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A Tax on Work for the Elderly: Medicare as a Secondary Payer

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Author Info
Gopi Shah Goda
John B. Shoven
Sita Nataraj Slavov

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Abstract

Medicare as a Secondary Payer (MSP) legislation requires employer-sponsored health insurance to be a primary payer for Medicare-eligible workers at firms with 20 or more employees. While the legislation was developed to better target Medicare services to individuals without access to employer-sponsored insurance, MSP creates a significant implicit tax on working beyond age 65. This implicit tax is approximately 15-20 percent at age 65 and increases to 45-70 percent by age 80. Eliminating this implicit tax by making Medicare a primary payer for all Medicare-eligible individuals could significantly increase lifetime labor supply due to the high labor supply elasticities of older workers. The extra income tax receipts from such a policy would likely offset a large percentage of the estimated costs of making Medicare a primary payer.

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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 13383.

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Date of creation: Sep 2007
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Handle: RePEc:nbr:nberwo:13383

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Find related papers by JEL classification:
H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
J14 - Labor and Demographic Economics - - Demographic Economics - - - Economics of the Elderly; Economics of the Handicapped
J21 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Labor Force and Employment, Size, and Structure
J26 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Retirement; Retirement Policies

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References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
  1. Eric French, 2005. "The Effects of Health, Wealth, and Wages on Labour Supply and Retirement Behaviour," Review of Economic Studies, Blackwell Publishing, vol. 72(2), pages 395-427, 04. [Downloadable!] (restricted)
  2. Gary Burtless & Joseph F. Quinn, 2002. "Is Working Longer the Answer for an Aging Workforce?," Boston College Working Papers in Economics 550, Boston College Department of Economics. [Downloadable!]
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  3. Sherry Glied & Mark Stabile, 1997. "Avoiding Health Insurance Crowd-Out: Evidence from the Medicare as Secondary Payer Legislation," NBER Working Papers 6277, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
    Other versions:
  4. Barbara A. Butrica & Richard W. Johnson & Karen E. Smith & Eugene Steuerle, 2004. "Does Work Pay at Older Ages?," Working Papers, Center for Retirement Research at Boston College 2004-30, Center for Retirement Research. [Downloadable!]
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Cited by:
(explanations, Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.)

  1. David Neumark, 2008. "The Age Discrimination in Employment Act and the Challenge of Population Aging," NBER Working Papers 14317, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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