Sweeney Legal

10/22/2026

This NYT article lays it out, and it is ugly.

There are much higher premium costs being shifted to the employees. There are higher deductibles and copays. People are avoiding care because of the cost. Fewer people are covered. There are more uninsured people. There are fewer people covered by Medicaid. The median household income is $88,000. The family health insurance premium is now $28,000. That is 32% of family income going to healthcare premiums. You have to add deductibles and copays to that to figure out the total cost.

I see no movement or discussion in the government to address this, and there are additional significant reductions in Medicaid coverage scheduled for after the midterms.

"Employers Shift Rising Health Care Costs Onto Millions of Workers.

Working families are paying much more for health insurance this year, with many postponing doctor’s visits, treatments or filling prescriptions. The number of uninsured Americans is rising as more people wrestle with unpaid medical bills.

Roughly six in 10 adults reported they were very or somewhat worried about affording care.

The number of people who said they had delayed or skipped care altogether because of the expense increased to 50 percent this year from 46 percent in 2022, according to the survey.

The majority of Americans — about 157 million — get insurance through their employer. But as costs for coverage have spiked, with increases in the high single digits, businesses have been shifting much more of the additional expenses onto their workforces.

Employees are paying more for coverage, especially if they work for a small business, according to KFF, which released its annual survey of employers about their health benefits.

Many people are also paying thousands of dollars in medical expenses when they get sick, because companies have increased the plans’ deductibles to offset increases in premiums.

The yearly price, on average, for employees to cover their family is now $7,471 a year, up 9 percent from 2025. The total cost for a family plan, including the amount the employer contributes to the annual premiums, has reached $28,303.
Overall, the average deductible for U.S. workers is approaching $2,000 before insurance kicks in, according to the survey.

The rollbacks in government programs like Medicaid and the Affordable Care Act have also left more people without health coverage, according to a separate survey from the Commonwealth Fund.

The share of working-age adults who are uninsured rose to 11.2 percent in 2026 from 8.9 percent in 2024, the Commonwealth study showed.

After Obamacare was enacted in 2010, the number of working-age adults and children without insurance fell from around 46 million to a low of about 25 million three years ago. The government changes, and soaring medical costs across the broader health sector have fueled a backslide in coverage, bringing the estimated number this year to 30 million uninsured, according to the Congressional Budget Office.

The increase in the uninsured rate was not unexpected, with some estimates showing that nearly five million people dropped their individual coverage. Many were no longer able to afford their Obamacare insurance after President Trump and Republican lawmakers declined to extend pandemic-era subsidies that had helped defray the cost of a typical plan.

Enrollment in Medicaid, the federal-state program for the poor, has also been declining, although the bulk of the cuts to that program as part of Mr. Trump’s One Big Beautiful Bill Act do not take place until next year. Over the last four years, the share of working-age adults enrolled in Medicaid dropped from 15.5 percent to 13 percent, according to Commonwealth.

The deepening strains on household budgets are also evident as the rate of medical debt or unpaid bills keeps rising, affecting even those who are insured. About a third of adults with individual policies and those with coverage from an employer reported they were paying off medical bills or medical debt they had already incurred, according to the Commonwealth Fund."

New surveys show that increases in premiums and deductibles are forcing people to forgo treatments or doctor’s visits while budgets are strained by higher food and gas prices.

09/03/2026

It is never too late to start working out. Your muscle mass determines your quality of life as you age.

“It’s never too late to start training. We’ve done research on people 75 years and older who’ve made substantive gains in strength and power in 8 to 10 weeks’ time. And it doesn’t require a lot of time. A couple of half-hour to 45-minute sessions per week is all you need. Even that small investment of time can have profound effects on your health and quality of life.
I think one of the most important factors from the standpoint of aging is reducing the risk of falls. If you start to lose balance, reversing that fall requires you to quickly use your strength. You need the speed as well as the strength.

Our muscles begin shedding power as we age, a process that typically begins in our 40s and accelerates in later decades.
“Power,” he continued, “is the ability to produce that force quickly. It’s force over time. So, you can be strong. But if it takes you time to produce force, you’re going to have less power than someone who can produce that same force more quickly.”

Similarly, in a recent scientific review co-written by Schoenfeld, older people who started weight-training programs focused on power tended to be able to get up from chairs, walk rapidly across a room and otherwise function better afterward than older people whose training focused only on strength.

Yes, muscular power usually declines earlier and more precipitously. It’s generally thought that’s because there’s a disproportionate loss of certain muscle fibers with age, and those are the fibers that produce the most force. Plus, the normal coordination between nerves and muscles can become dysregulated with age. So it becomes harder to produce force quickly.

You can build power at any age.

But for most people, the best approach is to do traditional weight training, but when you lift the weight, moving it against gravity, do it as fast as possible. Then when you lower the weight, returning it to the starting position, do it more slowly, under control, for something like two to three seconds.

If you’re 50 years old and you’ve never done any resistance training, I can pretty much guarantee that you’ve lost physical function and muscle mass, which has compromised your muscle power, and you need to address that — the sooner the better. For younger people, power training is also good, because you build up a muscle bank that you can draw on as you get older. If you start to lose power later, you’re still at a higher level than people who never trained.

It’s never too late to start building muscle power, a leading exercise researcher says.

08/28/2026

Increased Health insurance costs are causing finanical pain and people to drop coverage.

"Skyrocketing Health Insurance Forces Americans to Scramble for Care.

“When I saw the termination notice come in, it was kind of nerve-wracking.” James Digilio is 62 years old. He couldn’t pay for his health insurance after costs skyrocketed. “I was paying, last year, $57-a-month premium. And then it jumped up this year to $1,690 a month. When I first saw it, I was surprised. I thought this was a mistake.” Millions of people like James saw their insurance premiums soar in January after the Senate deadlocked on competing proposals, leaving the expanded tax subsidies to expire."

Older people who are medically high risk, but too young for Medicare are facing unaffordable health insurance premiums after federal health care credits lapsed earlier this year. Now that the grace period has expired, some Americans are struggling to get the care they need.

08/28/2026

Rising Costs are preventing people from having children.

"These Couples Wanted to Have Children. Rising Costs Are Stopping Them.
High mortgage payments, higher child care costs and economic uncertainty are making some people rethink their plans on starting a family.

But that vision shifted once they settled into their new home in Mapleton, about 50 miles south of Salt Lake City. The 2,000-square-foot house came with a $20,000 down payment and a $3,200 monthly mortgage. That financial pressure, combined with other rising costs such as gas and groceries, made them rethink parenthood. Adding a child would push them into living paycheck to paycheck, they said. Ms. Stewart said she would need to take on extra shifts, and Mr. Goodwin would have to give up hobbies he enjoys, like golfing. One of them might even need to stay home full time to care for a child.
After weighing all the costs, they decided not to have children at all.

“It’s just crazy right now,” Ms. Stewart said. “I have always told my husband, like, if we were rich, I would definitely have kids.”
Across the country, many households are struggling to pay for health care, education and housing. Child care costs in most states have risen more than twice as fast as overall prices, according to the Century Foundation, a left-leaning think tank. Home prices, adjusted for inflation, have surged about 60 percent over the past decade. Grocery prices have climbed more than 25 percent in the past five years.

In turn, many couples who once imagined larger families are scaling back or deciding to remain child free. About three in five Gen Zers and millennials said financial concerns influenced their choice not to have any or more children at this time, or caused them to be unsure about it.

High mortgage payments, higher child care costs and economic uncertainty are making some people rethink their plans on starting a family.

08/28/2026

Our government makes things hard.

"Americans Are Spending Luxury Dollars for Dive-Bar Service

Americans live in the wealthiest and most technologically advanced society the planet has ever known. They supply $8 trillion to the government each year, employing half a million elected officials, 2 million federal bureaucrats, and more than 4 million contractors. And they spend luxury dollars for dive-bar service.

That is what you get when you provide benefits the way the United States does: by discretion, with skepticism, through a perplexing variety of programs with a surfeit of fussy rules. The country does not simply approve benefits for those who qualify. It sets arcane standards, creates arduous enrollment processes, and imposes exacting criteria on desperate individuals.

In effect, it charges a fee for access to the safety net, payable in aggravation and frustration and effort and hours. I call it the time tax.

Estonians are automatically registered to vote and can do so online, a process that takes perhaps two minutes. Americans have to register of their own volition, and many then take time off from work to wait in line to cast their ballots, because elections are held on nonholiday Tuesdays.

The majority of Japanese citizens do not have to file an income-tax return, whereas the average American taxpayer spends 12 hours on the 1040 and $290 on private tax-preparation services every year.

Residents of Taiwan do not deal with insurer-specific provider networks, open enrollment, or prior authorizations for routine care. Working Americans spend half a billion hours a year on the phone with representatives from their health plan.
Every year, 11,000 Americans die waiting on a disability-insurance determination, and 5 percent of applicants submit more than 1,000 pages of medical paperwork to government bureaucrats. Half of workers with a flexible spending account (FSA) fail to spend all of the money in it each year, because FSAs are an inane, time-consuming blight. If a worker does not buy enough contact solution by the plan deadline, their employer gets to keep the money left in the account—diverted from the worker’s paychecks.
When a person needs help, the first challenge they face lies in figuring out what is out there. Washington sponsors more than 100 anti-poverty programs, nearly all of which are aimed at specific needs and many of which are targeted at specific populations.

If an applicant makes it through this gantlet, maintaining a benefit is often as difficult as procuring it in the first place. Every year, one in five SNAP households and one in 10 Medicaid recipients “churns” off of and on the program
The surest thing they do is the most obvious thing they do: strip people of time, energy, stamina, self-esteem, and cognitive

bandwidth.https://www.theatlantic.com/ideas/2026/08/time-tax-administrative-bureaucracy/688322/?utm_campaign=one-story-to-read-today&utm_content=20260827&utm_source=newsletter&utm_medium=email&lctg=67d2dee8a53dab2ef5055bd7&utm_term=One%20Story%20to%20Read%20Today

07/30/2026

More uninsured due to the loss of subsidies and being followed up by the loss of Medicaid. The consequence is a lot more uninsured people who are unhealthy and hospitals closing and reducing services, primarily in rural areas.

Here is the write-up from the NYT.

"More and more uninsured patients are showing up in hospital emergency rooms and clinics, having lost their coverage under the Affordable Care Act.

Executives running some of the biggest hospital systems, including large for-profit chains spanning many states, expressed concern over the unexpectedly sharp rise in uninsured patients and the costs associated with treating them.

The significant increase in uninsured patients, about 20 percent in some cases, was disclosed in earnings reports in the past week and interviews with nonprofit hospital groups. Major hospital officials expressed growing unease over lost revenues amounting to hundreds of millions of dollars across the country’s vast health systems.

Some executives attributed the diminishing numbers to the decision by congressional Republicans to end the more generous subsidies, or tax credits, that were initially put in place during the Covid pandemic and helped many people pay their monthly insurance premiums.

Since the beginning of the year, enrollment in Obamacare has dropped by about three million, or 13 percent, according to the latest government figures. Insurance companies expect even more people to drop their A.C.A. plans.

But relief from higher insurance and medical expenses is not about to arrive any time soon. Roughly 30 million adults and children in the United States are uninsured. And to offset the losses, experts predict that hospitals will raise prices for those enrolled in plans, including policies offered by employers.
Increases in both premiums and deductibles have affected Americans covered by private plans as well. Many individuals have been forced to seek out cheaper plans with high deductibles, which require patients to pay thousands of dollars in medical bills before their insurance kicks in.

Centene, the for-profit health insurer that specializes in government programs, told investors on Tuesday that its Medicaid enrollment was declining more than expected, even before the looming changes from the One Big Beautiful Bill Act. Millions of people on Medicaid are expected to lose coverage in the coming years.

The hospitals most vulnerable to the falloff in enrollment in government programs like the Affordable Care Act and Medicaid are smaller rural hospitals and safety net hospitals that treat a large share of people without insurance. Because these types of hospitals make so little profit, “every little weight on the scale brings additional challenges.

What is going on now is “a slow burn,” Ms. Perry said, but she warned that the impact would be greater as more people lost their insurance coverage in the coming years, and hospitals took more drastic steps to cut costs.

The Trump administration has described the falloff largely as a result of its crackdown on fraud.

More people who lost coverage after congressional Republicans ended enhanced federal subsidies are now seeking care in emergency rooms and unable to pay bills.

07/29/2026

It's getting ugly out there. Driven by cuts to Medicaid and restrictions on foreign doctors, the rural areas are going to suffer.

"The nation’s crisis in maternity care and newborn health is concentrated in the countryside—and federal policy is about to make that crisis significantly worse. In the months and years ahead, unless something dramatic changes, giving birth in a rural county is going to become an even more dangerous prospect. Care will be in shorter supply, travel distances will stretch further, and high-risk situations will more likely result in mortality.

On nearly every metric, rural mothers already fare worse. Maternal mortality—death during pregnancy, childbirth, and the first six weeks after delivery—averaged 81 percent higher in rural areas than in urban ones from 2016 to 2019. During that same period, rural women had a roughly 14 percent higher risk than urban women of needing treatment in an intensive-care unit during or after delivery; they are almost twice as likely to require transfer during or after birth to another hospital because a needed treatment is not available where they are.
These figures reflect the dismal state of rural-health-care infrastructure, which is particularly acute in maternity care. Since 2005, 109 rural hospitals have closed outright. Of those that remain, many have been closing down their labor-and-delivery units. Most rural hospitals no longer offer labor-and-delivery services, and in the past five years, an average of more than two rural hospitals a month have closed these units. As of 2023, 60 percent of rural counties had no hospital-based obstetric care. With few options available, rural women are less likely than urban women to receive prenatal care; this in turn makes them and their babies more susceptible to preventable complications.

Several related factors have contributed to these closures. Labor-and-delivery units have high fixed costs (physician and nurse salaries, birthing beds, fetal warmers), making them a financial liability if they are not operating at or near capacity. As fertility has declined, more units have gone into the red because they have too many empty beds. But even a steady flow of patients is not always enough: A rural hospital’s labor-and-delivery unit can struggle economically despite full beds because pregnant rural women are less likely than pregnant urban women to be enrolled in the commercial insurance plans that have high reimbursement rates. Instead, rural women are more likely to be enrolled in Medicaid, which has lower reimbursement rates, or to have no insurance at all.

As dire as this situation already is, public policy is about to make it worse. Prior to the second term of President Trump, rural areas were trying to make up for health-care-professional shortages through the H-1B visa program. The proportion of practicing physicians from other countries who are on an H-1B visa is almost twice as high in rural areas than in urban ones. Last September, Trump issued an executive order dramatically increasing the cost of H-1Bs to $100,000, which will surely have an effect on how many people can come to the United States with this status.

An even greater challenge will be the massive cuts to Medicaid within the One Big Beautiful Bill Act, many of which Congress set to go into effect after this fall’s elections. Medicaid covers more than 40 percent of American births overall and an even higher proportion in rural areas. More generally, the program is crucial to the financial viability of many rural hospitals, such that even if the cuts didn’t touch pregnant women at all, they could still deprive women of care by producing more rural-hospital closures. As an inducement to get votes from conservative rural congressional members, the OBBBA included a $50 billion Rural Health Transformation Fund, but this is substantially less money than the Medicaid cuts will total across rural America."

Care will be in shorter supply, travel distances will stretch farther, and high-risk situations will more likely result in tragedy.

07/29/2026

You think you get free healthcare at 65 on Medicare? Think again.

"A 65-year-old retiring this year can expect to spend $185,500 on health care and medical expenses throughout their golden years."

07/19/2026

The "good retirement" and longer life expectancy is limited to middle to upper class white collar workers.

Blue collar workers and low income people die earlier, have to stop working earlier due to physical limitations, and are not well prepared for retirement

"Work that is physically demanding and low-wage jobs extend inequality in the labor force to inequality in retirement, too, denying the benefits of a lengthier retirement to many older Americans, Mr. Sanzenbacher added. Black and Hispanic Americans, or people who live in multigenerational households where they support parents or children and grandchildren, are among the groups most likely to keep working well past retirement age.

“The expectation of longer lives post-retirement applies if you are a white, white-collar worker. That increase is very much seen in people with middle-class and better jobs,” said Ruth Finkelstein, executive director of the Brookdale Center for Healthy Aging at Hunter College. “Low-wage workers are facing exactly the same retirement they always have. They’re likely to have their health deteriorate before retirement age and continue to deteriorate.” And some of those retirees, she added, will have to keep working despite their declining health."

Workers often focus solely on their retirement savings balance. But figuring out how you want to spend the rest of your life could be job No. 1.

07/19/2026

Retirement is about optimizing your life, not your money.

“The biggest question that people miss is the goal-setting and lifestyle for retirement,” he said. “In retirement, you still have to figure out what’s really important to you. And people just aren’t having those conversations.”

Like Mr. Crews, an increasing number of financial planners now say the most important retirement question to answer isn’t your net worth, your marginal tax rate, your gift-tax exclusions or expected longevity. Instead, it’s this: How do you plan to spend your time?

“It’s not necessarily about optimizing your finances, it’s about optimizing your life,” Mr. Crews added. “The real question is: How much can you do in your life and not run out of money?”
“Most people haven’t thought through what their life will be like in retirement,” Mr. Crews said. “They’ll say, ‘I’ll figure it out. I’m going to go to Yellowstone, I’ll go on cruises.’ They need to consider the work benefits that don’t involve a paycheck — friendships, solving problems and feeling like you play a significant role. The question is, ‘Where are you going to find purpose?’ And it’s not going to be on a cruise ship.”

Workers often focus solely on their retirement savings balance. But figuring out how you want to spend the rest of your life could be job No. 1.