Medicare age increase/means testing

The Urban Institute and RWJ have a policy brief on Medicare options, the most interesting of which is a buy-in approach for persons between age 65 and 66 using ACA subsidies. You could call this raising the eligibility age or means testing (and conservatives could call it one thing and liberals another, which might be important). This is likely a more workable solution than a straight Medicare age increase because it imagines people in the 65-66 age band in the Medicare risk pool instead of in state based exchanges. Further, it would get around the problem of gaps in coverage in states that didn’t undertake the Medicaid expansion for older persons who could. From a purely political standpoint, it would put the fingerprints of the Republican party on the ACA exchanges since that is the subsidy mechanism for the income based subsidy coverage. This could be an important part of a political deal in which the policy is much better than a straight increase of the Medicare age.

About Don Taylor
Professor of Public Policy at Duke University (with appointments in Business, Nursing, Community and Family Medicine, and the Duke Clinical Research Institute). I am one of the founding faculty of the Margolis Center for Health Policy, and currently serve as Chair of Duke's University Priorities Committee (UPC). My research focuses on improving care for persons who are dying, and I am co-PI of a CMMI award in Community Based Palliative Care. I teach both undergrads and grad students at Duke. On twitter @donaldhtaylorjr

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