The National Committee to Preserve Social Security and Medicare Foundation and its Task Force on Health and Retirement Security has released a report analyzing the impact of raising the Medicare eligibility age from 65 to 67, a proposal that is featured in Speaker of the House Paul Ryan’s plan, “A Better Way: Health Care.” The research, conducted by the Actuarial Research Corporation (ARC), provides compelling evidence that suggests this would not be a “better way,” either for the health of Americans aged 65 and 66 or for the financial health of the institutions that provide care for them.
The ARC research provides a one-year snapshot of the impact of raising the eligibility age—taking a single year mid-way through the Trump administration, 2019, to illustrate the effect among people aged 65-66. It assesses the impact on health insurance coverage under two model scenarios: (a) assuming the Affordable Care Act (ACA) remains intact with conforming legislation to extend the premium subsidies and expand Medicaid eligibility to people aged 65-66 and, (b) assuming the ACA is repealed as proposed or is continued without conforming legislation.
The results are stark in both scenarios. Even with the ACA intact and modified to extend access to Medicaid to people aged 65-66, the number of people who would become uninsured rises significantly for both men and women and for all racial and ethnic groups. With repeal of the ACA the rate of uninsured increases even more dramatically.
In 2015, 98.9% of adults aged 65 or over had health insurance coverage, mainly through Medicare. According to ARC projections, if Medicare eligibility is raised to age 67 and the ACA remains in effect, by 2019 the percent uninsured among those aged 65 and 66 will increase more than nine-fold, from less than 2% to 18.7% (1.9 million people). If the ACA is repealed the uninsured rate will increase to 37%, more than one-third of those 65 and 66, affecting 3.8 million seniors.
Raising Medicare Eligibility Age from 65 to 67:
Number Uninsured (ages 65-66) With and Without the Affordable Care Act, 2019
|All||Men||Women||White Non-Hispanic||Black Non-Hispanic||Hispanic||Other|
According to the Chair of the Task Force, Marilyn Moon, director of the American Institute for Research’s Center on Aging, “After reviewing the ARC data, it’s clear that raising the Medicare age will undermine the health security of millions of older Americans. Those who become uninsured will have greater difficulty accessing health care, and as a result these individuals are likely to experience worsening health status. This will also impact the Medicare system because when they do qualify for Medicare at 67, their poorer health will generate increased financial demands on the program.”
If the age of Medicare eligibility is raised from the current 65 years of age to 67, people aged 65 or 66 will face three alternatives: private or employer-based health insurance (for the most fortunate in that age group), public health insurance (mainly thru Medicaid), or becoming uninsured. Repeal of the ACA would also eliminate the special protections that currently allow access to insurance without discrimination (pre-existing conditions clauses). Consequently, people with the most severe health problems would have the most difficulty in obtaining coverage and will generate significant costs for hospitals, providers and private insurers who experience “cost-shifting” as a hidden subsidy for care of the uninsured.
“The data would differ slightly depending on the time frame of implementation, but this analysis provides a useful framework to inform the public debate about the consequences of changing Medicare’s eligibility age,” said Max Richtman, President and CEO of the National Committee to Preserve Social Security and Medicare.
This research was funded by a grant from the Retirement Research Foundation to the National Committee to Preserve Social Security & Medicare Foundation. The summary and full report are available on the NC Foundation website.
The mission of the National Committee Foundation is to protect, promote, and ensure the financial security, health, and wellbeing of current and future generations of older Americans through research, analysis, and public education.
For inquiries about the report, contact:
Dr. Peter Arno, Principal Investigator –
Ann Beaudry, Project Director –