Medicare at 50 is a bill currently making its way through Congress that would allow anyone over 50 to buy into Medicare. Proponents of the bill want people between the ages of 50 and 65 to be able to purchase a private Medicare health insurance plan and obtain the same tax credits and cost-sharing subsidies as those offered under the Affordable Healthcare Act.
Medicare is a national health insurance program for Americans 65 and older that helps individuals pay for medical care and treatment, including hospitalizations, nursing home care, prescription drugs, and medical supplies and equipment, among others, as they age and retire. Medicare is not free. Seniors pay an annual deductible and are responsible for co-payments and part of their prescription bill.
By and large Americans, of all ages and political denominations, are worried about the availability and affordability of healthcare services. Individuals able to retire are postponing retirement in order to maintain employer sponsored healthcare. Especially if there is a spouse suffering from a chronic illness, the working spouse may need to maintain an employer-sponsored health insurance plan to keep a younger spouse insured.
According to the New York Times, there are at least 10 major proposals, including the Medicare at 50 bill discussed above, to expand Medicare and Medicaid health insurance coverage.
Medicaid is a joint federal and state program that provides health care insurance for individuals with low income. Each state has their own version of Medicaid. There is no age minimum to obtain Medicaid, so long as the individual’s income and assets are under a certain threshold. Medicaid covers children, pregnant women, parents of eligible children, and people with disabilities. Older Americans, with limited financial assets or long-term health care needs, also qualify for and use Medicaid to supplement Medicare coverage in lieu of purchasing additional Medicare Part C or D coverage, which requires the payment of additional premiums, copayments, and possible deductibles before medical care and treatment is covered.
We start the series by discussing the two ideas that are receiving the greatest amount of attention. Below is a list and brief description of the proposals being considered by Congress.
- Medicare for All is a set of bills before the Senate and House that would provide every American, regardless of age or financial circumstances, with government paid health insurance. This option would eliminate employer-sponsored health care insurance. The most contentious of the proposals, this option would require a complete overhaul of the healthcare insurance industry. Among the proposals on the table is expanding Medicare coverage to include vision, dental, or prescription drugs benefits.
- Medicare and Medicaid Buy-ins proposals before the Senate, would allow individuals to purchase Medicare or Medicaid privately and benefit from cost-savings of shared premiums and costs of medical services. This proposal is trying to attract individuals age 50 and older or those that have not been able to receive healthcare insurance through the Affordable Care Act.
Both the Medicare for All and Medicare and Medicaid Buy-in proposals would eliminate monthly premiums, copayments, and deductibles before coverage kicks in. There is a slight cost for prescription medications, with an annual cap of $200 in out of pocket expenses for insured people.
Elimination of employment-sponsored healthcare plans
The Medicare for All plan envisions eliminating employment-sponsored healthcare plans and replacing it with a universal health insurance program. The only annual out of pocket expense is $200 to assist with prescription drug benefits.
Targeting early retirees
Another bill would allow anyone over 50 to buy-in to Medicare through a private health insurance plan that would offer plan participants cost-sharing benefits like tax credits and lower premiums.
Two other proposals getting attention are sponsored by think tanks, or organizations that provide advice and ideas about solving a political, social, or economic problems. These proposals are trying to catch additional people that are currently left out of the Affordable Care Act or are shut-out of healthcare marketplaces. The main part of both of these proposals is to allow people to buy into government insurance or continue to buy private insurance to cover medical care and treatment not covered by Medicare. These proposals are as follows:
- Medicaid Extra for All is a proposal by the Center for American Progress that would only provide health insurance coverage for legal residents through a combination of private and public insurance health coverage options. The adoption of this program would be gradual and take decades to bring all Americans into the health insurance program.
- Healthy America, sponsored by the Urban Institute, is a plan that would provide health insurance coverage for 16 million people, not currently covered under the Affordable Healthcare Act. This plan also excludes undocumented persons and is limited to legal U.S. citizens or residents.
These two initiatives will not make healthcare insurance coverage more affordable. Particularly individuals in retirement or with limited income opportunity there is still a significant part of the population that cannot afford health insurance plans under the Affordable Care Act and/or whose income precludes them from seeking assistance from Medicaid. If you add individuals age 50 and over who have not retired but are no longer eligible for an employer sponsored healthcare insurance coverage the numbers are bleak. Neither of these private sponsored bills address the concerns of this segment of the American public.
A group that continues to see relief are individuals suffering from chronic illnesses. Options are available to contribute or pay for a majority of the medical care and treatment needed to manage chronic illnesses, like end-stage renal disease and Parkinson’s Disease. Also in the Medicare for All or Medicare and Medicaid buy-in programs, coverage would be expanded to include vision and dental benefits, currently excluded from Medicare.