Medicare Buy-in at 50

Medicare at 50?

This week, Devin and John talk about the pros and cons of different ideas about expanding Medicare coverage to folks of lower ages.

“Medicare for All” has been in the news a lot lately. Senator Bernie Sanders has announced that he is running for president, and that he thinks insurance companies should be abolished and everyone should get Medicare.

The Kaiser Foundation did a survey to ask voters what they thought about Medicare for everyone. Not surprisingly, the Democratic voters were in favor of it, the Republican voters were not in favor of the idea. Then, there was a follow up question: What would you think about allowing earlier access to Medicare, like perhaps at age 50? A majority of respondents thought that was a good idea and worth exploring.

For the last couple of years, Senator Stabanow has proposed the “Medicare at 50” plan. This year, it has quite a bit of support. This Medicare at 50 bill has a lot more support than the Medicare for All proposals.

Devin and John talk about their clients, many of whom have the financial means to retire prior to age 65, and yet have to keep working to maintain their health insurance. There are also folks who find themselves unemployed in their 50s and 60s, and it is hard to find work that includes health insurance.

While Devin and John haven’t gotten the actual text of the bill, so there are some questions:

How would we pay for it? Senator Stabanow has stated that lower-age Medicare would be self-funding. Individuals would pay the true cost of that coverage, which would be more expensive.

Devin asked Danielle Roberts from Boomer Benefits to share a little bit more about this proposal. She has some great insight.

Danielle thinks there are a couple of reasons why this idea is more popular now. Polling has shown that voters support having a public option, vs. a mandate that everyone be covered.

This current proposal would offer private Medicare plans to those ages 50-64. They would be sold via the health care exchanges. They would have the same subsidies and premium tax credits that are currently available to an individual purchasing coverage through the health care exchange. This would be a private Medicare plan.

There will be opposition will come from health care providers. They already have razor-thin margins on Medicare patients. This change would mean that many more patients would be using Medicare for their care, decreasing the reimbursement rates. Insurance companies will be concerned about this change being one step closer to a single payer system

Danielle agrees that we really have to see the details of the actual bill before we can understand all the implications.

John is not in favor of Medicare at 50. He points to the growth of concierge medicine, where doctors don’t take insurance at all. The rules about accepting Medicare are very limiting, and make it difficult for doctors to make money if they accept Medicare patients. This pushes some doctors to stop taking Medicare altogether. John is worried that the more people are on Medicare, the more that Medicare will try to push down the costs of coverage, which will further segment the health care offered to Americans.

Both Devin and John suggest that if you are eligible for a Healthcare Savings Account (HSA), you should be putting away as much money as you can.

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