Anyone nearing retirement – or already retired – should pay very close attention to the doings of the 115th Congress that was sworn in this week.
Repeal of President Barack Obama’s Affordable Care Act (ACA) tops the agenda for Republicans, who will control the White House as well as both houses of Congress when Donald Trump takes office on Jan. 20. That will place a heavy financial toll on millions of older Americans who do not have access to employer-sponsored insurance or Medicaid, and who are too young to enroll in Medicare. But repeal of the ACA will also raise the cost of Medicare for current and future enrollees.
The details surrounding the repeal of what became known as Obamacare – and how it will be replaced, if at all – are unknown. But it is clear that Republicans, rather than fix the existing system’s problems, intend to gut the most important social insurance legislation since the passage of Medicare and Medicaid in 1965.
In my Reuters Money column this week, I take a look at how full repeal of the ACA would impact older Americans.
Let’s start with older people still too young to enroll in Medicare. Here, ACA repeal will mean higher premiums and out-of-pocket costs. Most Republican proposals that have been circulated loosen or eliminate restrictions on higher policy prices for older buyers. The program’s income-related tax subsidies, which aim to make premiums affordable for middle- and lower-income households, likely would be replaced by a flat tax credit that shifts costs to enrollees. Some repeal-and-replace plans also weaken the current ban on covering people with pre-existing conditions.
Repeal of the ACA would also have a direct impact on Medicare spending and costs to beneficiaries.
Full repeal would increase Medicare spending by $802 billion from 2016 through 2025, according to the Congressional Budget Office (CBO), primarily by restoring higher payments to health providers and Medicare Advantage plans. That would lead to higher Part A (hospitalization) deductibles and copayments, and higher premiums and deductibles in Part B (outpatient services).
A detailed brief on how ACA repeal would impact Medicare can be found at the Kaiser Family Foundation website.
Perhaps most galling is the insistence by ACA opponents that the law if failing. ““The fact is the wheels have been coming off of Obamacare for a long time now,” Senator John Cornyn of Texas said this week, adding that he understood that the Democratic senators, “as a political matter,” feel that they need to defend the health care law.
We may be living in a post-fact, post-truth environment, but here is an interesting fact, nonetheless: a strong majority of people covered under Obamacare are quite satisfied with the coverage they are receiving. Last year, 77 percent of adults in marketplace plans, and 88 percent of those who received Medicaid coverage under the ACA expansion, were either very or somewhat satisfied with their coverage, according to polling by the Commonwealth Fund, a foundation focused on healthcare research: