health than their spouses, and men whose spouses have pension coverage from their own employers are more likely than other men to reject survivor protection.

IMPLICATIONS: Most workers appear to make payout decisions by rationally balancing the costs and benefits of each type of annuity, suggesting that existing measures to encourage joint and survivor annuities are adequate. However, the growth in 401(k) plans, which are generally not covered by existing laws protecting spousal pension rights, may leave widows vulnerable.

}, keywords = {Female, Humans, Male, Multivariate Analysis, Pensions, Socioeconomic factors, Spouses, United States}, issn = {0016-9013}, doi = {10.1093/geront/45.1.26}, author = {Richard W. Johnson and Cori E. Uccello and Joshua H. Goldwyn} } @article {5596, title = {Annuitized Wealth at Older Ages: Evidence from the Health and Retirement Study}, year = {2004}, institution = {Washington, DC, The Urban Institute}, keywords = {Net Worth and Assets}, author = {Richard W. Johnson and Burman, Leonard E. and Kobes, Deborah I.} } @article {5578, title = {Do Spouses Coordinate Their Retirement Decisions?}, year = {2004}, institution = {Center for Retirement Research at Boston College}, abstract = {The movement of married women into the labor market is transforming retirement behavior. A generation ago, when few married women spent many years in the labor force, it was relatively simple for spouses to coordinate their retirement decisions. Couples typically focused on the generosity of the husbands retirement benefits and the impact of his retirement decision on future benefits. Today, however, retirement decisions are more difficult to coordinate, because many women have accumulated substantial retirement benefits in their own names. As a result, many couples now need to consider how the decision to stop work will affect income and retirement benefits for both spouses. The evidence suggests that couples like to retire together and, since husbands tend to be older than their wives, the increased labor force participation of women may lead to later retirement of men. This brief examines retirement behavior and measures the extent to which husbands and wives appear to coordinate their retirement decisions.}, keywords = {Adult children, Retirement Planning and Satisfaction}, url = {http://www.bc.edu/crr}, author = {Richard W. Johnson} } @article {6958, title = {Economic status in later life among women who raised children outside of marriage.}, journal = {J Gerontol B Psychol Sci Soc Sci}, volume = {59}, year = {2004}, month = {2004 Nov}, pages = {S315-23}, publisher = {59B}, abstract = {

OBJECTIVE: Many single mothers are likely to face special economic challenges in old age, because they often have limited employment histories and cannot rely on husbands for financial support. This article examines the economic status of these women in later life.

METHODS: The analysis uses nationally representative data from the Health and Retirement Study to estimate multivariate models of income, assets, and poverty rates for women aged 65-75 in 1999.

RESULT: Controlling for education, current marital status, and race and ethnicity, the models indicate that women who spent > or =10 years raising dependent children outside of marriage are 55\% more likely to live in poverty at ages 65-75 than women who were always married when their children were young.

DISCUSSION: The financial difficulties confronting single mothers raising children persist into later life. Social Security reforms, especially those that are not tied to the current system of spousal and survivor benefits, could improve retirement security for these vulnerable women, whose numbers will begin to soar when the many women who raised children outside of marriage in the 1970s retire in coming years.

}, keywords = {Adolescent, Adult, Aged, Aging, Child, Child Rearing, Demography, Female, Humans, Illegitimacy, Middle Aged, Single-Parent Family, Social Support, Socioeconomic factors}, issn = {1079-5014}, doi = {10.1093/geronb/59.6.s315}, author = {Richard W. Johnson and Melissa Favreault} } @article {5602, title = {How Do Families Allocate Elder Care Responsibilities Between Siblings?}, year = {2004}, institution = {The Urban Institute}, keywords = {Adult children, Healthcare}, author = {Richard W. Johnson and LoSasso, Anthony T. and Lurie, Ithai Z.} } @article {6957, title = {Trends in Job Demands Among Older Workers, 1992-2002}, journal = {Monthly Labor Review}, volume = {127}, year = {2004}, pages = {48-56}, publisher = {127}, abstract = {The aging of the population raises concerns about the Nation{\textquoteright}s ability to support future retirees, whose numbers will soar once members of the {\textquotedblleft}baby-boom{\textquotedblright} cohort begin reaching old age in coming years. If current employment patterns persist, there will be fewer workers in the future available to produce goods and services, threatening standards of living for Americans of all ages. As long as job demands do not force many older workers into retirement, increasing employment among older adults could relieve these demographic pressures. This article explores the ability of the labor force to accommodate older adults by examining recent trends in job demands among older workers}, keywords = {Employment and Labor Force}, url = {https://www.bls.gov/opub/mlr/2004/07/art4full.pdf}, author = {Richard W. Johnson} } @article {6846, title = {Cash Balance Plans and the Distribution of Pension Wealth}, journal = {Industrial Relations}, volume = {42}, year = {2003}, note = {RDA 1998-006}, pages = {745}, publisher = {42}, abstract = {Recent pension plan coversions by numerous large employers have sparked debate about the merits of cash balance plans. This paper compares pension wealth in traditional defined benefit (DB) plans and cash balance plans for a national sample of coverred Americans aged 51 to 61. The simulations indicate that replacing DB plans with cash balance plans would redistribute pension wealth from those with long-term jobs to those with multiple short-term jobs and from those with substantial pension benefits to those with more limited benefits. Perhaps unexpectedly, women ad midlife in 1992 with DB coverage would lose wealth in cash balanace plans, but future cohorts of women are likely to fare better.}, keywords = {Net Worth and Assets, Pensions}, doi = {https://doi.org/10.1111/1468-232X.00314}, author = {Richard W. Johnson and Cori E. Uccello} } @article {5573, title = {Employment, Social Security, and Future Retirement Outcomes for Single Mothers}, year = {2003}, institution = {Chestnut Hill, MA, Center for Retirement Research at Boston College}, keywords = {Expectations, Social Security, Women and Minorities}, author = {Richard W. Johnson and Melissa Favreault and Joshua H. Goldwyn} } @article {6842, title = {Health Insurance Costs and Early Retirement Decisions}, journal = {Industrial and Labor Relations Review}, volume = {56}, year = {2003}, note = {RDA 1998-006}, pages = {716-729}, publisher = {56}, abstract = {The loss of health insurance may be an important component of the cost of retirement, especially for workers without retiree health insurance coverage. The authors find that insurance costs significantly reduce retirement rates for full-time wage and salary workers ages 51 to 61. Simulations suggest that a 1,000 increase in the net present value of health insurance premium costs reduces the probability of early retirement by 1.17 percentage points for men and by 0.24 percentage points for women, corresponding to elasticities of -0.22 and -0.24, respectively. The authors{\textquoteright} models predict that expanding the Medicare program to cover those aged 62-64 would increase retirement rates for workers with employer-sponsored coverage who lack retiree benefits, if the government subsidizes their coverage. However, the impact would be small, increasing overall retirement rates by only 7 .}, keywords = {Medicare/Medicaid/Health Insurance, Retirement Planning and Satisfaction}, doi = {10.2307/3590965}, author = {Richard W. Johnson and Davidoff, Amy J. and Perese, Kevin} } @article {6884, title = {Raising the Medicare Eligibility Age: Effects on the Young Elderly}, journal = {Health Affairs}, volume = {22}, year = {2003}, publisher = {22}, abstract = {ABSTRACT: If Medicare eligibility were delayed to age sixty-seven, as proposed periodically by policymakers, most sixty-five- and sixty-six-year-olds (the young elderly ) would find alternative sources of coverage. However, the loss of Medicare eligibility would leave about 9 percent of this age group uninsured, while another 11 percent would be underinsured because they could only afford limited nongroup policies. The impact would be much greater for certain subgroups, including blacks, Hispanics, and the poor. A buy-in plan that allows young elderly people to purchase Medicare coverage could reduce uninsurance rates, but only if it subsidizes premiums for those with limited incomes.}, keywords = {Medicare/Medicaid/Health Insurance}, doi = {https://doi.org/10.1377/hlthaff.22.4.198}, author = {Davidoff, Amy J. and Richard W. Johnson} } @article {5524, title = {Can Cash Balance Pension Plans Improve Retirement Security for Today{\textquoteright}s Workers?}, number = {14}, year = {2002}, note = {RDA 1998-006}, institution = {The Urban Institute}, abstract = {In recent years several large employers have replaced their traditional defined benefit pension plans with cash balance plans. This brief compares outcomes under each plan for a national sample of Americans near retirement with pension coverage. The findings show that cash balance plans would redistribute pension wealth from those who held long-term jobs to those with a series of short-term jobs. Individuals with limited pension wealth, especially those in the bottom quartile, would also benefit. Surprisingly, many women now approaching retirement age would lose pension wealth under cash balance plans, but future cohorts of older women are likely to fare better.}, keywords = {Pensions}, url = {https://www.urban.org/research/publication/can-cash-balance-pension-plans-improve-retirement-security-todays-workers}, author = {Richard W. Johnson and Cori E. Uccello} } @article {6811, title = {Does Informal Care from Adult Children Reduce Nursing Home Admissions for the Elderly?}, journal = {Inquiry}, volume = {39}, year = {2002}, publisher = {39}, keywords = {Adult children, Healthcare}, author = {LoSasso, Anthony T. and Richard W. Johnson} } @inbook {5178, title = {The Family, Social Security, and the Retirement Decision}, booktitle = {Social Security and the Family: Addressing Unmet Needs in an Underfunded System}, year = {2002}, note = {RDA 1998-006 ProCite field 6 : Chapter 9 in ProCite field 8 : eds.}, pages = {295-329}, publisher = {The Urban Institute Press}, organization = {The Urban Institute Press}, address = {Washington, DC}, keywords = {Adult children, Social Security}, author = {Melissa Favreault and Richard W. Johnson}, editor = {Melissa Favreault and Sammartino, F. and Steuerle, C. Eugene} } @article {6812, title = {Insuring the Near Elderly: The Potential Role for Medicare Buy-In Plans}, journal = {The Urban Institute}, volume = {The Retirement Project Brief Series}, year = {2002}, publisher = {The Retirement Project Brief Series}, abstract = {A Medicare buy-in allowing persons below the age of full eligibility to purchase Medicare coverage has been discussed as one way to help uninsured near elderly persons obtain insurance coverage. This brief summarizes findings from an Urban Institute report that examined potential participation rates in alternative buy-in plans and measured their potential impact on rates of uninsurance. Many individuals younger than 65 would purchase Medicare coverage, but without subsidies participation would be limited to those who could afford substantial premiums. Buy-ins would reduce uninsurance rates only if they provided subsidies to make the plans affordable to those with limited incomes.}, keywords = {Aging, Demographics, Medicare/Medicaid/Health Insurance}, url = {https://www.urban.org/research/publication/insuring-near-elderly}, author = {Richard W. Johnson and Davidoff, Amy J. and Marilyn Moon} } @article {5499, title = {A Medicare Buy In for the Near Elderly: Design Issues and Potential Effects on Coverage}, year = {2002}, institution = {Henry J. Kaiser Family Foundation}, address = {Washington, D.C.}, abstract = {A Medicare buy-in allowing persons below the age of full eligibility to purchase Medicare coverage has been discussed as one way to help uninsured near-elderly persons obtain health insurance coverage. This report describes estimates of participation rates in Medicare buy-ins and measures the potential impact of buy-in plans on uninsurance. The report also examines some key issues that arise in designing buy-in plans. The results suggest that many near-elderly Americans would purchase Medicare coverage, but the introduction of a buy-in would substantially reduce uninsurance rates only if premiums were related to income. }, keywords = {Demographics, Medicare/Medicaid/Health Insurance}, url = {http://files.kff.org/attachment/report-A-Medicare-Buy-In-for-the-Near-Elderly-Design-Issues-and-Potential-Effects-on-Coverage}, author = {Richard W. Johnson and Marilyn Moon and Davidoff, Amy J.} } @article {5505, title = {Medicare, Retirement Costs, and Labor Supply at Older Ages}, number = {WP$\#$2002-8}, year = {2002}, note = {RDA 1998-006}, institution = {Center for Retirement Research at Boston College}, address = {Boston}, abstract = {When workers retire, they forego the wages and many of the benefits they received while employed. By providing subsidized health insurance coverage to virtually every American at age 65, Medicare reduces the cost of retiring for workers who receive health benefits from their employers, especially when those benefits do not continue after retirement. As a result, an increase in the age of Medicare eligibility may lead many workers to delay retirement. This paper examines how a potential increase in the age of Medicare eligibility might affect retirement behavior by relating the health insurance costs of retirement to labor supply decisions. The insurance cost of retirement is the increase in health insurance premiums that workers face after they retire, relative to what they pay when working. We measure the effect of insurance costs on labor force withdrawals by including the net present value of premium costs in a multivariate model of retirement. We then simulate the impact of changes in the Medicare eligibility age by re-computing premium costs under the assumption that individuals could not receive Medicare coverage until age 67. We find that health insurance costs significantly discourage retirement, and that an increase in the age of Medicare eligibility would reduce retirement rates.}, keywords = {Employment and Labor Force, Medicare/Medicaid/Health Insurance}, url = {https://crr.bc.edu/working-papers/medicare-retirement-costs-and-labor-supply-at-older-ages/}, author = {Richard W. Johnson} } @article {5525, title = {Modeling Income in the Near Term: Revised Projections of Retirement Income Through 2020 for the 1931-1960 Birth Cohorts}, year = {2002}, note = {RDA 1998-006}, institution = {The Urban Institute}, address = {Washington, D.C.}, abstract = {The Division of Policy Evaluation (DPE) of the Social Security Administration (SSA) has entered into two contracts with the Urban Institute to help it develop a new tool for analyzing the distributional consequences of Social Security reform proposals. The first, awarded in 1998, led to the development of Modeling Income in the Near Term (MINT), a tool for simulating the retirement incomes of members of the Baby Boom and neighboring cohorts. The second, awarded in 2000, was to expand and improve on the first version of MINT. In all phases of the project, members of the research staff at SSA/DPE collaborated closely with the contractors. The Brookings Institution served as a subcontractor to the Urban Institute under both contracts and the RAND Corporation participated in the development of the initial version of MINT under a separate contract. This report describes the work of the researchers at Urban and Brookings under the second contract.}, keywords = {Disabilities, Net Worth and Assets, Pensions, Social Security}, url = {http://www.urban.org/UploadedPDF/410609_ModelingIncome.pdf}, author = {Toder, Eric and Thompson, Lawrence H. and Melissa Favreault and Richard W. Johnson and Perese, Kevin and Ratcliffe, Caroline and Karen E. Smith and Cori E. Uccello and Timothy A Waidmann and Berk, Jillian and Woldemariam, Romina and Gary T. Burtless and Claudia R Sahm and Douglas A. Wolf} } @article {6774, title = {Balancing Retirement Security with the Needs of Frail Parents: Caregiving, Financial Transfers, and Work by Women at Midlife}, journal = {North American Actuarial Review}, volume = {5}, year = {2001}, publisher = {5}, abstract = {Caring for frail elderly parents can interfere with work responsibilities. People who provide care to their parents may need to take time off from work or retire altogether. However, reductions in labor supply at midlife can have serious implications for retirement wealth and, as a result, on economic well-being in later life. This paper examines how family support for the elderly can affect retirement savings by examining the relationship between labor supply, time help to parents, and financial assistance to parents. Using data from the Health and Retirement Study on a nationally representative sample of women ages 53{\textendash}63, we found that women who helped their parents with personal care assistance worked significantly fewer hours than did those who did not help their parents, whereas those who provided financial assistance worked significantly more hours. Although few persons at midlife presently spend substantial amounts of time helping their elderly parents in any given year, for those who do, the costs can be high. Pressures on families are likely to mount in the near future as falling mortality and fertility rates continue to increase the proportion of the population that is very old and as women continue to play more important roles in the labor market.}, keywords = {Adult children, Demographics, Health Conditions and Status, Healthcare, Women and Minorities}, doi = {10.1080/10920277.2001.10595957}, author = {Richard W. Johnson and LoSasso, Anthony T.} } @article {5433, title = {Medicare and Retirement Decisions}, year = {2001}, institution = {The Urban Institute}, keywords = {Medicare/Medicaid/Health Insurance, Retirement Planning and Satisfaction}, author = {Richard W. Johnson} } @article {5459, title = {The Potential Effects of Cash Balance Plans on the Distribution of Pension Wealth at Midlife}, year = {2001}, institution = {The Urban Institute}, address = {Washington, D.C.}, abstract = {Recent pension plan conversions by numerous large employers have sparked debate about the merits of cash balance plans. This paper compares pension wealth in traditional defined benefit (DB) plans and cash balance plans for a national sample of covered Americans ages 51 to 61. The simulations indicate that replacing DB plans with cash balance plans would redistribute pension wealth from those who held long-term jobs for many years to those with multiple short-term jobs. Women at midlife in 1992 with DB coverage would have lost wealth in cash balance plans, but future cohorts of women are likely to fare better.}, keywords = {Net Worth and Assets, Pensions}, url = {https://www.urban.org/research/publication/potential-effects-cash-balance-distribution-pension-wealth-midlife}, author = {Richard W. Johnson and Cori E. Uccello} } @article {5453, title = {Retiring Together or Working Alone: The Impact of Spousal Employment and Disability on Retirement Decisions.}, number = {2001-1}, year = {2001}, note = {RDA 1998-006}, institution = {Center for Retirement Research at Boston College}, address = {Boston}, abstract = {It is commonly the case that spouses retire at the same time as one another, however, this study examines the effect of one persons decision to retire, because of injury, on their spouses work decisions. Understanding the effects of injury related retirement on the work status of the spouse is of great importance to policy makers. This article focuses on retirement decisions and how they are influenced by spousal health and employment status. Mathematical models and interpretations are made in order to analyze the data. They noticed that a vast majority of women that worked for pay did so when their husband was also employed. When the husband retired voluntarily women were slightly less likely to stay employed. Differences in spousal employment, especially between classes, was greatest when the husband was under 62 and therefore not able to receive Social Security. Men were less likely to work if their wife was not working. If the husband retired involuntarily the wife was more likely then not to return to the workforce or continue to work.}, keywords = {Adult children, Retirement Planning and Satisfaction}, url = {https://crr.bc.edu/working-papers/retiring-together-or-working-alone-the-impact-of-spousal-employment-and-disability-on-retirement-decisions/}, author = {Richard W. Johnson and Melissa Favreault} } @article {6686, title = {Economic, Cultural, and Social Origins of Emotional Well-Being: Comparisons of Immigrants and Natives at Midlife}, journal = {Research on Aging}, volume = {22}, year = {2000}, pages = {599-629}, publisher = {22}, abstract = {Linking theories of social stratification, ethnicity, and mental health with theories of human and social capital, the authors examine the impact of economic, cultural, and social factors on five different dimensions of emotional well-being for immigrants and natives at midlife. Based on data from the 1992 wave of the Health and Retirement Study, the authors found that economic factors and human capital variables are the most important determinants of emotional health for both immigrants and natives. The results indicate that cultural factors can enhance emotional well-being. Religious affiliation and participation are important for both immigrants and natives, but religious participation appears to be more beneficial for immigrants. Being part of a couple was also associated with better emotional health, especially for immigrants. The effects of several determinants of emotional health differed across immigrant groups. It was found that marriage, education, and the presence of economically stable kin are particularly important for Cubans. 6 Tables, 36 References. Adapted from the source document}, keywords = {Demographics, Health Conditions and Status, Other}, doi = {10.1177/0164027500226002}, author = {Hao, Lingxin and Richard W. Johnson} } @article {5413, title = {Family Support of the Elderly and Female Labor Supply: Tradeoffs Among Caregiving, Financial Transfers, and Work}, year = {2000}, institution = {The Urban Institute}, keywords = {Adult children, Employment and Labor Force, Healthcare, Women and Minorities}, author = {Richard W. Johnson and LoSasso, Anthony T.} } @article {6718, title = {Parental Care at Midlife: Balancing Work and Family Responsibilities near Retirement}, journal = {The Retirement Project Brief Series}, volume = {9}, year = {2000}, publisher = {The Retirement Project Brief Series}, abstract = {The costs of providing care informally at home to frail elderly persons can be substantial, especially if caregivers are forced to interrupt their careers or retire early when they provide care. This report describes findings from a recent Urban Institute study of the characteristics of persons in their fifties and early sixties who provide care to their elderly parents and the trade-offs that families face when they divide their time between the provision of informal care and paid work. Estimates were based on a sample of men and women between the ages of 53 and 65 in the 1994 and 1996 waves of the Health and Retirement Study. Only 11 percent of women and 6 percent of men at midlife devoted more than 100 hours per year to assisting their parents in 1994 with personal care, chores, or errands. However, for those who did provide informal care the costs were high. Results from simultaneous panel data models indicated that women who assisted their parents reduced their annual labor supply by 459 hours, which translated on average to about $7,800 in pre-tax lost earnings per year in 1994 dollars. The estimated effect was almost identical for men, who reduced their labor supply by 462 hours when they helped their parents. Although some proposed legislation would compensate caregivers for lost earnings and benefits with tax and Social Security credits, it is difficult to design policies that narrowly target those who reduce hours of work to help their parents.}, keywords = {Adult children, Demographics, Health Conditions and Status, Healthcare}, doi = {10.2139/ssrn.260259}, author = {Richard W. Johnson and Anthony T. Lo Sasso} } @article {6676, title = {Pension Wealth at Midlife: Comparing Self-Reports with Provider Data}, journal = {Review of Income and Wealth}, volume = {461}, year = {2000}, note = {ProCite field 3 : Urban Institute; Rutgers U; Rutgers U}, pages = {59-83}, publisher = {461}, abstract = {This paper evaluates the accuracy of estimates of pension wealth based on self-reports by comparing them to estimates based on provider data. Using data from the Health and Retirement Study, we found that few workers are well informed about their future pension benefits. Self-reports were often incomplete and typically varied widely from those based on information from providers. In defined benefit (DB) plans, discrepancies were greatest for workers who had limited education, earned low wages, and did not expect to retire soon. Differences in median pension wealth were smaller at the aggregate level than the individual level, because individual differences tended to offset each other when aggregated. Provider data appear better than self-reports for DB plans, but not for defined contribution (DC) plans. Where both are available, the best method of computing pension wealth may be to estimate DB wealth from provider data and to estimate DC wealth from self -reports.}, keywords = {Employment and Labor Force, Methodology, Net Worth and Assets, Pensions, Retirement Planning and Satisfaction}, doi = {10.1111/j.1475-4991.2000.tb00391.x}, author = {Richard W. Johnson and Sambamoorthi, Usha and Crystal, Stephen} } @article {5408, title = {The Trade-Off Between Hours of Paid Employment and Time Assistance to Elderly Parents at Midlife}, year = {2000}, institution = {The Urban Institute}, address = {Washington, D.C.}, abstract = {Although the family has traditionally been the primary caregiver for the frail elderly, the rising labor force participation rates of married women may interfere with their historical caregiving responsibilities. This paper explores time transfers to elderly parents and their impact on labor supply for persons at midlife. We estimate simultaneous panel data models of annual hours of paid work and the provision of time assistance to parents for a sample of men and women ages 53-65 in the Health and Retirement Study. Our results indicate that time help to parents substantially reduces labor supply for both women and men.}, keywords = {Adult children, Demographics, Health Conditions and Status, Healthcare}, url = {https://www.urban.org/research/publication/trade-between-hours-paid-employment-and-time-assistance-elderly-parents-midlife}, author = {Richard W. Johnson and LoSasso, Anthony T.} } @article {6698, title = {Uninsured status and out-of-pocket costs at midlife.}, journal = {Health Serv Res}, volume = {35}, year = {2000}, month = {2000 Dec}, pages = {911-32}, publisher = {35}, abstract = {

OBJECTIVE: To investigate how baseline health insurance coverage affects subsequent out-of-pocket costs and utilization of health services over a two-year period.

DATA SOURCE: The first two waves of the Health and Retirement Study, a nationally representative survey of the noninstitutionalized population, ages 51 to 61 at baseline. Interviews were conducted in 1992 and 1994. Our sample consisted of 7,018 respondents who did not report public insurance as their sole source of coverage at baseline.

STUDY DESIGN: We compared self-reports of physician visits, hospitalizations, and out-of-pocket health care costs, measured as payments to physicians, hospitals, and nursing homes, by type of insurance coverage at the beginning of the period. We estimated multivariate models of costs and service use to control for individual health, demographic, and economic characteristics and employed instrumental variable techniques to account for the endogeneity of insurance coverage.

PRINCIPAL FINDINGS: Controlling for personal characteristics and accounting for the endogeneity of insurance coverage, persons at midlife with job-related health benefits went on to spend only about $50 per year less in out-of-pocket payments for health services than persons who lacked health insurance at the beginning of the period. However, they spent about $650 more per year in insurance premiums than the uninsured. The uninsured used relatively few health services, except when they were seriously ill, in which case they were likely to acquire public insurance.

CONCLUSIONS: The medically uninsured appear to avoid substantial out-of-pocket health care costs by using relatively few health services when they are not seriously ill, and then relying upon health care safety nets when they experience medical problems. These results suggest that the main impact of non-insurance at midlife is not to place the locus of responsibility for costly health care upon individuals. Instead, it discourages routine care and transfers the costs of care for severe health events to other payers. Our findings on the high cost of employment-based coverage are consistent with evidence that the proportion of workers accepting health benefits from employers has been declining in recent years.

}, keywords = {Age Factors, Female, Financing, Personal, Health Care Surveys, Health Services, Health Status, Humans, Insurance Coverage, Insurance, Health, Longitudinal Studies, Male, Medically Uninsured, Middle Aged, Models, Econometric, Multivariate Analysis, Surveys and Questionnaires, United States}, issn = {0017-9124}, author = {Richard W. Johnson and Crystal, Stephen} } @article {6644, title = {Gender differences in pension wealth: estimates using provider data.}, journal = {Gerontologist}, volume = {39}, year = {1999}, month = {1999 Jun}, pages = {320-33}, publisher = {39}, abstract = {

Information from pension providers was examined to investigate gender differences in pension wealth at midlife. For full-time wage and salary workers approaching retirement age who had pension coverage, median pension wealth on the current job was 76\% greater for men than women. Differences in wages, years of job tenure, and industry between men and women accounted for most of the gender gap in pension wealth on the current job. Less than one third of the wealth difference could not be explained by gender differences in education, demographics, or job characteristics. The less-advantaged employment situation of working women currently in midlife carries over into worse retirement income prospects. However, the gender gap in pensions is likely to narrow in the future as married women{\textquoteright}s employment experiences increasingly resemble those of men.

}, keywords = {Female, Humans, Male, Occupations, Pensions, Sex Factors, United States, Women, Working}, issn = {0016-9013}, doi = {10.1093/geront/39.3.320}, author = {Richard W. Johnson and Sambamoorthi, Usha and Crystal, Stephen} } @article {6667, title = {The Gender Gap in Pension Wealth: Is Women{\textquoteright}s Progress in the Labor Market Equalizing Retirement Benefits?}, journal = {The Urban Institute}, volume = {The Retirement Project Brief Series}, year = {1999}, publisher = {The Retirement Project Brief Series}, keywords = {Demographics, Employment and Labor Force, Net Worth and Assets, Women and Minorities}, url = {https://www.urban.org/sites/default/files/publication/69736/310238-The-Gender-Gap-in-Pension-Wealth.PDF}, author = {Richard W. Johnson} } @article {6575, title = {Health insurance coverage at midlife: characteristics, costs, and dynamics.}, journal = {Health Care Financ Rev}, volume = {18}, year = {1997}, month = {1997 Spring}, pages = {123-48}, publisher = {18}, type = {Journal}, abstract = {

Recent data from the first two waves of the Health and Retirement Study are analyzed to evaluate prevalence of different types of health insurance, characteristics of different plan types, and change sin coverage as individuals approach retirement age. Although overall rates of coverage are quite high among the middle-aged, the risk of noncoverage is high within many disadvantaged groups, including Hispanics, low-wage earners, and the recently disabled. Sixty percent of individuals with health benefits are enrolled in health maintenance organizations (HMOs) or preferred provider organizations (PPOs). In addition, one-fourth of enrollees in fee-for-service (FFS) plans report restrictions in their access to specialists.

}, keywords = {Age Factors, Costs and Cost Analysis, Demography, Female, Health Benefit Plans, Employee, Health Care Surveys, Humans, Insurance Coverage, Insurance, Health, Logistic Models, Longitudinal Studies, Male, Middle Aged, United States}, issn = {0195-8631}, url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4194511/}, author = {Richard W. Johnson and Crystal, Stephen} } @article {5330, title = {Employer-Provided Health Benefits Among Middle-Aged Americans: Coverage Patterns and Transitions}, year = {1996}, institution = {Washington, DC, Department of Labor, Pension and Welfare Benefits Administration}, keywords = {Medicare/Medicaid/Health Insurance}, author = {Crystal, Stephen and Richard W. Johnson} } @article {5302, title = {The Impact of Worker Preferences On Pension Coverage in the HRS}, year = {1993}, institution = {University of Michigan}, abstract = {Heterogenous workers place different valuations on employer-provided pensions, depending upon such factors as the individual{\textquoteright}s degree of risk aversion, life expectancy, personal rates of time preference, earnings and access to alternative sources of retirement income. As a result, workers with relatively strong preferences for deferred compensation may sort themselves into jobs which offer generous pensions. Using primarily experimental data from the first wave of the Health and Retirement Survey, this paper tests the extent to which pension coverage is driven by worker demand. Probit estimates indicate the risk averse workers have significantly higher rates of pension coverage, particularly among those with low earnings. Among workers who recently began their jobs, those expecting to live longer are also more likely to be included in a pension plan. Rates of time preference have a marginally significant impact on pension coverage. There is no evidence that employer pensions substitutes for other forms of retirement saving.}, keywords = {Other, Pensions}, url = {http://www.psc.isr.umich.edu/pubs/series.html}, author = {Richard W. Johnson} }