- There is a proposal to lower the Medicare eligibility age from 65 to 60.
- A new study concludes that the change would not necessarily lower medical costs for all people in that age group.
- Some experts say the lower age would help reduce expenses and premiums for people in lower- and middle-income groups as well as increase their access to healthcare services.
One of President Biden’s election promises to lower the Medicare eligibility age from 65 to 60 is beginning to gain traction.
While most healthcare experts are still waiting for more details on how and if the proposed reduction in the minimum age will help, studies are beginning to be published on how it may impact individuals, the government, and private insurance companies.
Those who support the proposal say that expanding Medicare will improve affordable insurance access to more than 20 million people in the United States.
A letter to the president and Congress signed by 45 national advocacy groups states that the proposed change will “save lives and prevent suffering and financial hardship for families across the nation.”
People ages 60 to 65 are “the most expensive folks to insure,” said Eagan Kemp, a healthcare policy advisor for Public Citizen and an expert on Medicare and other insurance programs.
A lot of people in that age group, Kemp told Healthline, tend to put off medically necessary care until they reach 65 and can access that care more affordably through Medicare.
That's not always a wise choice.
“It’s much easier to deal with stage 1 cancer than stage 4,” Kemp said.
Kemp is quick to point out that he and his organization are supporters of Medicare for All and see the age reduction as a “positive step” toward that goal.
“That would take the most popular program in the United States and broaden it,” he said. “We’d be serving a complex population in a cost-effective way.”
Studies dig into possible challenges
As currently proposed, the change may not mean automatic savings for every American over the age of 60, according to a study published last week by Avalere Health.
“Simply expanding Medicare eligibility does not guarantee premium affordability,” the study authors concluded.
The study looked at the Affordable Care Act and its marketplace, where many between 60 and 65 can now often find more affordable healthcare options.
That's something that the public will need to weigh and compare if the Medicare age is lowered.
The study concludes that for a middle-class person in that age group, Medicare would bring cost savings. For those in lower-income households as well as those who are uninsured, the change could help with both savings and access to treatment.
Kemp said there is hesitancy around the issue for businesses. The issues include how the lower age may impact their private insurance coverage, as some executives have concerns that a shift in eligibility age could force private insurance to have even higher premiums. They also have concerns that this will open the door to more people retiring at a younger age.
Kemp feels with more research available, businesses will find that the change will improve their private healthcare situation.
“If they are honest with themselves and look at what is driving up their premiums, they’ll see that,” he said.
Kemp said that for many companies, particularly smaller ones, a single insured employee receiving a cancer diagnosis can cause coverage cuts or premium increases the following year.
With those ages 60 to 65 at higher risk of many diseases, he said, a lower age could help.
Another challenge could be that hospitals and other medical providers could pass on the income they lose to the general public.
“The reason is that hospitals lose 10 to 20 percent on their Medicare population and offset those losses in their commercially insured population of patients. Hospitals operate in the black by hitting the right mix between those two populations of patients,” John Hansbrough, a benefits advisor with The LBL Group in California, told Healthline.
“If we shift patients [with higher costs] to Medicare, hospitals will lose revenue and need to increase prices to the remaining commercially insured population,” he added.
Some experts see distinct advantages to lowering the Medicare eligibility age.
The plan is still vague, so it’s “hard to tell (yet) who will actually be affected,” Alexandra Glynn, a PhD candidate at the University of Pittsburgh School of Public Health who works daily in Medicare issues, told Healthline.
However, Glynn points out there is one way she feels the lower age could benefit all, not just those who would be able to afford better insurance.
“One in three (people ages 60 and up) have some form of diabetes,” she said.
Since people who have high copayments and deductibles tend to skip tests and regular physical exams, she said, that means many delay medical care until treatment may be more expensive.
Lowering the age for Medicare, she said, could help save money across the board by giving people access to care earlier and thus allowing providers to both detect and treat emerging conditions.
If more are eligible for Medicare, more of those situations will be caught earlier, Glynn said.
Kemp sees another bonus. The change could amp up the entrepreneurial programs in America.
“It’s not so much about retirement,” he said. “A lot of people look to start a business at 65, when they are no longer tied to a job. So this could be done even younger.”
If the age is lowered, Glynn said people reaching 60 will need to weigh and compare the marketplace, their private insurance options, Medicare costs, additional plan costs, and Medicare Advantage, something Glynn points out was not considered in the Avalere study.
“We all have a lot more to learn about this,” she noted.