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450,000 Seniors Would Lose Coverage Under Medicare Eligibility Age Increase

Pelosi says she opposes raising the Medicare eligibility age

The ferocious pushback on a trial balloon offer to raise the Medicare eligibility age continues, now at a very high level. First, adding to something started over the weekend by the Center for American Progress’ Neera Tanden, the think tank put out a white paperrejecting raising the eligibility age, because it would “harm seniors and increase health care spending.” I don’t think you have to say much more than that. But here’s the key point:

Using 2011 census data to add to existing Congressional Budget Office calculations, we estimate that in a single year, almost 435,000 seniors would be at risk of becoming uninsured. Our estimate is conservative and understates the impact of raising the eligibility age because the number of seniors affected will only continue to grow over the next decade as the boomer generation retires.

They fully explain the methodology for arriving at this number in the report. Consider that we know that certain percentages of the uninsured die from lack of coverage. The American Journal of Public Health study most frequently cited shows 45,000 deaths annually from a lack of coverage. That’s in a pool of around 50 million uninsured, or a little less than 1%. So this plan to raise the eligibility age, based on those numbers, would kill as many as 4,000 senior Americans, every year (maybe more, as this is a sicker population). I’m sorry to be crass about this, but those are the stakes.

In addition to CAP, House Democratic Leader Nancy Pelosi published her own opposition to raising the eligibility age in USA Today.

Raising the Medicare eligibility age is a case in point. On paper, it appears to save money for the federal government. In practice, it simply shifts the cost of health care to newly uninsured 65- and 66-year-olds, forcing them to pay more for their care out of their own pockets. It makes older Medicare beneficiaries pay higher premiums.

Under the Republican plan, it shifts costs to employers who wish to do right by their workers and cover their retirees for two additional years. It adds costs to states, as low-income seniors find themselves forced to seek out coverage through Medicaid.

It raises premiums for younger Americans who don’t receive insurance through their jobs and who are set to purchase coverage through new insurance exchanges. It asks them to foot the bill to cover the cost of insuring the many 65- and 66-year-olds who would enter the system at the same time […]

Put another way: raising the Medicare age asks the most vulnerable citizens to pay more with little to show for it in terms of long-term deficit reduction or more affordable care, for seniors or anyone else. It increases health spending across-the-board. It takes money out of the pockets of a small slice of Americans.

Pelosi’s being a good soldier by calling this “the Republican plan.” In reality, this makes it extremely difficult for any Democrats to carry this plan forward, at least if they expect to get votes of Democrats in the House (which they will probably need, since a substantial chunk of anti-tax Republicans will never vote for a deal that increases tax rates).

Given this fire against raising the eligibility age, I would expect similar scorn for ideas like cutting Supplemental Security for children with disabilities (heretofore known as the “clueless pundit Nick Kristof plan”), or using a “blended rate” for federal Medicaid participation, which amounts to a cut in funding. Chatter has increased on using the chained CPI to change the cost-of-living adjustment over a variety of federal programs, but when everyone realizes this constitutes a real benefit cut, mostly for the poor, but also for veterans benefits, as well as a regressive tax hike, I doubt that chatter will last too long.

None of which is to say that any of these ideas are truly dead.

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David Dayen

David Dayen