The Medicare Trustees had great news for American seniors on Friday: the program’s solvency has been extended for two full years past what the trustees predicted in 2012.

In their annual report, the trustees wrote that Medicare’s hospital insurance trust fund will be fully solvent through 2026. That’s over a decade longer than what the trustees projected back in 2009. In general, Medicare inflation has been lower than general economic growth over the last three years.

That means that the program has more funds to pay for seniors’ medical care, making extreme cost-cutting measures such as slashing benefits for prescription drugs or other services unnecessary. Congressional Republicans have regularly insisted on reducing the federal deficit by making seniors pay more for their medical care.

The upward projections are likely a consequence of several factors. First, the 10-year revision from 2009 is a direct result of Obamacare. The health law takes $700 billion of excessive and wasteful payments made to private providers that service the Medicare Advantage program and reallocates it to traditional Medicare. Conservatives have made the outlandish claim that this “robs Medicare,” when in fact it does the exact opposite, and Republicans have included the same savings in their own budgets.

Then there’s the fact that that health care cost growth has slowed dramatically in recent years. Studies on the exact reason for that slowdown are conflicted on the extent to which it will be permanent. Some experts believe that it is largely due to lower medical consumption because of the recession, and will return to traditionally higher pre-recession levels as the economy gets better.

Others disagree, crediting structural changes to the health care system encouraged by Obamacare. For instance, the health law incentivizes the creation of accountable care organizations (ACOs) in which doctors, nurses, hospitals, social workers, and pharmacists work together to improve seniors’ health and reducing excess Medicare spending.

That’s a more likely explanation, since Obamacare is already fostering these positive collaborations in health care. In fact, the slowdown in health care cost growth has already forced the Congressional Budget Office (CBO) to revise its long-term deficit projection down by more than $500 billion, since Medicare spending is the primary driver of U.S. debt.

Only time will tell if the changes really are permanent. But for now, it seems that Medicare is only getting stronger — and that’s a huge relief for sick American seniors.

As the Baby Boomer generation begins to enter their senior years — the first Baby Boomers to hit 65 years old passed that milestone in 2011 — analysts are warning that the impending demographic shift could put a serious drain on the nation’s health resources. Seniors already tend to consume more health care than younger Americans, but Baby Boomers are also expected to be sicker and live longer than previous generations.

Since the United States is continuing to grapple with growing rates of chronic diseases like obesity and diabetes, an aging population could soon signal a health care crisis, a new report from the United Health Foundation finds. “This is a really important time in our nation’s history for us to take a look at this demographic change and the health and behavior outcomes for this population. If we don’t measure it, we won’t know what to do about it,” Rhonda Randall, one of United Health Foundation’s senior advisers, explained.

After analyzing multiple sources of government data, the report found that nearly 8 in 10 seniors are currently living with at least one chronic health condition. And many of those health issues stem from the nation’s ongoing struggle with obesity. About 25 percent of seniors are obese, 20 percent have diabetes, and more than 70 percent have heart disease. Since obesity rates among those ages 50 to 64 increased 8 percent between 1995 to 2010, the next generation of seniors will likely experience higher rates than current seniors do.

The states with the worst health outcomes for seniors are concentrated in the South, where seniors are more likely to live in poverty and lack access to the health treatment they need:

Treating those health issues for an aging population won’t come cheap. Americans over 65 spend three to five times more on their health care than adults younger than 65 — and that demographic sector will explode as Baby Boomers continue to age. In 2030, when the entire Baby Boomer generation will have turned 65, seniors will make up one-fourth of the entire population. And, since medical advances are now allowing Americans to live longer, 5.8 million of those seniors are projected to be older than 85.

The report’s findings should be “a heads-up to the providers, and a real heads-up to policy makers,” Jennie Chin Hansen, the CEO of the American Geriatrics Society, told USA Today.

The United Health Foundation’s findings echo previous data that has found that Baby Boomers are sicker than their parents’ generation. Although Baby Boomers are living longer than their parents did, their quality of life has significantly declined, thanks in large part to the wide-ranging public health consequences of the persistent obesity epidemic.

Preliminary analyses of the 2010 U.S. Census indicated that less than one in ten American seniors live in poverty. But a new and more nuanced “supplemental” poverty metric finds that number may actually be closer to one in seven seniors when accounting for their out-of-pocket medical bills.

The “original” poverty metric has been used since the 1960s. But some argue that it’s an archaic measuring stick, since health care costs and — consequently — out-of-pocket spending on medical services have exploded in the ensuing decades. That means that, despite access to relatively generous health coverage through Medicare (another 1960s-era program), seniors have been forced to pay an increasing share of their retirement income on hospital and drug bills over the last 50 years. And seniors who suffer from costly, chronic medical conditions such as cancer and Alzheimer’s are especially burdened by those escalating costs.

Since the new measure takes these contemporary expenses into account, it paints a more accurate picture of the American poverty landscape. And as a state-level analysis of the numbers by the Kaiser Family Foundation highlights, things don’t look very good:

The share of seniors living in poverty is higher in every state under the supplemental measure than under the official measure, and at least twice as high in 12 states: California, Colorado, Connecticut, Hawaii, Massachusetts, Maryland, Minnesota, New Hampshire, New Jersey, Nevada, Wisconsin, and Wyoming.

The share of seniors living in poverty under the supplemental measure is especially high in some areas. Based on the supplemental measure, about one in four seniors (26%) are living in poverty in DC and roughly one in five seniors are living in poverty in six states: California (20%); Hawaii, Louisiana, and Nevada (19%), and Georgia and New York (18%).

One possible reason that senior poverty rates in the aforementioned states are so high when taking medical expenses into account is that hospitals in those regions may charge more money for drugs and medical services — certainly a possibility considering that U.S. medical prices are essentially arbitrary. Another potential explanation is that these states have more seniors who are less likely to be eligible for Medicare due to immigration or citizenship status, and a higher number of poor seniors with chronic medical conditions.

But the key takeaway from the numbers is that, despite many seniors’ access to generous public health entitlements, they still can’t afford the associated costs of their medical care. And that means that efforts to reduce the federal deficit through cuts to health care programs amounts to putting more fiscal strain on a vulnerable population that can’t even afford treatments under the status quo.

Yet, the congressional GOP — and some Democrats — has vehemently encouraged such cuts. For instance, Republicans insisted on raising the Medicare eligibility age from 65 to 67 during budget negotiations in February, even though such a move would only net $5.7 billion in federal savings while shifting double that amount in costs onto seniors.

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A new study published in the Journal of the American Medical Association (JAMA) Internal Medicine raises a provocative question: can patients’ religious faith — and the spiritual support given to them by their caregivers — influence their decisions on end-of-life medical services and health care spending? The short answer, according to researchers’ findings, is yes — with some caveats.

Dr. Tracy Balboni of Dana-Farber Cancer Institute in Boston led the new study, which tracked 343 Americans with advanced cancers from its launch in 2002 up through their deaths. The results were striking. Compared to those who reported a lower level of spiritual support, the 43 percent of study participants who reported “high spiritual support” from religious communities were about a third as likely to receive end-of-life (EoL) hospice care, over two and half times more likely to to receive some form of aggressive — and expensive — EoL service (like being put on a ventilator or pursuing additional chemotherapy), and five times more likely to die in a hospital ICU in their last week of life.

Furthermore, patients who self-reported the highest levels of “religious coping” during their final days were 11 times as likely to receive aggressive EoL treatments and 22 times more likely to die in the ICU compared to those with lower levels of religious coping. Those numbers were also elevated for minority populations, particularly African Americans, who are among America’s most religious ethnic groups.

So what’s at the root of these notable trends — and what lessons do they hold for doctors who want to provide their patients with the best care while also reducing the number of unnecessary procedures they must undergo in their last days? Researchers speculate that the numbers may have something to do with religious Americans’ belief in a higher power and the prospect of God working through medical professionals. “One possibility is that religious people consider medicine to be a primary means of divine intervention,” wrote Balboni and her colleagues. They also mused that strong religious community support could foster the desire to “persevere” through “hope found within suffering” — in essence, the mettle to refuse to call it quits.

But as the study’s findings on these religious community-supported patients’ ICU death rates shows, channeling that faith-based will to live into aggressive medical care isn’t necessarily effective — and, to be blunt, it contributes to wasteful health care spending by Americans and public entitlement programs such as Medicare. EoL hospice care isn’t a huge proportion of total health care spending — but aggressive medical interventions for chronically ill elderly Americans on the cusp of death is, with the top five percent of such patients accounting for over $600 billion in health spending every year.

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According to a new study commissioned by Bank of America Corp’s Merrill Lynch, health problems and health care are the top concerns for the Americans who are approaching retirement. Even among wealthier Americans — defined in this survey as those who have more than $250,000 in investable assets — health care expenses represent the most pressing financial concern they anticipate having during their retired years.

When asked to rank their financial worries for retirement, respondents overwhelmingly selected health care expenses as their biggest concern. Over 50 percent of the Americans in the wealthier group, as well as nearly 40 percent of those who were defined as less wealthy, said they were most worried about struggling to afford their health costs:

Health problems, rather than financial success, were also ranked as the top reason that the retired respondents decided to stop working. That could point to the fact that many Americans aren’t saving up as much money as they would like to before retiring. That’s consistent with previous research that shows that the Great Recession has negatively impacted older Americans’ ability to retire. Almost two-thirds of working Americans now report they’re planning to delay their retirement, and most Americans say they’re putting off retiring so they can continue to access health benefits through their employer-sponsored insurance plans.

Medical costs have been soaring across the entire health care sector — and, since end-of-life care is typically expensive, that trend especially impacts retired seniors. The median cost of living in a nursing home is now more than twice as much as a private college tuition. High medical costs end up bankrupting one in four U.S. seniors, despite the coverage offered under Medicare.

On Tuesday, Rep. Renee Ellmers (R-NC) introduced H.R. 1416, The Cancer Patient Protection Act of 2013. According to a press release on Ellmers’ congressional webpage, the bill would reverse sequester cuts to Medicare funding for physician-administered chemotherapy drugs, which she calls “an unintended consequence of sequestration,” and reimburse doctors for any cuts that have affected them since the beginning of the month. The sequester’s two percent cut to Medicare Part B has been forcing community cancer clinics to turn away thousands of Medicare beneficiaries and deny them their treatments.

Although the congresswoman — a registered nurse — claims that the cuts to oncologists administering chemotherapy are simply an “unintended consequence,” they are anything but. The Budget Control Act, which included the sequester, specifically states that Medicare is subject to an across-the-board two percent cut. That’s about as intentional as you can get.

What Ellmers is really saying is that she didn’t realize exactly what those cuts would mean for the well-being of real Americans once they were actually implemented. She voted for the Budget Control Act back in 2011 and was still arguing the merits of sequestration earlier this year. “I do believe [the sequester] will start a very important process that will help our economy to start to grow. The debt that we have at the federal level is our biggest threat for our country,” she told the Washington Post in February.

That’s a shift from the recent rhetoric from Ellmers’ GOP colleagues. Republicans in Congress have been largely brushing off the sequester cuts, claiming their impact has been exaggerated and they aren’t actually a big deal. But now that the cuts are forcing schools, aviation centers, health care providers, and countless other organizations that receive federal funding to make tough decisions in the face of sequestration — decisions that affect Republican constituencies just as much as they affect Democratic ones — it’s becoming clear that abstract numbers on a balance sheet have tangible, real-world effects.

According to CNNMoney, the median cost of living in private nursing homes and assisted living facilities has ballooned by 24 percent and 23 percent, respectively, over the last five years. The median annual cost of private nursing home care is now $83,950 — almost two and half times the mean tuition at private not-for-profit colleges in 2010-2011.

Semi-private room costs in nursing homes have risen to $75,405 per year, and even a stay at an assisted living facility — where patients do not receive anywhere near the level of care that they would at a private nursing home — now tends to cost over $41,000 per year. As Bob Bua, vice president of long-term care provider Genworth, explained, employees at nursing homes “rarely get pay decreases, food rarely costs less, rent rarely goes down — it’s an ever-increasing cycle.”

The CNNMoney article points out that less costly alternatives include hiring home health care aides and other live-in assistance. The median price for those services have only risen at about one percent per year over the last half decade to about $44,000 annually. But considering health aide salary data released last month, even that comparatively low price is a figure that is greatly inflated by organizations providing assistance services to the elderly. Home health aid — the fastest-growing job in America — pays less than $10 per hour, meaning that a full-time worker makes only around $20,000 per year.

These new numbers underscore the financial and medical strain put on elderly Americans due to the ever-increasing cost of health care services. Despite generous coverage under Medicare, high out-of-pocket costs bankrupt one in four American seniors because medical services themselves cost so much money. And more than half of Americans will delay their retirement so as not to lose health benefits — a consequence of America’s entrenched system of employer-sponsored insurance.

On Tuesday, the Associated Press (AP) published an article recounting a Society of Actuaries (SOA) study that finds health insurance premiums “will jump an average 32 percent for Americans’ individual policies under President Obama’s overhaul.” That titillating claim formed the basis of multiple news agencies’ headlines Wednesday morning, including NBC News, Fox News, and U.S. News and World. But as several other analyses show — and the report’s own authors admit — these assertions are based on an extremely narrow interpretation of the health care law that assumes rising costs in perpetuity while ignoring its very real cost-cutting measures.

In essence, SOA argues that Obamacare provisions extending health coverage to all Americans regardless of their pre-existing medical conditions will dramatically raise costs in the individual insurance market — especially since sicker, older Americans will have guaranteed access to insurance and cannot be charged more than three times the premiums of younger people. The Society’s projections are quite dramatic, finding that premium rate increases by 2017 “would be 62 percent for California, about 80 percent for Ohio, more than 20 percent for Florida and 67 percent for Maryland.”

Corporate insurance giants have used many of these same arguments to dishonestly justify double-digit rate hikes on their customers, despite soaring profits. But these claims are founded on a baseline that assumes current health care cost trends to be set in stone, and ignore — even by the SOA’s own admission — almost all of Obamacare’s most important consumer protections and market regulations aimed at lowering overall costs. Rick Foster, a retired Medicare actuary, admitted that, although the study’s projections are consistent with certain health care trends, they don’t necessarily reflect the bigger picture:

“Having said that,” Foster added, “actuaries tend to be financially conservative, so the various assumptions might be more inclined to consider what might go wrong than to anticipate that everything will work beautifully.” Actuaries use statistics and economic theory to make long-range cost projections for insurance and pension programs sponsored by businesses and government. [...]

Kristi Bohn, an actuary who worked on the study, acknowledged it did not attempt to estimate the effect of subsidies, insurer competition and other factors that could mitigate cost increases. She said the goal was to look at the underlying cost of medical care.

In fact, more comprehensive studies of the health reform law that incorporate all of its provisions — rather than just the potentially negative ones — have found that “[m]ost young adults and families will be largely shielded from the full effects of the narrower age rating bands thanks to the ACA’s increased eligibility for Medicaid and tax credits offered through state health insurance exchanges or through access to employer-sponsored insurance,” and that Americans between the ages of 21 and 27 purchasing insurance through the individual market “will be protected by Medicaid/CHIP or exchange-based subsidies under reform.”
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