Roughly 2.4 million additional Americans retired in the first 18 months of the pandemic than expected, making up the majority of the 4.2 million people who left the labor force between March 2020 and July 2021, according to Miguel Faria-e-Castro, a senior economist at the Federal Reserve Bank of St. Louis.
The percentage of retirees returning to work has picked up momentum in recent months, hitting a pandemic high of 3.2 percent in March, according to Indeed. In interviews with nearly a dozen workers who recently “un-retired,” many said they felt comfortable returning to work now that they’ve gotten the coronavirus vaccine and booster shots. Almost all said they’d taken on jobs that were more accommodating of their needs, whether that meant being able to work remotely, travel less or set their own hours.
“This is primarily a story of a tight labor market,” said Bunker of Indeed, who added that there was a similar rebound in people returning from retirement after the Great Recession. “For so much of last year, the big question in the labor market was: Where are all the workers? This year we’re seeing that they’re coming back.”
U.S. births increased last year for the first time in seven years, according to federal figures out on Tuesday that offer the latest indication the pandemic baby bust was smaller than expected.
American women had about 3.66 million babies in 2021, up 1% from the prior year, according to provisional data from the Centers for Disease Control and Prevention’s National Center for Health Statistics. It was the first increase since 2014. The rebound spanned age groups, with birthrates rising for every cohort of women age 25 and older.
Births still remain at historically low levels after peaking in 2007 and then plummeting during the recession that began at the end of that year. The total fertility rate — a snapshot of the average number of babies a woman would have over her lifetime — was 1.66 last year, up from 1.64 the prior year, when it fell to the lowest level since the government began tracking it in the 1930s.
Experience has once again verified Friedman’s and Lucas’s theories, reducing to nothing the naïve propositions of Modern Monetary Theory, a recent delusion of the American Left. According to this unscientific, ahistorical theory, legislatures can control the production of money and distribute it in a way that satisfies all needs, with no destructive consequences from expanding the money supply. The question of reimbursing a gigantic public debt is not supposed to arise, because no one can force the government to pay what it owes. But this magical solution, adopted in part by Joe Biden, ignores the fact that public debt produces inflation and that a debt that is not repaid, as in the case of Argentina, eventually ruins the currency. All this was well known, at least by economists, so it is surprising that governments in America and Europe had not taken it into account of late. They have short memories. From the 1980s until recently, inflation had been constrained thanks to public policies inspired by Friedman—but policymakers had forgotten its threatening presence, as if it belonged only to the past. We can liken inflation with pathogens: smallpox has disappeared, but vaccination is what made it disappear; stop vaccinating, and the evil can return. In the 1980s, central banks helmed by Friedman’s disciples, such as Paul Volcker in the United States or Jean-Claude Trichet in Europe, raised interest rates and defeated inflation by reducing the money supply. Today, economic policymakers will need to apply the same remedy as in 1980. Central banks are working on this, but their conversion comes late; they have waited for inflation to establish itself before responding, a delay that will make the remedy more painful.
The ongoing COVID-19 pandemic has now spanned three years. A lot has changed and will continue to change once society and every industry, especially health care, adjusts to the new post-COVID world. With the pandemic, a federal public health emergency (PHE) was declared, and legislation was then passed that had a major impact on how health care is administered from both an operational and financial perspective. Many temporary provisions were put into place that mostly impact Medicaid but ultimately affect all health insurance payers. As we look ahead to a point at which the PHE ends, those temporary provisions start to end in what many in the industry are calling the “unwinding of the PHE.” This article aims to provide an overview of the flexibilities that have been offered as a result of legislation tied to the PHE, examine the impacts of increased Medicaid enrollment, and assess how the risk profile of covered lives for all health insurance payers has changed.
The PHE that has been in effect because of the virus SARS-CoV-2 (which causes the disease COVID-19, or simply COVID), was declared on March 12, 2020, retroactively effective as of Jan. 31, 2020.
Where does this leave us now? At the time of this writing, the PHE is under its ninth renewal (90-day extensions) and is set to expire July 15, 2022. HHS has previously informed states that at least 60 days’ notice will be provided, which means the end of the PHE will occur July 2022 or later. States receive the additional FMAP bump through the end of the quarter in which the PHE ends, which is slated to be Sept. 30, 2022. Before the omicron wave, many thought the PHE would end in early 2022. Popular opinion seems to have shifted to a later time period, with mid-to-late 2022 being the likely end of the PHE. Any continued uncertainty with the pandemic, such as another wave of cases, is likely to extend the PHE.
As we get close to the end of the PHE though, the focus shifts from case counts and test kits to the virus becoming endemic and moving past the PHE. This puts, front and center, the unwinding of all of the operational and financial elements that have been tied to the PHE since FFCRA was passed. When the unwinding starts, it will radically change the risk profile of Medicaid and all other health payors. Measuring and mitigating against this changing risk profile is where the nature of our profession as actuaries becomes critical. The biggest driver in the changing risk profile is the enrollment growth that has occurred with Medicaid since the pandemic began, as a number of these new members are at risk of losing their coverage.
If we consider how risk events unfold in reality, they usually occur through a sequence of interacting factors (see Figure 1). For example: A control does not quite work as intended because the usual supervisor is not available, and coincidentally a staff member has unintended access to a system from which they are able to extract personal information. On any other day, those conditions might have been different and resulted in another outcome. The reality, therefore, is that risks emerge as a result of a complex series of interactions among a large number of factors, and small changes in conditions can lead to significantly different risk outcomes.
Risk events also often involve active participants who learn and adapt their behaviors accordingly. Cyber is a good example—the attacker generally is trying to outthink their adversary and stay one step ahead. All of this means that past performance is not necessarily a reliable predictor of the future. There are too many things that can be subtly different, leading to hugely different outcomes.
The pandemic’s death toll in the United States will surpass 1 million people in the coming days. Conveying the meaning or the magnitude of this number is impossible. But 1 million deaths is the benchmark of an unprecedented American tragedy.
Consider this comparison: The population of D.C. is about 670,000 people. Try to imagine life without every person, in every building, on every street, in the nation’s capital. And then imagine another 330,000 people are gone.
To attempt to put the 1 million deaths in context, we plotted its damage over more than two years and compared the continuing death toll with the tolls from previous catastrophes in our history.
Reinsurance Group of America — a Chesterfield, Missouri-based reinsurer — said its U.S. COVID-19 individual life claims fell to $260 million in the latest quarter, from $340 million a year earlier.
“Our U.S. individual mortality results are very consistent with what we are seeing in the general population this quarter,” Jonathan Porter, RGA’s global chief risk officer, said Friday, during a conference call with securities analysts. “We saw a reduction in our claim cost per 10,000 general population deaths as compared to the third quarter and fourth quarter of 2021. This improvement, we believe, is in part due to the lower proportion of deaths in working ages.”
Here’s what happened to U.S. COVID-19 claim statistics at some other life insurers, including some that are known mainly for group life:
MetLife: $230 million in world group life claims this quarter, down from $280 million a year earlier.
Hartford Financial: $96 million before taxes this quarter, down from $185 million a year earlier.
Unum: 1,400 deaths at an average of $55,000, or $77 million, down from 1,725 deaths at an average of $65,000, or $112 million, a year earlier.
Lincoln Financial: $53 million in group life claim claims and $18 million in group disability claims this quarter, down from $83 million in group life claims and $7 million in group disability claims a year earlier.
Voya: $35 million in group life claims this quarter, up from $29 million a year earlier.
Primerica: $16 million in life claims this quarter, down from $21 million a year earlier.
Growing popularity in no-medical-exam life insurance products has had one expected outcome: More life insurance policies with accelerated underwriting options available in the marketplace. For example, Policygenius offered just three accelerated underwriting options in 2020. In 2021, that number more than doubled to seven, and more options will likely be available in 2022.
Additionally, while such policies had historically only been available to applicants who were young and in good health, the competitive market has prompted more widespread availability. Now, applicants across all health classes can get no-medical-exam policies.
While no-medical-exam policies tend to be about the same cost as fully underwritten policies, applicants tend to favor them even when they are more expensive due to the convenience and expedited turnaround time.
This conversation about protecting hospitals, back in the era when New Yorkers were still being encouraged to go to restaurants, well before the coasts’ contagion began closing in on the Midwest in earnest, helped define what became, by some measures, one of the most effective and balanced Covid responses in the United States. Ricketts is a mandate-shunning Republican who runs a heavily Republican and rural state with a middling vaccination rate — factors that have been linked to worse pandemic health outcomes in other states. He never ordered a statewide shutdown when 43 other governors, Democrats and Republicans, did so; he has stood against, or even supported lawsuits over, local mask requirements; he has told state agencies not to comply with federal vaccine mandates and gotten scolded by the U.S. secretary of defense for objecting to such requirements for the National Guard. And yet by the fall of last year, when POLITICO crunched the data of state pandemic responses on a combination of health, economic, social and educational factors, one state came out with the best average: Nebraska.
The state had the best economic performance of any in the pandemic up to that point, and its students, according to available data, appear to have suffered little to no learning loss. Whereas many states saw a trade-off between health and wealth in the pandemic — often corresponding to more-restrictive Democratic leadership and less-restrictive Republican leadership, respectively — Nebraska also scored above the national average for health outcomes POLITICO evaluated last year (20th of 50 states). Nebraska was the first state to accumulate a 120-day stockpile of PPE in the nationwide scramble for supplies; was a national leader in opening schools; and was among the quickest getting federal aid to small businesses. As of now, its cumulative pandemic death toll per capita is near the lowest of all 50 states, according to the Kaiser Family Foundation. This, however, is grading on a hideous curve in a country that hasn’t managed the pandemic well in general: More than 4,000 Nebraskans have lost their lives to Covid. Lawler of the University of Nebraska Medical Center, who helped design the state’s early Covid response but has since grown critical of Nebraska’s approach, notes that South Korea has 14 times lower per capita Covid mortality than Nebraska. “Nobody,” he told me via text, “should be patting themselves on the back for doing 14 [times] worse.”
Here’s a graph for 1999 through the provisional 2021 result (as of 3 April 2022 data from CDC WONDER):
You can see the crude rate is higher than the age-adjusted rate for most of the years, and that’s due to the aging of the population. Basically, the Boomers have been getting older, and their older ages (and higher mortality compared to where they were in 2000), have an effect on how many deaths there are overall — thus the crude rate continually increasing as there are more and more old people.
However, until the pandemic hit, the age-adjusted death rate in general decreased, though we had a few years in the 2010s in which the age-adjusted death rate did increase… and yes, that was due to drug overdoses. We will get to that in a bit.
In any case, both the crude rate and age-adjusted rates did jump up by a lot in 2020 due to the pandemic, and COVID deaths were even higher in 2021. But there were other causes of death also keeping mortality rates high in 2021.
I will point out that even with all this extra mortality, the age-adjusted death rate in 2021 is still below where it was in 1999.
That does not mean things are hunky-dory.
This is one of the dangers of collapsing death rates into a single number. The increase in death rates has differed by age group, and it has been far worse for teens and young adults through even young middle-age than it has been for the oldest adults.
Yes, COVID has killed the oldest adults the most, but their death rates have increased the least. It’s all relative.
The number of births in advanced economies has largely rebounded to levels before the coronavirus pandemic, a Financial Times analysis shows, a recovery that experts say was partly because of stimulus policies deployed to mitigate the economic impact of the crisis.
Births began to fall sharply in late 2020 after Covid-19 took hold and people were confined to their homes in lockdown, worsening an already perilous demographic trend of population decline in wealthy nations.
The trend mirrored drops during the 1918 flu pandemic, the Great Depression and the global financial crisis in 2008. But an analysis of national data shows a rapid rebound in most developed countries.
The global fertility rate peaked at five in 1960 and has since been in freefall. As a result, demographers believe that, after centuries of booming population growth, the world is on the brink of a natural population decline.
According to a Lancet paper published in 2020, the world’s population will peak at 9.7bn in about 2064, dropping to 8.7bn around the end of the century. About 23 nations can expect their populations to halve by 2100: Japan’s population will fall from a peak of 128mn in 2017 to less than 53mn; Italy’s from 61mn to 28mn.
Low fertility rates set off a chain of economic events. Fewer young people leads to a smaller workforce, hitting tax receipts, pensions and healthcare contributions.
This year we had record participation with over 250 insurance professionals taking part. This is the fifth iteration of this poll and 2022 shows some consistency along with some very new risks. Inflation, Employee retention and Ability to hire new employees are three new risks to the top of this poll, but they should not be surprises.
2. INFLATION Up very sharply – Previously #52 Prices are rising faster than they have since the 1980s in most of the developed world. Insurers will be hit with a double whammy as the real value of invested assets decays and the cost of doing business and claims costs increases at the same time.
EMPLOYEE RETENTION Not on the list previously The Great Resignation makes the headlines. COVID seems to have accelerated the timeline for the inevitable wave of Boomer retirements. Also concerning are the numbers leaving due to health care burnout and caregiver responsibilities. The problem for insurers is figuring out how to respond to the massive loss of experience.