« Let’s Not Forget the Battles to Create Social Security and Medicare | Main | Enjoy This New Health Care Reform Ad…We Did! »
Age Discrimination and Health Care Reform
By NCPSSM | November 24, 2009
Guest Contributors: Carroll Estes, Ph.D., Peter Arno, PH.D. and Deborah Viola, Ph.D.
The health care reform bills now before Congress contain an unpleasant surprise for older Americans: Age-based increases in health insurance premiums for those under 65. This is nothing more than a giveaway to the private insurance industry.
At first blush, it might appear that this is justified assuming that as we age, we cost the health care system more. In fact, age is far from an entirely reliable predictor of health care costs, accounting for less than 20% of the variation in costs across age groups. A healthy 55-year-old may well consume fewer health care dollars than a 35-year-old who is obese or has diabetes.
Both the House and Senate bills include provisions to eliminate pre-existing condition clauses, which clearly serve the public interest. Permitting premiums to rise with age contradicts the intent, if not the letter, of that regulation as aging can reasonably be considered an immutable, pre-existing condition. Moreover, the new regulation disproportionately affects Americans between 55 and 64, who already shoulder a financial burden for health care that is higher than any other age group, regardless of insurance status.
The current House bill would allow someone 55 or older to pay premiums that are twice as high as a young enrollee (a 2:1 age rating). The Senate agreed to a 3:1 age rating, which would allow premiums to be three times higher for older people. In a recent briefing, Karen Ignagni, head of the American Health Insurance Plans that represents private health insurers, called for a 5:1 age rating.
Here’s a question for policymakers and the public to consider: Will the proposed age-rating of premiums, coupled with the absence of a robust, affordable public option, push more older Americans into the pool of people unable to afford health coverage?
This is not just a numbers game. There is both a human and financial toll to be paid. A recent Harvard study published in the American Journal of Public Health found that American adults under 65 who lack health insurance have a 40 percent higher risk of death than those who have coverage. Ailing and uninsured people in their 50s and 60s will likely add to the strain on Medicare’s budget as they seek care for neglected health problems as soon as they become eligible for this entitlement.
Americans need to seriously consider the implications of stealth budgetary techniques, such as discriminatory, age-related premiums. The private insurance industry stands to make big profits from the millions of new customers it will pick up through health care reform. Adding to its bounty by putting the squeeze on the finances of older Americans is not only unjust, it is poor economic policy.
Carroll Estes, Ph.D., Chair of the Board of Directors, National Committee to Preserve Social Security and Medicare Professor and Founding Director Institute for Health & Aging University of California, San Francisco
Peter Arno, PH.D., Professor & Director, Doctoral Program, Department of Health Policy and Management School of Health Sciences and Practice New York Medical College Valhalla, NY
Deborah Viola, Ph.D., Associate Professor,Department of Health Policy & Management New York Medical College School of Health Sciences & Practice Valhalla, New York
Topics: Aging Issues, Medicare, healthcare | 2 Comments »
November 25th, 2009 at 12:06 pm
What’s worse is the sheer stupidity of the concept. We all will get older, and if medical care costs are going to go up, it would make more sense to pay a high enough premium while young (and employed) to spread out the cost.
But american workers aren’t smart enough to understand that. And neither, apparently, are our representatives, or the non partisan experts who advise them.
November 27th, 2009 at 6:53 pm
Thank you for shining a light on this discriminatory element of financing reform. Reform is neccessary and all of us will have to pay more to help cover those who have no coverage at this time- however – allowing people over 50 to pay premiums as high as 4X (Senate bill) is unfair and will leave many unable to comply with the “individual mandate.” Senate staff offer an unsubstantiated reason for this unfair burden: 1) people over 50 use more health services – on the contrary, women in their reproductive years and children requiring emergency care are higher utilizers. Indeed many people develop pre-existing conditions by age 50 – this is a form of discrimination against people with pre-existing conditions. Spread the costs across the larger risk pool – we are all in this together.