Medicare has been providing health coverage for older adults and disabled Americans since 1965, and it’s a bit of a triumph of social insurance. The program is designed to ensure that some of the neediest and most medically vulnerable members of society can access services they need, and that’s why conservative proposals (and potential liberal compromises) to raise the eligibility age should be viewed with considerable skepticism. Currently, all seniors qualify at age 65 for Medicare services, and pushing that age up could have dire consequences.
1. The road to privatization. Conservative attempts to privatize all government services in the United States range from education to services for low-income Americans; it’s no surprise that they’re also interested in attacking Medicare. If they succeeded, it could spell trouble for seniors, many of whom are low-income themselves and unable to secure health insurance on their own. Matthew Yglesias (and others) argue that pushing the age up could be a key step in a move to privatize Medicare, because as people are dropped for the rolls, the program would be underutilized, presenting an ideal argument for removing it altogether.
2. Hundreds of thousands uninsured. A study released in December 2012 suggested that raising the age by just two years, from 65 to 67, could leave almost half a million seniors uninsured. Low-income seniors could have nowhere to go for insurance coverage in a number of states, even after the Affordable Care Act, and tragically, the poverty rate is especially high for seniors living in states that are refusing the Medicaid expansion which could help them access affordable insurance.
3. Raising the eligibility age wouldn’t save money, it would just shift costs. None other than Nancy Pelosi, writing in defense of Medicare for USA Today, notes that raising the eligibility age wouldn’t mean that 65 and 66-year-olds magically didn’t need health care anymore. Instead, they’d need to pay out of pocket for services, and a ripple effect would spread through the system as the cost for their care distributed through the states, older Medicare beneficiaries, employers, and younger workers. She says: “the Kaiser Family Foundation estimates that higher state and private sector costs would be twice as large as the total federal savings.”
4. Increasing inequality among seniors. Among low-income seniors, some are even more low-income than others. Women and minorities are much more likely to be poor, and have a hard time surviving after retirement. They’d be hit especially hard by an increase in the eligibility age, which could leave them scrabbling for health care coverage, and more likely to delay needed medical treatment and other interventions because of concerns about affordability. With gaping income inequality already a huge issue in the United States, exacerbation is the last thing we need.
5. Moving goalposts sets a dangerous precedent. Those paying into Medicare right now, especially older adults in their 50s and 60s, are expecting Medicare to be there when they need it. Pushing back the eligibility age leaves them out in the cold, and also destabilizes other social welfare programs; once this key element of Medicare is changed, others could change as well, and so could other programs intended to help people who need help accessing health care, education and other services in the United States. A shift in the retirement age would represent a broken promise to all of us who paid into the system with an expectation that we’d get benefits.
Photo credit: 401(k) 2012