Much like Social Security, Americans across the political spectrum prize Medicare. Medicare provides the anchor for their health security if they are over 65 or have a disability and offers peace of mind to their families. People love Medicare -- a government health insurance program -- even though they don't love government. But, Republicans in Congress want to transform Medicare as we know it, turn it into a voucher program, even though it would mean shifting more costs to older adults, people with disabilities and their families.
Here are four ways Congressional leaders could weaken Medicare if Trump becomes President:
- Republicans in Congress want to privatize Medicare and turn it into a defined contribution program. They want to give people with Medicare vouchers that contribute to some of the cost of their health care coverage and make them pay the rest. Congress could limit the amount of the Medicare vouchers from one year to the next, shifting more costs to people with Medicare. They want to move Medicare from a defined benefit program covering all the care people need, to a defined contribution program. Sometimes they call this "premium support." But, whatever you call it, it would inevitably mean forcing people to pay more for their health care. Commercial insurers likely would have few constraints on the premiums, deductibles and copays they charged, and people with Medicare would be left largely on their own to afford them.
- Republicans in Congress want to do away with traditional Medicare. Seven out of ten people with Medicare still opt for traditional Medicare because it gives them the wide choice of doctors and hospitals anywhere in the country and the ease of access that they value. It is also extremely cost-effective, spending only two percent of its budget on administrative costs. And, it has done a far better job of reining costs than Medicare Advantage plans, offered by commercial insurers; at the same time, it has helped ensure the Medicare Advantage plans keep their costs in check to remain competitive. Moreover, the federal government is able to drive improvements to the health care system through traditional Medicare. Regardless, Republicans in Congress want to eliminate traditional Medicare, reducing people's access to doctors and hospitals and driving up health care costs.
- Republicans in Congress want to means-test Medicare even further. Like Social Security, Medicare is an earned benefit. People contribute to Medicare throughout their working life. Medicare covers people in America over 65 and people with disabilities who have paid in, regardless of their health or wealth. Already, Congress has passed a law forcing about six percent of people with Medicare -- individuals with incomes over $85,000 and couples with incomes over $170,000--to pay more for Medicare. Republicans in Congress want to increase premiums for middle-class and wealthier Americans even further threatening Medicare's affordability. Also, the more that these individuals are asked to pay for Medicare, the more Congress positions Medicare as a welfare program and erodes support for Medicare.
- Republicans in Congress want to raise the age of Medicare eligibility. People eligible for Medicare based on age can enroll when they are 65. Republican leaders want to raise the age at which people can enroll in Medicare to 67. Many Americans depend upon Medicare to provide them with health care coverage once they lose their employer coverage. While they can enroll in the state health insurance exchanges, the state exchanges provide neither the broad choice of doctors and hospitals nor the continuity of care that Medicare offers. Easy access to doctors and hospitals as well as continuity of care are especially important for older adults who use three times more health care than people under 65.
Earlier on Huff/Post50: