Betwixt and between: targeting coverage reforms to those approaching Medicare

Area of Science:

• Health Policy
• Gerontology
• Public Health

Background:

• Recent Medicare buy-in proposals suggest eligibility at age sixty-two.
• Disagreement exists on whether eligibility should be tied to loss of employer-sponsored insurance or financial need.
• Declining access to retiree health insurance affects older Americans.

Purpose of the Study:

• To examine the arguments for and against targeting incremental Medicare coverage for older Americans based on loss of employer insurance or ability to pay.
• To evaluate the effectiveness of different eligibility criteria for expanding health insurance access to the pre-Medicare population.

Main Methods:

• Analysis of arguments presented in recent Medicare buy-in proposals.
• Examination of the potential impact of targeting strategies on different subgroups of older Americans.
• Consideration of trade-offs between age-based versus needs-based eligibility criteria.

Main Results:

• Targeting loss of employer insurance may not resolve insurance issues for many older adults.
• Focusing solely on ages sixty-two to sixty-four overlooks sicker, less resourced individuals.
• Eligibility criteria based on ability to pay may capture a more vulnerable population.

Conclusions:

• Current Medicare buy-in proposals present differing strategies for eligibility.
• Both age-based and needs-based targeting have limitations.
• Policy decisions require careful consideration of trade-offs to effectively improve coverage for older Americans.