It's Not Clear What Single-Payer Health Care Would Mean For Older Workers

Under a system like "Medicare for All," there are questions about job loss and older insurance workers. Studies show that job retraining is less effective for older workers.

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Health care is a top issue in the Democratic presidential contest. There've been a lot of arguments about what the single-payer plan called "Medicare for All" would mean for choice and costs. But what's rarely discussed is what it would mean for the roughly half a million people working in the health insurance industry, some of whom could lose their jobs. NPR's Ina Jaffe reports that for workers age 50 or more, surviving layoffs can be especially tough.

INA JAFFE, BYLINE: Bernie Sanders says his Medicare for All bill would smooth the transition for displaced health insurance workers. Here he is at a debate in Des Moines, Iowa.

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BERNIE SANDERS: We build into our Medicare for All program a transition fund of many, many billions of dollars that will provide for up to five years - income and health care and job training for those people.

JAFFE: Government statistics suggest that about 1/4 of those people are age 55 or more. There's evidence that they may not benefit much from the plan Sanders is proposing. It's similar to another government program for workers displaced by trade deals. That program has been around for decades. And it's been studied a lot, including by Peter Schochet, a senior fellow at the think tank Mathematica. He says a job retraining hasn't been that helpful for older workers.

PETER SCHOCHET: Because it takes time to train. And it takes time to reintegrate after your training.

JAFFE: By which time the worker is a couple of years older and perhaps that much closer to retirement.

SCHOCHET: The retraining seems to make more sense for younger workers. And employers are potentially more willing to hire them simply because there's a longer-term benefit for them.

JAFFE: But you don't have to be in a vanishing industry to experience this kind of bias, says Cristina Martin Firvida, vice president for government affairs at the AARP.

CRISTINA MARTIN FIRVIDA: We know that 56% of all older workers are pushed out of a job before they're ready to retire and that only 1 in 10 ever again earns as much as they did before they were involuntarily terminated.

JAFFE: In fact, one of Schochet's studies shows that retrained workers over 60 make a little more than half of what they made in their old jobs. Another study shows that since the Great Recession, older workers are much more likely to join the ranks of the long-term unemployed. The AARP's says Martin Firvida says...

MARTIN FIRVIDA: Age discrimination is real. Six in 10 people see it.

JAFFE: Older workers are supposed to be protected by a law that's been around for over 50 years. It's called the Age Discrimination in Employment Act. But in a case about a decade ago, the Supreme Court decided that law required people suing for age bias to meet a higher standard of proof than people claiming other kinds of discrimination. The plaintiff in that case was Jack Gross, a Des Moines, Iowa, insurance worker who was demoted when he was in his mid-50s.

JACK GROSS: My job performance was in the top 3 to 5% of the company. I'd received steady promotions, increasing job responsibilities. And then all of a sudden, this happened. Again, it was wrong.

JAFFE: Since Gross lost his case, every Congress has considered a bill to increase protections for older workers and job seekers. And last month, for the first time, the Protect Older Workers Against Discrimination Act passed the House with bipartisan support. Its chances look dim, though. The White House has already announced that if the bill reaches President Trump's desk, he's likely to veto it. Ina Jaffe, NPR News.

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