Rising Medicare Premiums Will Hit Retirees Hard

Medicare premiums might soon start crushing retiree spending power. I estimate that many a long-lived couple might need to reduce their retirement spending on non-medical consumption by 13 percent to 26 percent to avoid sharp declines in purchasing power as they get older.

This is not an alarmist fantasy. My estimates come from projecting historical cost rates into the 30-year retirement of a couple retiring this year.

Here are the facts: Since 1965, the year Medicare was created, the consumer price index has risen at a 4.5 percent annual rate ~ but the Medicare premium has inflated at an 8.4 percent rate over the same period. Worse, the gap appears to be growing.

Between 2000 and 2008, the monthly Medicare premium grew from $45.40 to $96.40. That’s a 9.9 percent annual rate of increase. During the same eight-year period, the consumer price index rose at only 2.8 percent a year. So Medicare costs are now rising 7 percentage points a year faster than the general inflation rate.

You can understand what this means for real people by considering the future of an imaginary couple, Mr. and Mrs. Retirenow.

They both turned 65 in January. They have $10,000 in cash, $300,000 in IRA investments, and they own their $200,000 home in Texas, free and clear. He collects $1,200 a month in Social Security, slightly above average. She collects $600 a month in spousal benefits. Neither has a pension, but they think they can get along pretty well on $21,600 in Social Security benefits and $15,000 from their IRA accounts, a total of $36,600 a year.

They feel pretty safe about that $15,000 a year from their investments because they found they would get that much if they purchased an inflation-adjusted joint life annuity from Vanguard. They’ll leave the house to the kids, but nothing else.

Another reason they feel positive about their retirement is that they live in a no-income-tax state. They also don’t owe anything in federal income taxes. Finally, we’re going to assume that they earn 7 percent on their investments and that inflation runs at 4 percent a year ~ a little less than it has been since they started working in their early 20s.

Just weeks before they retired, they figured they would spend $2,314 of their $36,600 income on Medicare Part B premiums and $8,200 paying the insurance, taxes and operating expenses of their house. That would leave them with $26,086 to spend on everything else.

To be sure, they’d never be candidates for Lifestyles of the Hideously Rich and Notorious but, well, who cares?

In fact, their lifetime spending will be lower. Although a portion of the reduction will come from a slowly increasing federal income tax bill, most of the reduction will be due to rising Medicare Part B premiums.

To find out how much lower, I used ESPlanner, the most powerful and comprehensive financial planning software available today. It’s also the foundation for “Spend ’til the End,” the recently published book on financial planning I co-authored with Boston University economist Laurence J. Kotlikoff.

ESPlanner, which I’ve mentioned in many columns, uses dynamic programming to actually solve the question most retirees ask: How much can I spend and have a level standard of living for the rest of my life?

ESPlanner tells us that the Retirenows would have $24,460 a year to spend until they died at age 95 if Medicare premiums rose only at the general inflation rate. But with a long-term premium increase that’s nearly 4 percent higher, their spending power drops to $22,809. And if Medicare inflation continues to run 7 percentage points faster than inflation, their spending power drops to $21,289 a year, a reduction of 13 percent.

Because the growth of Medicare Part B premiums is likely to be paralleled by the growth of premiums for Medigap policies (which often cost about as much as the Part B premium), the lifetime loss of living standard over a long retirement is likely to be about 26 percent.

How will younger people who retire in the future be affected?

Sadly, the younger you are, the greater the impact of rising Medicare premiums because the premium is rising faster than both wages and Social Security benefits.

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