Bill Overview
Title: Helping End Lifetime Penalties Act of 2022
Description: This bill limits certain Medicare late enrollment penalties to 12 months (rather than for the lifetime of coverage).
Sponsors: Rep. Gohmert, Louie [R-TX-1]
Target Audience
Population: Individuals subject to Medicare late enrollment penalties
Estimated Size: 6000000
- Medicare is a federal health insurance program primarily for people aged 65 and over, although it is also available to younger people with disabilities and those with End-Stage Renal Disease.
- Late enrollment penalties are fees added to the premiums of individuals who didn't sign up for Medicare coverage when they were initially eligible.
- The bill aims to limit the duration of these late enrollment penalties, affecting those who delay enrollment and are currently or will be subject to penalties lasting the duration of their coverage.
- There are approximately 60 million Medicare beneficiaries in the United States.
- A portion of these beneficiaries, estimated around 10% or about 6 million, may be affected by the late enrollment penalties historically.
- The global impact is limited to the United States since Medicare is a U.S. federal program.
Reasoning
- The policy targets a specific group within the Medicare population – those facing late enrollment penalties. Given the U.S. has about 60 million Medicare beneficiaries and about 10% might face penalties, we're focusing on roughly 6 million people.
- The policy is intended to have direct financial benefits for those affected by reducing penalties, potentially improving their financial well-being and overall life satisfaction.
- Budget constraints ensure the program can't universally impact all Medicare users equally, but should provide meaningful relief to those it serves, effectively transforming lifetime penalties to 12 months.
- The diversity of the Medicare population, including varied incomes, health statuses, and geographical locations, will result in a range of impacts on wellbeing.
Simulated Interviews
Retired teacher (Dallas, TX)
Age: 68 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 10/20
Statement of Opinion:
- I wish I had known the penalties were so high before delaying.
- This policy is a great relief if it means I won't have to pay the extra fees forever.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 8 | 5 |
| Year 20 | 8 | 5 |
Retired nurse (Burlington, VT)
Age: 72 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 8.0 years
Commonness: 8/20
Statement of Opinion:
- The penalties are quite a burden on my limited income.
- Great to see some relief coming, I could use the savings on essentials.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 7 | 5 |
Retired postal worker (Miami, FL)
Age: 78 | Gender: male
Wellbeing Before Policy: 3
Duration of Impact: 7.0 years
Commonness: 5/20
Statement of Opinion:
- It's tough balancing all the expenses in retirement.
- This feels like a step towards fairness for those of us who missed out initially.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 3 |
| Year 2 | 6 | 3 |
| Year 3 | 7 | 3 |
| Year 5 | 7 | 3 |
| Year 10 | 7 | 4 |
| Year 20 | 7 | 4 |
Retired accountant (Charleston, SC)
Age: 65 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 6.0 years
Commonness: 7/20
Statement of Opinion:
- It seems unfair to penalize those who miss deadlines due to unforeseen circumstances.
- Happy to see the policy easing our financial burdens.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 7 | 5 |
Retired journalist (Seattle, WA)
Age: 70 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 6/20
Statement of Opinion:
- Understanding enrollment periods was incredibly confusing.
- I'm relieved this policy might ease my financial burden.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 7 | 5 |
| Year 20 | 7 | 5 |
Retired librarian (Phoenix, AZ)
Age: 75 | Gender: female
Wellbeing Before Policy: 3
Duration of Impact: 8.0 years
Commonness: 4/20
Statement of Opinion:
- The penalty has been an extra stress.
- This policy provides some much-needed relief.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 3 |
| Year 2 | 6 | 3 |
| Year 3 | 6 | 3 |
| Year 5 | 6 | 3 |
| Year 10 | 7 | 4 |
| Year 20 | 7 | 4 |
Retired engineer (Minneapolis, MN)
Age: 66 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 9/20
Statement of Opinion:
- While I found the penalties manageable, lifting them will definitely free up some funds for travel.
- I'm glad others who struggle more might see significant benefits.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
Retired farmer (Rural Kansas)
Age: 80 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 7.0 years
Commonness: 3/20
Statement of Opinion:
- I regret ignoring the reminders but what's done is done.
- Glad for the policy, it's about time they limit penalties.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 6 | 4 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 5 |
Retired lawyer (New York, NY)
Age: 73 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 6/20
Statement of Opinion:
- The decision was strategic on my part to delay.
- However, reducing penalties would definitely aid us financially.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 5 |
Retired actor (Los Angeles, CA)
Age: 67 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 9.0 years
Commonness: 5/20
Statement of Opinion:
- Missed the initial enrollment due to unsteady employment.
- This policy could help stabilize my financial outlook.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 6 | 4 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 5 |
Cost Estimates
Year 1: $1000000000 (Low: $800000000, High: $1200000000)
Year 2: $1000000000 (Low: $800000000, High: $1200000000)
Year 3: $1000000000 (Low: $800000000, High: $1200000000)
Year 5: $1000000000 (Low: $800000000, High: $1200000000)
Year 10: $1000000000 (Low: $800000000, High: $1200000000)
Year 100: $1000000000 (Low: $800000000, High: $1200000000)
Key Considerations
- The change will decrease direct income from Medicare penalties, impacting Medicare trust fund solvency.
- Behavioral responses might include increased enrollment timeliness due to capped penalties, yet no historical precedent accurately predicts this outcome.
- Long-term changes could require additional legislative action to address Medicare funding shortages.