• Grand bargains and Medicare

    Ezra Klein following up on Marc Goldwein’s defense of slowly raising the Medicare age to 67 from 65. As Austin and Aaron wrote in response to Sen. Lieberman’s suggestion, raising the Medicare eligibility age and doing nothing else would harm the health of persons in that age group, because it would lead to more uninsurance. Their piece notes that the paper they were referencing that showed health harms due to lack of insurance did not imagine the implementation of insurance exchanges with income based subsidies starting in 2014 that are a part of the ACA.

    McWilliams et al.’s analysis does not take into consideration the effect of health reform. Provided it stays on the books, the non-elderly will have different options in 2014. Still, the analysis shows the value of health insurance, and in particular of universal coverage.

    In October of 2009, I wrote a commentary with Frank Hill who was former Senator Elizabeth Dole’s Chief of Staff. It came out of he and I trying to see if we could agree on some steps ahead in how the then Senate bill could be tweaked to try and get some bipartisan support for health reform. One of the things we landed on was raising the Medicare eligibility as Lieberman suggested BUT that was in the context of moving ahead with insurance exchanges being implemented with income based subsidies.

    If you raise the Medicare eligibility age and do nothing else (repeal the ACA) then it is a very bad policy. However, if it were a part of a political negotiation that lead to the agreement by both parties to implement the ACA, it would be a policy worth considering depending upon the other elements of the elusive grand bargain. Eventually SOME health reform strategy has got to become the policy of both political parties if we are ever going to work things out.

     

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