Proposals in Congress seek to increase the age of eligibility for full Social Security benefits to 70. These proposed changes are happening against the backdrop of Congressionally authorized amendments to the age at which people qualify for 100% of Social Security, which is transitioning to 67 by the year 2027. Both sets of changes cut benefits and run counter to the sharp and ongoing decline in U.S. life expectancy.
As I argued in a piece posted last month, the most important yet often ignored health story in the U.S. is the alarming decline in life expectancy. A Commonwealth Fund study released at the end of January reinforces this message. Compared to other high-income nations the U.S. has the lowest life expectancy at birth, caused in part by the highest death rates among its peers for avoidable or treatable conditions.
Average life expectancy at birth in the U.S. was 76.1 years in 2021, more than six years lower than the average among comparable (similarly wealthy) nations. This brought U.S. life expectancy at birth to its lowest level since 1996. Here, average life expectancy numbers mask racial and ethnic disparities. Non-Hispanic American Indian-Alaskan Native people had the biggest drop in life expectancy in 2021; 1.9 years. Their life expectancy is now 65.2 years. Non-Hispanic white people in the U.S. had the second biggest decline in life expectancy in 2021; one full year from 77.4 in 2020 to 76.4 in 2021. And, non-Hispanic Black people had the third biggest decline; a 0.7 year drop from 71.5 years in 2020 to 70.8 in 2021.
Despite the news on U.S. life expectancy being incredibly dismal, some American politicians are acting as if they’re unaware of the issue when proposing rather drastic changes to age eligibility. While rhetorically, elected representatives promise not to cut social security, their actions tell a different story. First, under amendments signed 40 years ago, we have already entered a phased transition to a full retirement age of 67. This means for people to be able to claim their full Social Security benefits that they’ve earned, they will soon no longer be able to do so at 65.
Furthermore, ostensibly because of Social Security and Medicare funding deficits, a Republican proposal has suggested pushing the ages of eligibility for both programs higher than 67. Republicans are calling for Social Security’s full retirement age to increase considerably. Based on their proposal, people born in 1978 or later would have a full retirement age of 70.
It’s striking that the Chairman of the Republican Study Committee that released its annual alternative budget for fiscal year 2023, Kevin Hern (R-OK), says he wants to index the changes to life expectancy. Well, if that’s the case then it may be worth reminding him that U.S. life expectancy is at the lowest point in 26 years. And, preliminary data suggests a further decline in life expectancy will be recorded for 2022.
What makes this all the more troubling is that the problem is not simply due to Covid-19. In 1980, U.S. life expectancy at birth was similar to other wealthy countries. But, during the past four decades, life expectancy has improved by much more in all peer nations than it has in the U.S. As the graph below shows, the U.S. is a rather extreme outlier.
In the U.S., life expectancy has been stagnant or decreasing for more than a decade. Moreover, discrepancies in life expectancy between groups paint an even worse picture. Black and Latino populations are experiencing declines in life expectancy at birth that are three to five times the reduction for the Caucasian population.
There are many reasons for this disturbing development. At the top of the list is inadequate support for – and sometimes wholesale neglect of – public and population-based health at the local, state, and federal levels. In this context, public and population-based health is concerned with educating the public, disease control and prevention, and identifying the social determinants of health.
The list of mostly neglected areas in U.S. public health is long and includes, among other things, obesity, infant and maternal mortality, gun violence, and substance abuse.
Public and population-based health isn’t the only determinant of life expectancy. But it’s certainly a key factor. Unfortunately, the U.S. public health system has been severely underfunded for decades. If the U.S. is going to stem the tide of decreasing life expectancy, it will have to reorder its healthcare priorities and invest significantly more in effective public health programs.
Compounding the cited public health issues is a chronic lack of affordable access to healthcare for a steadily growing number of underinsured people in the U.S.
So, now might not be the right time to consider radical changes to the age at which people qualify for full Social Security benefits, especially since this is a program that is self-funded. It is not an entitlement. That is, Social Security gets its funds through payroll taxes paid by U.S. workers and employers. Any time the retirement age is raised the government is cutting earned benefits. Given the lowering average life expectancy, the cuts become draconian, particularly for lower socio-economic strata who have experienced a precipitous decline in healthy years of life expectancy. Here, a change in eligibility will have a discriminatory effect, as it has the most impact on those whose life expectancy is lower to begin with and deteriorating more rapidly.