By Geoff Williams via US News

It’s that time of year when everyone is looking ahead – but if you’re feeling really reflective, you may be looking ahead many years ahead. That is, you may be wondering what your retirement will look like. And why not? Whether you love or hate your career, it’s always interesting to contemplate what one’s life will be like after you stop working full time.

It can be scary to contemplate as well. Last year, the Employee Benefit Research Institute’s 2017 Retirement Confidence Survey, which surveyed 1,671 individuals, found that just six in 10 Americans said they had saved money for retirement and only 40 percent had tried to calculate how much income they’d need each month after leaving work.

Still, if you’re looking for some good news and wondering what the future holds, there are a number of things that will likely make your retirement better than the one your grandparents lived.

Technological advances. But, of course, technology will make our retirement lives easier, and it’s the most fun part of the future to speculate about. Roger Whitney, a certified financial planner and advisor who specializes in retirement – he has a book coming out in 2018 called “Rock Retirement” and a podcast called “The Retirement Answer Man” – says that technology will significantly improve people’s lives in the future.

“Your smart mattress will personalize your sleep experience and notify loved ones when you get up in the morning. Smart carpet will control lights as you move around, so you don’t fall when you get up at night, and notify loved ones if someone falls. Your refrigerator will monitor your groceries and order them automatically,” Whitney says.

He adds that even your coffeemaker, if it notices you not drinking your coffee or conducting some odd behavior related to the machine, may well alert family members that there may be a problem.

Driverless cars, he also points out, will allow future retirees mobility like they’ve never had before.

Of course, all of this technology costs money, and given how carpets and mattresses can run a consumer thousands of dollars today, it’s easy to imagine a tomorrow in which future retirees on a fixed income feel as if they can only afford the dumb carpet and dumb mattress instead of the smart ones.

As for driverless cars, there’s been little research on what the costs might be, but according to a 2014 study put out by the research company IHS Markit, self-driving cars will be $7,000 to $10,000 more than the average car in 2025. By 2030, a self-driving car will cost $5,000 more than a conventional vehicle, and by 2035, it’ll cost about $3,000 more.

In other words, depending on your age, you may not be living your retirement walking around on a smart carpet and being chauffeured in a self-driving car, but your kids or grandkids probably will. Then again, maybe you will, too. The year 2035 is only 17 years away.

You will probably be sought after – as a contract employee. Art Koff has some good – and maybe bad – news for you. Health permitting, you may never stop working. Which is great if you love what you do. Not so great if you don’t.

Koff, an 82-year-old Chicago-based consultant who founded RetiredBrains.com in 2003 and works with companies looking to market to seniors, says that employment opportunities will likely be ample for future retirees who want to do more than be a department store greeter. Koff thinks that a lot of people who worked in an office will be able to continue indefinitely in a state of semi-retirement, working part time or as a freelancer doing temporary and project-based jobs.

“Employers will be primarily interested in hiring workers where they do not have to pay benefits,” Koff says.

So that’s the good news. You will likely remain hireable, if that’s what you want. The bad news is that your gig income probably won’t be going toward a vacation or a kitchen addition, according to Koff. That’s where the irony of your not being paid benefits will come in.

“Retirees will find that the out-of-pocket costs of health care will have skyrocketed to a point where they need additional income,” he says.

Planning for retirement will change. That is, as a country, we’ll likely get smarter in how we save money. Hopefully.

It’s inevitable that retirement planning will evolve, according to Robert Johnson, president and CEO of The American College of Financial Services in Bryn Mawr, Pennsylvania.

Because we’re all blowing out candles for a much longer time than our grandparents and great-grandparents did, instead of planning a retirement for the average lifespan, we need to start thinking about planning for the longest lifespan, Johnson says.

For instance, Johnson cites a 2014 study by the Employee Benefit Research Institute that estimated a 65-year-old couple should save between $241,000 to $326,000 to cover medical and drug costs.

“That doesn’t include long-term care,” he adds.

“Retirement savings will have to increase and last longer to reflect this increasing longevity,” Johnson says.

Johnson also thinks that it’ll soon become more common for retirees to allocate more investments to stocks, as it becomes clear people are going to be sticking around longer and can risk a little more money than they used to. He also thinks that longevity insurance will become increasingly important.

“In essence,” he says, “one needs to build an age-100 portfolio.”

By Jodan Rau via The New York Times

The Trump administration is scaling back the use of fines against nursing homes that harm residents or place them in grave risk of injury, part of a broader relaxation of regulations under the president.

The shift in the Medicare program’s penalty protocols was requested by the nursing home industry. The American Health Care Association, the industry’s main trade group, has complained that under President Barack Obama, federal inspectors focused excessively on catching wrongdoing rather than helping nursing homes improve.

“It is critical that we have relief,” Mark Parkinson, the group’s president, wrote in a letter to Mr. Trump in December 2016.

Since 2013, nearly 6,500 nursing homes — four of every 10 — have been cited at least once for a serious violation, federal records show. Medicare has fined two-thirds of those homes. Common citations include failing to protect residents from avoidable accidents, neglect, mistreatment and bedsores.

The new guidelines discourage regulators from levying fines in some situations, even when they have resulted in a resident’s death. The guidelines will also probably result in lower fines for many facilities.
Continue reading the main story
Related Coverage

Trump Moves to Impede Consumer Lawsuits Against Nursing Homes AUG. 18, 2017
Poor Patient Care at Many Nursing Homes Despite Stricter Oversight JULY 5, 2017

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Continue reading the main story

The change in policy aligns with Mr. Trump’s promise to reduce bureaucracy, regulation and government intervention in business.

Dr. Kate Goodrich, director of clinical standards and quality at the Centers for Medicare and Medicaid Services, said in a statement that unnecessary regulation was the main concern that health care providers raised with officials.

“Rather than spending quality time with their patients, the providers are spending time complying with regulations that get in the way of caring for their patients and doesn’t increase the quality of care they provide,” Dr. Goodrich said.

But advocates for nursing-home residents say the revised penalties are weakening a valuable patient-safety tool.

“They’ve pretty much emasculated enforcement, which was already weak,” said Toby Edelman, a senior attorney at the Center for Medicare Advocacy.

Medicare has different ways of applying penalties. It can impose a specific fine for a particular violation. It can assess a fine for each day that a nursing home was in violation. Or it can deny payments for new admissions.

The average fine in recent years has been $33,453, but 531 nursing homes amassed combined federal fines above $100,000, records show. In 2016, Congress increased the fines to factor in several years of inflation that had not been accounted for previously.

The new rules have been instituted gradually throughout the year.

In October, the Centers for Medicare and Medicaid Services discouraged its regional offices from levying fines, even in the most serious health violations, if the error was a “one-time mistake.” The centers said that intentional disregard for residents’ health and safety or systemic errors should still merit fines.

A July memo from the centers discouraged the directors of state agencies that survey nursing homes from issuing daily fines for violations that began before an inspection, favoring one-time fines instead. Daily fines remain the recommended approach for major violations discovered during an inspection.

David Gifford, the American Health Care Association’s senior vice president for quality, said daily fines were intended to prompt quick remedies but were pointless when applied to past errors that had already been fixed by the time inspectors discovered them.

“What was happening is you were seeing massive fines accumulating because they were applying them on a per-day basis retrospectively,” Mr. Gifford said.

But the change means that some nursing homes could be sheltered from fines above the maximum per-instance fine of $20,965 even for egregious mistakes.

In September 2016, for instance, health inspectors faulted Lincoln Manor, a nursing home in Decatur, Ill., for failing to monitor and treat the wound of a patient whose implanted pain-medication pump gradually slipped over eight days through a ruptured suture and protruded from her abdomen. The patient died.

The Centers for Medicare and Medicaid Services fined Lincoln Manor $282,954, including $10,091 a day for 28 days, from the time the nursing home noticed the problem with the wound until supervisors had retrained nurses to avoid similar errors. An administrative law judge called the penalties “quite modest” given the “appalling” care.

The fines were issued before the new guidelines took effect; if the agency had issued a one-time fine, the maximum would have been less than $21,000.

Lincoln Manor closed in September. Its owner could not be reached for comment, and his lawyer did not respond to an interview request.

Advocates for nursing home residents say that relaxing penalties threatens to undo progress at deterring wrongdoing. Janet Wells, a consultant for California Advocates for Nursing Home Reform, said the changes come as “some egregious violations and injuries to residents are being penalized — finally — at a level that gets the industry’s attention and isn’t just the cost of doing business.”

In November, the Trump administration exempted nursing homes that violate eight new safety rules from penalties for 18 months. Homes must still follow the rules, which are intended, among other things, to reduce the overuse of psychotropic drugs and to ensure that every home has adequate resources to assist residents with major psychological problems.

In June, the Centers for Medicare and Medicaid Services rescinded another Obama administration action that banned nursing homes from pre-emptively requiring residents to submit to arbitration to settle disputes rather than going to court.

“We publish nearly 11,000 pages of regulation every year,” the agency’s administrator, Seema Verma, said in a speech in October. That paperwork is “taking doctors away from what matters most: patients.”

Janine Finck-Boyle, director of health regulations and policy at LeadingAge, a group of nonprofit nursing homes and other entities that care for older people, said the group’s members had been struggling to cope with regulations.

“If you’re a 50-bed rural facility out West or in the Dakotas,” she said, “you don’t have the resources to get everything done from A to Z.”

If you’re 65 or older and meet certain income requirements, the Credit for the Elderly or the Disabled may knock thousands off your tax bill.

By: Wendy Connick (imwconn) Featured on The Motley Fool

If you’re among the 23% of married retirees or the 43% of single retirees who rely on Social Security for 90% or more of their income, then you likely qualify for the Credit for the Elderly or the Disabled — a tax credit that can save you thousands of dollars every year. For that matter, even retirees with other sources of income may qualify for this tax credit. Here’s how to find out if you’re one of them.
Requirements for the Credit for the Elderly or the Disabled

The Credit for the Elderly or the Disabled is intended for two different groups of people — and you’ve probably already guessed who they are based on the name of the credit. You can qualify for this credit if you’re either 65 or older by the end of the year, or you’re younger than that and you retired early on permanent and total disability.

You’ll also need to meet certain income limits to qualify for the credit. There are two different sets of income limits: one that looks at your adjusted gross income (AGI) for the year and one that looks at the total of your nontaxable Social Security benefits, pensions, annuities, and disability income. If you meet both of these income limits, you can qualify for the credit. Here are the limits for 2017:

Filing Status                                                 AGI Limit                                            Nontaxable Income Limit

Single, head of household,                               $17,500                                                    $5,000
or qualifying widow(er)

Married filing jointly                                         $20,000                                                  $5,000
and only one spouse qualifies

Married filing jointly                                         $25,000                                                  $7,500
and both spouses qualify

Married filing separately                                  $12,500                                                    $3,750
(only if you lived apart from your
spouse for the whole year)

How the income limits work

It’s possible to have quite a lot of nontaxable income in retirement if you’re lucky enough to have an employer-provided pension or an annuity purchased with post-tax funds. Because the Credit for the Elderly or the Disabled is meant for low-income retirees, the IRS doesn’t want to hand it out to people with loads of nontaxable income. Therefore it splits the income limits for this credit into two parts: one that looks at a retiree’s total taxable income and another that looks at certain types of nontaxable income.

Your gross income is the total taxable income you received for the year; adjusted gross income is your gross income minus certain adjustments. For example, you’d subtract student loan interest, tuition and fees, and alimony payments from gross income to arrive at your AGI for the year. You’ll find your AGI on line 21 of Form 1040A and line 37 of Form 1040.

The nontaxable income limit includes the nontaxable part of your Social Security benefits plus any nontaxable pension, annuity, or disability income you received during the year. Interestingly, this limit does not include distributions from any Roth accounts you possess.

How to claim the credit

To claim the Credit for the Elderly or the Disabled, you’ll need to fill out Schedule R and use Form 1040 or Form 1040A for your tax return (not 1040EZ). The maximum amount you can claim ranges from $3,750 to $7,500 depending on your filing status. There’s a worksheet on Schedule R that you can use to calculate the amount of your credit. You can also ask the IRS to calculate your credit for you. Note that this is a nonrefundable credit: It cannot exceed the amount you owe in taxes for the year, so it can’t get you a refund check (or increase the refund you’re already getting).

If you decide you want the IRS to calculate the credit for you, you’ll need to complete Part I and (if you’re disabled) Part II of Schedule R, along with lines 11 and 13 from Part III. If you use a Form 1040A for your tax return, write “CFE” to the left of line 32; if you use Form 1040 instead, check box “c” on line 54 and write “CFE” on the line next to that box. If you use Schedule R to calculate the amount of your credit, write “Schedule R” instead of “CFE” on those lines on your 1040 return and enter the amount from line 22 of Schedule R.

Claiming this tax credit does add a certain amount of hassle to preparing your tax return, but because it can reduce your tax bill by thousands of dollars, it’s worth the trouble. If you’re having trouble completing your tax return, consider making an appointment at your nearest Tax Counseling for the Elderly (TCE) office. These volunteers will provide free tax help and are specially trained in preparing returns for taxpayers aged 60 and up. They’ll be able to help you claim this tax credit and any others you qualify for, knocking your tax bill for the year to the bare minimum.

Talk in Washington of entitlement reform that would include reductions in Medicare spending is almost certain to give private health insurance companies a greater role in administering the nation’s health insurance program for the elderly.

Medicare Advantage plans contract with the federal government to provide extra benefits and services to seniors, such as disease management and nurse help hotlines, with some even providing vision and dental care and wellness programs.

It’s long a tradition for Republicans when they are in control of Congress to want to hand off more business to the private sector. That happened with the Balanced Budget Act of 1997 when private insurers saw big increases in enrollment thereafter. But Medicare Advantage also had bipartisan support under the Obama administration and the Affordable Care Act of 2010 when major Medicare spending reforms were implemented. That, too, triggered more enrollment in Medicare Advantage plans.

More recently, GOP House Speaker Paul Ryan talked of “entitlement reform” as a way to reduce spending and healthcare being critical to his goal. Ryan’s staff includes former executives at the health insurance lobby, America’s Health Insurance Plans who will bring the industry closer to any legislative discussions about the future role of Medicare Advantage in entitlement talks.

Seniors are already moving in large numbers to Medicare Advantage plans because out-of-pocket costs tend to be larger in traditional fee-for-service Medicare. Seniors in traditional Medicare “find their 20% coinsurance responsibility more burdensome as healthcare expenses continue to increase,” L.E.K consulting said in a November report.

When seniors find their out-of-pocket costs rise, they are more open to switching to a Medicare Advantage plan, analysts say.

“Medicare cuts almost certainly mean more cost-sharing and higher deductibles for beneficiaries,” John Gorman , executive chairman of the Gorman Health Group says. “Medicare Advantage offers more benefits for lower cost, and offers an annual limit on out of pocket costs that will be even more attractive after cuts.”

Already, health insurance companies are making moves to prepare for increased enrollment in Medicare Advantage. Anthem last week closed on its acquisition of Florida’s HealthSun, which is a Medicare Advantage plan with 40,000 members. That deal came after Humana agreed to take a stake in Kindred Healthcare’s home division, which provides home health services to seniors and has significant overlap with the insurer’s Medicare Advantage membership.

And once CVS Health completes its acquisition of Aetna, the pharmacy chain and health insurer plan to roll out more programs to coordinate care for seniors in Medicare Advantage plans as a way to step up their marketing to potential customers.

Increasingly, seniors are choosing Medicare Advantage. Currently, just under 35% of Medicare beneficiaries, or about 20 million Americans, are enrolled in MA plans . But Medicare Advantage enrollment is projected to rise to 38 million, or 50% market penetration, by the end of 2025 , L.E.K. Consulting projects.

Insurers are banking on that figure. Four months before the L.E.K report, UnitedHealth Group executives predicted 50% Medicare Advantage penetration but didn’t say how soon that would happen.

“We do think there’s an opportunity to further advance the penetration of Medicare Advantage,” UnitedHealthcare CEO Steven Nelson said on the company’s second-quarter earnings call in July. “Where it can go, hard to tell, but I don’t think it’s unreasonable to think about something north of…40% approaching 50%. It doesn’t seem like an unreasonable idea to us.”

Article By:  Bruce Japsen

Featured on Forbes.com

When House Speaker Paul Ryan banged his gavel down on a $1.5 trillion tax cut, the prospect of looming revenue shortfalls didn’t temper his joy a bit.

To the contrary, revenue shortfalls could make his other political goals easier to achieve. Less revenue means government can do less — and Ryan wants government to do less.

That simple reality explains the head-snapping turnabout in Washington’s deficit debate. Under President Barack Obama, amid the Great Recession, congressional Republicans assailed $1 trillion deficits as a spending-induced threat to America’s future. Under President Donald Trump, with the economy humming, they’ve slashed taxes, even though the Bipartisan Policy Center now warns that deficits may reach $1 trillion in the next fiscal year.

To Ryan-style Republicans, then and now represent entirely different circumstances. And yet they face serious risks to their majorities in 2018, just as Democrats did seven years ago after the passage of economic stimulus legislation and the Affordable Care Act.

Deficit debate shifts on Capitol Hill
7:47 AM ET Wed, 27 Dec 2017 | 04:01

When House Speaker Paul Ryan banged his gavel down on a $1.5 trillion tax cut, the prospect of looming revenue shortfalls didn’t temper his joy a bit.

To the contrary, revenue shortfalls could make his other political goals easier to achieve. Less revenue means government can do less — and Ryan wants government to do less.

That simple reality explains the head-snapping turnabout in Washington’s deficit debate. Under President Barack Obama, amid the Great Recession, congressional Republicans assailed $1 trillion deficits as a spending-induced threat to America’s future. Under President Donald Trump, with the economy humming, they’ve slashed taxes, even though the Bipartisan Policy Center now warns that deficits may reach $1 trillion in the next fiscal year.

To Ryan-style Republicans, then and now represent entirely different circumstances. And yet they face serious risks to their majorities in 2018, just as Democrats did seven years ago after the passage of economic stimulus legislation and the Affordable Care Act.
Sen. Lamar Alexander: Nobody likes to cut entitlements but the Republicans should
Sen. Lamar Alexander: Nobody likes to cut entitlements but the Republicans should
7:14 AM ET Mon, 20 Nov 2017 | 01:18

Ryan views tax cuts as a policy to spur economic growth — no matter what the state of the federal budget. An increase in the deficit, which mainstream economists consider a certainty, is beside the point.

Rising debt, in fact, strengthens his zeal for his preferred deficit-reduction policy. That policy is to reduce spending by shrinking the size and scope of government that Democratic political initiatives have built.

In particular, Ryan wants to curb spending on the giant “entitlement” programs of Social Security, Medicare and Medicaid. “How you tackle the debt and the deficit,” the speaker declared recently, is by “entitlement reform.”

Democratic presidents saw those programs as a means of preventing destitution and medical calamity among senior citizens, the disabled and the poor. More than any other contemporary Republican leader, Ryan represents the philosophical tradition that opposed their creation in the first place.

After Franklin Roosevelt signed Social Security into law in 1935, his Republican opponent Alf Landon condemned it as “the largest tax bill in history,” a “cruel hoax” and “a fraud on the workingman.” A generation later, the emerging conservative leader Ronald Reagan offered similar arguments in debates leading up to the establishment of Medicare and Medicaid.

“One of the traditional methods of imposing statism or socialism on a people has been by way of medicine,” Reagan argued in 1961. “It’s very easy to disguise a medical program as a humanitarian project.”

In office, Reagan and other Republican leaders resigned themselves to the permanence of Social Security and Medicare, given their strong support among senior citizens, who vote in large numbers. Spending-cut efforts have usually centered elsewhere in the budget, especially on more politically vulnerable programs serving the poor, including Medicaid.

But Ryan entered politics as a devotee of 20th-century author Ayn Rand, who opposed tax-and-spend benefit programs as immoral confiscation that sapped the power of capitalism. More aggressively than most, he has refused to accept the major entitlement programs in their current forms, insisting on spending curbs rather than tax increases as the path to solvency.

Thus the speaker has supported partial privatization of Social Security, conversion of Medicare to a “premium support” program for purchase of private insurance, and per-beneficiary Medicaid limits that would reduce federal spending by hundreds of billions of dollars. In opposing the 2010 Simpson-Bowles deficit reduction report, which called for both tax hikes and spending limits, he explained, “Increasing the government’s take from the economy hinders growth.”

But there’s huge political jeopardy for Republicans in moving to shrink government to fit the reduced tax revenues they’ve decided to generate. Evidence indicates that, unlike Ryan, most Americans want government to do more, not less.

During last year’s presidential campaign, leaders of both parties vowed to assist average families left behind in an era of high corporate profits but slow-growing wages. Trump, pledging not to touch Social Security, Medicare and Medicaid, galvanized “forgotten” blue-collar whites anxious about threats to their benefits.

Voters applauded those messages. In an NBC News/Wall Street Journal poll in April, 57 percent of all Americans agreed that government should do more to meet people’s needs, outpacing the 39 percent who said government is doing too much.

That represented the strongest support for more government action in the two decades that the NBC/WSJ poll has asked that question. Two-thirds of college-educated white women and 59 percent of both independents and non-college white women favored more government action.

All represent critical constituencies for embattled Republicans fighting to keep control of the House and Senate next November. Senate Majority Leader Mitch McConnell, less ideologically driven than Ryan, has noticed.

Citing Democratic opposition to curbing entitlements, McConnell said last week: “I would not expect to see that on the agenda” in 2018.

By: John Harwood CBS News
Published 6:07 PM ET Tue, 26 Dec 2017 Updated 9:17 AM ET Wed, 27 Dec 2017 CNBC.com1