PIERRE, S. D. – Some health experts are warning that insurance rates could rise significantly for people in the individual market who are between 50 and 64, or have a pre-existing condition – once states start taking advantage of new flexibility granted this week by the Trump administration.

States can now redirect federal subsidies to people buying cheaper, so called “skinny” plans that do not offer the minimum benefits required under the A-C-A.

Sabrina Corlette, a research professor at the Georgetown University Center on Health Insurance Reforms, says the new plans will be able to reject people because of their age or health status.

"They can deny people outright if they have a health condition that they don't want to cover,” she points out. “They can cap your benefits. They cannot cover major benefits like prescription drugs or preventive care. They are really completely unregulated."

Supporters of the new federal guidance say the less comprehensive plans will encourage more young, healthy people to buy insurance.

Each state will still be required to offer more comprehensive, ACA-compliant plans, but Corlette predicts the pool of people left in them will be older and sicker, which will lead insurance companies to raise rates or leave the ACA market altogether.

So, the battle over the ACA now moves to the state level.

Corlette adds that red states such as South Dakota, which has sued to invalidate the ACA, may be more likely to seek a waiver that would undermine the program – and that could hurt people approaching retirement.

"If you are between 50 and 64, the affordability of insurance, if you have to buy it on your own, is going to vary,” she explains. “And there are some states, in the name of greater choices – particularly for young and healthy people, you know – the trade-off is that insurance becomes more expensive for people who are older, who have pre-existing conditions."

If states are granted a waiver under the new rules, the new types of plans could come onto the market in 2020.



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Drawing attention to a housing option that could make it easier for older Nebraskans to "age in place" is one of the goals of an AARP Community Challenge grant-funded contest.

Omaha by Design was awarded a nearly $24,000 AARP "Demonstration Grant" for its "Duplex by Design" contest. The contest is for duplex designs which "promote health and greater autonomy" with their accessibility and affordability.

Abe Lueders, director of urban design and affordable design fellow at Omaha by Design, explained duplexes are one type of badly needed "missing middle housing."

"When we say 'missing middle,' we're talking about basically small multifamily buildings," Lueders noted. "That includes duplexes but also up to quadplexes, townhomes; things that are bigger than a house but smaller than an apartment."

AARP maintains one reason small, affordable housing is missing in many communities is too little of it has been built since the 1940s. This causes some seniors to remain in larger homes than they need.

Empty-nest Baby Boomers in the United States currently own twice the number of large single-family homes as Millennials raising children.

Todd Stubbendieck, state director for AARP Nebraska, said not only is there a need for more "accessible" senior housing but also for more housing options that allow seniors to live independently for as long as they can.

"Duplexes provide that opportunity for a little smaller space, downsized, maybe less stairs and just more of an age-friendly design option for folks," Stubbendieck outlined. "This project is going to highlight and raise awareness of duplexes and create some buildable designs that folks in Omaha can work with."

Lueders stressed in addition to being more affordable and accessible, "missing middle housing" creates more housing on a single lot. He pointed out duplexes are "the next rung up" on the housing ladder, since they are built on the same scale, use the same construction methods and are subject to the same residential building codes as single-family homes.

"It seemed like a really fruitful housing type to explore because of how low the bar for entry is," Lueders emphasized. "Because part of the goal is that you want to create a design that smaller developers can build. Maybe people that are newer to development that have a small piece of land and want to create some housing."

Contest designs must all fit a specific lot, which Lueders added ensures every designer is working with the same real-world constraints.

Registration for "Duplex by Design" closes Sept. 16, after which designs will be accepted until Oct. 18. The first, second and third place winners will receive cash awards of $2,500, $1,500 and $1,000.

A new report found Connecticut residents will benefit from Medicare's new out-of-pocket cap.

An estimated 49,000 people in the state would see prescription costs reduced because out-of-pocket costs will be limited to $2,000 per person each year. The report estimated the number of residents using the cap will hit more than 62,000 by 2029.

John Erlingheuser, senior director of advocacy and outreach for AARP Connecticut, said unaffordable prescriptions are forcing people to take matters into their own hands.

"We continually hear from folks that cut back on the number of pills they're supposed to take," Erlingheuser reported. "Maybe they're taking them every other day as opposed to every day, or they're cutting pills in half and taking a partial dose every day as opposed to taking the dose that they're required to take."

This cap stems from the health care reforms in the Inflation Reduction Act. Other reports showed more than 11,000 Connecticut Medicare enrollees using insulin can save about $590 per year. The out-of-pocket cap goes into effect on Jan. 1.

However, state lawmakers are reviewing other options to reduce prescription prices such as establishing a prescription drug affordability board, an independent body tasked with evaluating drug prices to determine if a price increase is valid.

Erlingheuser explained it can help keep prescription drug costs from getting too high.

"What it'll do is really allow the state of Connecticut to monitor the cost of prescription drugs, compare it with other states, and really put a downward pressure on those manufacturers to bring down those costs," Erlingheuser outlined.

Connecticut's most recent bill to establish a prescription drug affordability board failed to pass due to last-minute hurdles during the shortened legislative session. Public hearing testimony was mixed with many praising the idea of saving people money. However, some opposed Connecticut's bill creating a board because its members would not be representative of people who need lower drug costs.

A new online resource guide is available to help Mainers prepare for the upcoming presidential election.

It includes key dates for voter registration, information on absentee ballots, and recent changes in Maine election law.

Jane Margesson, communications director with AARP Maine, said the guide is strictly nonpartisan and useful to both first-time and lifelong voters.

"No matter what your question might be, or how you intend to vote," said Margesson, "all of the resources are right here for you and of course it's all absolutely free."

Margesson said Maine voters age fifty-plus made up nearly 60% of the electorate in the 2020 presidential election, and she said she expects high turnout among that age group again.

The election guide is available on the AARP Maine website.

Polls show strengthening the economy and making sure Social Security is fiscally sound are top issues for older voters this election.

The fund's reserves could become insolvent in 2035, and preventing any shortfalls will require Congressional action.

Margesson said caregiving is another top-of-mind concern. She said roughly 160,000 Mainers provide unpaid care for a parent, spouse or loved one - often while juggling a full or part-time job.

"We really are looking to candidates once again to come together in a bipartisan voice," said Margesson, "to take a look at the caregiver situation and find ways to help caregivers through better support."

Margesson said while Social Security and the challenges of caregiving may be top issues for older voters, they impact everyone and the state's economy.

She said every voice matters in this election and that Mainers should know help is widely available to ensure they can take part.