HEALTH CARE/Joan Retsinas

Medicare on Chopping Block

From 65 to 67. Only two years. What’s the big deal? Candidate Romney, who just turned 65, has proposed upping the age of Medicare eligibility from 65 to 67 – a “cut-federal-spending” initiative that reflects his savvy as a corporate hit-man.

On the surface, this sounds almost reasonable. The Social Security Administration has delayed the onset of eligibility for Social Security stipends; why not follow suit with Medicare? Sens. Joseph Lieberman (I-Conn.) and Tom Coburn (R-Okla.) have proposed just that. Budget analysts, keen to cut spending, have put a two-year delay on the proverbial table of choices. Uncle Sam would save money.

But a swathe of the 58 million “boomers,” ages 50-64, would suffer. Many are not so fortunate as Candidate Romney. They are not so wealthy. They are not so well-insured. And they are not so eager to defer Medicare. Indeed, they have been awaiting Medicare. Instead, Republicans would give them a card marked “delay.” It is of course better than a pink slip. They won’t be dropped from the rolls; they’ll just have to wait.

In 2010, 8.9 million of these boomers were uninsured, up from 3.7 million in 2000. (“Health Costs and Coverage for 50-64 Year-Olds,” AARP Public Policy Institute Fact Sheet 247, February 2012, Gerry Smolka, Megan Multak, Carlos Figueiredo). The plight was worse for Hispanic and African American boomers: 1 in 3 of the former, 1 in 5 of the latter had no insurance.

And the “individual market,” where Americans can buy insurance outside a group, leaves most boomers adrift. Insurers in this market are selective. They can reject applicants who are bad risks; and the illnesses that grow more frequent with age constitute bad risks. The AARP found that insurers rejected more than 20 percent of applications from “older Americans”.

The impact on family budgets is not surprising: more than 1 in 3 older Americans spent more than 10% on health care. Half of poor older Americans spent more than 10% on health care.

Delaying Medicare would pare federal spending by burdening the “ordinary everyday Americans” politicians profess to like. Perhaps Republican candidates see these folks as collateral damage in the campaign to cut spending.

For older Americans, the recently-passed Affordable Care Act will come to their rescue, relieving their burden. Starting in 2014, insurers must accept every applicant, regardless of medical condition. While insurers will still factor age into the premium, the insurers will face limitations on pricing. Poor uninsured Americans, whether or not they have dependent children, will be eligible for Medicaid. The “Exchanges” will insure others in this group. The AARP estimates that 7.3 million of the 8.9 million uninsured people ages 50-64 could be covered through either the Exchanges or Medicaid.

Under the Affordable Care Act, the nation could still up Medicare eligibility to age 67; the option deserves discussion.

The Republicans, though, want not only to delay eligibility for Medicare, but to turn back the clock. They wax nostalgic for the world before Obama.

They have vowed to repeal the Affordable Care Act. And they want to push back Medicare too.

President Bush used to tout his “compassionate conservatism.” Today’s Republicans tout “cruel conservatism.”

Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email

From The Progressive Populist, April 15, 2012

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