Leading up to a Republican-led Congress, lawmakers are considering major reforms to the Medicare program that could change the way older adults pay for coverage.
Although it’s still unclear whether legislators will take on a Medicare overhaul, House Speaker Paul Ryan has said any discussions about repealing and replacing the ACA should include Medicare and Medicaid reform. President-elect Donald Trump’s views on Medicare have wavered, but experts say value-based care initiatives integrated through the ACA are likely to remain intact.
Changes to Medicare could come in a variety of forms, including a long-term transition toward a “premium support” or “voucher” model that would allow seniors to purchase coverage through private insurers, according to The Wall Street Journal. Ryan advocated for a premium support model in his ACA replacement plan released earlier this year, along with raising the Medicare eligibility age to 67.
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But immediate alterations to the ACA also could directly impact Medicare. Juliette Cubanski, associate director of the Kaiser Family Foundation’s program on Medicare policy told the WSJ that the health law has close ties to the Medicare program, including free coverage for essential health benefits, and limiting the costs of prescription drugs.
Critics say a premium support model would mean higher out-of-pocket costs for beneficiaries, particularly if government subsidies can’t keep pace with rising healthcare costs or don’t adequately account for changing health conditions. Republicans have been frequent proponents of a premium support model in the past, arguing it would increase competition among insurers, although studies have indicated that privatizing Medicare could increase premiums by as much as 59 percent.