@techreport{NBERw13383,
 title = "A Tax on Work for the Elderly: Medicare as a Secondary Payer",
 author = "Gopi Shah Goda and John B. Shoven and Sita Nataraj Slavov",
 institution = "National Bureau of Economic Research",
 type = "Working Paper",
 series = "Working Paper Series",
 number = "13383",
 year = "2007",
 month = "September",
 URL = "http://www.nber.org/papers/w13383",
 abstract = {Medicare as a Secondary Payer (MSP) legislation requires employer-sponsored health insurance to be a primary payer for Medicare-eligible workers at firms with 20 or more employees.  While the legislation was developed to better target Medicare services to individuals without access to employer-sponsored insurance, MSP creates a significant implicit tax on working beyond age 65.  This implicit tax is approximately 15-20 percent at age 65 and increases to 45-70 percent by age 80.  Eliminating this implicit tax by making Medicare a primary payer for all Medicare-eligible individuals could significantly increase lifetime labor supply due to the high labor supply elasticities of older workers.  The extra income tax receipts from such a policy would likely offset a large percentage of the estimated costs of making Medicare a primary payer.},
}