March 30, 2021 Peter Wehrwein
Insurers might benefit from increase in the number of
beneficiaries in their Medicare Advantage plans.
Biden administration is pushing infrastructure spending first.
But when it unveils its major healthcare plan next month, one of the central proposals
will be the lowering of the age at which Americans are eligible for Medicare
from 65 to 60 , the Wall Street Journal is reporting today.
The administration is also preparing to push for legislation
that would let CMS to negotiate drug prices, according to the newspaper.
The Biden administration’s plans overlap with Sen. Bernie
Sanders what has been talking about Sanders, who is now chairman of the
powerful Senate Budget Committee, has said recently that he favors using the
budget reconciliation process to get a bill passed that would lower the age of
Medicare eligibility (perhaps to 55 rather than 60( and have federal government
negotiating drug prices. Sanders has said savings from drug price negotiation
can be used to expand Medicare coverage so it includes dental services , vision
and other services.
Insures might see some benefit from the lowering age of Medicare
eligibility. Medicare
Advantage has been one of the fastest growing lines of business
for insurers; new and young beneficiaries enroll disproportionately in their
Medicare Advantage plans instead staying in traditional Medicare. According to
the Kaiser Family Foundation, in 2020, 39% of Medicare beneficiaries were
enrolled in Medicare Advantage plans.
Hospitals, on the other hand, are at the very least leery and
publicly opposed to expanding Medicare expansion because Medicare pays
hospitals at a lower rate than do commercial insurers. The Wall Street
Journal quotes an American Hospital Association official as saying
that expanding Medicare eligibility would be “extremely harmful to the
healthcare system.”
By some estimates, lowering Medicare eligibility to 60 would
expand the program to 23 million more Americans. In an article last year
in JAMA Health Forum, Marilyn
Moon, Ph.D., of the American Institutes for Research, and Cori E. Uccello,
MPP., of theAmerican Academy of Actuaries, put the number at 18 million.
Furthermore, they estimated that 12 million people would keep their
employer-based coverage, leaving six million from whom Medicare would become
the primary payer.
Interestingly, Moon and Uccello said lowering Medicaid
eligibility would not make a major dent in the number of uninsured Americans
because older Americans already high rates of coverage. “Instead,” they wrote,
“it would mainly shift where they get their coverage.”
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