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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.”