A new bill would lower the Medicare age to 50, expanding coverage to an additional 60 million adults
Adults over the age of 50 grapple with high premiums and limited coverage options.
A new legislative proposal seeks to expand Medicare coverage to those 50 years and older, in an effort to offer federal healthcare insurance to those facing high costs on the private market or who don't have access to insurance at all.
The proposal, called the Medicare at 50 Act, would give Americans between the ages of 50 and 64 the option to buy into Medicare or Medicare Advantage before reaching the traditional eligibility age of 65.
While healthcare coverage is important for all ages, this 50-to-64-year-old group often faces limited insurance options if they don't get coverage through their employer. Jobs for older workers also can be harder to secure, putting health insurance out of reach for many. Without an employer-sponsored plan, these older adults may have limited options, such as keeping costly COBRA coverage through a former job, buying insurance on the Affordable Care Act marketplace or going without insurance altogether.
"For too many folks in their 50s and early 60s, finding affordable health insurance means paying through the nose or going without the coverage they need altogether. That's just not right. We can and must be bold and meet the moment to lower the cost of healthcare," said Sen. Tammy Baldwin, a Democrat from Wisconsin, who sponsored the bill.
The proposal, similar to an effort proposed in 2021, comes after the Democrats won control of Congress following the midterm elections. Affordability and healthcare were among the top issues raised by voters.
More than 60 million Americans are between the ages of 50 and 64, and this population faces significant challenges accessing affordable, comprehensive health insurance, Baldwin said in a statement.
While the Affordable Care Act expanded access to coverage, millions of older Americans continue to face high premiums, out-of-pocket costs and limited coverage options, she said. About 11.5% of Americans between the ages of 55 and 64 remain uninsured, Baldwin said.
Under the proposal, individuals who enroll in Medicare at 50 would receive the same benefits and protections available under Medicare Parts A, B, and D - which cover hospital, doctor's visits and prescription drugs. The bill also includes the option to enroll in a Medicare Advantage plan. It would also allow eligible individuals to receive the same premium tax credits and cost-sharing subsidies they would qualify for through the ACA marketplace.
In 2026, premiums for Americans ages 50 to 64 purchasing insurance through the ACA marketplace doubled, while enrollment among that population fell by 6%, Baldwin said.
"Millions of Americans are being priced out of healthcare and remain uninsured or underinsured - that is unacceptable," said Sen. Chris Van Hollen, a Maryland Democrat, who co-sponsored the bill. "The Medicare at 50 Act begins to address some of the gaping holes in affordable coverage and provides millions of Americans with more options for affordable, quality care. This is an important step in the right direction to ensuring that every American has the healthcare they need."
The measure was also co-sponsored by Democratic senators including Richard Blumenthal of Connecticut, Cory Booker of New Jersey, Ed Markey of Massachusetts, Kirsten Gillibrand of New York and others.
The measure does not go as far as other proposals, such as "Medicare for All," which was introduced by Bernie Sanders, the independent senator from Vermont, last year. That bill called for a national health-insurance program covering all U.S. residents.
The cost of the proposed "Medicare at 50 Act" was not available.
"This is a dangerous proposal," said Michael Cannon, director of health-policy studies at the Cato Institute, a libertarian think tank. "It would make more people more dependent on government subsidies when we can't afford the subsidies we have now. The federal debt is larger than the economy. This cannot go on forever."
Cannon said the complexities and costs of the Medicare program make expanding it expensive and difficult. Expansion could also undermine the quality of care received by beneficiaries, he said.
Other analysts said the proposal could make costs to the average individual lower by expanding the pool of healthier - and therefore less costly - beneficiaries.
"The proposal would tend to temporarily lower overall per-person Medicare costs because of the influx of younger, healthier adults to the insurance risk pool. This could potentially mean lower Part B and Part D premiums for all beneficiaries, regardless of age," said Mary Johnson, an independent Social Security and Medicare analyst.
In the Senate, it takes 60 votes to advance major legislation. Democrats have won 54 seats in the chamber and if they pick up Alaska and Mississippi, their total will be 56 - meaning they'd need a handful of Republicans to move big bills.
When asked whether "Medicare at 50" has any chance of succeeding in the soon-to-be Democratic-led Congress, Johnson said it would take some bipartisan support.
"This is a goal that has been around for awhile ... our new members of Congress campaigned on restoring those ACA premium tax credits that were cut by tax legislation and strengthening the ACA insurance offerings for as many as possible," Johnson said. "A lot depends on getting as many on board as possible. Just as we learned last week of the big majorities - it will take joining arms and moving forward together as veto-proof majorities."
-Jessica Hall
Comments