Former Vice President Joe Biden, the de facto Democratic nominee
for president, said on April 9 that he will work to lower the eligibility age
for Medicare to 60 if elected. In a blog post laying out his plans to tackle
COVID-19 and the resulting economic contraction, Biden positioned the Medicare
proposal as part of his larger health care reform program, which would include
a universal public insurance option.
The proposal suggested a 60-year-old enrollee would enjoy
identical benefits as existing Medicare beneficiaries. If implemented as Biden
suggests, the proposal would substantially expand the number of people eligible
for Medicare Advantage plans. The one notable detail — and difference from the
existing Medicare program — included in the policy proposal is its revenue
source: the expansion would be paid for from the federal general fund, rather
than the Medicare Trust Fund.
Chris Sloan, an associate principal at Avalere Health, says that
while the proposal is vague, it could seemingly offer a substantial savings for
people in the 60 in 65 age range, whose premiums in the commercial market are
high. Sloan also suggests that the proposal could improve the risk pool for
both the commercial market and Medicare itself.
"In the individual market and the traditional employer
market, generally the most expensive patients are the older patients,"
Sloan says. "If you take a lot of these people out of the individual
market and put them into Medicare, where they may be some of the healthiest
people, you can help improve the risk pools of [both] those markets. You could
have some positive impacts on average premiums."
Still, Sloan says there are some pitfalls with the plan. He says
Biden's public option proposal would shape the boundaries of the Medicare
eligibility expansion, and policymakers would have to consider how to offer
benefits to potential enrollees who could carry dependents on a commercial
plan.
Sloan says carriers who deal in Medicare Advantage would have
ample reason to support the plan, while firms dealing primarily in employer
plans might give pause, risk pool benefits aside. He also observes that the plan
may not be more likely to clear Congress than any other specific element of
Biden's health care policies.
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