FHS 327 Week 3 Lecture Notes
FHS 327 Week 3 Lecture Notes FHS 327
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This 5 page Class Notes was uploaded by Kaitlyn Endo on Monday October 17, 2016. The Class Notes belongs to FHS 327 at University of Oregon taught by Alltucker K in Fall 2016. Since its upload, it has received 4 views.
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Date Created: 10/17/16
Notes Week 3 • What do you know about Social Security? • Social Security: An important part of the US Economy, social fabric, and major funding source for human services o The original law was passed in 1935, signed by FDR (after the great depression) o Original law had 2 “titles”—focused on old age, survivors, and disability insurance (OASDI) o Since 1935, Congress has added 19 “titles” to the law (now there are 21 titles) § Titles are targets towards specific groups of people who qualify o Confusing: when people say “social security” they usually mean the OASDI art of the law but there are other important titles § Title III: unemployment payments § Title IV: child welfare/foster care § Title V: maternal and child health § Title X: aid to the blind § Title XVI: supplemental security income § Title XVIII: Medicare § Title XIX: Medicaid § Title XX: block grants for social services (block grants given to state; states can apply and then if they earn the grant has a lot of freedom to use that money) § Title XXI: state children’s health INS program o 60 million people receive social security benefits (that’s 1 out of every 4 households) o how does it work? § Workers and employers each pay 6.2% of the worker’s earnings into the program • A key concept you should understand—eligibility o There are four § Health status: people who are blind are eligible, people with developmental disabilities eligible for Medicaid, SSI, and Social Security Disability income § Age: people 62 and older are eligible for OASDI benefits; people 65 and older are eligible for Medicare (full benefits at age 65) § Income: low income people are eligible for Medicaid benefits; children with low income parents are eligible for schip benefits § Death: when a family member who has paid social security taxes dies, certain family members are eligible for survivor benefits. Including widow(ers). Divorced widow(ers), children, dependent parents o Sidenote: pension is a term used to describe older people’s portion of social security; entitlement is the overarching term for all those entitled to ss, not just old people. • Social Security Funding Notes o You have to have enough water coming inà lets say you have a water delivery business, every month, you promise to fill your customer’s glasses full of waterà to always have enough water for your customersà Social Security (OASDI) is kind of like that! o FICA (Federal Insurance Contribution Act) § 15.3% Paycheck; paychecks up to $118,000 à Most of FICA goes towards funding OASDI • 12.4% to OASDI • 2.9% to Medicare o is social security going broke? • Let’s Revisit Eligibility o What other kinds of eligibility do you feel should be included? § Age, death, health status, income, § There are a couple more you should know about: unemployment, children with documented abuse and neglect • Most people don’t think that unemployment has to do with SS but it does. § What other kinds of eligibility do you feel should be included? • Homeless • Families affected by addiction • Domestic violence • Undocumented children and students • Severe mental health disorders • Children with incarcerated parents § Last year’s FHS 327 class identified Youth Violence, and At-‐Risk Early Childhood, as possible additional eligibility requirements to consider • Think About the Golden Triangles o What are some other issues that you feel should be included in entitlement funding? § The things listed above would be at the top of the triangle o Whatever the issue, it needs to have wide-‐spread support across the nation • Why it matters to know about social security o Most older Americans rely on SS (OASDI) for a majority of their income o $1,237 is the average monthly benefit o Alert! Starting in 2034, will collect only enough taxes (remember FICA) to pay 80% of benefits. Unless congress fixes that, will be automatic 20% cut in benefits. • Falling U.S. Birthrates—that means fewer workers paying into the system (FICA) o Possible solutions (besides more babies) § Raise payroll taxes § Decrease monthly benefits (decrease cost of living increases) § Raise retirement age o Immigration has helped (but not enough) o 1960 5.1 workers per beneficiary o 2016 2.8 workers per beneficiary Notes • Let’s Hear from the candidates—both have said little, even though it’s a main driver of long term budget problems o Hilary: § Expand benefits for widows and family caregivers § Remove wage cap ($118,500)—meaning wealthier folks would pay more into the fund o Donald Trump § Has broken away from republican position and promised not to cut social security § Has said he will revisit the program after his tax cut plan boosts economic growth Oct 13 Medicaid Basics—stuff you should know • 1965 signed into law by president Johnson • Title 19 provides medical care and long term care for low income people • Medicaid is an entitlement • Anyone meeting eligibility entitled to receive Medicaid benefits, but each state operates its own Medicaid program à that means a lot of variability between states • $475 Billion o Oregon $6.8 billion for 800k people • 68 million low income American s o 33M children o 18M adults o 6M seniors o 11M people with disabilities • Average federal match—57% • Oregon federal match –64% • Matching Funds—super important concept o Each state legislature decides how much they can budget for Medicaid services in their state o the federal government adds “matching funds” according to each state’s Federal Medical Assistance Percentage (FMAP) § FMAP based on poverty rates in state. Minimum match is 50% § Oregon, the match rate is: 64% • In Oregon: $1.00 (state) + $1.81 (federal) = $2.81 o States “put up” their money FIRST, then federal govt adds matching funds per FMAP formula. State money comes out of the state’s budget :general fund” (appropriations) à important because Medicaid $ come out of the appropriated part of the state’s budget—and that means it could take $ from other appropriations (this means that money could be coming out of other programs) § In Oregon, that means Human Services, K-‐12 ed, and public safety; Oregon spends about 20% on Medicaid Notes • But How Much Income? Means Tested o Typical Medicaid coverage is low in the “average” state coverage is limited to working parents with incomes at 61% of FPL à that means the Federal Poverty Line for Family of 3 is $26,000/year à so 61% of that is $15,860 § Assume $9/hr min wage: $15,860 + $9/hr = 1,762 hrs/year divided by 52 weeks/yr = 34 hours/week à if you work more than 34 hours/week at minimum wage you don’t qualify Budget Defense and Social Security nondefense 24% discretionary 34% Medicare 14% Other 13% Medicaid 9% Net Interest 6% rd o Medicaid is the 3 largest domestic program in the federal budget • Where Does the Money Come From? Who pays for this? o Taxesà states: most have a provider tax § Hospitals § Nursing homes § Care facilities for people w/ developmental disabilities § Doctors § Managed care organizations o U.S. Gov’t: § Income tax § Corporate tax o BUT NOT FICA! THAT’S FOR MEDICARE • Obamacare o The Affordable Care Act (Obamacare) is an expansion of Medicaid and has reduced the number of citizens who are uninsured (about 10% remain uninsured). All individuals are mandated to have health insurance (either from employers, private, or Obamacare). States are not required to expand Medicaid. 30 states + DC have chosen to expand Medicaid • The Oregon Budget and Medicaid – two funding sources are drying up o There is a forecasted $1.2 billion budget shortfall Notes o Oregon health authority is requesting the money to come from Oregon’s “general fund” o Shortfall is caused because of TWO reasons § Federal Govt waiver $2B in 2011 is ending (made to shore up the Oregon health plan—Medicaid) § Federal govt is ending paying for increases in Obamacare cost (per law) o If more money goes to Oregon health authority, less will go to education, public safety, and other human service programs o